The Interplay of Biology, Psychology, and Society: The Biopsychosocial Model

In the quest to understand health and illness, the biopsychosocial model emerges as a revolutionary framework that transcends the narrow confines of traditional medicine. Conceived by Dr. George Engel and Dr. John Romano, this model illuminates the intricate tapestry of factors that constitute our well-being. It posits that health is not merely the absence of disease or infirmity but a dynamic state shaped by the complex interplay of biological, psychological, and social influences.

This holistic approach challenges us to consider the full spectrum of human experience in healthcare, from the molecular to the societal, and invites a more compassionate and comprehensive response to healing. As we delve into the biopsychosocial model, we uncover the rich layers of human health and the potential for a more nuanced understanding of the human condition.

Introduction to the Biopsychosocial Model

In his classic paper published in 1977 George Engel proposed a new model for medicine, the biopsychosocial model. Engel argued that the biomedical model was “limited, and insufficient for many aspects of medical science and healthcare” (Bolton & Gillett, 2019). Engel subsequently, presented the biopsychosocial model as a more holistic approach to medicine than the predominantly accepted biomedical model. The biopsychosocial model is a comprehensive approach to health and illness that considers three interconnected dimensions: biological, psychological, and social factors.

Physicians may use the biopsychosocial model to understand the complex interactions between these factors and how they contribute to an individual’s health. It’s a holistic perspective that moves beyond the traditional biomedical approach, which often focuses solely on physical aspects of health. This model is particularly relevant in healthcare, as it can lead to more effective treatment by considering the full range of influences on a person’s health.

The Biomedical Model

The biomedical model is a traditional approach to understanding and treating illness that focuses on biological factors such as genetics, physiology, and pathology. It views health and disease as solely the result of physical processes within the body, often overlooking other important factors like social, psychological, and environmental influences. This model is typically used in Western medicine to diagnose and treat medical conditions through interventions such as medications, surgeries, and other medical procedures.

Engel argues that the success of the biomedical model has further entrenched dualism and reductionism. Moreover, the success of the biomedical model also “encourages its more enthusiastic advocates to promote the biomedical model as ultimately capable of explaining all aspects of health and disease” (Engel, 1978).

Not every doctor visit is the context for a holistic examination of the patient’s life. Some needs may be outside the doctor’s purview. In regards to somatic awareness, Bakal, Coll, and Schaefer wrote that somatic awareness is “an experiential guide or meta-skill rather than a treatment technique.” They do not suggest that the physician begin holistic treatment. Rather, they suggest that the “physician and patient…decide together what modality treatments and resources available in the community might strengthen this skill and the patient’s self healing” (Bakal, Coll, & Schaefer, 2008).

If you visit the emergency room of a hospital, you still see the biomedical model in full swing. Perhaps, this is rightfully so. they deal with immediate acute illness and injury. However, in family practice, the primary caregiver often employs some version of the biopsychosocial model, examining not only the acute injury or disease but practices and lifestyles that may enhance symptoms and vulnerability.

Emotions and the Biopsychosocial Model

Emotions seem to be the bridge between all three aspects of health. Kenneth L. Davis and Christian Montag wrote:

“Mother nature (aka evolution) speaks to mammals in the oldest language, the language of emotional affects. The ancestral voices guide their choices as they navigate life” (Davis & Montag, 2019).

Our emotional journey all begins with these pangs of feeling arising from neural structures that evolved to sustain life. Feeling affects motivate behavior. Our social environments ignite feelings which eventually translate into action. In psychology, several theories describe how cognitions translate feeling affects into recognizable emotions. Accordingly, emotions provide a window into a biological process (stress response) that helps and hurts the organism. By addressing environmental contributors to heightened and continued stress, individuals can mitigate the stress. Consequently, this strengthens their immune system and reduces vulnerability to illness and disease.

A Closer Look at the Three Elements in the Biopsychosocial Model

Biological Factors

In the context of the biopsychosocial model, biological factors refer to the physiological aspects that can influence an individual’s health and behavior. These include:

Genetics: Our genetic makeup can predispose us to certain health conditions or behaviors.
Brain Chemistry: Neurotransmitter levels and brain function can affect our mood and behavior.
Illness Pathology: The presence of diseases or physical disorders can impact mental health, such as how chronic pain may lead to depression.
Physical Health: Overall physical well-being, including factors like nutrition, exercise, and sleep, can influence mental health.

These biological factors interact with psychological and social factors to influence an individual’s overall health and well-being, as proposed by the biopsychosocial model.

See Neurobiology for more on this factor

Psychological Factors

In the biopsychosocial model, psychological factors encompass the internal cognitive and emotional aspects that influence an individual’s mental health and behavior. These include:

Thoughts: Patterns of thinking, beliefs, and attitudes that can affect how we perceive and interact with the world.
Emotions: Feelings such as happiness, sadness, anger, or anxiety that can impact our mental state and behavior.
Behavior: The actions we take in response to our thoughts and emotions, which can also influence our health and well-being.
Coping Strategies: The methods we use to manage stress, adversity, and life’s challenges.
Personality Traits: The stable characteristics that define how we typically think, feel, and behave.

