Paradigm Shifts after the Decline of the Medical Model

‘Neuroenhancement’ in its various forms, whether applied to cognitive tasks, or social functioning, looks initially like one more medical intervention. This, however, is misleading. For all of its flaws, the medical model is relatively simple and static. The idea is to identify pathology or malfunction, and to remedy it. Where the pathology in question is a positive symptom or syndrome, medical intervention is relatively free of controversy.

We can contrast this with the sort of paradigm implicit in neuroenhancement, as well as certain schools of psychotherapeutic intervention. From this latter perspective, pathology is not so important, since it is dissolved into a series of continuums or spectrums for each subject, all assessed by a clinician who is more mobile than the steadfast medico. The idea is to locate the subject within these matrices irrespective of any positive symptom, and to intervene in the name of optimal functioning, productivity, and so forth. This is far more sophisticated than the medical model, but for that very reason, far more insidious, as it aims at a totalising (‘holistic’) auto-Taylorism. By abandoning the concept of ‘symptom’, and aiming instead at higher functioning (or ‘positivity’, or ‘wellbeing’), the possibilities for intervention are almost limitless. For my part, I believe that there are good reasons to criticise the medical model, especially as it relates to mental health, but it is concerning that some of those seeking a paradigm shift are unwittingly replacing it with psychological neoliberalism.


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