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The Rise and Fall of the Biopsychosocial Model

, 272 pages

2 line drawings

November 2009



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The Rise and Fall of the Biopsychosocial Model

Reconciling Art and Science in Psychiatry

2010 Outstanding Academic Title, Choice Magazine

This is the first book-length historical critique of psychiatry’s mainstream ideology, the biopsychosocial (BPS) model.

Developed in the twentieth century as an outgrowth of psychosomatic medicine, the biopsychosocial model is seen as an antidote to the constraints of the medical model of psychiatry. Nassir Ghaemi details the origins and evolution of the BPS model and explains how, where, and why it fails to live up to its promises. He analyzes the works of its founders, George Engel and Roy Grinker Sr., traces its rise in acceptance, and discusses its relation to the thought of William Osler and Karl Jaspers.

In assessing the biopsychosocial model, Ghaemi provides a philosophically grounded evaluation of the concept of mental illness and the relation between evidence-based medicine and psychiatry. He argues that psychiatry's conceptual core is eclecticism, which in the face of too much freedom paradoxically leads many of its adherents to enact their own dogmas. Throughout, he makes the case for a new paradigm of medical humanism and method-based psychiatry that is consistent with modern science while incorporating humanistic aspects of the art of medicine.

Ghaemi shows how the historical role of the BPS model as a reaction to biomedical reductionism is coming to an end and urges colleagues in the field to embrace other, less-eclectic perspectives.

S. Nassir Ghaemi, M.D., M.P.H., is a professor of psychiatry at Tufts University School of Medicine and director of the Mood Disorders Program at the Tufts Medical Center in Boston. He also serves on the faculty of Harvard Medical School. He has written several books including Mood Disorders: A Practical Guide; A Clinician's Guide to Statistics and Epidemiology in Mental Health: Measuring Truth and Uncertainty; A First-Rate Madness: Uncovering the Links between Leadership and Mental Illness; and The Concepts of Psychiatry: A Pluralistic Approach to the Mind and Mental Illness, the last also published by Johns Hopkins.

"Ghaemi's book is highly relevant. It is also very well written and appears meticulously researched, and it should be of interest to everyone with a professional relation to psychiatry. Hereby recommended."

"Provocative... Ghaemi claims that one should leave muddled views behind and recognize that humanism in medicine is compatible with the bio-physiological model. The author offers William Osler's humanism and Karl Jasper's method-based existentialist psychiatry as exemplars. Essential."

"This is a thoughtful and well-researched book. At minimum, it is an essential read for academic psychiatrists and residents involved in teaching and learning. More broadly, it is a good read for anyone interested in the historical and philosophical aspects of psychiatric theories."

"Impassioned and thoughtful... Ghaemi has produced both a penetrating analysis of the ascent of the biopsychosocial model as a psychiatric theory-of-everything and a weapon designed to bring about its decline."

"A provocative and valuable piece of scholarship."

"This book is especially suited for those who want to ponder the direction of our field and who worry about the theoretical disorientation of modern psychiatry and our resulting need for deep organizing principles. Ghaemi's grasp is wide. His book will be as much disturbing as satisfying but will provide the reader a sense of where our field has been and where it may need to go."

"It may become an influential, revolutionary book... Stimulating and thought provoking."

"A psychiatrist criticizes the idea of psychiatric disease as a product of biological and social factors."

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