The biological model can be criticised both positively and negatively. One of its main strength is that a medical diagnosis of mental illness can reduce the factor of blame that would usually be placed on the family and the sufferer. As a medical condition there is not one person responsible for the illness. This is helpful and regarded as more human because there are no feelings of guilt linked to the diagnosis.
However, with the suggestion of genetics as a causal factor, for some people this may reintroduce a feeling of guilt and anxiety. There is the guilt from older generations for passing down a ‘faulty’ gene that caused the sufferer to have the condition. There is also the anxiety that as genetic condition other family members may show the illness at some stage in their life. There would be a potential risk of the sufferer being able to have their own children and passing the gene to further generations as well. There could be a potential anxiety amongst other family members of the illness resurfacing elsewhere. Being a genetic condition it would also suggest that the illness cannot be recovered from, as it stems from a cellular level involving the individual’s DNA. This creates another source of anxiety, as the family and the individual know that they must learn to cope, however they will never properly recover or return to “normal”.
This model is criticised for the use of drug therapy in treatment options. Drug therapy is said to be too heavily relied upon and is too quickly assumed to be the cure for the problem. This does not take into account that chemical imbalances may be a symptom of the illness, not a cause. Therefore the symptom is being treated and is unlikely to be seen, however the underlying problem will remain. This is shown as patients cease drug treatment and symptoms soon begin to reoccur. Although drugs may be a viable coping method- to prevent and control the number of psychotic episodes, for example- they are not a cure for the psychological abnormality. Drugs may also cause other side effects which could lead a patient to becoming physically ill, they may be allergic or intolerant to the drug course prescribed for them, or they may become addicted to the drugs. Each of these possibilities poses a new problem. A drug addiction is hard to beat and may lead to a long term dependency on the drugs- this will require further therapy (such as cognitive therapy, rather than further medical treatments) in order to discontinue the medication course and may be very psychologically demanding on an already psychologically fragile individual. If the sufferer is allergic or intolerant to the drugs they may become severely physically sick and will be unable to continue the treatment- in the biological approach this would leave only two other possible therapies to continue with (ECT and psychosurgery).
Some research into psychological abnormalities shows support for the genetic theory of causation in the biological model. The study carried out by Holland et al. (1984) into the prevalence of Anorexia Nervosa amongst twins suggests a link between genetics and the illness. Monozygotic twins showed a 55% concordance rate (where one twin initially has Anorexia and the second later develops the disorder), whilst dizygotic twins showed a lower 7% concordance. As the monozygotic twins are genetically identical this suggests that genes may be a related factor to developing the disorder, as the concordance rate was higher than that of the dizygotic twins who shared only half of their genes. However, if the presence of the illness was due to genetics alone it would be expected that the monozygotic twins would show 100% concordance. As this is not so, there must therefore be other factors involved in causing Anorexia. This study supports the biological theory due to the evidence suggesting that genetic factors may be involved; however it opposes the idea that biological causes alone are the key factor in developing a psychological abnormality.
The reliability of this study is low, as it was a natural study (so the independent variable could not be controlled) and there were a large number of possible confounding variables present. This means that causation cannot be inferred; only a casual link between the variables can be drawn from the results.
Associated to the results of Holland’s study and other studies into psychological abnormalities caused by biological factors, it has been said that this approach is reductionist. It tries to explain phenomenon such as psychological disturbances in a simple form- reducing the problem to an abnormal behaviour of brain cells. This oversimplifies the matter and it is not often thought to be effective to bring such illnesses down to such a fundamental level. There is likely to be a number of different factors that will cause and treat psychological abnormalities, and these are not all considered by the biological model.
Generally the biological model is seen to be strong as it has a certain degree of treatment success in its therapy approach; however the treatments offered are not suitable for everyone. It has been suggested that the therapies allow for control of the symptoms of the psychological illness, however do not cure the underlying problem, meaning that an individual will still suffer if they were to cease treatment.
The model has been criticised for being ineffective in many cases and often unethical. It causes some degree of blame reduction as the illness is medically diagnosed and therefore no one can be blamed, however the genetic factor of an illness can reintroduce the feelings of guilt and anxiety to other family members. As this may cause distress not only to the patient but to the relatives as well the model is deemed, in some cases, to be unethical. The lack of consistent positive results and finding undoubted cures for the actual illnesses leads the model to be considered as ineffective- although some therapies appear to work they may not be resolving the illness, just the symptoms.
