1/ thread

I am slowly & tentatively coming around to the view that phrase "the medical model" is source of endless confusion, since everyone immediately assumes they know what it means... but different parties think it means different things.
Instead, I find myself thinking https://twitter.com/AnneCooke14/status/1354339428341264385

2/ of Martin Buber's distinction between I-it and I-though relationships, the former being a relationship with a "thing" & the latter a mutual relationship with an agent/subject. As applied to treatment, it is not the case that one is good & other bad. They are *different* & each

3/ is needed. If I need treatment for influenza or surgery for appendicitis, I do not need or want my physician to regard with my condition as a self-aware agentic subject with thoughts, feelings, motives, & inner conflicts. I want the fucking Tamiflu, and I want the appendix out

/4 with minimal discomfort and complications. I would prefer if the physician regards *me* as subject, but the influenza & the appendix are not me & not part of my selfhood. They are things, matter, "it." An I-it relationship is needed.

But when we speak of matters of self &

5/ subjectivity, I no longer want an I-it relationship and may find the assumption or imposition of such a relationship diminishing and offensive. My appendix does not seek mutuality and self-understanding, but *I* do. In this realm of self, I want to do something *with* one

6/ another (I-though), not have something done *to* me (I-it). Influenza or depression are easy. But what of my depression? Is that an "it" unrelated to my selfhood, or part of my selfhood? We can contrive examples where an I-it relation to "depression" seems proper & helpful,

/7 as in @SameiHuda's example of depressive sx due to hypothyroidism. It's debatable whether that should be considered "depression" at all. In fact, DSM comes down squarely on one side of that debate and says it is NOT depression. Diagnostic criterion C for MDE requires

8/ that "the episode is NOT attributable to the physiological effects of... another medical condition." That's pretty clear.

But what about "depression" rooted in personality processes, psychological experience, worldview, personal outlook, and life choices? Am I going to

9/ welcome someone approaching that as an I-it relationship, to do something "to" (vs. "with")? Assuredly not.

I'm leaning to the view that debating about "the medical model" in this context leads in leads circularly to nowhere, & the only answers that arise hinge on semantics,

10/ which is to say they're not answers all, only a reworking of definitions that beg the question (as term is used in logic) by assuming the conclusions.

Maybe a more meaningful question is:
Is this the time & place for an I-it relationship or an I-though relationship?

* I-thou relationship