Our view of the body and health has changed over time and this affects how we treat illness
By Paul Bolger. Chartered Physiotherapist at Nano Physiotherapy, Kilkenny (www.nanophysio.ie).
Last week we started to explore the mind-body connection and how the ideas of a 17th century French philosopher have influenced how we view the body and mind today. These ideas influence culture and the medical world – impacting how scientists and doctors approach health and illness.
The biomedical model of health and illness has shaped how we treat disease for several centuries. Simply put, this model imagines the body as a machine made up of different parts. If there is a problem with any of these parts, then fixing, removing or replacing it will return that body to health.
Let’s look more closely at how this model has been useful and effective in healthcare, but also how it falls short in addressing health in us complex living beings.
Heart Disease
Cardiovascular disease (disease involving the heart and/or blood vessels) is the second highest cause of death in Ireland today, just behind cancers. Having high levels of cholesterol in the blood, specifically LDL (low-density lipoprotein) cholesterol, is an irrefutable causal factor of atherosclerosis (i.e. buildup of plaque in arteries).
Viewing the body through the biomedical lens, scientists have been able to reduce levels of LDL cholesterol in the blood via changes to diet and medications like statins. This is highly effective in cutting down on issues in the arteries.
In Ireland, deaths associated with heart disease have declined over the past number of decades, partly due to our ability to test for LDL cholesterol and intervene to lower it. Brilliant – the biomedical model works! But it has its limitations…
Humans are Complex
We are not robots. We are complex beings living in complex societies. The biomedical model falls short in this context. Enter the biopsychosocial model of health.
The biopsychosocial model views the health of a person through three different headings – biological (e.g. cholesterol levels, body chemicals, cells, organs), psychological (e.g. personality, thoughts, emotions, behaviours) and social (e.g. environment, social support, education, economic status). All these factors blend together and impact upon one another. Biology affects psychology, psychology impacts biology, both alter social circumstances, and social circumstances affect both biology and psychology – all melding together in an inseparable web. This is where the concept of a separate and independent mind and body begins to unravel.
Looking at the problem of heart disease and plaque buildup in arteries through a biopsychosocial lens, we begin to form a more rounded picture of how to deal with it.
A More Whole Approach
Using this approach, we may still prescribe medication to lower LDL cholesterol levels, but we might also begin to appreciate how factors like stress levels, emotional difficulties, education and social support affect a person’s ability to lead a healthy life. Appreciating this, we might devise strategies to help such a person to meet their dietary and lifestyle needs in a more holistic and sustainable way.
On a societal level, we may provide more significant resources to projects that improve education, access to quality healthcare and psychological support, physical activity levels and easy access to quality food. While this approach is happening, we could make a more serious effort at making it a reality sooner rather than later. Viewing health through a biopsychosocial lens and appreciating that we cannot truly separate body from mind is, in my opinion, part of the process.
