Spirit and soul in mental health: going beyond the medical model. Andrew Baxter, April 2003.

In January 2000, after a long period of depression and mental confusion, I suffered a psychotic breakdown, or spiritual crisis, which led to my encounter with the psychiatric services as a patient at Ridge Lee mental hospital in Lancaster for five months. Over the past three years, I have been struggling with the aftermath of this, going through a whole range of difficult mental states and experiences. From July 2000 to October 2001, I was staying as a resident at Lothlorien Therapeutic Community in South West Scotland; the positive, healing, environment there gradually helped me start to feel better in myself. I have now returned to Lancaster, and over the last eighteen months have been starting to pick up the pieces of my life again. I am writing this because, although the psychiatric treatment I have received has been helpful to me in some ways, it has only been a small part of my journey, and I have come to the view that the medical model of mental health on which it is based offers only a limited perspective on mental illness. I hope that by sketching an outline of a broader view of mental health, and by telling some of the ways in which I have learned to help myself cope with the chaos of my own mind, I may in some way help future people going through the same kind of troubles. Although what I have to say is in some places critical of the psychiatric services, it is not meant to disparage the good motivation of individuals within them; I am more trying to point out problems with the system and world view which they are working within.

The target of my criticisms here is what I am calling the medical model of mental health; although there may be relatively few people who hold to this dogmatically in its purest form, I suspect that this bundle of views holds strong sway over the collective imagination and traditions of practice of the psychiatric profession, and thus acts to marginalise alternative therapeutic approaches and self-help methods, to the detriment of patients. So, to give a clear sense of what it is that I am criticising, the medical model is the view that:

I realise that I am not the first person to criticise the above view, and that there have been ongoing debates within psychiatry about this for a number of years; however I am trying to write this as much as possible from my own experience, so as to communicate my own view of what I have been through to the people I have met personally in the psychiatric system, rather than engage in the wider debates.

In saying what I have to say below, I am not suggesting that people do not have troubles in their lives, and that these troubles may at times reach a proportion where we find it difficult to live our lives and need some sort of outside help; rather that by locating these troubles firstly within the individual patient, and secondly and even more narrowly in the states of activation of various neurochemical circuits in their brains, the medical model as described above shows an unfortunate and in some cases actually harmful or repressive failure of imagination on the part of the psychiatric profession.

I will now set out in point form some of the problems that I see with the medical model. This document was originally intended as the introduction to a longer piece in which I would expand on each of the points in more detail with examples from my own experience, and then describe some of the things which have helped me recover some degree of stability of mind and well-being; however for now I will leave these points as they are.