In this essay, I want to argue that we should refer to psychotic disorders as brain disorders, but that doing this doesn’t mean giving primacy to the biomedical view versus the biopsychosocial view.
In keeping with some of my previous thoughts, let’s assume you get a broken leg. Furthermore, let’s assume that your broken leg is due to a social ill—someone assaulted you.
You go to the doctor. You get a cast, but, in addition, as you heal, you may need physical therapy in order to heal better in your leg.
Seeing a broken leg as a medical issue doesn’t mean you won’t need treatments other than having a cast, and using crutches until you heal.
In fact, this may be yet one more trauma in your life that you don’t need.
Now imagine that, years down the road, you become psychotic. Imagine further that this is because you have experienced hardship, childhood abuse, and trauma, including being assaulted by someone who broke your leg, years back.
You are taken to the hospital. The psychiatrists there see you as a brain patient. They try to treat your brain by giving you antipsychotics.
But, in addition, you are assigned a treatment team that includes social workers, case managers and counselors.
Seeing psychosis as a brain issue doesn’t mean you won’t need other treatments, like counseling. And, further, your society may need some treatments of its own, if it produces people who traumatize and torments people, and produces social injustice.
Calling psychosis a brain illness doesn’t negate other biopsychosocial causes or cures, just as thinking of a broken leg as a medical issue doesn’t negate the fact that you have been assaulted, and may need counseling, or physical therapy. In other words, calling schizophrenia a brain disorder doesn’t commit us to the biomedical model over the biopsychosocial model.