The second explanation of psychological abnormality is the psychodynamic model. This was developed by Freud and other psychologists in the nineteenth century whilst working with patients suffering from psychological disorders. The belief supported by this model is that psychological problems arise from the personality (psyche) rather than from physical causes (as the biological model suggests).
Freud believed that the psyche consisted of three interconnected systems; the Id, Ego and Superego. The Id is the unconscious, insatiable instincts a person is born with; making the Id pleasure-related and selfish. Whilst the Superego is the learnt moral sector of the personality; the Superego is concerned with moral standards and expectations. The Ego is the arbitrator between the Id and the Superego, and is the last part of the psyche to develop.
As the Id and Superego are always in direct conflict the Ego is required to mediate between both sets of demands. The Ego is said to decide how and when the Id and Superego ought to express themselves. A strong Ego (of a well-adjusted person) will be able to do this task well, managing both the Id and the Superego appropriately. A weak Ego (of a less well-adjusted person) will not be able to control the Id or the Superego, so one of the elements of the Psyche will dominate the individual’s personality. A stronger Id will lead the individual to be destructive and immoral, appearing disorderly in childhood and psychopathic in adulthood. A stronger Superego will prevent the individual from enjoying even socially accepted pleasures- this would appear through neurosis in the form of anxiety, phobias and obsessions.
Therefore, according to the psychodynamic model, a psychological disturbance is due to the inability of a person’s Ego to control the Id and Superego of the person’s psyche. Freud claimed that these processes occurred at an unconscious level, so the individual would be unaware of the influence.
The conflicts between the Id and the Superego occur throughout life, though they can be most damaging in childhood. This is because the Ego is the last part of the psyche to develop and so may not be strong enough to act as an arbitrator between the Id and the Superego. The Ego will be unable to cope in traumatic events, such as maternal deprivation or sibling rivalry, and so such events will be pushed into the unconscious as the Ego cannot deal with them and needs protecting. The act of forcing a painful memory into the unconscious is known as Repression. The feelings that surround the traumatic event do not disappear; instead these are merely repressed into the unconscious where they may then appear as dreams, irrational behaviour, or eventually a psychological disorder. The idea of repression is to protect the fragile Ego when a traumatic event is too painful for it to cope, or when the child does not have enough knowledge of the world to understand how to deal with the event.
The Ego must use defence mechanisms whilst balancing the demands of the Id and the Superego. These defence mechanisms act to distort or deny reality in order to protect the Ego from stress and allow the individual to cope with events that occur throughout life. These defence mechanisms will effect an individual’s behaviour, and are seen as a natural and normal way to deal with the demands of the Id and Superego. This allows a protection for the Ego, however they are not solutions to the problem and overuse of defence mechanisms may also lead to a psychological disturbance.
Geiselman (1988) gave examples of six defence mechanisms: repression (sending unacceptable desires, motivations or emotions into the unconscious), projection (attributing unacceptable faults or wishes to another person), denial (refusing to believe events or emotions), regression (adults behaving in childlike ways which were previously used as coping mechanisms), displacement (diverting emotions onto someone else, such as by bullying), and sublimation (diverting emotion onto something else, such as by exercising).
Freud believed that everyone has some form of abnormal behaviour to a certain extent which is caused by the conflict of the Id and the Superego. Therefore it is not unusual for a person to experience anxiety, as abnormality is inevitable and beyond conscious control.
In relation to this new model of abnormality treatments needed to be devised to cure those suffering from psychological illness. Freud was successful in expressing the possibility that physical symptoms could be triggered by psychological causes, and in doing so he changed the way that mentally ill people were thought of. His solution to such problems was psychoanalysis, which is often referred to as the “talking cure” due to its emphasis on discussion with a therapist to uncover unconscious conflicts and abnormalities. This allows an individual to discover, with help from their therapist, what is causing the abnormal behaviour and to understand how their psyche has been affected in the past. The patient is then able to consciously deal with the issues and resolve them, enabling them also to handle current life situations better.
As it is suggested in the psychodynamic theory, repressed memories may resurface from the unconscious in the form of dreams. For this reason dream analysis is used to interpret the true meaning of a person’s dreams, which represent the repressed memories or emotions. Free association may also be used, where a client will say whatever comes into their head; the theory being that uncensored thoughts will emerge that can be interpreted by the therapist.
