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The biopsychosocial model and disease?

 

What is biopsychosocial?

 

For some years now, we've been hearing about the biopsychosocial field, even though this concept dates back to the 50s. This vision concerns the study and care of the body through a broader reading of the causes of pain, symptoms and pathologies that the body and mind can present, as well as the consequences that can arise in everyday life.

 



So what exactly are we talking about?

 

There are 3 different parts to this model.

 

Bio: everything to do with the body, the physical and the pathological manifestations it may present.

 

Psycho: this covers everything to do with the psyche, the mind and emotions, whether conscious or unconscious.

 

Social: this refers to the environment, everything that surrounds us, be it material, climatic, electromagnetic or living, i.e. absolutely 100% of what surrounds each and every one of us, including our family, friends, work colleagues or simply the people we meet on a daily basis.

 

Together, these 3 fields represent absolutely everything that touches a person in any way, and of course the values of each of these fields vary constantly but are also different for each of us.

 

So how does this triple system work?

 

To get a clearer picture of how these 3 systems interact, we're going to start by defining more precisely how the body works; because it's from this completely physiological model that the phenomena governing the appearance of pain, disorders and pathologies derive.

 

Biopsychosocial chronology

 

To do this, we're going to take a step back a few billion years (2,1) to the appearance of the first multi-cellular organisms, the precursors of more complex organisms that have evolved to become...us and all living beings on this planet.

These organisms were subject to their environment, playing the lottery of who lives and who dies. This is not very practical for a species to perpetuate itself. So, the first membrane receptors appeared, admittedly very rudimentary, but nonetheless able to give the organism the first useful information about what was going on outside.

But it's all very well knowing what's going on out there, but not being able to react renders the information useless.


In a second phase, the first very rudimentary motor system (membrane cilia) appeared, enabling the organism to flee or move closer to the source of the information.




The chronology of this evolution is very important, as it is still true today in the way we function. In other words, we receive information from outside, informing us at multiple levels and in various ways, and then we process the information in order to respond to it; except that in the middle has crept a nervous system whose function is comprehension, analysis, coordinated response and memorization.


The latter has facilitated the management of this information, but has also simultaneously made it more complex, thanks to the immense wealth of stimuli and sensations provoked in the body.

 

This evolution has been driven by the need to maintain or improve the organism's equilibrium over time - in other words, to simply live! The life drive is what drives us to do everything we can to improve our equilibrium; it's what maintains homeostasis, i.e. the body's ability to function despite the blockages and brakes it faces. Let's close this little parenthesis.

 

So we have a body (Bio) which receives external information (Social) and processes it (Psycho) in order to respond or not.

 

In modern medicine, we try to look only at the bio or psycho as the origin of our ailments.


In other words, if we have joint pain, for example, we only look at the local inflammatory phenomenon as the cause; if we have neuralgia, it will always be linked to mechanical stress on the nerve (hernia, for example); if we have eczema, we look at what's going on at skin and hormonal level, but modern medicine never goes any further, a bit like stopping at the tree when there's still the whole forest behind it...

So, of course, I'm not saying that modern medicine and science are wrong; on the contrary, they are right about these phenomena.

But if the treatments resulting from this analysis were 100% effective, this article would have no point in existing. Unfortunately, this is not the case, which means that there are factors missing from the disease equation!

So where do the missing factors lie?

 

What other vision of health can explain these imbalances?

 

We, or someone close to us, have all experienced disorders, pain or pathologies as a result of events in our lives. Some doctors even say it's "because you're stressed" or "it's because you've lost your intel". It's a simple empirical observation that aches and pains appear after everyday events. But why don't we investigate this?


The answer is simple: we're not trained to do so, and the task is complex: if we try to correlate a particular event with a symptomatology, it doesn't always work! In fact, the loss of a loved one does not systematically lead to depression, a fright to a phobia, sexual intercourse to a urinary tract infection, or smoking to cancer...

These few examples clearly show that external factors "can" lead to a specific symptomatology, but not in 100% of cases!

And the reverse is also true, i.e. each pathology can appear in the face of very distinct situations.


So, we can see that social factors do not systematically influence organic factors in the same way, making it impossible to establish links with any certainty.

 

So perhaps there's another factor missing from the equation?

 

What makes you different from me? From your friends or your neighbor? Do you behave in the same way? Do you react in the same way to the same event?

The answer is no, and fortunately not!


In fact, we all have many different ways of behaving, of perceiving a situation, emotions that fluctuate differently from others, experience and upbringing that are just as different. It's all about psycho!

 

This richness in diversity and uniqueness offers richness and interest in the relationship with others, different skills, different pleasures.

But then, we're faced with an infinite number of possible cases that can't be exploited in their current state. A lifetime's work wouldn't be enough to grasp half the possible scenarios.

 

What's important to look at in terms of psychology is not the thought and analysis of a situation, but the feeling linked to this event, because feeling is much more limited in perspective. Indeed, feeling is linked to the limbic system, which processes all sensory, proprioceptive and interoceptive information, giving the individual emotions and variations of these, all included in his system of thought, beliefs and education. And emotions are finite...so easier to inventory and correlate with external situations. They are also a common basis for all beings, since they derive from the evolution of the nervous system.

