are of biopsychosocial cause.
Biology includes genetic predisposition and evolutionary preprogramming
of individual psychology as well as the biological impact of the
environment during the individuals' life. The psychosocial is the other
part. Its the impact of experiences and other people's behaviours. Its
the mix of predisposition and change affected by the environment. Its
the social constructs of the time and the individual's ability to fit
within them and/or survive the negative impact of temporal maladaption
(i.e. in another time with social progress they would not be
maladapted). Its life events, stressors and triggers, resilience and stigma.
This mix is the cause of individiality of behaviour, emotional
experience and consciousness. Its positivistic so there is no inclusion
of the idea of a soul or a non-corporeal, eternal part of the individual
as in many religions and cultures.
One day it may be possible to understand the complex interplay of the
biopsychosocial history of any individual, to see the predisposition but
to also see the effect of life and events. Genetics research in mental
health is a minefield compared to the science with physical conditions
because the effect of the psychosocial is considerably greater on the
mind. Psychology is complex and sociology is barely a 'proper' science
but they are essential to the quasi-correct understanding of the an
individual.
Its very, very difficult to do given current state of science in this
area. This is just a thought about the future.
That description or understanding would be an objective map of the
elements of individuality and what it is to be. To be truly scientific
it would make no judgements on what was normal and illness: all is
normal as much as all is illness. That is the only objective truth. It
is the decision of the society at the time through formal structures and
informal public structures as to what was weird, illness, or whatever.
The clarity would exist. The idea of illness is a way of understanding
mental illness but it is not a truth. In the past a similar construct
was called demonlogy instead of psychopathology or psychiatry, though
the 'pathology' was religous in basis. What was subjectively considered
'disorder of the mind' could be clearly marked upon an objective truth.
By the time this sort of understanding of the individual has developed
to become usable I expect and I desperately hope that society would have
advanced in other ways. The understanding of the modern medical model
provides the concept of the privelidge of illness or disability. It is
necessary because in 2010 society is far from advanced though I percieve
that the rate of change is accelerating. I think it is described well by
the social model of disability: the individual is not ill per se but is
disabled by the constructs of society and social prejudice. This way of
understanding is something the public consciousness can understand when
they can not understand the idea of what mental illness actually is as a
construction of society though one that came into being because of the
stigma of behaviours, emotional extremes and unusual experieinces of
consciousness.
In other weird way that's what the mental health system is. It developed
after the Age of Reason took power away from religion and gave it to
science, and mental health took over the role as the new religion
accepted by the scientific paradigm. The exact same experiences that
came to be described as dementia praecox, melancholia and ...mania (I
forget the other Kraeplinian major diagnoses) existed for millenia and
will continue to. Certain behaviours, extremes and unusual experiences
or people have and will always exist. What society chooses to call them
is not an objective truth and there have been many worse interpretations
than the psychiatric understanding of illness.
The pervasive understanding of the social model of disability offers the
best hope for the near future but at its core the mental healthcare
systems - doctors, nurses and other mental health professionals - are
still strongly medical-model based. Some professionals, for example
those with degrees in sociology or psychology, are taught to understand
the social model of disability and social theory however this is not
covered in depth in medical education. Certainly the many doctors I've
spoken to see to understand the social model in principle but without
true understanding of the depth of what it actually means and what it
means to medicalise individuals with socially-constructed illness, and
what it means for mental healthcare.
No comments:
Post a Comment