The Failure of the Medical Model

The meaning of "healing", to make whole, remains elusive in the context of psychotherapy, but the medical model has a somewhat easier time with it. By reducing the image of the body to that of a machine, medicine can say that the functioning of the machine is impaired, incomplete, and thus requires healing. Medicine entertains an idea of a healthy body, a body at an ideal level of functioning where everything works properly, and when some organ or system is somehow prevented from working properly, it uses this ideal as a goal toward which the progress of healing is always moving. The wound or disease is an abhorration in the wholeness of the machine, and this wound must be repaired, healed, so that the body can return to its previous level of functioning.

The psyche, however, does not lend itself easily to this convenient reduction. It is more difficult to imagine psyche as a machine than it is to imagine body as one. What would be the ideal functioning of the psyche? Ask a thousand people and get a thousand answers. Five hundred patients will give five hundred answers, and five hundred therapists will give five hundred more-but none of these answers are to be taken too concretely.

Healing Healing

Now, near the end of this paper's excursion into healing, I can begin to heal the paper, to make it whole, helping all of its parts- ideas, words, phrases, paragraphs, sections- come together and function as a whole. It is only here at the end, at the completion of the work that I can say what wholeness means. If I were to have had an image of what the wholeness of this paper was at the beginning, its writing (and probably its reading) would have been only an event, not an experience. I would have missed the many surprises, the sudden realizations and shifts in the way I imagined healing which have occurred during the course of its writing, right up until the end.

My presenting complaint with this paper was that I really had no idea whatsoever what "healing" meant. If I would have believed that complaint to be an illness in need of healing, I would have diligently invented some scheme which meant nothing to me and force fed it to the reader until the symptom had disappeared and I had a definition. Instead, the paper was allowed freedom to constantly re-imagine what it was doing, and the presenting complaint, while never being cured, turned out not to be a problem at all, but the very source of the paper's vitality.

Likewise, as much as we have spoken against wholeness and medicine in the context of psychotherapy, they can also serve psychology as long as we imagine them as psychology's sickness, and as long as we include sickness in our fantasy of psychological health.