When you get sick, you go to the hospital. Once there, medical professionals examine your body, and they try to determine the best course of treatment to eliminate the condition. Your visit to the hospital is the result of biomedicine: applying the science of molecular biology to healthcare. This biomedical model of treatment has revolutionized human life in the last few centuries. Surgeries, vaccinations, antibiotics, and other treatments have extended life expectancy and health in ways which were unimaginable even three or four generations ago.
However, in 1977 a psychiatrist named George Engel asked a question: does biomedicine adequately address all the factors that influence health and disease? Biomedicine, charged Engel, “leaves no room within its framework for the social, psychological, and behavioural dimensions of illness.”1 For example, if someone is living in a cold, damp, and mouldy apartment, does the biomedical model really address and treat their pneumonia? How are one’s social, economic, and relational issues not equally important to consider when treating a person’s health? Furthermore, how could a person’s psychological wellbeing and behavioural decisions be ‘divorced’ from their molecular, biological health?
In summation, Engel argued that to effectively and holistically treat disease, the strict biomedical model was inadequate — the social and psychological conditions of a patient are too important to brush aside in order to focus on disease solely at the microscopic level of bacteria and viruses.
Engel thus suggested a new approach to medicine: he coined it the Biopsychosocial Model “which includes the patient as well as the illness.”2 At the heart of the model was a simple assumption: you cannot think about a person’s mind, social conditions, and physical health in separate, unrelated compartments. Each factor is interconnected and influences the others. In contemporary terms, these three factors are referred to as the biological, cognitive, and socioemotional.3
Think about how stress affects your mind, which affects your choices, which affects your eating, which affects your health, which affects your mood, which affects your mind…
Think about how the conditions in which a child is raised affects their learning, which affects their schooling, which affects their income, which affects their living conditions, which affects their health, which affects their choices, which affects their learning…
The biopsychosocial4 model is a reminder that everything about your life is systemic: you, your body, your choices, and your environment are constantly influencing each other. In fact, to think of these as separate ‘entities’ is actually a little bit of make-believe. This means that every choice you make today has consequences. Do not think of today’s diet, housecleaning, reading list, work, and exercise in separate silos — each activity, in some way, impacts all the rest.
Engel, George. (1977). The Need for a New Medical Model: A Challenge for Biomedicine. Science, New Series, Vol. 196, No. 4286 (Apr. 8, 1977), pp. 129-136 ↩
Ibid. 131 ↩
Santrock, John. (2007). A Topical Approach to Human Life-span Development (3rd ed.). St. Louis: McGraw-Hill. p. 13 ↩
Gatchel, Robert J. (2004). Comorbidity of Chronic Pain and Mental Health Disorders: The Biopsychosocial Perspective. American Psychologist, Vol 59(8), Nov 2004, 795-805. ↩