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Mental Disorders: External Behavior or Internal

Mental Disorders: External Behavior or Internal

Mechanisms Two frequent criticisms of Wakefield’s concept of internal mechanisms are that the notion is both ‘‘mentalistic’’ (a term that drives strict behaviorists crazy) and biological. Most psychologists would agree that what goes on inside a person is important.

However, important scientific methods and procedures must be considered when dealing with ‘‘unobservable’’ events. Operational definitions and similar procedures have facilitated the cognitive revolution in psychology, which is interested, primarily, in unobservable events. Not even the most radical behaviorist would deny the importance of internal mechanisms insofar as they are addressed scientifically. Consider, for example, the topics of memory, information processing, and similar areas of important recent cognitive research. Are we to dismiss these advances as mentalistic? The criticism of internal mechanisms as biological or genetic is also nonsensical. Few cognitive psychologists who deal constantly with internal mechanisms would label their explanations of these mechanisms as biological or genetic. Internal mechanisms can be created by environmental events and learning, as well as by biological factors. Internal does not necessarily mean biological. A person with a memory disorder may not exhibit obvious behavior that indicates this problem, and a ‘‘fine-grained analysis with all neuropsychological tests’’ may be necessary to detect the problem. Further, the memory deficit may be psychological or biological. There are numerous other examples.

On occasions, labeling a person as ‘‘disordered’’ when the problem resides in the environment is a mistake. For example, the loss of loved ones will cause people to look like they are depressed, but when a suitable time has passed, they again appear normal. The point is that a depressive disorder resides in the person and is due to the disruption of a normal mechanism, such as the emotional response system. This does not mean that environmental events cannot cause disruption of internal events. They can and do. Posttraumatic stress disorder is one such example. There are numerous other conditions caused by a malignant environment or an interaction of a malignant environment and biological predispositions. Internal dysfunctions must be demonstrated by careful evaluation of environmental events, behavior, and internal functions. This process is called case formulation. Not all abnormal behavior is a disorder. This distinction is important legally (e.g., is the individual innocent because of mental disorder?) and socially (is oversensitivity to a Black person due to a politically repressive environment or a disorder such as ‘‘paranoia’’?).

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