The Biopsychosocial Model of the Mind

"Traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing awareness of what is played out inside." - Bessel van der Kolk

The biopsychosocial model of mental health is a comprehensive approach that considers biological, psychological, and social factors when assessing and treating mental health conditions. In simple terms, it looks at the whole person and their environment, instead of focusing solely on the individual's brain or biology.

Biological factors include genetics, brain chemistry, and overall physical health. Psychological factors encompass an individual's thoughts, emotions, and coping mechanisms. Social factors, on the other hand, involve relationships, support networks, and cultural or socioeconomic influences.

Here's an interesting hypothetical that demonstrates the biopsychosocial model in action. Imagine a scenario where a patient is diagnosed with depression. Initially, the patient is prescribed antidepressants (addressing the biological aspect) but showed little improvement. When the treating therapist begins exploring the patient's life circumstances, they discovered that the patient is dealing with a difficult work environment and a recent divorce (social factors). Additionally, the patient has developed negative thought patterns and poor coping mechanisms (psychological factors) along the way. By addressing all three aspects, the therapist is able to create a more effective treatment plan, which includes cognitive-behavioral therapy and encouraging the patient to seek social support. This comprehensive approach is more likely to lead to significant improvement in the patient's mental health as opposed to any single approach. It's a good way of thinking about the biopsychosocial model in action.

These anecdotes highlight the importance of the biopsychosocial model in understanding and treating mental health conditions. By considering the complex interplay of biological, psychological, and social factors, this approach enables more tailored and effective treatment plans that address the unique needs of each individual.

Examples

"The Body Keeps the Score" by Dr. Bessel van der Kolk is a wonderful book that explores the impact of trauma on the mind and body. You can tell by the huge number of reviews on Amazon that the book has sent shockwaves throughout the world of mental health. The biopsychosocial model is evident throughout the book, as Dr. van der Kolk emphasizes the importance of addressing the interconnected biological, psychological, and social aspects of trauma recovery. Here are some examples from the book:

• Trauma-sensitive yoga: In the book, Dr. van der Kolk discusses the use of trauma-sensitive yoga as a therapeutic approach. This practice incorporates physical movement (biological), mindfulness (psychological), and a supportive environment (social) to help trauma survivors regain a sense of safety and control over their bodies.
• Eye Movement Desensitization and Reprocessing (EMDR): EMDR is a therapy that addresses the biological aspect of trauma by stimulating both sides of the brain through eye movements or other sensory stimulation (such as pulsing paddles that you hold in your hands). At the same time, it incorporates psychological elements by helping patients process traumatic memories and reframe their negative beliefs. The therapy often takes place in a supportive, therapeutic relationship, addressing the social aspect. It's a modality that I used a handful of times to process childhood trauma that undergirded many of my trauma triggers and post-traumatic responses.
• Neurofeedback: he also discusses the use of neurofeedback to help trauma survivors regulate their brain activity (biological). This approach also involves teaching patients self-awareness and self-regulation techniques (psychological), often within the context of a supportive therapeutic relationship (social).
• Group therapy: his book also highlights the benefits of group therapy for trauma survivors, as it provides a safe space for individuals to share their experiences and connect with others who have faced similar challenges (social). Group therapy can also include psychoeducation and coping skills training (psychological), and may incorporate body-based practices, such as breathwork or relaxation techniques (biological). When I was in rehab, I regularly participated in group therapy, group acupuncture, and group meditation and found the combo especially powerful when helping me release trapped emotions.

Important People in the Biopsychosocial Model

There's a large and growing list of experts who utilize the biopsychosocial model in their work:

• George L. Engel: An American psychiatrist who first introduced the biopsychosocial model in the late 1970s. Engel emphasized the importance of considering biological, psychological, and social factors when understanding and treating illnesses, including mental health conditions.
• Bessel van der Kolk: who I've mentioned many times in this post, is Dutch psychiatrist known for his extensive work on trauma and its effects on the body and brain. His book, "The Body Keeps the Score," illustrates the application of the biopsychosocial model in understanding and treating trauma through various therapeutic approaches.
• Judith Beck: An American psychologist and daughter of Aaron T. Beck, the founder of cognitive therapy. Judith Beck's work in cognitive-behavioral therapy integrates the biopsychosocial model by addressing the interplay of biological, psychological, and social factors in the development and treatment of mental health disorders.
• Gabor Maté: A Hungarian-born Canadian physician who has explored the connections between stress, trauma, and addiction from a biopsychosocial perspective. His work highlights the importance of addressing underlying psychological and social factors, in addition to biological ones, when treating addiction and other mental health conditions.
• Marsha Linehan: An American psychologist who developed dialectical behavior therapy (DBT) for treating individuals with borderline personality disorder. DBT integrates the biopsychosocial model by focusing on the interplay of biological, psychological, and social factors in the development and treatment of emotional dysregulation.
• John Bowlby: A British psychoanalyst known for developing attachment theory, which explores the importance of early relationships and social factors in shaping emotional development. Bowlby's work has contributed to the biopsychosocial understanding of mental health by emphasizing the role of social connections and attachment in emotional well-being.
• Jon Kabat-Zinn: An American professor and creator of the Mindfulness-Based Stress Reduction (MBSR) program. Kabat-Zinn's work integrates the biopsychosocial model by addressing the impact of stress on the body and mind, and emphasizing the importance of mindfulness and self-awareness in promoting psychological and physical well-being.

Questions for Self-Inquiry

Biological factors:

• How is my overall physical health, and are there any ongoing medical issues that could be affecting my mental well-being?
• Are there any genetic factors or family history of mental health conditions that I should be aware of?
• How do my sleep patterns, diet, and exercise habits influence my mood and mental health?
• Do I have any substance use habits or addictions that could be affecting my mental health?

Psychological factors:

• What are my dominant thought patterns, and do I tend to think negatively or positively about myself and my experiences?
• How do I cope with stress or difficult emotions? Are my coping strategies effective and healthy?
• Have I experienced any past traumas or adverse events that could be impacting my mental health today?
• What are my beliefs and values, and how do they influence my emotions and behaviors?

Social factors:

• How would I describe the quality of my relationships with family, friends, and romantic partners? Do I have a strong support network?
• Are there any current stressors in my life, such as work-related or financial issues, that might be impacting my mental health?
• How does my cultural background and upbringing influence my mental health and the way I perceive and cope with challenges
• Do I experience a sense of belonging and connectedness in my community, and how does this impact my well-being?