 


We can therefore count 5 or 6 major basic emotions listed by Eckmann (joy, fear, anger, sadness, surprise and disgust) and other researchers such as Carroll Izard, Alan Fridlund and Sylvan Tompkins, as well as finer, equally common emotions that influence our bodies on a daily basis.


For although we believe that emotions originate in the body, they are also the consequence of brain states (Bodily maps of emotions, Lauri Nummenmaa & al https://www.pnas.org/content/111/2/646).


This phenomenon is induced by the neurovegetative system, which modifies the body's vascularization, muscular activity (motor and visceral) and hormonal secretions.

 

The biopsychosocial field and pathology

 

Can you see what's happening?


Our cerebral state, which depends both on who we are and what we experience, leads to changes in the body at all levels simultaneously.

If we consider that the nervous system can block certain information and make it permanent - which is the case - then so too can stimulation of the body, leading to over-stimulation of certain systems and regions, thus inducing a more fragile terrain.


Locally, and sometimes more generally, there is a drop in vascularization, leading to both a drop in oxygenation and an increase in toxins; this induces metabolic acidosis, which can be aggravated by a diet rich in sugar and industrial products, for example.


These are the factors that lead to inflammation and loss of visceral, metabolic, or mechanical functionality; in other words, the body goes haywire and sounds the alarm.

 

Nevertheless, we can find common denominators that exist between all individuals, thanks in particular to these permanent stimuli from the nervous system on the body.

Indeed, as the nervous system is constantly modifying the local vascular state, a trained hand can use the fascias and a very specific approach to identify these tensions, i.e. these emotional memories in the body!


For we all have a unique mechanism based on a common functional mapping linked to neurophysiology, i.e. to the networks and structures governing our emotions.


This mapping defines both levels of functioning, like levels of consciousness, but also variations in emotions within each level.


If we consider each organ as being linked to an emotion, we can then have a program of each level on a system of emotions which will then always be the same, inducing always similar attitudes linked to this programming.


And of course, if we find similar emotions on several levels, the intensity of stimulation of tissues and organs will be even greater, weakening the terrain. Conversely, if many zones are stimulated, we'll have a more balanced terrain.

 

So, to sum up, we have a multitude of different environmental stimuli and information confronting our internal functioning, inducing numerous bodily and behavioral reactions. When these reactions become too strong, the stress exceeds the individual's tolerance threshold, resulting in a new recorded emotion, a new trauma, i.e. somatization.

 

How to restore well-being through biopsychosocial action?

 

How can we act on this triptych?

 

We can act on one or more factors simultaneously, thereby modifying the sources of stress. Changing one's work environment, social circle or diet are relatively easy factors to modify, but do not always bring satisfaction in terms of the pathology or disorder.

We see that acting on the body isn't enough either, as there are many failures in allopathic therapy.

We can also act on the mind, and approach it through psychology or mental coaching, for example. This allows us to take note of the environmental factors that stress our mind, but without targeting the body and its pathologies.


Finally, we have the more holistic body therapies, but which lack a common framework of consensus and do not demonstrate clearly quantifiable or objectifiable results.

 

Then there's Neurolink!



With Neurolink we can not only identify these recorded traumas, identify all levels of the individual's functioning in an objective way, but also enable the nervous system to definitively release these traumas and modify the patterns that lead to problems in all spheres of the individual.


This is a true vision and a true holistic therapy, working on the intrinsic mechanisms of the individual at the root of his or her ailments. Indeed, it is this intrinsic terrain that is the source of pathology, since when faced with similar environmental stimuli, not everyone will regulate in the same way!


So trying to solve the problem of pathology without addressing this primary factor is futile. From a medical point of view, we observe these intrinsic specificities, but without explaining them, except through genetics. But genetics are permanently modified by these environmental factors and our chosen behaviors (The NASA Twins Study: A multidimensional analysis of a year-long human spaceflight, Francin e. Garret-Bakelman & al, https://doi.org/10.1126/science.aau8650).

So, in my opinion, it's too easy to indulge in the adversity of genetics, but that's a debate for another article!

 

The biopsychosocial field is therefore a global and logical approach, since it takes into account the very physiology of the body as a whole.

 

Here are a few research articles dealing with the biopsychosocial field:

 

Engel GL: The need for a new medical model: a challenge for biomedicine. Science 1977;196:129-136. Engel GL: The clinical application of the biopsychosocial model. Am J Psychiatry 1980;137:535-544.

 

Frankel RM, Quill TE, McDaniel SH (Eds.): The Biopsychosocial Approach: Past, Present, Future.University of Rochester Press, Rochester, NY, 2003.

 

Borrell-Carrió F, Suchman AL, Epstein RM: The biopsychosocial model 25 years later: principles, practice, and scientific inquiry. Ann Fam Med 2004;2:576-582.

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