Thursday, April 21, 2011

What should alternative to biomedical model be called?

Tim Thornton has posted a chapter on his In the Space of Reasons blog entitled "The recovery model, values and narrative understanding ". He points to the confusion about the meaning of recovery, and even more so about what a recovery model might be.

As I wrote in my paper "Redressing the chemical imbalance", the concept of recovery is inherently critical of the biomedical model, and Tim Thornton seems to agree with me. I think the problem is its acceptance into official policy and nullification of its impact by interpretation within the biomedical context.

The use of the term 'recovery model' is unlikely to help fully define an alternative psychosocial paradigm. Nor, despite its merits, do I think the notion of 'narrative' will either. I've always said that the origin of the psychosocial approach was with Ernst von Feuchtersleben's The principles of medical psychology, first published in german in 1845 (see my article).

An optimisitic moralism, such as an emphasis on recovery, has always had its moments, perhaps particularly identified in the progressive outlook before the First World war. This can be contrasted with the materialism of an emphasis on structural pathology, producing a therapeutic pessimism, minimising the potential of people to change. It is important to give people hope in mental health services. This strand is one of the sources for a psychosocial alternative to the biomedical model, but I think it's unlikely to define the whole paradigm.

1 comment:

Anonymous said...

Interesting read, but as I understand it, recovery thinkers/writers are increasingly critical of ideas of recovery as 'model'; rather they see it as a set of values and principles. I guess then 'recovery' is about working to individuals' framings of distress, and enabling them to choose/construct the model(s) that best apply to them. Of course all models come with pros and cons (medical/illness models tend to over-focus on - often harmful - pharmaceutical solutions/distractions; psycho-spiritual models might over rely on religious ritual; social models might reject entirely a role for medication; psychological models might locate false, unfalsifiable causation in the person's past); the challenge being to maximise that which holds therapeutic value. I tend to like David Eagleman's discourse of 'Possibilianism', and see many parallels with the challenge of mental health.

"The possibilian perspective is distinguished from agnosticism [and dogmatism] in that it consists of an active exploration of novel possibilities and an emphasis on the necessity of holding multiple positions at once if there is no available data to privilege one over the others. Possibilianism reflects the scientific temperament of creativity, testing, and tolerance for multiple ideas."

Anyway, all the best.