Biopsychosocial model: what is mental health and how it is understood

The concepts (and states) of disease and health can be understood from different models or approaches. Until a few years ago, the predominant model in medicine and psychology was the biomedical model, centered on the disease itself and the “mind-body” dichotomy.

However, in 1977, with the help of psychiatrist George L. Engel, a new model emerged, which has come to stay in many areas of health: the biopsychosocial model, which takes into account the biological, psychological and social factors of the person to explain, understand and manage a certain health condition or disease, disability or disorder.

    Biopsychosocial model: definition and characteristics

    The biopsychosocial model is one of the models that we find in the field of psychology, even psychotherapy. It is an approach that affirms that several factors influence a person’s development and well-being, in the context of an illness, disorder or disability.

    These factors, as indicated by the name of the model itself, are three types: biological (genetic, inheritance …), psychological (behaviors, emotions, thoughts …) and social (Educational opportunities, poverty, unemployment …).

    Origin: George L. Engel

    The origin of the biopsychosocial model can be found in the ideas of the American psychiatrist and internist George L. Engel (December 10, 1913 – November 26, 1999), who in 1977 proposed a model based on the idea that in all phases of a given disease, disorder or handicap, the three types of factors mentioned coexist (to which we can also add the spiritual factors).

    This is extrapolated to the state of health; that is, all of these factors combine to influence both health and disease. Thus, the biopsychosocial model introduced by Engel, moves away from the “mind-body” dichotomy postulated by the traditional medical model (and which we will see a little later), and considers the functioning of people from a point of view. Holistic and comprehensive.

    Thus, in this complex system of factors of various kinds, other subsystems interact, which are interdependent by a dynamic process.

    Beyond the biomedical model

    The biopsychosocial model is a breakthrough in the understanding of health in general and mental health in particular, because before him, the predominant model was the medical or biological model (A traditional reductionist model, where only biological factors count).

    In this way, the biopsychosocial model goes one step further and argues that we must understand health and disease as two states that result from the combination of these three types of factors in a person’s life. Also, from this approach it works not only for the well-being of the person or patient, but also for that of their family and community.

      Traditional biological model vs. biopsychosocial model

      As we have seen, the traditional biological model has a reductionist characterAs this suggests that a person’s illness can only be explained on medical and biological terms, understanding illness as a mere deviation from the person’s normal functioning, caused by a particular pathogen, a genetic mutation. , etc.

      Additionally, in this model, the patient is not part of their healing process, which can lead to resistance to change.

      This model, also called the “biomedical model”, was introduced by the English physician Richard Bright (1789-1858) in the 19th century. Thus, this model starts from a pathological approach, where the disease acquires a great relevance, forgetting other factors which have a great influence on its origin, its development and its cure. On the other hand, it is a model based on the “mind-body” dichotomy.

      however, in the biopsychosocial model, he believes in the power of the person to counter the effects (or obstacles) arising from his disorder, Disability or illness. That is to say that in this model, the patient is found to have a more active role, since he is himself an agent of change, and that is why he is given the power – to the extent possible – three aspects: biological, psychological and social.

      Thus, according to the biopsychosocial model, unlike the traditional medical model, it is no longer the body that is sick, but the person as a whole, with all that that implies.

      Factors of the biopsychosocial model

      As we have seen, the biopsychosocial model breaks with the traditional medical model because it takes into account factors that, until now, had not been taken into account in the understanding of a pathological process, or of a state of health. Let’s see, in a nutshell, what each of these factors consists of.

      1. Biological factors

      Biological factors have to do with a person’s biology, that is, their anatomy, their genetics., The cause of the disease in case of suffering, mobility, physiology, etc. These are the predominant factors in the biomedical model.

      2. Psychological factors

      Psychological factors in the biopsychosocial model have to do with the most personal sphere of the person and encompasses their thoughts, emotions, behaviors, cognitive processes, Coping styles, psychopathologies, personality, disease behavior …

      In this group of factors, we could also include the more spiritual side of the person (or even place them outside of it), as they also play a key role in many pathological processes and in their own health.

      3. Social factors

      Finally, among the social factors that establish to take into account the biopsychosocial model in the development and adaptation to a certain disease or disability condition, we find stress, the perception of it, the economic and employment situation (For example the unemployment situation), the perception of the daily load, whether family or professional, etc.

      Application areas

      The biopsychosocial model has been a booming approach for a few years now, and that one finds not only in psychology (and consequently in psychotherapy), but also in other sciences and fields of knowledge, in particular in the field of in the field of health, such as: pedagogy, psychiatry, social work, occupational therapy, sociology, physiotherapy …

      On another side, in the field of intellectual disability and chronic diseases, the biopsychosocial model acquires a special role. This is due, among other reasons, to the fact that the people who work in the care and the care of these people work in this field, and that from this model they can meet their needs with the necessary importance to all these factors for rehabilitation. or the betterment of the person who you remember is trying to take an active role in their well-being and / or healing.

      Bibliographical references:

      • Amic, I. (2012). Manual of Health Psychology. Madrid: Pyramid.
      • Dowling, AS (2005). George Engel, MD (1913-1999). American Journal of Psychiatry, 162 (11): 2039.
      • Engel, GL (1977). The need for a new medical model: a challenge for biomedicine. Science, 196: 129-136.
      • Oblitas, L. (2006). Health psychology and quality of life. 2nd. Ed. Mexico: Thomson.

      Leave a Comment