Models of Illness
Dr Bruce Davies
Why Models?
What is an illness?
What is health?
Not just the absence
of disease.
Many ways of looking
at what constitutes
health and disease.
Roles
Help us understand
our role and the needs
of patients.
Why?
Illness behaviour.
Fashion.
Social context.
Political context.
Illness Models
Magic model.
Moral model.
Political model.
Behavioural model.
Psychoanalytical model.
Cognitive dissonance model.
Illness Models
Systems theory model.
Anti-psychiatric model.
Radical model.
Sociological model.
Humanistic model.
Magic Model
Said to be common in Haiti, perhaps a
rather condescending idea!
The western model of “it’s a viral
infection” is however identical!
Moral Model
Retribution for
deviant behaviour.
Where the blame is
shifted to the patient.
“Perhaps that will
teach you to do as you
are told and keep your
coat on.”
Political Model
Improved working
conditions will treat
back pain.
Higher pensions will
make all the elderly
well.
Better housing etc.
Behavioural Model
Manipulative behaviours.
Compensation claims.
Secondary gains.
What are they getting out of it?
Enhanced benefits if unemployed.
Psychoanalytical Model
Illness is the ego’s attempt to defend itself
against unresolved unconscious conflicts.
Why is cancer more likely within 18
months of a bereavement?
Cognitive Dissonance Model
Discrepancy between
self-image and reality.
Classic example is
anorexia nervosa.
Systems Theory Model
Regulating factor modifying or stabilising
a family’s interpersonal processes.
For example asthma in a 6 year old, in a
marital breakdown.
Anti-psychiatric Model
Illness is “A booby prize for being the loser
in a family’s internal power struggle”
Radical Model
An invented label.
The monopolistic
medical profession.
Why to rates of
common operations
(i.e. hysterectomy)
vary with out
measurable effects on
health?
Sociological Model
Illness is what you
call it if you want a
doctor to deal with it
– ie delinquency.
Anti-social behaviour
is what you call it if
you want the legal
system to deal with it
– ie delinquency
etc
Humanistic Model
Illness is a sign of frustrated human
potential.