Discussion 1
I do not agree with Szasz on his stand that mental illness is not real. Szasz describes the
symptoms of what we would view as mental illness as our feelings about problems of everyday life.
To me, he has taken the feelings of hopelessness and despair that someone in depression may feel
and minimized the severity, subsequently normalizing it. I found the article extremely difficult to
understand. While I understood his point clearly, the method by which he used to rationalize and
prove his point was wordy and lacked empathy.
I believe mental illnesses are real medical illnesses. As we learn in Chapter 1 of the text,
mental illness has been known to be around since 500 B.C. with explanations and treatments.
Throughout history, the explanations and treatments have changed and are still evolving. We don’t
know everything there is to know about mental illnesses, and some we know less of than others but
against what Szasz has used as one of his arguments, mental illnesses have been evidenced by
diagnostic testing such as brain imaging, hormone, mineral, vitamin and neurotransmitter levels. It
is not as simple or direct as in most medical illnesses of the body. Chapter 2 talks about the many
different types of studies that are used to learn more about mental illnesses. Still, the trouble is
identifying if a real mental illness is present. Diagnosing by symptoms alone is not conclusive and
even defining mental illness by the the 4 D’s (deviance, distress, dysfunction, dangerousness) can
be difficult. Sure, I believe that what Szasz says about the regular problems in life is true about
some people, but there is also a population out there undergoing more suffering than what would
be in the realms of normalcy, where the suffering is detrimental to their functioning, their lives and
those around them. There is so much more to learn about mental illnesses, many more advances
to be made but the belief that people like Szasz, certain cultures, societies and others have about
mental illness just creates obstacles. A point that Szasz makes that I can agree with is that the
label of mental illness imposed on someone may be a method of which to control them. For
instance, a person or people who are different or don’t share the same views as the majority or
even the government can be silenced by the label of having a mental disease.
In American culture, the stigma of mental illness still exists but I believe it has decreased.
We have come a long way from the times described in Beers’ autobiography with open abuse
towards the mentally ill. However, the use of physical restraints was normal not very long ago;
many seasoned healthcare workers can tell stories of a time when it was acceptable. According to
the Department of Health and Human Services in a summary to state survey directors for nursing
homes, over the last 20 years, the percentage of people in nursing homes in daily physical
restraints has decreased from almost 20% to less than 5%. Facilities may be given heavy citations
if abuse (including restraints) occurs. The use of chemical restraints (medications) is also not
allowed but for patients that are mentally ill, caregivers may use medications to deal with the
symptoms of the illness, or subdue them, rather than take the time to formulate a plan and
treatment that the patient may so desperately need. A lack of education on mental illness and
financial reasons, just like in Beers’ times, drives the mistreatment of mental illness patients by
health professionals. The moral treatment movement was also short-lived for similar reasons. It
was sickening to read through the experiences Beers had at the hands of those that were supposed
to care for him and help him get better. The reform that has come from such times is a long leap but
I believe more needs to be done.
The one thing that stood out to me in reading the textbook was how health insurance
companies deal with coverage for mental illnesses. Even though they are required by law to provide
coverage, they have found ways to get around providing adequate coverage. Not only does society
and those uneducated about mental illness have a stigma towards it but ironically so do these
, health insurance companies. The message they are sending to those with mental illness is that
their illness is either not real, or doesn’t matter. Society’s stigmas already cause many with mental
illness to keep quiet, not seek support and treatment, to suffer alone and potentially become more
ill; and now the health insurance companies are also telling those people that they don’t deserve
proper care and treatment. The health insurance companies believe this so strongly that they go
around the law and find loop holes to underinsure people that need help. I believe the laws
surrounding mental illness coverage should be much stronger and more enforced to not only
provide proper coverage to those that are sick but to send a message to society that mental illness
is real and we care about making people well.
Also the vocabulary we use as a society, such words as crazy, nuts, antisocial, weird,
continue to act as obstacles in removing the stigmas of mental illness. We have to make a
conscious effort to watch how we use words like this and think about what they really mean and
how they may affect someone with mental illness.
