Generaleneral Psychologysychology

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Medical Model of Abnormal Behavior

The medical model of abnormal behavior developed in the latter half of the nineteenth century and views abnormal behavior as a disease.  As you are aware, diseases have causes such as germs, viruses, or destructive organisms that frequently produce disease symptoms.  For instance, a virus is the cause of a cold and a cough is a symptom resulting from that cause.  Physicans were well aware that treating a symptom could eliminate a symptom, like a cough, but that this would do little to destroy the disease.  Furthermore, treating the symptom often produced undesirable side effects.

Freud and others adopted this model in an effort to explain abnormal behaviors.  The behaviors themselves, like seeing hallicucinations or phobic responses, were considered symptoms.  More difficult was identifying the underlying cause.  Freud postulated that these "mental illnesses" were often the result of hidden psychic conflicts.  Kraft-Ebing's discovery in 1897 that a spirochete caused many of the behaviors associated with the final stage of syphilis produced an optimism that the medical model would be a useful conceptual tool for understanding abnormal behavior.

The application of the medical model to abnormal behavior had a number of positive and negative aspects.  A few of these are summarized below with a special emphasis given to Freud's theory and therapeutic procedures.

 I. Positive Aspects

  •  Making "mental illness" just like "any other illness" meant that people with abnormal behaviors  were treated with kindness as if they were a sick person.  Educated people came to believe that persons exhibiting abnormal behaviors were sick and not possessed by demons.

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  • Since cures and treatments were found for other illnesses, there was a belief that mental illness was also curable and treatable.

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  • Freud provided very good descriptions of neurotic behavior; his explanations are very questionable.

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  • Freud emphasized the importance of the social environmental causes in causing abnormal behavior.  Unfortunately, he stressed the social environment of children and neglected the importance of the adult social environment.
II. Negative Aspects
  • Many Freudian concepts such as libido, ego strength, or an underlying conflict, are difficult to scientifically test.  The problem is that many of these concepts are difficult or impossible to measure. We cannot measure libido, we do not know objectively how much ego strength a person has, nor can we observe the presence or absence of an underlying conflict.

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  • Freudian theory did make a clear-cut prediction that was open to scientific investigation and to experimental testing; but this hypothesis of symptom substitution was not validated. The Freudians would say that since abnormal behavior is only a symptom of an underlying cause, if only the abnormal behavior is removed without considering an underlying cause (which is what behavior modification does since it only deals with behavior), then the underlying cause will manifest itself in a new symptom. This is the concept called "symptom substitution". Evidence (Cahoon, 1968; Lazarus, 1963; Yates, 1958) has shown that symptom substitution usually does not occur; in fact, when behavior modifiers improve abnormal behavior, the person’s overall life tends to improve, rather than new symptoms appearing.

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  • Labeling a person as "mentally ill" is a stigma.  Research indicates that people who have been diagnosed with mental illnesses are often not given an fair chance.

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  • Labeling people as "ill" implies a passivity and that they must be cured by others and have no active involvement in changing their own behavior.

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    Psychoanalysis is a costly and usually time consuming treatment, requiring a highly trained specialist.  Even if psychoanalysis were always successful, it would still have little impact when one considers the number of persons that would benefit from therapy.

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