Exploring anxiety
Exploring anxiety

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Exploring anxiety

The biomedical model

The view that has predominated in medical practice over the last century, and still holds to varying degrees around the world, is one where mental illness is seen as a ‘disorder’, a ‘pathology’ or a ‘disease’ to be diagnosed, treated and ultimately ‘cured’. The focus on ‘disease’ rather than the person as a whole requires definitions of what is considered ‘normal’ versus ‘pathological’ and judgements that are concerned with establishing boundaries, leading to a diagnosis.

This biomedical model (see Engel, 1977) suggests that disease is by definition, associated with identifiable disturbances in the body and can be defined in terms of such disturbance. A cure would consist of correcting the disturbance. So, by this criterion, cancer is clearly a disease, as is coronary artery disease (an artery blocked by build-up of cholesterol and other material causing narrowing of the blood vessels). If a form of mental distress has as its cause a measurable basis in a bodily disturbance then, applying this criterion, it would be considered a disease for which medicine is the obvious treatment. But how can psychological distress fit within the criteria for ‘disease’? This has led to a dichotomy in views amongst mental health professionals on what is or is not considered a disease, based upon biological criteria.

Others have suggested that the biomedical model can be universally applied to all forms of distress, whether or not there is an identifiable disorder in the body. Hence, no matter what the distress, presumably a biological intervention in the form of medication (pharmacological treatment) would be appropriate.

There are limitations to the biomedical model. Usually, an individual in mental distress will present because of some form of pain, discomfort or distress which is subjectively experienced. Even if a disturbance within the body can be identified, it may not necessarily be the primary reason for which an individual presents for treatment (Engel, 1977). There are also cultural and social dimensions in how such expressions of distress are made and help is sought. A biological explanation alone, therefore, cannot provide the full picture.

The biopsychosocial model rejects the neat dichotomies of the biomedical model.


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