Discussion 2
The family-social model would include John’s mother and brother in therapy. It aims to
work on the communication and family dynamics that may be leading to the abnormal behavior. It
is based on the family systems theory which states that the family is a system of interacting parts,
where the family’s structure and communication may cause an individual to have abnormal
behaviors. Because of John’s age now and especially his age when he started drinking, his
immediate family’s impact on his behavior and recovery are important. This model would focus not
just on John’s abnormal functioning but the behavior and responses of the family that continue the
problem John has with alcohol. Even though John may realize that his drinking problem is causing
problems between himself and his family, he may keep doing it to cope with the tension, as
evidenced by his tendency to drink until he passes out when his anxiety is too high. The continual
reference to him being like his father who was an alcoholic, may further push him into his behavior,
believing that it is his destiny. The relationship John has with his family is negative, where they call
him the rebellious one and the black sheep destined to be like his father. Hearing this could
influence his drinking behavior for the worse. With the family systems model, the relationships can
improve on the road to and during recovery for John. The role of the therapist here would be to help
John’s family to understand his drinking problem, help John and his family through recovery and to
show the family how to support John during recovery. The psychologist could further refer John and
his family or just the family to therapy groups or community treatment.
Looking at John’s situation from the psychodynamic model, we will not put all of the focus
on the actual act of him drinking but why he is doing it and what is causing the anxiety causing him
to drink so much that he passes out. There are a few issues here that can be explored to help John –
the fact that he has been drinking since he was 12 years old, his anxiety and its origin, the death of
his father by alcohol and the image he may have of himself. In the psychodynamic model, it is
believed that an individual’s abnormal behavior is a manifestation of underlying conflicts that may
have been caused by traumatic experiences or childhood problems. Methods such as free
association could help John to uncover the roots of his anxiety and coping mechanism to drink
heavily. John’s thoughts and beliefs about himself have shaped his behavior to a point of
dysfunction, with his family contributing to the negative thoughts and beliefs. Transference would
also be beneficial for John to sort through the feelings he may have towards his mother, and even
his father.
I do not agree with Szasz on his stand that mental illness is not real. Szasz describes the
symptoms of what we would view as mental illness as our feelings about problems of everyday life.
To me, he has taken the feelings of hopelessness and despair that someone in depression may feel
and minimized the severity, subsequently normalizing it. I found the article extremely difficult to
understand. While I understood his point clearly, the method by which he used to rationalize and
prove his point was wordy and lacked empathy.
I believe mental illnesses are real medical illnesses. As we learn in Chapter 1 of the text,
mental illness has been known to be around since 500 B.C. with explanations and treatments.
Throughout history, the explanations and treatments have changed and are still evolving. We don’t
know everything there is to know about mental illnesses, and some we know less of than others but
against what Szasz has used as one of his arguments, mental illnesses have been evidenced by
diagnostic testing such as brain imaging, hormone, mineral, vitamin and neurotransmitter levels. It
is not as simple or direct as in most medical illnesses of the body. Chapter 2 talks about the many
different types of studies that are used to learn more about mental illnesses. Still, the trouble is
identifying if a real mental illness is present. Diagnosing by symptoms alone is not conclusive and
even defining mental illness by the the 4 D’s (deviance, distress, dysfunction, dangerousness) can
be difficult. Sure, I believe that what Szasz says about the regular problems in life is true about
some people, but there is also a population out there undergoing more suffering than what would
be in the realms of normalcy, where the suffering is detrimental to their functioning, their lives and
those around them. There is so much more to learn about mental illnesses, many more advances
to be made but the belief that people like Szasz, certain cultures, societies and others have about
mental illness just creates obstacles. A point that Szasz makes that I can agree with is that the
label of mental illness imposed on someone may be a method of which to control them. For
instance, a person or people who are different or don’t share the same views as the majority or
even the government can be silenced by the label of having a mental disease.
In American culture, the stigma of mental illness still exists but I believe it has decreased.
