Biopsychosocial Approach to Modern Health and Illness

Biopsychosocial Approach to Modern Health and Illness

Health is traditionally equated to the absence of disease. A lack of a fundamental pathology was thought to define one's health as good, whereas biologically driven pathogens and conditions would render an individual with poor health and the label "diseased". However, such a narrow scope on health limited our understanding of wellbeing, let down our treatments efforts, and perhaps more importantly, suppressed prevention measures.

Many institutions and medical doctors have managed to incorporate a holistic view of health in sound medical application, primarily based on the Biopsychosocial (BPS) Model of Health and Illness. The concept of wellness is particularly stressed, where the state of being in good health based on the Biopsychosocial model is accompanied by good quality of life and strong relationships.

In 1977, American Psychiatrist George Engel introduced the major theory in medicine, the BPS Model. This model accounted for biological, psychological, and sociological, as each a systems of the body. The model accompanied a dramatic shift in focus from disease to health, recognizing the psychosocial factors (beliefs, relationships, stress) that greatly impact recovery and the progression of and recuperation from illness and disease. Dr. Engel has offered a view on physiological effects;

To provide a basis for understanding the determinants of disease and arriving at a rational treatments and patterns of health care, a medical model must also take into account the patient, the social context in which he lives and the complementary system devised by society to deal with the disruptive effects of illness, that is, the physician role and the health care system. This requires a Biopsychosocial model.

Today, individuals are living with diseases that would have taken their lives in the past. We see health and wellness is a broader environment. Medical practitioners are more frequently adopting the Biopsychosocial form in their clinical practice.

Prior to George Engel's research, most medicine used the Biomedical Model approach to curing patients. The Biomedical model conceptualized the human body as a machine in which all the parts functioned together to ensure health; if some parts broke down, clinicians intervened to limit and treat damage. (Jones, 1994 block 1, p.88) The statement above is a good way of describing the biomedical approach; its focus lays on curing the disease not the whole person. The approach generally involves looking for a single, but very specific cause for illnesses, with corresponding specific treatments, like antibiotics for infections which are expected to work effectively with the illness in most people, under most conditions.

In 1977 George Engel released a paper The Need for a New Medical Model: A Challenge for Biomedicine. In this article George Engel proposed the Biopsychosocial model in what soon became a landmark event for understanding medicine as a science. The model prompted a revolution in medical thinking by providing an argument and rationale that better linked medicine to science. Following the revolution in physics at the turn of the last century, science gradually moved away from previous linear, cause-effect thinking. To that point, understandably, medicine's guiding biomedical model focused only on diseases. Beginning with Engel's model, medical thinking has slowly evolved by incorporating and integrating psychosocial components. The Biopsychosocial model stems from what many consider the modern articulation of science, general system theory. Engel's model prescribes a fundamentally different path from the still-guiding biomedical model: to be scientific, a model for medicine must include the psychosocial dimensions in addition to the biological aspects (diseases) of all patients. By integrating these multiple, interacting components of the subject of science we also become more humanistic. We link science and humanism. While this revolution/evolution in medicine has not yet replaced the biomedical model, the Biopsychosocial model now is taught in most medical schools, and most practitioners are familiar with the term and its meaning. But the problem we now face is that the model itself does not address the intricate process needed for achieving relevant Biopsychosocial understanding of the patient.

"The biomedical model was devised by medical scientist for the study of disease. As such it was a scientific model; that is, it involved a shared set of assumptions and rules of conduct based on the scientific method and constituted a blueprint for research" (Engel, 1977, p.196). The biomedical model was derived from the use of technology. At the turn of the century when new technological advance were take place and new ideas were being formed, doctors migrated from an early form of the BPS form of medicine to the biomedical model. Doctors truly stopped listening to what patients were saying and only heard symptoms. Doctors then only tried to solve the symptoms of disease and not and not curing the patient. When George Engel proposed the BPS model he was met with some resistance, as he did the idea when he first began theorizing it in 1942 while working at the University of Cincinnati.

George Engel is the nephew of Dr. Emanuel Libman and was raised in his household. "Uncle Manny", was renowned for his work on the blood-culturing of bacteria and for identifying the condition of substance bacterial endocarditis. George Engel did not want to embarrass his uncle so in 1930 he enrolled at Dartmouth College and majored in chemistry. One of the major influences in George Engel's life at the time was the work of Jacques Loeb, the famous "apostle of mechanistic conceptions in biology." After Dartmouth, George Engel attended the Johns Hopkins Medical School. It was the obvious place to go for an aspiring biomedical scientist. While at Johns Hopkins he was asked by the Rockefeller Foundation to spend two months during the summer of 1935 at the Leningrad Institute of Experimental Medicine in the laboratory of Alexander Gurwitsch, a Russian physiologist working on "mitogenetic