The above question is asked by people who confuse the use of medicine with the practice of psychotherapy. Individuals making such an error assume that the medical and the mental can be thought of and talked about in the same manner and with the same terms. This error is one of using the medical model to justify the use of psychotherapy.
In the field of logic this is what is known as a false analogy. One logic text explains:
An argument from analogy draws a conclusion about something on the basis of an analogy with or resemblance to some other thing. The assumption is that if two or more things are alike in some respects, they are alike in some other respect.1
In regard to a false analogy the text says:
To recognize the fallacy of false analogy, look for an argument that draws a conclusion about one thing, event, or practice on the basis of its analogy or resemblance to others. The fallacy occurs when the analogy or resemblance is not sufficient to warrant the conclusion, as when, for example, the resemblance is not relevant to the possession of the inferred feature or there are relevant dissimilarities.2
In the medical model physical symptoms are caused by some pathogenic agent. For example, a fever may be caused by viruses; remove the pathogenic agent and you remove the symptom. Or, a person may have a broken leg; set the leg properly and the leg will heal. We have confidence in the medical model because it has worked well in the treatment of physical ailments. With the easy transfer of the model from medicine to psychotherapy, many people believe that mental problems can be thought of in the same way as physical problems.
Applying the medical model to psychotherapy and its underlying psychologies came from the relationship between psychiatry and medicine. Since psychiatrists are medical doctors and since psychiatry is a medical specialty, it seemed to follow that the medical model applied to psychiatry just as it did to medicine. Furthermore, psychiatry is draped with such medical trimmings as offices in medical clinics, hospitalization of patients, diagnostic services, prescription drugs, and therapeutic treatment. The very word therapy implies medical treatment. Further expansion of the use of the medical model to all of psychotherapy was easy after that.
The practice of medicine deals with the physical, biological aspects of a person; psychotherapy deals with the social, mental, and emotional aspects. Whereas medical doctors attempt to heal the body, psychotherapists attempt to alleviate or cure emotional, mental, and even spiritual suffering and to establish new patterns of social behavior. In spite of such differences, the medical model continues to be called upon to support the activities of the psychotherapist.
Additionally, the medical model supports the idea that a person with social or mental problems is ill. And with much sympathy we label people mentally ill, and we often categorize mental problems under the key term mental illness. Dr. Thomas Szasz explains it this way:
If we now classify certain forms of personal conduct as illness, it is because most people believe that the best way to deal with them is by responding to them as if they were medical diseases.3
Psychotherapy deals with thoughts, emotions, and behavior, but not with the brain itself. Psychotherapy does not deal with the biology of the brain, but with the activity of the mind and the social behavior of the individual. In medicine we understand what a diseased body is, but what is a parallel in psychotherapy? It is obvious that in psychotherapy mental illness does not mean brain disease. If brain disease were the case, the person would be a medical patient, not a mental patient.
Szasz very sharply refers to the “psychiatric impostor” who “supports a common, culturally shared desire to equate and confuse brain and mind, nerves and nervousness.”4
The assumption that medical illness and mental illness are alike is further dealt with by Szasz in his book The Myth of Mental Illness. He says:
It is customary to define psychiatry as a medical specialty concerned with the study, diagnosis, and treatment of mental illnesses. This is a worthless and misleading definition. Mental illness is a myth.5
I have argued that, today, the notion of a person “having a mental illness” is scientifically crippling. It provides professional assent to a popular rationalization—namely, that problems in living experienced and expressed in terms of so-called psychiatric symptoms are basically similar to bodily diseases.6
Although one may result from the other, medical illness and mental illness are simply not the same. Biological and psychological are not synonymous. One has to do with the organic processes and the other with the thought and emotional life. We should have rejected the word illness after the word mental from the very beginning.
The use of the medical model in psychotherapy does not reveal truth; instead it merely disguises psychotherapy with the mask of medical terminology and ends up confusing everyone. Research psychiatrist Dr. E. Fuller Torrey says:
. . . the medical model of human behavior, when carried to its logical conclusions, is both nonsensical and nonfunctional. It doesn’t answer the questions which are asked of it, it doesn’t provide good service, and it leads to a stream of absurdities worthy of a Roman circus.7
Using the medical model of human behavior and confusing medical with mental through false analogies can lead to justifying support for ESP, past lives, UFOs, Eastern religions, and the occult. Transpersonal or religious psychologies are being supported through such false analogies and usage of the medical model.
Through such transpersonal psychotherapies, various forms of Eastern religion are creeping into Western life. Psychologist Daniel Goleman points out that Asian religions “seem to be making gradual headway as psychologies, not as religions.”8 Jacob Needleman says:
A large and growing number of psychotherapists are now convinced that the Eastern religions offer an understanding of the mind far more complete than anything yet envisaged by Western science. At the same time, the leaders of the new religions themselves—numberless gurus and spiritual teachers now in the West—are reformulating and adapting the traditional systems according to the language and atmosphere of modern psychology.9
Needleman also says:
With all these disparate movements, it is no wonder that thousands of troubled men and women throughout America no longer know whether they need psychological or spiritual help. The line is blurred that divides the therapist from the spiritual guide.10
Related to this inclusion of the spiritual into the mental, which is erroneously confused with the medical, is the new category of “mental illness” in the soon-to-be-released fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. The new category has to do with spiritual and religious problems.11
The error of applying medical terminology to mental life causes erroneous thinking and responding. The very word medical carries with it the suggested treatment, for if we are dealing with an illness, medical treatment is implied. Therefore, whenever someone suggests that you should believe in psychotherapy because you believe in medicine, remember that medical and mental are not the same. It is a false analogy and a false application of the medical model.
Using false analogies and misapplying the medical model to the mind could even lead one to ask, “If you go to a medical doctor when you’re sick, what’s wrong with seeing a witch doctor?”
Psychology grew out of philosophy. Each theory behind each therapy provides a philosophy of life and a theology of man—why we are the way we are and how we change. In fact, psychotherapy resembles religion more than it resembles medicine. After all the word psychology comes from two Greek words meaning the study of the soul. However, many psychotherapists and their advocates misuse the medical model to support psychotherapy. They continue to make this false analogy out of gross ignorance—to their own shame and to the detriment of others.
1Robert M. Johnson, A Logic Book, Second Edition (Belmont, CA: Wadsworth Publishing Company, 1992), p. 256.
2Ibid., p. 258.
3Thomas Szasz, The Myth of Psychotherapy (Garden City: Doubleday/Anchor Press, 1978), pp. 182-183.
4Ibid., p. 7.
5Thomas Szasz, The Myth of Mental Illness (New York: Harper and Row, 1974), p. 262.
7E. Fuller Torrey, The Death of Psychiatry (Radnor: Chilton Book Company, 1974), p. 24.
8Daniel Goleman, “An Eastern Toe in the Stream of Consciousness,” Psychology Today, January 1981, p. 84.
9Jacob Needleman, “Psychiatry and the Sacred” in Consciousness: Brain, States of Awareness, and Mysticism. Daniel Goleman and Richard Davidson, eds. (New York: Harper & Row, 1979), pp. 209-210.
11Brain/Mind, December 1993, p. 6.
(From PAL V2N2)