The psychodynamic theory is different from other models of abnormality as it cannot be scientifically tested. Because of this it cannot be said whether the model is valid or not. There is no way to prove that an individual has suffered conflicts between the Id and the Superego; there is only an assumption.
Some studies have been able to link traumatic experiences in childhood with psychological disorders in later life; however this only suggests a link with the psychodynamic theory- it does not prove nor disprove it. One such study was carried out by Wonderlich et al. (1996) into the effects of childhood abuse on the development of Bulimia Nervosa. It was found that women who had been sexually abused as children were significantly more likely to develop Bulimia than those who did not report being abused. The abuse would be a traumatic event for the child, causing conflict in the psyche, and due to lack of understanding the Ego would not be able to cope; this would lead to possible repression of the memory, which eventually could become the psychological disorder Bulimia Nervosa.
However, it cannot be concluded that the traumatic experience alone led to the disorder; other factors may play a significant role- such as environment or genetics. Therefore the development of Bulimia cannot be said to come purely from psychodynamic causes, but the conflict between the Id and the Superego may play a part.
In some cases it is difficult to prove that a person has even suffered a traumatic experience in childhood. Elizabeth Loftus carried out research into the theory of ‘false memories’, where it has been seen to be possible for a therapist to implant an idea into a vulnerable client’s memory using suggestion, and for the client to then believe the memory is truly their own. Due to the way the human memory works, the client will seem to recall the event as if it really happened, developing complex details and feelings about the experience.
Because the event happened in the past it is almost impossible to tell whether it really happened or not- the evidence is reliant on the client’s belief and memory recall. This could invalidate any research conducted as the retrospective data cannot be relied upon.
As with the theory itself, the defence mechanisms that feature as part of the explanation of abnormality cannot be demonstrated experimentally. The only evidence that supports the existence of defence mechanisms is everyday experiences. It would be unethical to force a participant into a traumatic experience to see how they cope, and although defence mechanisms may be displayed, evidence of the psyche’s conflict would be intangible.
It has been seen that not all children who experience a traumatic event later develop a psychological disorder, however many people suffering from an illness do report to having been involved in some form of emotional trauma. The psychodynamic theory does not explain why some children can cope with these experiences but others can. It may be explained simply by the fact that some children have a stronger Ego than others, however other factors may play a role- such as having a predisposition to a certain illness or not.
The psychodynamic model is described as being determinist- individual’s have little involvement in the development of their own personality. This is because psychological development is influenced by an individual’s relationship with their parents in early childhood. The abnormal behaviour is believed to be derived from unconscious conflicted, related to innate and biological drives.
As the model is deterministic the sufferer has no blame for their own disorder- they are not in control and could not have done anything differently to prevent the development. However, a parent may feel guilt as they were involved in raising the child and forming early relationships with the child- according to psychodynamic theory this is important in shaping the way the child’s personality will form. This may lead a parent to feel that they are to blame for their child’s psychological problems, as although they felt they were doing their best it clearly wasn’t good enough according to this approach.
As the treatment in the psychodynamic model is talking the therapy may be extensive, taking a long time and costing a lot of money. A therapist must gain their client’s trust first, as the client will be divulging a lot of personal information and feelings. It will take some time to build up this relationship. Through the methods of talking, dream analysis and free association the client’s unconscious conflicts and desires will come out, however this will not be a quick process. The therapy would require regular sessions over a long period of time in order to discover and resolve underlying issues. As a result this therapy will be both time consuming and expensive. That is why many clients would prefer to use treatment from another model, such as the biological, where taking prescribed drugs will be much quicker and possibly equally as effective. (In one legal case of 1995, a woman decided to sue her therapist after three weeks of Prozac had benefited her more than three years of therapy).
The psychodynamic theory is faced by issues concerning cultural and historical relativism. When Freud devised this theory it was heavily based on the client’s he was working with, not people in general. As most of his client’s were higher-class women from Vienna, the basis of his theory is somewhat biased. It does not take into account the way people from different cultures or social classes may react to stressful situations. For example, certain people (due to their upbringing) may be better at coping in traumatic events because they have learnt to cope, not because their Id and Superego are in any less conflict, or their Ego is better able to arbitrate.
The way the family dynamic works is different in modern times, so the idea that children need solid relationships from both parents may have changed over the course of time. Children may have adapted to survive better with only one parent rather than two, due to the high number of single parents in current times.
