mental illnesses resemble physical illnesses and can therefore be diagnosed and treated in a

similar way.

Factor Explanation
Genetics The genes we inherit from our parents provide the blueprint for our bodies and
brains. A slight
abnormality in the genes could result in abnormalities in a persons brain functioning with
the consequence
that their behaviour becomes abnormal.
Infection The brain itself has no immune response. It relies on keeping infections (e.g.
bacteria or viruses) out with a
barrier. Infections that get into the brain can cause widespread damage, and if the brain is
damaged then a
person may start to have abnormal experiences or to behave in abnormal ways.
Chemicals To operate properly, the brain relies on hundreds of different chemicals all being
in the correct balance.
These chemicals (neurotransmitters and hormones) are used to send messages round the
brain and
nervous system, so too much or too little of any of them can cause the brain to function
abnormally.
Environmental
factors
Although the medical model focuses on internal, biological processes, it does not ignore the
possibility that
the environment can have a role to play in abnormality. On the one hand, a persons
experiences, such as
high levels of stress, can cause biological reactions that have a knock-on effect on the
brains functioning.
On the other hand, there are some toxins and pollutants in the environment that affect brain
functioning
directly, such as mercury, which can cause irrational behaviour and lead, which can affect
childrens

development.

Biological and Psychological Models of Abnormality

Introduction
The many different models used to explain the nature and treatment of mental illness
compound the problems of defining and classifying abnormal behaviour. Five major schools
of thought are summarised below.
The biological (medical) model
The medical of abnormality model has dominated the psychiatric profession since the last
century . The underlying assumption of this model is that mental illnesses resemble physical
illnesses and can therefore be diagnosed and treated in a similar way. Just as physical
illnesses are caused by disease producing germs, genetic factors, biochemical imbalances or
changes to the nervous system, it is assumed that this is also true of mental illnesses.
Because it assumes that mental disorders arise from such physical causes, the medical
model is therefore a biological model.

Example
A patient presenting with symptoms of depression (e.g., extreme tiredness, difficulty in
sleeping, lack of interest in life, possible suicidal tendencies) would be diagnosed as having
a problem resulting from an imbalance of brain chemicals. This could be corrected by
prescribing drugs to restore the balance, or in severe cases ECT (electro convulsive therapy).

Evaluation of the biological model

Assuming that psychological disorders are the result of biological factors is not without its
problems. For example, the classification of physical illnesses involves observation and
measurement of objective symptoms such as broken bones, fever, blood pressure etc.,
whereas with mental illnesses, the symptoms are much more subjective e.g., feelings of
despair, lack of energy or hearing voices. These cannot be easily measured, so the clinician
must make a judgement based largely on experience.
Also, the difference between physical and mental illness is that diagnosis of physical illness
can normally relate to the causes of the problem (known as aetiology). For example,
measuring blood sugar levels could check a diagnosis of diabetes. However as we will see,
the causes of many mental illnesses are unknown. This has an important consequence for
treatments based on the biomedical model, as they can be criticised as focusing only on the
symptoms of mental disorders and not the causes.
Finally, humanistic and existentialist biased therapists aften point out that the medical
model in encouraging the view that people who suffer from mental disorders are patients',
hands responsibility over to doctors and other professionals. In this way the individual is
discouraged from taking control of his or her own life and as a consequence his or her
problems will ultimately remain unresolved.

Against these negative criticisms could be set the undeniable progress that has been made
in understanding the biological basis of many mental disorders (especially schizophrenia)
and the successful development of bio-medical treatments.

