Pros and cons relating to the Medical Model of recovery and the BioPsychoSocial Model of recovery – John Nash – A Beautiful Mind (Russell Crowe)

John Forbes Nash Mental Health Assignment – Part I

1. How do these experiences show the DSM/Medical Model to be useful and helpful? In other words, what is it about John Nash’s experience that shows the DSM/Medical Model is a good/valid way to help someone with M. Illness?

Schizophrenia is a brain disease of enormous seriousness that has some common symptoms of mixed-up thoughts, delusions, hallucinations and bizarre behavior (Report, p. 50) that may be associated with other brain or biological diseases (Article). The disease normally affects about 1% of the population (PowerPoint, slide 2; Report, p.50) and typically occurs between adolescence and mid-30’s (Report, p. 51.). Nash’s symptoms of grandiose delusions (Article, p. 58) while at MIT such as powers from outer space were sending him coded messages, he was on the cover of Life Magazine disguised as Pope John Paul XXIII due to his favorite prime number being 23 and turning down a job at the University of Chicago because he was chosen to be the next emperor of the Antarctica while talking about the people from outer space destroying his career (Video, 18:45) came on all of sudden. According to his wife Alicia, his personality began to change within a week or so (Video, 20:10).

When Alicia became overwhelmed and decided to seek help from a psychiatrist, she was advised that Nash should be hospitalized. While taking Nash out of his natural environment and placing him in a private hospital, he was diagnosed with paranoid schizophrenia (Video, 21:42). Schizophrenia does not have one symptom or one disease that solidifies schizophrenia, and there are many symptoms of schizophrenia that are also present in other mental illnesses that may lead a mental health expert to give the wrong diagnoses. For example, in the article Surviving Schizophrenia on page 32 it mentions a patient that was analyzed with schizophrenia should not have been diagnosed with schizophrenia but with hysteria. The most prevalent precipitating factors that suddenly caused Nash’s schizophrenia was the news of his wife’s pregnancy, the mental and physical stress while working on the Holy Grail of math problems and the worry and anxiety that his best years were behind him. Therefore, in Nash’s case, the DSM came to be useful in regard in that he was diagnosis properly.

After being diagnosed properly by the mental health professionals at McLean’s Hospital, Nash was given antipsychotic medication to calm him down (Video, 21:45). Although, at the time, schizophrenia was thought to be incurable, medications were, and still are critical in controlling symptoms of schizophrenia (PowerPoint, slide 13; Report, p. 54).

Along with the help of his friends and the usefulness of the medical model of placing Nash on drugs to manage his schizophrenic symptoms allowed him to become ‘nice person’ according to his friends (Video, 40:00). He also reconnected with his first son and his mother (Video, 40:19).

In summary, using Axis 1, 2 & 3 of the DSM was useful in Nash’s instance by providing the correct diagnosis of his disease according to the description in the DSM of having delusional thoughts and hallucinations that are consistent with the time frame, duration and intensity that is not common in other diseases (Video). The DSM was also useful in educating his wife with the details of what the disease was about so that she may try to take care of John herself rather than have him in a hospital. This information helped Alicia make the decision in 1970 to take Nash back into her dwelling and take care of him herself in providing him with the basic needs of food, shelter and protection (Video, 43:47). The DSM does not suggest or prescribe cures for any of the diseases listed in its content; the medical and mental health professionals attempt to provide the cures by prescribing medications rather than focusing more on a psycho-social level. The benefits of putting a patient, Nash, on medication are that the symptoms became manageable a in a much shorter period of time.

John Nash is one of the 25% of people that recover from schizophrenia after thirty years of initial onset (PowerPoint, slide 18).

John Forbes Nash Mental Health Assignment – Part II

2. What aspects Nash’s experience point to flaws in the DSM/medical model of mental illness? What parts of his experience show the limits of the DSM/Medical Model approach.
How was this approach not helpful to John Nash?

The DSM’s ability to describe the symptoms of a disease is more far reaching that any other document or tool before, and since its inception. However, the DSM does not provide a suggested treatment(s) for the mental health diseases it describes within the first three of five axes. The DMS operates on the biological aspects of the illness, whereas the medical model focuses on the medication side of the illness. Neither the DSM and/or the Medical model work in tandem with the social aspect of a person’s life to help identify causes or courses of treatment and recovery, as shown in the case of John Nash.

Although the correct diagnosis was made in Nash’s case, the reason why schizophrenia was diagnosed was incorrect, not only once but twice. In the first instance at McLean’s hospital, Nash’s state of mind attributed to problems in childhood or problems in mothering (Video, 22:00). In the second occurrence when he was diagnosed at Trenton hospital, the contributing factors were related to a state of irregular glucose regeneration (Video, 31:42).

Not only did the DSM\Medical Model approach not give Nash an opportunity to direct what care he receive in the course of his treatment, the treatment he receive had adverse effects. This is shown through Nash’s own account when he states in reference to the insulin treatment he received at Trenton Hospital: I became a vegetarian while at Trenton Hospital. That one could protest this sort of treatment (Video, 33:14). Nash’s friends describe him after coming out of Trenton hospital as being battered (Video, 33:58) and having a loss of early memory (Video, 34:15). The Medical Model approach while at Trenton did not take into account what the long term effects on Nash’s brain or body would be by prescribing such aggressive invalid treatment that was not reliable or proven to work (Video, 33:44). Some other noticeable flaws of the Bio-Medical model that neglect the sphere of treatment and recovery are present throughout the course of Nash’s illness.

Many flaws in the Medical Model approach were prevalent in Nash’s treatment. For instance, Nash’s colleagues were worried about how admission to a hospital such as Trenton would protect his mind in the name of national interest (Video, 31:08). By continuing with the treatment that was given to Nash the concerns of social support were ignored. Not only was Nash’s mind altered with the antipsychotic drugs (Video, 41:08), his individuality was taken away when he was assigned a number once admitted to Trenton Hospital and mocked (Video, 30:48).

Throughout the course of Nash’s illness he was on and off medications where his symptoms became pronounced when he was off and subdued when he was on his medications. However, Nash was always a strong and active man taking off to various places in the world only to come back to his place of origin to the support of his friends and family, which is needed in the psycho-social aspect of treatment (PowerPoint, slide 16). Failing to realize that having a support system of family and friends (Report, p. 54) the medical models does not realize in Nash’s case that this would be the basis of his recovery. The most highlighted aspect of Nash’s experience is that those who were close to him treated him as a human being (Video, 49:58) and were extremely supportive; contrary as to how he was treated at Trenton Hospital (Video, 30:48).

In short, the limits of the DSM\Medical Model were not helpful because the opportunity to have Nash involved in his own treatment were not present to begin with. The area of Nash’s strengths was not taken into account and the illness was the focus of his treatment and not the whole person. Medications had adverse effect on the chemical makeup of Nash’s mind. Although the antipsychotic drugs helped in the short term there were no long lasting positive effects of using drugs. The DSM, although comprehensive, is not 100% reliable.


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