Some cultures still see mental illness as taboo, and so would most likely prefer to believe that it cannot be caused by the way a child is raised. The biological model would be more satisfactory as science can be blamed rather than upbringing traditions. In these cultures it would be highly unlikely for a person to seek help from a psychiatrist.
The treatment option of talking therapy may not be suitable to people of all cultures either. The idea of talking as a cure may not be taken as seriously as traditional medicine. Therefore less people would opt to follow this course of treatment.
It is also unsuitable for people with poor language skills, and in some cases (where people are suffering from low-esteem) could cause further emotional harm by making the client feel useless or a failure as they are unable to participate in this kind of therapy.
This model was instrumental in changing the way that people saw mental illness and introducing the idea that a psychological disorder can come from the mind rather than from biological causes. Freud succeeded in creating new methods of treatment to help clients, such as talking therapy. Although this therapy is expensive and slow, it can be seen as more preferable than medical treatments. There is lower risk in undergoing psychotherapy as there is no chance of addiction or allergic reaction as with drug therapy, and it is not physically invasive or requiring a medical procedure like electro-convulsive therapy or psychosurgery. However, psychotherapy is more emotionally invasive- it forces clients to face and understand their underlying, unconscious conflicts and desires. For some clients this process may be too painful, and they may prefer the medical approach instead- which does not involve them having to tackle the actual problem themselves, rather a doctor will take care of the patients instead. The client would be able to relinquish more responsibility if being treated as a patient by a medical team.
However, it is believed that through the psychodynamic approach the underlying problem will eventually be resolved, whereas in the biological approach it is believed that only the symptoms are cured.
The psychodynamic approach is likely to be affected by cultural relativism more than the biological model, as the approach is not appropriate for all cultures, whereas the biological model is suitable for everyone. Not all cultures would consider talking therapy or ideas about the psyche to be at all accurate, whilst a greater majority (although not all) of cultures do believe in some benefits of medicine.
Overall this model is effective for some people, but unsuitable for others- some have claimed (such as Eysenek) that psychodynamic treatment is less effective than no treatment at all.
The third approach of explaining abnormality is the cognitive model. This model was developed by Albert Ellis and Aaron Beck, because they believed the behavioural approach to be too simple as it did not take into the account the mental processes involved in a psychological illness.
The main assumption of this model is that emotional problems can be directly caused by distortions in a person’s thinking processes. These distortions are: negative thoughts, irrational beliefs, illogical errors (such as polarized thinking), and overgeneralization. It is believed that these thought processes are automatic and take place without full awareness.
Ellis and Beck claimed that cognition (thinking processes) occurring between a stimulus and a response could cause the feeling component of a response. It has been said that everyone experiences both rational and irrational thinking, however a psychological disorder can develop when an individual regularly engages in this maladaptive thinking and it begins to affect both them and people around them.
According to the cognitive model, when a person is thinking rationally they will also behave rationally, so as a consequence they will be both happy and effective in their life. However, when a person is thinking irrationally for a sustained period of time a psychological illness may develop as the disturbed thinking becomes habitual. It is argued that irrational thinking may be expressed through the use of certain words, such as ‘should’, ‘ought’ and ‘must’.
Irrational thinking may also be seen as an individual exaggerates or ‘catastrophizes’ events that happens to them. In this way they experience something mundane – such as someone not responding to them – and they find internal fault in order to explain the event – such as believing they are being ignored as they are a bad person. With rational thinking the event could be explained by the other person not hearing them, or perhaps feeling ill. An irrational thinker is unable to find rational alternatives.
Beck studied people suffering from depression in order to discover whether negative thoughts underlie a mental disorder, and how these people in particular develop depression. He found that in general, people suffering with depression would draw illogical conclusions when they evaluated themselves. The negative thought pattern they showed would lead to negative feelings, which leads back to depression in a cycle. From his study Beck was able to identify three forms of negative thinking that were typical of those suffering depression, and he called this the ‘cognitive triad’. The cognitive triad featured ‘negative views about the future’, ‘negative views about the world’ and ‘negative views about oneself’.
Treatment associated with the cognitive model involves both talking with a therapist and evaluating one’s own thought patterns. A client will work with a therapist in order to discover the beliefs and expectations that cause their unhappiness. They are encouraged to and taught how to replace these negative thoughts with rational, positive ones- giving them a more adaptive thinking pattern. A therapist will set a client reasonable goals so that they can introduce realistic and rational beliefs into their thought pattern.
