It’s said that the five dimensions are all inter related and so if one is c hanged then the other dimensions will all be impacted in some way or another. In a sense I feel that holism is practical as it explores several avenues in order to treat mental illness rather than the bio-medical approach which uses only one. The World Health Organisation (1946), define health in the following way ‘a state of complete physical, mental and social wellbeing and not merely the absence of disease and infirmity’. This definition of health supports both the medical and social models.
In suggesting that wellbeing is the key to health the definition embraces the idea that in the treatment of illness all factors, social, mental and physical must be taken into account. If this definition is what professional’s base their treatment of mental health upon, then it could be seen that the medical and holistic models are intertwined and should in fact work in harmony. Yet one model holds dominance over the other. It is the medical model which is predominantly used in the treatment of mental health (Bentall, 2003) The Biomedical Model
The bio medical model evolved as a response to diseases in the 19th century. German psychiatrists then used this model, based on their beliefs and not hard evidence, to categorize the symptoms of mental distress into distinct conditions, one of which was Schizophrenia (Bentall, 2003). The model suggests that mental health is an illness, characterised by specific symptoms that have a pathological base. This came about because research supported the notion that mental ill health was due to chemical imbalances, body dysfunction or injury (McCullough et al, 2005, Pritchard, 2006).
However there is another suggestion that mental health is a hypothetical construct” (Boyle, 2002: 14). The fundamental focus of this model is that the individual is the source of their mental illness. Therefore the person can be treated and as with most illness the medical model will look at medication as the way forward (Beresford, 2005). Within this model the body is seen as a device rather than a person and as an appliance its functions will often need repair (Giddens, 2006). This thought process is damaging, it can encourage a poor relationship.
When the ‘person’ becomes lost and is seen as a list of symptoms, they become stigmatised and labelled. This labelling can cause further mental distress and so more ‘symptoms’ may be seen (Thompson, 2006). The medical model sees mental illness as a brain malfunction, an imbalance, a set of symptoms, to restore mental health the medical experts will endeavour to adjust the imbalances with a variety of drugs. The use of drugs often does give a quick fix to some symptoms; however the use often creates a dependence, which may last until death (Harris et al, 2007).
This dependence on drugs will give further credence to the medical model. Many researchers point out that this reliance on medication causes further mental distress, as the side effects can be many and enduring, adding further problems to those with a diagnosis of mental illness(Wallcraft, 2005,Usher et al, 2006). The Holistic Model As we know the holistic model is not the most popular model, it is however very important as it represents a way of thinking and understanding mental distress and gives a positive approach to working with and supporting people experiencing mental illness.
Each person’s experience of mental illness is unique. Seedhouse (2000, pp 59-60) suggests that holism makes two main claims: that the whole cannot be fully understood separately and that they separate parts cannot be understood apart from the whole. Holism has many available methods including counselling, and congestive behaviour therapy. Although all of these aspects work together each promotes its own therapeutic power, which doesn’t really take a holistic perspective as it claims to. This can be very confusing and distressing for a user who has only ever encountered the biomedical model.
A good example of this is (Taussig, 2002, p10) “the recovery from breakdowns has always been slow and painful, and each one has brought a different treatment ranging from C. B. T therapy to psychoanalysis. On each occasion when I called on the providers to help me out of the dark, each stood proudly alone protesting their own therapeutic power and efficacy”. Holism allows users to see how the body and mind are connected by letting them reflect. Reflection matters because it is continuous with practise.
How you think about what you are doing affects how you do it, or whether you do it at all. It may direct your research or your whole attitude to people who do things differently, or indeed your whole life. (Blackburn 1999) However holistic approaches can bring the mind-body divide to the forefront as its been proven that reflecting on emotions can bring on physical distress such as raised heartbeat, headaches, and pains. Bringing supressed thoughts to the surface can also cause people to become dependent on such things as alcohol and drugs which need some biomedical intervention.
Mind-body relations are always mutual and bidirectional-the body affects the mind and is affected by it. mind and body are so integrally related that, in practise], it makes little sense to refer to therapies as solely “mental” or” physical”, rather mind-body could perhaps be best regarded as an overall process that is not easily dissected into separate and distinct components or parts. (Seedhouse 2002, p55). . Whilst there are arguably opposing principles within the medical and holistic model it can be suggested that the diversity can be productive.
There are aspects of both models that may help with the diagnoses of mental illness. The bio medical model through research will continue to strive for a specific, pathological base. Medicine aims to prevent mortality, with a high incidence of morbidity within the group of people diagnosed with mental illness, on-going research is a must (Muir-Cochrane 2006). The holistic model will strive to ensure, that the person with mental distress will have an individual programme tailored to their needs and therefore a selection of treatments may be the answer.
The Hippocratic Oath which is fundamental in medicine suggests that interventions delivered from the medical profession of which psychiatry belongs ‘do no harm’ Sokol (2008). If the so called experts used the model to treat service users with a diagnoses mental illness in a way that caused no harm they would strive to ensure that when assessment was undertaken all aspects of the medical and holistic models of mental distress would be taken into account.
The complex nature of mental illness would be identified and a more impartial framework of support could be supplied. It could look at solutions and ways of coping, rather than problems and illness. It would value the service user with mental distress, building a relationship and remembering that ‘mental illness’ it is not just an illness, a list of symptoms, there is a person present that needs to be respected. Perhaps the unification of these two models would enable the treatment for mental illness to be more people centred and unique.
Service users could define what help was needed, and the balance of power would be with the expert. (Warren, 2007). References Beresford, P. (2005) Social Approaches to Madness and Distress: User Perspectives and User Knowledge, In J Tew (Ed), Social Perspectives in Mental Health: Developing Social Models to Understand and Work with Mental Distress, London: Jessica Kingsley. Bentall, R. P. (2003) Madness Explained: Psychosis and Human Nature, London: Penguin.
Blackburn, (1999) Bowen, P. (2007) Blackstone’s Guide to the Mental Health Act 2007, Oxford: Oxford University Press. Boyle, M. (2002) Schizophrenia: A Scientific Delusion, London: Routledge. Giddens, (2006) Harris Et Al (2007) McCullogh Et Al (2005), Pritchard (2006) Muir-Cochrane (2006) Seedhouse (2000 P59-60) Seedhouse (2002 p55) Sokol (2008) Thompson (2006) Toussig (2002 p10) Usher Et Al (2006) Warren (2007) Word Count -1750 including references