While a great deal of the excitement about advances in psychological treatments comes from the potential for research in neuroscience to unlock the secrets of the brain, many mental health experts would like to temper this enthusiasm. A special issue of the Behavior Therapist released this month calls into question the predominant conception of mental illnesses as brain disorders.
The biomedical model of mental illness assumes that abnormal psychological states or experiences are the results of abnormalities in the brain or genetics and, as such, necessitate medical or chemical treatments that specifically target these biological abnormalities. In his introduction to the special issue, Jonathan Abramowitz, a psychologist at the Unversity of North Carolina at Chapel Hill and the president of the Association for Behavioral and Cognitive Therapies, points out that while it is tempting to think of mental illnesses as diseases like diabetes, “the truth is that there is no credible scientific evidence for this assumption.”
Abramowitz goes further and points to research that suggests that this medical model of mental illness may actually increase the stigma and social distancing felt by those diagnosed with mental disorders. Antistigma campaigns have promoted the idea that thinking of mental illness as a disease will convince the public that those with disorders are victims of their biology, thus reducing shame. Research by Schomerus, Deacon, Baird, and others, however, reveals that thinking about mental illness in this way serves to “reinforce (unfounded) concerns about the chronic and untreatable nature of mental disorders” and has increased a desire among the public to avoid those labeled with a mental illness.
The special issue includes several significant contributions from award-winning scientists and journalists, including Mad In America founder Robert Whitaker. The editors indicate that proponents of the medical model were invited to submit pieces but declined. The medical model proponents included NIMH director Thomas Insel, National Institute on Drug Abuse director Nora Volkow, and former president of the American Psychiatric Association (APA) Jeffrey Leiberman.
A list of all of the articles included appears below. To access the full issue click here →
Jonathan S. Abramowitz- The Biomedical Model: Caveat Emptor
Brett Deacon and Dean McKay– Introduction to the Special Issue
Scott O. Lilienfeld, Seth J. Schwartz, Alan Meca, Katheryn C. Sauvigné, Sally Satel- Neurocentrism: Implications for Psychotherapy Practice and Research
Kichuk, Matthew S. Lebowitz, T. Grover Adams Jr.- Can Biomedical Models of Psychopathology Interfere With Cognitive-Behavioral Treatment Processes?
Amitai Abramovitch and Avraham Schweiger- Misuse of Cognitive Neuropsychology in Psychiatry Research: The Intoxicating Appeal of Neo-Reductionism
Robert Whitaker- Anatomy of an Epidemic: The History and Science of a Failed Paradigm of Care
Glen Spielmans- When Marketing Met Science: Evidence Regarding Modern Antidepressants and Antipsychotic Medications
Jeffrey R. Lacasse and Jonathan Leo- Antidepressants and the Chemical Imbalance Theory of Depression: A Reflection and Update on the Discourse
Joanna Moncrieff- The Myths and Realities of Drug Treatment for Mental Disorders
Stanton Peele- Why Neurobiological Models Can’t Contain Mental Disorder and Addiction
Steven C. Hayes, Brandon T. Sanford, Timothy K.- Feeney Using the Functional and Contextual Approach of Modern Evolution Science to Direct Thinking About Psychopathology
Peter Kinderman– A Psychological Model of Mental Health and Well-Being: Rational but Radical
Brett J. Deacon and Dean McKay- The Biomedical Model of Psychological Problems: A Call for Critical Dialogue