Is the Medical Model Appropriate for Psychoanalysis?

The term “model” has been employed with at least two different though related meanings: (1) As an organizer of information, in an epistemological sense, a model is a construct that allows us to better understand the nature of a complex phenomenon by virtue of its analogous structure. A model can be a physical structure or a conceptual system which clarifies the interrelationships of its parts by the correspondence with the object with which it is compared. (2) In a pragmatic sense a model connotes something that is worthy of imitation, an exemplar or ideal. This is the case when we speak of a role model or a set of rules for conduct.

In the first sense a model illustrates how we may think about something or how we can visualize it in our mind. In the second sense a model indicates how we act or should act.

A model is neither true nor false; it is either useful or inappropriate.

For the purpose of this presentation I shall mean by “medical model” a set of elements underlying the theories of medicine and a set of rules governing the behavior of people involved in its practice.

To determine whether and to what extent the medical model is appropriate for psychoanalysis I shall examine whether the principles underlying the theories and practices of medicine have validity for the ways psychoanalysts approach corresponding issues.

For the sake of brevity I shall limit my discussion to three key concepts regularly associated with the medical model: (1) the concept