'Diagnosis determines intervention.'
There’s a very big difference between ‘What’s wrong with you?’ and ‘What’s happened to you?’ Jo Watson’s book, Drop the Disorder (2019) is a timely and courageous personal-professional challenge to the creeping influence of the biomedical model into social-psychological therapeutic thinking and practice. In her aptly titled article in the book, ‘There’s an intruder in our house!’, she reflects with a pained air of near-despair on this gradual, alarming and depressing diagnostic drift:
‘It wasn’t always like this. I joined a profession that held a shared belief about the nature of human emotional distress. We understood that the many forms of human suffering we witnessed – ranging from feeling low and suicidal to self-injury, hearing voices, overwhelming anxiety and dissociative experiences – were responses and reactions to what had happened in people’s lives and, in many cases, the resourceful and creative coping strategies they had developed to survive.
We clearly and consistently made links between emotional distress and causal factors like poverty, racism and abuse. There was a deep, collective ‘knowing’ that social circumstances were linked directly to human suffering and this acknowledgement translated into a connection with the political arena. Yet, as I write, this work has been consumed by a biomedical monster that has crept into our house and made itself very much at home. In fact, I don’t feel this is my home anymore.’
Jo is challenging a fundamental risk of the biomedical therapeutic model, that it locates a perceived problem in an individual, irrespective of a broader context. In doing so, Jo echoes disaster management expert Marcus Oxley’s insight (in a different arena) that, if we see a pattern of symptoms in people attending an Accident & Emergency unit, it may well reveal something implicitly about conditions in that context. It’s always about the person, but it’s rarely only about the person.
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