The Myth and the Scientific Fraud of the bio-psycho-social model

Hvem hadde trodd dette? Tror jeg hadde satt pris på å ha lest dette på ett tidligere tidspunkt. Synes det var noe som manglet da jeg leste Engels artikkel i fra 1977, men kunne ikke sette fingeren på det. Den australske psykriateren Niall McLaren har derimot sett igjennom det vitenskapelige grunnlaget for blandt annet modeller i psykriatien. De eksisterer ikke. Ikke en eneste modell……

scientific_progress_goes_boink_calvin_and_hobbes

The myth and the Scientific Fraud of the biopsychosocial model – the officially‐endorsed biopsychosocial model is pure humbug because it does not exist.

Sitater i fra psykriater Niall McLaren (AU) bok Humanizing Psychiatrists: Toward a Humane Psychiatry : an Application of the Philosophy of Science to Psychiatry (2011) og litt mer om denne personen, vil vise litt senere. I denne bloggposten henviser jeg derimot til samme sak med sitater i fra professor Malcom Hooper (vil komme flere i fra han senere også – det er tross alt 12 mai snart med det formål å bevissgjøre)

Sitater i fra Professor Malcolm Hooper (2010) MAGICAL MEDICINE: HOW TO MAKE AN ILLNESS DISAPPEAR (s.31-32)

Peter White is known for his published belief that: “some people believe that medicine is currently travelling up a ‘blind alley’ (and) that this ‘blind alley’ is the biomedical approach to healthcare. The biomedical model assumes that ill‐health and disability is directly caused by diseases and their pathological processes (but) there is an alternative approach – the biopsychosocial approach is one that incorporates thoughts, feelings, behaviour, their social context and their interactions with pathophysiology” (Biopsychosocial Medicine. An integrated approach to understanding illness. OUP 2005. Ed. Peter White).

There is a long history of the biopsychosocial model of disease being discarded once the evidence is obtained that disproves it – according to one eminent NHS Consultant Clinician who specialises in ME/CFS, the psychosocial model is a default posture which some people embrace when they do not know what is going on or do not understand the science (personal communication).

In 1998 psychiatrist Niall McLaren showed that the biopsychosocial model was a mirage (A critical review of the biopsychosocial model. Australian and New Zealand Journal of Psychiatry 1998:32:8692) and in his 2002 paper he showed how reliance upon such a non‐existent model is nothing but illusion (The myth of the biopsychosocial model. Australian and New Zealand Journal of Psychiatry 2002:36:5:701).

McLaren points out that psychiatrists have made a mistake in crediting Engel as author of the biopsychosocial model of disease, when Engel did not write any such model. All the model consists of is three words: “The Biopsychosocial Model”.

McLaren notes that psychiatry seems to have mistaken Engel’s call for a more considerate model with an assumed existence of such a model

To quote McLaren: “Nothing (Engel) wrote constituted a coherent series of propositions that generated testable predictions relating to the unseen mechanisms by which mind and body interact, ie. a scientific model for psychiatry”.

McLaren notes that some psychiatrists repeatedly invoke Engel’s biopsychosocial “model” and that they accept without demur (or references) that it is a reality, when nothing could be further from the truth.

He asks: “Why do these intelligent people, their reviewers, their editors and, above all, their readers, continue to pay homage to something that does not exist?”

Wessely School psychiatrists, however, appear certain that their own beliefs and their reliance upon the “biopsychosocial” model are correct. They have built their careers upon it, so they must be right.

To quote McLaren: “A Medline search of the word ‘biopsychosocial’ yielded nearly four hundred references, not one of them critical. Indeed, the Journal of Psychosomatics now uses the terms ‘psychosomatic’ and ‘biopsychosocial’ interchangeably. In its present form (it) is so seriously flawed that its continued use in psychiatry is not justified. In a word, the officially‐endorsed biopsychosocial model is pure humbug because it does not exist.

“Psychiatrists have long attempted to convince the general public, the funding bodies and, most significantly, the younger generations of students and psychiatrists that the profession has articulated a rational model which grants it special and unique knowledge of the aetiology of mental disorder. It is my view that we are guilty of the grossest intellectual neglect or of outright scientific fraud” (The Biopsychosocial Model and Scientific Fraud. N McLaren.
May 2004; available from the author at jockmcl@octa4.net.au ).

McLaren is not the only psychiatrist to raise concerns about the lack of attention by certain psychiatrists to causal research.

Per Dalen, a Professor of Psychiatry in Sweden, comments: “There is a theme that not only survives inside the medical culture in spite of an almost total lack of scientific support, but actually thrives there due to the support given by leading circles. This is the use of psychological theories as a means of reclassifying bodily symptoms as mental problems in cases where conventional medicine is at a loss for an explanation, particularly patients with so‐called new diagnoses.

“Since I am a psychiatrist, I have for a long time been intrigued by the extraordinary use of psychiatric causal explanations for illnesses that not only go with predominantly somatic symptoms, but also lack any basic similarity to
known mental disorders.

Sluttkommentarer:

Malcom Hooper er ett icon i England, når det kommer til å ha avslørt Wessley og følgere i deres taktikk for å overbevise en hel verden om at ME ikke eksisterer og når «sånne som oss» oppsøker lege, så er det en mental sykdom – intet unntak. Malcom Hooper står fremdeles, ikke alle er like heldig i møte med Wessley-skolen. Så noen sitater i fra Hooper er essensielt for å forstå debatten om ME.

McLaren har vist seg til å være en interesant fyr og på utsiden. Ikke overraskende er black-suit psykriaterene, nå idehistorikere, sosialmedisinere og lignende vesen ikke så stor fan av hans arbied. Det viser seg opplagt at det kun eksisterer svært få abstrakter i pubmed. Bøker har han skrivd.

Insane_mental kreativitet_humor

 Kronikken En integrert forståelse av subjektive lidelser i klinisk praksis i Tidskriftet

har flere gode kommentarer, men kanskje en bør se den i ett annet lys. (bare lyst å bemerke at Wyller kjører en integrert ehh ja modell)
NB! Dersom det ikke kommer flere innlegg, kan ikke garatere eller love noe, så vil jo enhver ME-pasient forstå hvorfor.

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Kortlenke til dette blogginnlegget er: http://wp.me/p1wvHk-1t0

2 kommentarer om “The Myth and the Scientific Fraud of the bio-psycho-social model

  1. Og likevel, når man stiller spørsmålstegn ved den biopsykososiale teorien og modellen så blir man gjerne ansett som «litt dum….»?

  2. Reblogged this on Utting-Wolff Spouts and commented:
    “There is a theme that not only survives inside the medical culture in spite of an almost total lack of scientific support, but actually thrives there due to the support given by leading circles. This is the use of psychological theories as a means of reclassifying bodily symptoms as mental problems in cases where conventional medicine is at a loss for an explanation, particularly patients with so‐called new diagnoses. Since I am a psychiatrist, I have for a long time been intrigued by the extraordinary use of psychiatric causal explanations for illnesses that not only go with predominantly somatic symptoms, but also lack any basic similarity to known mental disorders.” Hear, hear.

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