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.