Biomedical
Mental illness arises due to chemical imbalances in the brain. Healing can occur through treatment with appropriate drugs. With the development of new drugs, such as SSRIs, in the last thirty years, this has become widely used by psychiatrists and medical doctors. There is no doubt that many people, including myself, have benefited significantly from these drugs. Unsurprisingly, big pharma strongly pushes this point of view. However, drug treatment is not always successful and it is debated whether such drugs are over-prescribed. Even among psychiatrists, the biomedical model is contested because it ignores thinking patterns and the social interactions of the patient. Recently, the New York Times had op-ed articles by a doctor and a patient contesting this model.
Mental Illness Isn’t All in Your Head
Lisa Pryor
It’s Not Just a Chemical Imbalance
Thinking of my mental illness as preordained missed many of the causes of — and solutions to — my emotional suffering.
Kelli María Korducki
Psychological
Mental illness arises due to negative thought patterns.
Healing can occur through psychotherapy.
Freud drew an analogy with grief over the death of a loved one to argue that depression arose due to the patient turning their anger inward about losing an ideal object.
Cognitive behaviour therapy seeks to train the patient to think in more positive ways.
Other approaches focus on past trauma and/or unresolved conflicts, particularly from childhood.
Mindfulness uses meditation exercises to help the patient learn to control their thoughts.
Many people, including myself, have benefited from this approach. However, there are many people for which this approach is ineffective, particularly without medication.
Social
People are social beings. When they are isolated from true community mental illness results. One of the first advocates of the social model was Emile Durkheim, one of the founders of sociology. He found suicide rates varied significantly between different social groups, and argued that this was related to the levels of social integration felt by individuals.
A recent popular advocate of the social model is Johan Harari, in Lost Connections.
The best treatment for patients is to help them establish meaningful relationships in the context of a community.
Marxist
In capitalism, people are defined by their jobs, by their relationship to the "means of production'', the technology that is at the heart of the economy. As a result, they are alienated from one another, from nature, and from meaningful work. The solution is political and economic: revolution leading to a socialist economy where workers own and control the ``means of production.''
Spiritual
The most extreme form of this model is that mental illness arises due to demon possession. Healing can occur through prayer, particularly exorcism. Advocates will point to accounts in the Gospels such as Jesus healing the demoniac. A milder form of this model is that mental illness arises due to the sin or lack of faith of the individual. The solution is repentance and faith. There is no doubt that substance addictions and abuse are bad for mental health. Studies also show that forgiving others is beneficial for mental health.
These competing models raise fundamental questions such as
What really defines a human person?
How do you define human well-being?
Is a human essentially biological (biochemical and genetic), mental, social, political/economic, or spiritual? These models for mental illness tend to each assume an extreme reductionistic view of the essential character of a person.
However, Jesus seems to have had a more integrated view. He said people should love God with all their heart, mind, soul, and strength. He is not presenting a partition of a person, but saying a person is a complex unity of emotions, brain, spirit, and body. Furthermore, the incarnation is about God taking on a human body. Jesus promises his followers will be resurrected with him: not disembodied souls, but rather bodies.
[Figure from Sanctuary Mental Health ministries]
Rather than seeing that one of the models as being mutually exclusive I see that they all have strengths and weaknesses. Individuals are complex and diverse and they live in diverse contexts. Hence, causes and solutions for mental health may vary significantly.
This week I am giving a talk on Jesus and Mental Health for Jesus week at UQ. More to follow.
Thanks for this post. With my own experiences and those in the family, I think another dynamic is at play in that some mental afflictions often originate with spiritual decisions where one initially chooses wrong (try this recreational drug, peek at porn, absorb/embrace wrong influences from culture and music, adopt a lifestyle contrary to God's values), but then becomes entrapped (addiction, compulsion, anxieties and such) in a way that has a definite physical (biological) component. For many, this entrapped state cannot be changed by will power or repentance alone, at least not initially. However, truly believing that the initial choices were wrong and life-sapping, and embracing better values is key to the restoration in the long term. So in the case of, say, drug addiction, at one point one has the ability to make a (spiritual/moral) choice. Later on that ability is gone and it might be correctly labeled a (biological) disease requiring supplementary treatments. But long term healing also requires a process that at risk of oversimplification might be something like believing --> doing --> becoming. Or, I'll take God at his word, act on it (even when it doesn't feel right), and eventually will be transformed.
ReplyDeleteHi Alex, Thanks for sharing your thoughts and experience. I agree it is very hard to separate out the spiritual/moral/biological/psychological dimensions. Approaches that cut out one or more of these dimensions are problematic.
DeleteMy experience confirms that the causes & cures of mental health issues involve multiple models. Thanks for this.
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