The Biopsychosocial Model of Health, Wellness, Illness, and Disease
Let's explore the holistic view of healthcare known as the BioPsychoSocial Model, a healthier way than the previously used biomedical model.
July 3, 2023 Written by Dr Rudy Wietfeldt 0 Comments
The biomedical model has been a dominant theoretical framework that has shaped healthcare for centuries. It views illness and health through primarily a biological lens, focusing on the physiological and physical aspects of pathology and disease. The roots of the biomedical model date back to ancient civilizations such as Egypt, Mesopotamia and Greece. During this time, medical theories were often based on observations, mystical beliefs, and supernatural explanations. Hippocrates, the great Greek physician, emphasized naturalistic approaches to medicine and laid the groundwork for a more scientific understanding of health, wellness, and illness.
The Renaissance period marked a significant shift towards scientific inquiry and empirical observation. Repetition as part of the scientific method began to be introduced. Improved understanding of the human body were provided by prominent anatomists such as Andreas Vesalius and William Harvey. The Enlightenment era further promoted the application of reason and evidence-based thinking to medical practice.
The 19th Century witnessed major advancements in the basic sciences of medicine, particularly microbiology, physiology and pathology. Scientists like Louis Pasteur and Rudolf Virchow contributed to the development of germ theory, which emphasized the role of microorganisms in the cause of illness and disease. This period saw a proliferation in medical research, laboratories, and the integration of basic sciences into medical practice and education.
The 20th Century saw increasing prominence of the biomedical model, especially after the discovery of antibiotics, vaccines, DNA structure, and the advancement in various pharmaceutical agents and surgical techniques.
The biomedical model is founded on:
1) Objectivity: The model aims to be scientific and non-subjective in its approach. The biomedical model emphasizes empirical evidence, laboratory tests and quantitative measurements to diagnose diseases and to assess results of treatments. It values objective data over subjective experience and relies heavily on the use of technology and specialized testing.
2) Biologic causation: The model focuses on how diseases are caused by biological factors, such as genetic abnormalities, physiologic dysfunctions, or pathogens, such as viruses or bacteria.
3) Reductionism: The biomedical model breaks illness and health factors into their smallest component features, such as genes, cells, organs, and biochemical processes. It seeks to understand disease and therapeutics by studying these individual components and their various interactions with treatment components.
4) Biomedical Interventions: The model is based on using pharmaceuticals, surgical interventions, medical devices and any other treatment modalities that focus on the underlying biological cause of the disease.
While the above characteristics should and do have a vital role in medical therapeutics and the understanding of pathology, the biomedical model overlooks the importance and influence of the psychological, social, and environmental factors deeply involved with health, wellness, illness and disease.
This critique paved way for Dr George Engel to describe the biopsychosocial model in the 1970s. It is a holistic approach to understanding and explaining human health, well being, and prevention of disease. It recognizes that health and illness are influenced by a complex interplay of biological, psychological, and social factors, rather than being solely determined by biological factors alone.
As the name clearly suggests, there are three primary domains:
1. Biological: This domain encompasses all the biological and physiological aspects of an individual's health. It includes all the aforementioned particulars, including genetics, biochemistries, anatomical abnormalities, and other physiological factors that can influence wellbeing.
2. Psychological: This domain refers to all the psychological and emotional aspects of health and wellness. It recognizes the role of thoughts, emotions, behaviors, attitudes, beliefs, personalities, coping mechanisms and more in shaping an individual's health outcomes.
3. Social: This aspect includes the social and environmental context in which an individual lives. Factors such as religious and existential beliefs, family dynamics, socioeconomic status, cultural norms, social supports, and access to healthcare, as well as other social determinants of health.
Psychologists play a crucial role in improving health outcomes in many ways. With the dualism of mind and body as separate having been eroded in the new model, psychologists helping mental health are simultaneously helping, quite simply, health.
The World Health Organization has said that health is "not merely the absence of disease or infirmity," nor is health realistically able to be considered "physical health" or "mental health" under the new model.
In the next blog, we'll explore more about how psychologists can explicitly help achieve better health and wellness outcomes. See you soon!
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