This therapy is mainly used by people who are suffering with depression. The aim of the therapy is to enable the client to monitor the situation where they begin to make negative assumptions or irrational thoughts, and then to challenge these thoughts and replace them through a range of activities.
Although this therapy is traditionally used to treat depression, it is becoming more widespread, and is now considered appropriate for managing stress, dealing with family or marital problems, and for helping eating disorder patients.
Beck proposed another form of cognitive therapy, known as Rational-Emotive Behaviour Therapy (REBT). This treatment is more confrontational about the irrationality of the individual’s beliefs and how these thoughts are damaging them.
In REBT the therapist will agree the nature of the problem (by identifying the irrational beliefs) with the client and will set goals for them to reach. The therapist will then use a range of methods such as humour, argument, persuasion and reasoning in order to challenge the negative thoughts. The client ought then to be able to accept that the negative thoughts are irrational and unrealistic, which will give them a more positive self-worth and greater self-esteem.
A strength of the cognitive model is that it avoids the stigma of mental illness through the promotion of psychological wellbeing by offering a ‘model of living’. This is preferable for many clients as they do not have to live under the label of having a mental illness, which also makes it easier for family to accept. This helps provide a positive attitude towards recovery and more support from the family.
This method of approach has proved successful with many patients recovering from their psychological disturbance through cognitive therapy and REBT. It is believed that this can be attributed to the less deterministic approach empowering clients.
Ethically the diagnosis of ‘faulty thinking’ can lead to a feeling of guilt being placed upon the client. Therapists must place great emphasis upon the point that the client is not to blame, otherwise their psychological disturbance may worsen- the client is already vulnerable, and someone suffering with depression may feel even more useless and worthless if they believe that they are the cause of their own illness. It is particularly difficult to work with such vulnerable people and encourage them to recover through a therapy which implies some degree of blame upon the client. The maladaptive cognitions may be due to the social environment, not just the individual; this is not taken into account in the cognitive model in either its assumptions or treatments. If a client is able to resolve their problems in cognition, they may relapse if they return to the same negative social (or otherwise) environment and have not learnt to cope there, or have not made significant changes that will enable them to continue with their recovery.
Research carried out by Gustafson (1992) provides support for the idea that maladaptive thinking processes are present in people suffering from psychological disorders such as anxiety and depression. However, this does not suggest that maladaptive thinking is the cause of the illness- some psychologists have suggested that the negative cognitions may be a symptom of the illness instead. Arnkoff and Glass (1982) argued that maladaptive thought processes were not necessarily to blame for the development as a psychological illness as these may be a reflection of a certain personality structure. This suggests that cognitive restructuring through cognitive therapy will not be successful in curing an individual’s psychological problems.
Overall, as with the other models discussed, the cognitive approach is both successful and unsuccessful- it will work for some clients but not for everyone. The cognitive model explains well how a person’s maladaptive thoughts may lead to the development of a psychological disorder with support from research studies. However, it cannot be proved whether the thought cycles are a symptom or cause of the psychological abnormality.
Cognitive treatments require a strong-willed and well-motivated client in order to work; which is often difficult as clients with psychological disorders are more likely to be vulnerable and have a low opinion of themselves. Ethically it is difficult to use cognitive therapy due to the implication of blame upon the client for their illness.
Like the other approaches, the cognitive model overlooks other causal factors in developing a psychological disorder, such as environment, genetics, the unconscious and emotions.
Each of these three models has shown their strengths and weaknesses. All of them are narrow-minded in their assumptions; not taking into account other factors as they are based purely on one theory. For this reason the weaknesses often out weigh the strengths. For further application in psychology a mixture of the three approaches (or using the behavioural model as well) is more ideal. This can enable a better chance for a patient’s recovery and is more likely to explain the different factors that can contribute to abnormality. Often more than one treatment will be required in a successful recovery, as more than one factor has contributed to the development of the disorder. Such applications included the use of cognitive behavioural therapy (which considers both the cognitive and behavioural approach), or another example is in psychiatric units where often patients are given both drugs and cognitive therapy in order to aid their recovery (a combination of the biological approach and the cognitive approach).
“Genome” by Matt Ridley , Harper Perennial 2004, Ch.7 P.92