Friday, July 25, 2008

Moving Beyond the Disease Model (in Psychology and Beyond!)

One of the great benefits of trying to engage with work in other disciplines is you sometimes have a EUREKA! moment when you come across the work of someone working on a related issue from a different perspective. And the light then clicks on and the things you were pondering for years now start to become clearer in your own mind.

Well this week I had one of these experiences. I came across this excellent Ted's talk by Penn Psychology Professor Martin Seligman. It is a fascinating talk, so I recommend you listen to the whole presentation. Below I will briefly outline some of the details of what he calls "positive psychology". But let me briefly mention how this talk helped me piece together two distinct areas of my research.

Two central interests of mine are the aspiration to retard human aging (see the previous 2 posts)and my perfectionist account of ethics (see here). The former topic is perceived by many as very contentious because it asks us to transcend the limits of the current approach to medical research. The current approach is to tackle each specific disease of aging (cancer, AD, diabetes, etc.). But we need to supplement this approach with one that also tackles aging itself, for doing that would make all our lives better in significant ways (i.e. more health, less disease and frailty, sounds good to me!).

My interest in retarding aging relates to my account of ethics. Perfectionists care about human flourishing, and they celebrate excellence. And so I think my interest in these two issues are fuelled by each other.

And listening to Seligman's presentation made me realise what a natural fit my two interests are. Seligman begins his talk by mentioning the benefits of the "disease model" in psychology. But then he highlights 3 major drawbacks. Firstly, psychologists became victimologists and pathologizers (they forgot people make choices, that they have responsibility). Secondly, they forgot about improving normal lives and high talent (the mission to make relatively untroubled people happier, more fulfilled, more productive). And thirdly, in their rush to repair damage, it never occurred to us to develop interventions to make people happier, positive interventions.

The points raised by Seligman remind me of this previous post and the importance of fostering the "genetics of health" (rather than just study the genetics of disease).

Seligman's insights are profound indeed, and they apply to *ALL* medicine, not just the treatment of mental illness. One reason why many recoil at the thought of cognitive enhancers, or slowing aging, is that they do not see the general goal of improving people's lives as something medicine should strive for. Medicine is limited to the goal of treating or preventing disease. But by limiting ourselves to this narrow understanding of medicine we threaten to forfeit great improvements to humanity. Why not strive for longer, healthier, happier lives? I'm amazed that so many people find it hard to be persuaded that such a goal is laudable, let alone something medicine should seek to promote.

Seligman then outlines the aspirations of what he calls "positive psychology", an approach that has emerged over the past decade. Positive psychology emphasises the following three things:

(1) we should be just as concerned with human strength as weakness
(2) we should be just as interested in building the best things in life as in repairing the worst
(3) we should be as concerned with making the lives of normal people fulfilling and with nurturing high talent as with health pathology.

So how happy are you? Seligman has an interesting questionnaire online here. I just registered for the test myself this morning and took the "Authentic Happiness Inventory Score".

The findings of positive psychology should be of great interest to moral philosophers. Rather than just invoking Aristotle's account of the good life, we can now invoke the empirical evidence that backs up what we thought all along- that Socrates was right, "The unexamined life is not worth living!".