Friday, 16 January 2015

Reframing the psychological and psychiatric models.

Edited for clarity
I do realize that professionals have positive associations to the terms "psychological model" and "medical model".   


But I suggest substituting them with four terms:

Two are related to actions:

  • Medical mental help
  • Non-medical tools and processes. 
And these really are complementary. Informed and careful use of drugs can be helpful additions to other kinds of help. 

Two are descriptions of cognitive frames:

  • Frame of mental illness
  • Frame of trauma and societal harm
And they are not complementary. But there might be a third frame, where outside factors can cause mental illness. And other frames that I haven't thought of. Suggestions?

Terms like this, however many, could make "choice" a clear and present alternative for people who need help.


Valuing and empowering choice is just as important for psychology as it is for psychiatry.

When it is natural for people to see their symptoms in a frame of mental illness, trying to force them to look at "what happened to you" is an act of unwitting mental violence.

Insisting that depression, psychosis, PTSD, BPD and so on are mental illnesses when people need to see their symptoms in a frame of what has happened and is happening to them is also unwitting mental violence.

As I see it, coerced medication and coerced CBT or DBT are equally harmful, and both types of coercion are frighteningly common in so-called "mental health care".

And I do realize how difficult, maybe even impossible, it can be for people in the mental help professions to assimilate information that they may be harming more people than they help.

But there comes a time when information of harm is so ubiquitous and easily accessible that the word "unwitting" loses its relevance. And maybe that time is now?
Lagt inn av kl.

2 comments:

  1. SRK18 January 2015 at 15:36

    Your point re coercion is most important. I believe, like Szasz, that eliminating coercion from mental health care is the key.

    ReplyDelete
    Replies
    1. Ivaa24 January 2015 at 01:20

      SRK - I AGREE! We have a word in Norwegian that does not seem to exist in English: "avmakt" ... off-power or un-power. Which, I think, has a nuance beyond "powerlessness": the act of off-powering or un-powering someone.

      And a Norwegian definition of trauma is "extreme un-power and isolation".

      So any kind of therapy that invoves overt or covert coercion is a repetition of th original trauma.

      Delete

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