Who controls the definition of what is really real controls how we see.
The medical model has controlled the definition of reality in the mental health system for years. It defines illness as the fundamental reality. The recovery model on the other hand defines people as the fundamental reality. Which definition you accept has radical consequences. It largely defines goals, roles, procedures, and expectations. Much of the debate in the mental health system is truly one of what is really real.
The medical model is a vertical model. If illness is the fundamental reality then the most important thing is the knowledge needed to diagnose it and provide treatment. Professionals as the holder of the knowledge then have the upper hand. Treatment is what is done to sick people. And the people that do it, because of the special knowledge they have, have power over the ones they are trying to help. The problem is that people have an annoying habit of not being very compliant or obedient. One solution, one of the most frequently used, is to define that disobedience as a symptom of the sickness they are trying to treat. Disagreement, criticism, anything less than full agreement then becomes a symptom of illness instead of a choice made by a human being that is entitled to make his own choice.
If people who disagree with you or dont accept your advice are defined by virtue of that disagreement as symptomatic then you never have to prove anything. Everything is assumed to be true. The medical model as much as it tries to portray itself as a scientific enterprise is as much as anything else a faith based effort.
And it is a powerful faith. And it needs to be. Its assumptions need to be powerful because the evidence behind many of them are weak at best. Medication despite all the advertising fervor attached to it simply doesnt deliver as advertised for many people. It is not even that it just that it doesnt work well. It may in fact for many people make things a lot worse. Countless people are finding out that the research they believed about the medication doesnt hold water and it fact finding out that they are part of the experimental generation. They are the proof and the initial returns are not always so positive.
Diagnoses are founded in committee votes. It is the only form of medicine that human agreement is seen as the same thing as medical discovery. The common joke in my town is that if you want to have bipolar and dont want to have it go to Dr. x. He believes everybody is bipolar. If you have bipolar and want to get rid of it go to Dr. y. He believes no one is bipolar.
The recovery model is a horizontal model. Knowledge is still important but it doesnt define you as more important. What matters is what happens between people. Tools are important. Knowledge is important. But connection, respect and empowerment are more important. No distress, no misery, no hard times a person has makes them less of a person. No person is what is hard for them or what they have difficulty doing. It does not measure help by how much you know, but how much and how well you care.
The debate about vision is not one about empty things. It matters. It matters in everything. Life is hard. Injury is a human experience. Pain is known by all of us. But hope is also. And life, no matter how difficult, can be better