Diagnosing Mental Disorders
12/07/09: I get asked for my thoughts about psychopathology and mental disorders pretty often. Many practicing psychologists have an opinion on the debate to determine what a "disorder" is and isn't, and the place I stand is with the "harmful dysfunction model", first proposed by Jerome Wakefield. Essentially, this model states that a mental "disorder" must be a dysfunction of a naturally occurring system that is harmful to the person as judged by cultural standards.
This view integrates neurochemical, environmental, cultural, and evolutionary explanations for the problems, making it fairly cutting edge. An example would be that what we call 'depression' is a harmful dysfunction of the natural sadness/loss system. Another example would be generalized anxiety disorder being a harmful dysfunction of the threat-detection/response system.
This model stands in contrast to the prevailing reductionist 'medical model', which philosophically believes that there are underlying pathogens or disease patterns in psychological issues, which mirror other medical illnesses. This means that something like depression is viewed as purely the result of neuro-biological issues, making medical interventions (drug therapy) the front line treatment, even if the last 10 years of research has not completely supported this. The medications are very helpful to a lot of people, but they are not the panacea that it was once hoped they were.
Another view can be summed up as a 'social construction model', which believes that everything we view is simply naturally occurring phenomena that we judge culturally as being 'unhealthy'.
I encourage anyone in therapy to talk with their therapist about diagnosis and become more educated about the different perspectives. It can be enlightening and empowering to have this information and the ability to apply it to your life.
This view integrates neurochemical, environmental, cultural, and evolutionary explanations for the problems, making it fairly cutting edge. An example would be that what we call 'depression' is a harmful dysfunction of the natural sadness/loss system. Another example would be generalized anxiety disorder being a harmful dysfunction of the threat-detection/response system.
This model stands in contrast to the prevailing reductionist 'medical model', which philosophically believes that there are underlying pathogens or disease patterns in psychological issues, which mirror other medical illnesses. This means that something like depression is viewed as purely the result of neuro-biological issues, making medical interventions (drug therapy) the front line treatment, even if the last 10 years of research has not completely supported this. The medications are very helpful to a lot of people, but they are not the panacea that it was once hoped they were.
Another view can be summed up as a 'social construction model', which believes that everything we view is simply naturally occurring phenomena that we judge culturally as being 'unhealthy'.
I encourage anyone in therapy to talk with their therapist about diagnosis and become more educated about the different perspectives. It can be enlightening and empowering to have this information and the ability to apply it to your life.