In summary, the strengths of the biological model are:

The model is based on well established sciences such as medicine
There is evidence that biochemical and genetic factors are associated with some
mental illnesses: schizophrenia, for example
It provides a structured and logical system of diagnosis and treatment
 If mental illness has a physical cause, patients cannot be blamed the person is not
responsible for the abnormal functioning
The weaknesses of the biological model are:
The model does not explain the success of purely psychological treatments for
mental illnesses
For most mental illnesses, there is no definite proof of a physical cause
The model does not include consideration of social and cultural factors which do
seem to be statistically linked to mental illness, e.g., higher rates of mental illness
amongst the poor
Even if physical changes are associated with mental disorders, it is not clear whether
they are the cause or the effect of the illness

The psychodynamic model

The psychodynamic model was first formulated by Sigmund Freud at the end of the 19th
century and since that time has had an enormous influence on the entire area of abnormal
psychology. It still offers for many therapists a preferred alternative to biological approaches
to abnormality. The core assumption of this approach is that the roots of mental disorders
are psychological. They lie in the unconscious mind and are the result the failure of defence
mechanisms to protect the self (or ego) from anxiety. Many of these intrapsychic conflicts
involve basic biological instincts, especially sexual ones. Many adult problems are reflections
of these earlier conflicts, particularly those stemming from infancy and early childhood (such
as the Oedipus conflict).

Treatments based on the psychodynamic model focus on gaining access to the

unconscious and exploring the conflicts with the patient so that they are able to confront
them and resolve them in an adult way. The emphasis is on the patient gaining insight into
the origins of their problems. This technique is known as psychoanalysis. The method of
psychoanalysis first developed by Freud is still practised, but perhaps more common today
are the psychodynamic psychotherapies. These share the fundamental principles of
psychoanalysis, but are more eclectic and relaxed in their treatment of patients.
Example
A patient presenting with anxiety symptoms would be encouraged to explore his past in
order to discover problems occurring during one of the psychosexual stages (oral, anal,
phallic and genital). In order to deal with this problem the patient has used ego-defence
mechanisms, such as repression or denial. These have taken up a lot of psychic energy,
leaving the patient with fewer resources to deal with everyday life. The anxiety itself may
have become directed towards someone or something else in the patients world
(displacement). Treatment would involve, among other things, helping the patient to gain
insight into the causes of his anxiety.

Evaluation of the psychoanalytic model

The psychodymamic model has a number of strengths which account for its enduring
popularity:
Many observations of psychodynamic therapists appear to be borne out in everyday
life, e.g., defence mechanisms
Many people with psychological disturbances do recollect childhood traumas
Freudian theory provides a comprehensive framework to describe human personality
Freud rehumanised the distressed, making their suffering more comprehensible to
the rest of society
By developing a method of treatment, Freud encouraged a more optimistic view
regarding psychological distress. Mental illness could, in some cases at least, be
treated!
Weaknesses of the psychoanalytic model are:
The tendency to ignore the patients current problems by focusing on past conflicts
(though this is not true of many later versions of psychoanalysis)
A lack of scientific evidence concerning major theoretical assumptions
As the source of many of the conflicts are often parents, there is a tendency to give a
lot of responsibility to parents for the psychological health of their children
Psychodynamic theory underestimates the role of situation and context, and
overemphasises internal instincts and conflicts

The behavioural model

The behaviourist approach dominated psychology in the first half of this century, especially
in the USA. The goals of behaviourism were to move psychology toward a scientific model,
which focused on the observation and measurement of behaviour. Its assumptions were that
behaviour is primarily the result of the environment rather then genetics (or instincts) and so
the behaviourists reject the view that abnormal behaviour has a biological basis. Like the
psychodynamic theorists, behaviourists have a deterministic view of mental disorders: they
believe that our actions are largely determined by our experiences in life. However, unlike
Freud, they see abnormal behaviour is a learned response (through conditioning) and not as
the result of mysterious (and they would argue unknowable) unconscious processes. While
much of our behaviour is adaptive, helping us to cope with a changing world, it is also
possible to learn behaviours that are abnormal and undesirable. However, such maladaptive
learning can be treated by changing the environment so that un-learning could take place.
Example
A patients fear (phobia) of heights would be explained through the process of classical
conditioning. Some time in the past, she would have learned to associate the emotion of fear
with the stimulus of being in a high place through a chance association between the two
stimuli. As a result, she would avoid heights, and therefore not have the opportunity to
relearn the association in a more adaptive way. Treatment would involve desensitising the
fear through conditioning techniques.

