Agree that we need to move away from a binary "root cause" of mental illness that seems to pervade society, patients, and even amongst some of our colleagues! You bring up chemical imbalance, genetics, drugs, and trauma all being potential causes - is this not just really Engel's biopsychosocial model? :)
I see the biopsychosocial model as the antithesis to "root cause" question and use this model everyday in my own clinical practice. I often may spend a significant chunk of my consult time explaining to my patients the distress they have is through a complex interplay of these 3 factors, and some factors may have more weighting than others (for some patients, "depression" is 90% psychosocial and 10% biological, and others vice versa).
A thoughtful biopsychosocial formulation is often more validating than a simple biomedical explanation ("you don't make enough serotonin"). This takes a lot more time and effort for the psychiatrist though, and as a consequence, uptake and use seems to vary significantly between psychiatrists in different jurisdictions. @Awais Aftab also had a similar post about the hermeneutic silence that is occurring in our clinics when we don't have a more nuanced conversation about the source of psychiatric symptoms (whether or not a patient accepts this nuance is another question!)
I'm curious in UK psychiatry training how much emphasis is placed on learning and practicing biopsychosocial formulation? It is emphasized quite heavily here in Canada where I trained, and part of our Royal College examinations and residency training.
Agree that we need to move away from a binary "root cause" of mental illness that seems to pervade society, patients, and even amongst some of our colleagues! You bring up chemical imbalance, genetics, drugs, and trauma all being potential causes - is this not just really Engel's biopsychosocial model? :)
I see the biopsychosocial model as the antithesis to "root cause" question and use this model everyday in my own clinical practice. I often may spend a significant chunk of my consult time explaining to my patients the distress they have is through a complex interplay of these 3 factors, and some factors may have more weighting than others (for some patients, "depression" is 90% psychosocial and 10% biological, and others vice versa).
A thoughtful biopsychosocial formulation is often more validating than a simple biomedical explanation ("you don't make enough serotonin"). This takes a lot more time and effort for the psychiatrist though, and as a consequence, uptake and use seems to vary significantly between psychiatrists in different jurisdictions. @Awais Aftab also had a similar post about the hermeneutic silence that is occurring in our clinics when we don't have a more nuanced conversation about the source of psychiatric symptoms (whether or not a patient accepts this nuance is another question!)
I'm curious in UK psychiatry training how much emphasis is placed on learning and practicing biopsychosocial formulation? It is emphasized quite heavily here in Canada where I trained, and part of our Royal College examinations and residency training.