By Swami Dr Snehananda Jyoti on 04-11-2010
of Psychopathology – 1
Psychopathology or the study of mental
dysfunctions or disorders is looked at from the points of view of various
schools of psychology. Each school has its own understanding of psychological
wellness, disease process, treatment, and as well as its own model of
psychopathology. Evidence-based studies with regard to the effectiveness of
diagnosis and treatment of mental disorders are coming in. At some point in the
future, I hope, we will arrive at one effective model of psychopathology that
will help accurately diagnose and treat various mental disorders. Currently I
am going to describe some of the important models of psychopathology.
Medical Model: This model presupposes
that there is a chemical cause in the brain for the origin of mental disorders.
By blocking or increasing appropriate neurotransmitters by means of drugs
chemical balance is restored and the respective mental disorders are brought
into remission. The word cure is rarely used in treating mental
disorders; the operative word is remission.
Persons who arehavingmental disorders often talk about having chemical
imbalance – a socially acceptable term – in the brain, and are prescribed
psychiatric drugs. Many thousands of mental patients that were kept in huge,
secure mental hospitals were released into the community with out-patient
clinic services with the advent of powerful psychotropic drugs. Chemical
restraints in terms of drugs substituted crude, cruel, and inhuman physical
restraints. More humane treatment of mental disorders was instituted. Currently
violent, psychotic, and unmanageable patients are sedated. There are
tranquilizers that calm and relax patients, and hypnotics that induce sleep.
There are problems with medical model as well as medications. Identical twins
reared apart may not all develop disorders.
There are severe side effects of medications for which further
medications will be necessary. Some medications are addictive. Once a patient
is on medication, he or she may be on it interminably. Poly-pharmacy
(combination of medications to treat a disorder) is not uncommon. The
effectiveness of medication in mental disorder is not proven as in physical
disease. Psychiatrists can be vulnerable
to drug companies that provide very attractive inducements and tempting offers
to prescribe their products. It is also important to note that drug companies
spend more money on advertisements and commercials than on actual research and
development of drugs.
Psychoanalytic-Psychodynamic Model: The
psychoanalytic model had its day; the psycho-sexual stages developed by Sigmund
Freud exerted great influence in the field of psychology. The personality is
formed at a very early age. The core of personality consists of id (the
pleasure-seeking aspect) ego (the reality, executive function), and super-ego
(the conscience, the moral-ethical guide). An optimal balance between these
three elements constitutes a balanced and healthy personality. Heredity and
psychic determinism play an important role. The arrest of development at any
particular psycho-sexual stage leads to certain typical mental disorders.
Psychoanalysis is the treatment of choice. The ego psychologists extend the
psycho-sexual stages into adult life to cover the entire span of one’s life.
Erik Erickson’s eight stages of psychosocial development consisting of Trust
versus Mistrust, Autonomy versus Shame, Initiative versus Guilt, Industry
versus Inferiority, Identity versus Role Confusion, Intimacy versus Isolation,
Generativity versus Stagnation, and Ego Integrity versus Despair are worthy of
note. In these stages virtues/challenges
such as hope, will, purpose, competence, fidelity, love, care, and wisdom are
to be acquired/mastered. Each succeeding stage is built on the preceding stage.
And a healthy personality passes through successful completion of all stages to
arrive at the goal of wisdom. Challenges not successfully completed lead to
problems/disorders in life. Psychodynamic psychotherapy is the treatment of choice.
About The Author
Dr. John K Thekkedam (Swami Snehananda Jyoti) spent most of his life as a clinical psychologist in USA. He began his public life as a Jesuit priest. Quite attracted in distinct philosophies, he left the society and founded 'East West Awakening'.