Abnormal behavior, or mental illness, is highly individualized. Its causes, functions, and treatment are very difficult to generalize into the distinct models of abnormality. Each model is valid, yet no single method is sufficient to treat most individuals. I have an eclectic or integrated view of abnormal psychological function.
From my own experience with mentally retarded and developmentally disabled persons, the chief causes of their maladapted behaviors appear to fit into the biological, behavioral, and socio-cultural models. The most common treatments employed are from the behavioral and biological perspectives. After reading Comer’s description of all the behavior models, some aspects of both the humanistic and socio-cultural models could be helpful to address self-image and create a sense of unconditional positive regard.
Many of the most serious cases seem to have multiple possible causes. For example, one could consider a mentally retarded woman with facial disfigurement and all the socio-cultural bias that entails. She is deeply self-conscience, and despite her high level of functioning, calls herself retarded and has very low self-esteem. This is compounded by her biological schizophrenia. She has auditory and visual hallucinations and is often violent predisposing her to violent retaliation. She has also suffered a lifetime of physical and sexual abuse resulting in post traumatic stress disorder. This woman’s challenges should be addressed with a combination of biological, behavioral, humanistic, cognitive, and psychoanalytic therapies.
If I were working in as a clinical psychologist, I would favor the humanistic-existential model. Behavioral and biological treatments do not address the soul or humanity inherent in each person. I appreciate the exsistential emphasis on personal responsibility and the individual’s freedom to choose to live authentically. The existential model alone is not always sufficient to address the multi-layered causes of mental illness. Combined with other therapies, I think it could lead to a productive, more positive state. It reminds me of The Book of Job. Through numerous trials Job remains self-aware. Though he slay me, yet will I trust in him: but I will maintain mine own ways before him (Job 13:15, New King James Version [NKJV]). Even though he received counsel from his closest friends and his wife, he knew himself and what was right in his heart.
Treatment plans should combine necessary treatments from every theory in whatever combination works best for the client. When medication is available and appropriate, it is a good and often necessary complement to talk or behavior therapy. However, prevention is key and that there are many improvements to social and economic systems that would benefit the mental health of everyone.
When I look at mental illness in the community at large, I see the most common complaints; stress, depression, and anxiety; as social ills as well as individual illness. “Now he who received seed among the thorns is he who hears the word, and the cares of this world and the deceitfulness of riches choke the word, and he becomes unfruitful” (Matthew 13:22, NKJV). The evolutionary aspect of the biological perspective makes sense to me. Humans are trying to bend themselves to live in a modern environment for which they are not well suited. Humans have physiological responses to stress that are more appropriate for being confronted with a saber tooth tiger than an overwhelming case load at work.
Women have the added cultural pressure of trying to navigate in social and economic stratifications that were primarily designed to accommodate men half a century ago. I suspect this is one of the chief causes of the disparity between men and women in levels of depression. In the U.S., 40 percent of women report depression compared to 25 percent of men (Payne, 2006).
Frequently, mental illness has multiple and individualized causes. Therefore, mental illness should be viewed in and individualized way and therapists should take from all the collective knowledge available and design therapy and treatment strategies that address each patient’s unique needs. Each model is valid and useful and frequently a combination of models would yield greater results. Additionally, social structures need to be modified in ways which enhance our humanity rather than erode our mental health.
References
Comer, R. J. (2008). Fundamentals of Abnormal Psychology, Fifth Edition. New York. Worth Publishers.
Payne, S. (2006). The Health of Men and Women. Boston. Polity Books.
What does the Bible have to say about overcoming stress? (2009). Bible Answers. Retrieved May 17, 2009 from www.bible.com/bibleanswers_result.php?id=127