We have come a long way from the times described in Beers’ autobiography with open abuse
towards the mentally ill. However, the use of physical restraints was normal not very long ago;
many seasoned healthcare workers can tell stories of a time when it was acceptable. According to
the Department of Health and Human Services in a summary to state survey directors for nursing
homes, over the last 20 years, the percentage of people in nursing homes in daily physical
restraints has decreased from almost 20% to less than 5%. Facilities may be given heavy citations
if abuse (including restraints) occurs. The use of chemical restraints (medications) is also not
allowed but for patients that are mentally ill, caregivers may use medications to deal with the
symptoms of the illness, or subdue them, rather than take the time to formulate a plan and
treatment that the patient may so desperately need. A lack of education on mental illness and
financial reasons, just like in Beers’ times, drives the mistreatment of mental illness patients by
health professionals. The moral treatment movement was also short-lived for similar reasons. It
was sickening to read through the experiences Beers had at the hands of those that were supposed
to care for him and help him get better. The reform that has come from such times is a long leap but
I believe more needs to be done.
The one thing that stood out to me in reading the textbook was how health insurance
companies deal with coverage for mental illnesses. Even though they are required by law to provide
coverage, they have found ways to get around providing adequate coverage. Not only does society
and those uneducated about mental illness have a stigma towards it but ironically so do these
, health insurance companies. The message they are sending to those with mental illness is that
their illness is either not real, or doesn’t matter. Society’s stigmas already cause many with mental
illness to keep quiet, not seek support and treatment, to suffer alone and potentially become more
ill; and now the health insurance companies are also telling those people that they don’t deserve
proper care and treatment. The health insurance companies believe this so strongly that they go
around the law and find loop holes to underinsure people that need help. I believe the laws
surrounding mental illness coverage should be much stronger and more enforced to not only
provide proper coverage to those that are sick but to send a message to society that mental illness
is real and we care about making people well.
Also the vocabulary we use as a society, such words as crazy, nuts, antisocial, weird,
continue to act as obstacles in removing the stigmas of mental illness. We have to make a
conscious effort to watch how we use words like this and think about what they really mean and
how they may affect someone with mental illness.
Discussion 2
The family-social model would include John’s mother and brother in therapy. It aims to
work on the communication and family dynamics that may be leading to the abnormal behavior. It
is based on the family systems theory which states that the family is a system of interacting parts,
where the family’s structure and communication may cause an individual to have abnormal
behaviors. Because of John’s age now and especially his age when he started drinking, his
immediate family’s impact on his behavior and recovery are important. This model would focus not
just on John’s abnormal functioning but the behavior and responses of the family that continue the
problem John has with alcohol. Even though John may realize that his drinking problem is causing
problems between himself and his family, he may keep doing it to cope with the tension, as
evidenced by his tendency to drink until he passes out when his anxiety is too high. The continual
reference to him being like his father who was an alcoholic, may further push him into his behavior,
believing that it is his destiny. The relationship John has with his family is negative, where they call
him the rebellious one and the black sheep destined to be like his father. Hearing this could
influence his drinking behavior for the worse. With the family systems model, the relationships can
improve on the road to and during recovery for John. The role of the therapist here would be to help
John’s family to understand his drinking problem, help John and his family through recovery and to
show the family how to support John during recovery. The psychologist could further refer John and
his family or just the family to therapy groups or community treatment.
Looking at John’s situation from the psychodynamic model, we will not put all of the focus
on the actual act of him drinking but why he is doing it and what is causing the anxiety causing him
to drink so much that he passes out. There are a few issues here that can be explored to help John –
the fact that he has been drinking since he was 12 years old, his anxiety and its origin, the death of
his father by alcohol and the image he may have of himself. In the psychodynamic model, it is
believed that an individual’s abnormal behavior is a manifestation of underlying conflicts that may
have been caused by traumatic experiences or childhood problems. Methods such as free
association could help John to uncover the roots of his anxiety and coping mechanism to drink
heavily. John’s thoughts and beliefs about himself have shaped his behavior to a point of
dysfunction, with his family contributing to the negative thoughts and beliefs. Transference would
also be beneficial for John to sort through the feelings he may have towards his mother, and even
his father.