Evaluation of the the behavioural model

Among the strengths of the model are:
 It has led to the development of specific behavioural therapies, many of which have
had high success rates
It is widely regarded as lending itself to scientific study and evaluation
Proponents of the model argue that once the symptoms of an illness are alleviated,
the complaint disappears
Weaknesses include:
The model is reductionist in the sense that it reduces the complexity of human
behaviour to behavioural responses to environmental stimuli
Only the symptoms of illnesses are treated, not the underlying causes
The model provides a limited view of the causes of mental illness and does not
explain the evidence relating to genetic predispositions to mental illness
Environmental causes of abnormal behaviours are only rarely discovered in patients

One important extension of the behaviourist approach is known as social learning

theory (SLT). These theorists (e.g. Bandura) argue that observation and imitation (known as
modelling) are an important forms of learning neglected by the early behaviourists. Thus
maladaptive behaviour can be learned from poorly functioning parents through imitation.
But it can also be treated by therapies based on modelling (for example a person with a
snake phobia might learn from watching a person handle snakes). Because many therapists
who use this approach act as a bridge between the behaviourist and the cognitive
approaches, they are usually known as cognitive-behavioural therapists.

The cognitive model

The cognitive approach is both an outgrowth from, and a reaction to, the behaviourist
approach. The basic assumption of the cognitive approach holds that mental events cause
behaviour in that we interpret our environment before we react to it. In the case of abnormal
behaviour, it is the interpretations and disordered cognitions that lead to the behaviour.
Emotional problems can be attributed to distortions in our cognitions or thinking processes.
These distortions are in the form of overgeneralisations, irrational beliefs, illogical errors or
negative thoughts. The focus of treatment is on understanding the disordered thoughts and
working with the patient to change these.

Example
A patient suffering from a depressed mood after failing a driving test may be having
negative thoughts not only about that specific failure but may be generalising those to other
areas of her life. She may believe she is a failure in all aspects of her life and will never be
successful again. These thoughts are irrational and polarised, and the therapist would strive
to teach the patient ways of changing her thoughts. The therapist might also emphasise the
importance of increasing positive reinforcements, and suggest ways in which this might be
achieved.

Evaluation of the cognitive model:

Supporters of the cognitive approach claim that the strengths include:
There is much evidence of maladaptive thought processes in people with
psychological disorders
This model promotes psychological well being by teaching people the means of
control over their own lives
On the other hand, weaknesses of the cognitive model:
The disordered cognitions may be a result of the disorder, not the cause
The emphasis on the individual draws attention away from social support systems
and the need to locate the causes of psychological distress in wider social, political
and cultural contexts

The humanistic model

Sometimes referred to as the third force in psychology, the humanistic movement was a
reaction against the determinism of the psychodynamic and behaviourist paradigms. It
attempted to focus more on the individual as a whole person. According to Carl Rogers and
other leading figures in this movement, people are rational beings, able to make their own
choices, and are motivated toward a state of fulfilment. Psychological problems occur when
people experience an incongruence between their real self and their ideal self. This
generates a feeling of low self-worth. The humanistic model does not believe in labelling
people by diagnosing them as having specific mental disorders. Every individuals problems
are seen as unique and the therapy lies in providing nurturing therapeutic conditions which
enable the person to find his/her own way forward in dealing with problems.

Example
An individual with feelings of despair and a lack of motivation to live would be understood in
terms of a low sense of self-worth, perhaps to do with the lack of a nurturing environment.
This has led to them losing touch with their true self. They are valuing themselves in overly
negative ways, and feel that they are unacceptable and unlovable as a person. In order to
get in touch with their true self, it is necessary to experience conditions that offer empathy,
acceptance and genuine understanding.

Strengths of the humanistic model:

There is a large body of research, particularly case histories, to back up the claims of
the humanistic model
The model offers an optimistic view of personality
It is regarded as an ethical model because it focuses on the person rather than the
diagnosis
The model facilitates the human capacity for self-cure
Weaknesses of the humanistic model:
The focus on the individual carries the assumption that people should be able to help
themselves, and may neglect important environmental and social factors (e.g.,
poverty and discrimination)
 Some disorders requiring medical treatment may go untreated due to the reluctance
to diagnose
The model tends to espouse western ideals of individuality and freedom, which may
not take into account more collectively based cultures.