These psychological factors are considered alongside biological and social factors to provide a comprehensive understanding of an individual’s health within the biopsychosocial model.

See Understanding Psychology for more on this factor

Social factors, often referred to as Social Determinants of Health (SDOH), have a significant impact on an individual’s health and well-being. Here are some examples:

Economic Stability: Income, employment, job security, and financial resources influence access to healthy food options, healthcare services, and other necessities that contribute to overall health.
Education Access and Quality: Educational opportunities and literacy levels can affect health outcomes by shaping employment opportunities and the ability to understand health information.
Healthcare Access and Quality: Availability and affordability of healthcare services determine the ability to receive preventive care and treatment for illnesses.
Neighborhood and Built Environment: The quality of housing, availability of transportation, safety, and access to parks and recreational areas can influence physical and mental health.
Social and Community Context: Social interactions and community engagement, including support systems and exposure to crime and violence, can affect mental health and stress levels.

These factors are interconnected and can create a cascade of effects on an individual’s health. Addressing these social determinants is crucial for improving health outcomes and reducing health disparities

See Social Psychology for more on this topic

Example of Applied Biopsychosocial Model of Health Care

Here are some examples of how the biopsychosocial model is applied in real-world healthcare settings:

Chronic Pain Management: The biopsychosocial model has been used to develop new treatment approaches for patients living with chronic pain. This includes integrating physical and psychological therapies, such as cognitive-behavioral therapy, to address both the biological aspects of pain and the psychological factors that can exacerbate it (Trachman, 2023).
Mental Health Treatment: In mental health care, the biopsychosocial model informs treatment plans by considering the patient’s social environment, psychological state, and biological factors. For instance, a treatment plan for depression might include medication (biological), psychotherapy (psychological), and community support programs (social) (Sus, 2023).
Rehabilitation Services: Rehabilitation programs for individuals recovering from injuries or surgeries often use the biopsychosocial model to tailor a holistic recovery plan. This can involve physical therapy, counseling, and support groups to address the full spectrum of recovery needs (Sus, 2023).
Healthcare for the Elderly: Geriatric care frequently employs the biopsychosocial model to address the complex needs of older adults. This includes managing chronic diseases, addressing cognitive and emotional changes, and ensuring social support systems are in place (Xiao et al., 2021).

These examples illustrate the practical application of the biopsychosocial model in healthcare, emphasizing the importance of addressing the multifaceted nature of health and illness. By considering the biological, psychological, and social dimensions, healthcare providers can offer more comprehensive and effective care tailored to the individual’s unique circumstances

The Stress Response and the Biopsychosocial Model

A primary example of the link between psychological events, social environments, and biological reactions is stress. Stress creates a biological response that cascades through the organism. Jaak Panksepp explains that the “fundamental emotional powers of the mind, which are closely affiliated with a variety of bodily states and nonspecific brain arousal systems (e.g., norepinephrine and serotonin), concurrently generate distinct emotional action tendencies as well as raw feeling states that rapidly get linked to a variety of events in the world through classical conditioning and other basic learning mechanisms” (Fosha, Siegel, & Solomon, 2009).

This interaction between the brain (bio) and the world (socio) give rise to emotions (psycho). Basically, this is the framework of the stress response. It is a biological reaction that motivates action. However, science has discovered that excessive stress from the environment creates a biologically toxic environment for the organism. Too much activation impacts healthy functioning of the organs, leading to vulnerability to disease.

Excessive stress also leads to habituation of the stressful reaction. Accordingly, the processing of the hormones and behavioral reactions change as an attempt to adapt to the excessive stress (Lightman, 2005). However, the adaptation of response does not change the biological limitations of the organs to process the excessive hormones in the system.

Associated Concepts

Whole Person Wellness: This refers to a holistic approach to well-being that encompasses all aspects of an individual’s life. This includes physical, mental, emotional, and spiritual health, as well as factors such as social relationships, environmental well-being, and overall lifestyle.
Social Determinants of Health: These are the conditions in which people are born, grow, live, work, and age that affect health outcomes.
Broaden and Build Theory: This theory proposed by Barbara Fredrickson, suggests that positive emotions broaden an individual’s thought-action repertoire. Positive emotions lead to increased creativity, resilience, and overall well-being. Positive affect promotes approach behaviors, contributing to flourishing by building enduring resources for coping and broadening cognitive horizons.
Stress Management: This refers to the techniques and strategies used to control, reduce, and cope with the negative effects of stress. It involves identifying stress triggers, implementing healthy coping mechanisms, and making lifestyle changes to enhance well-being.
Four ‘Ps’ of Case Formulation: This refers to predisposing, precipitating, perpetuating, and protective factors that influence an individual’s mental health and treatment.
Mental Health: This refers to a person’s emotional, psychological, and social well-being.
Whole-Body Therapy: These are treatment styles that focus on the connection of mind and body that utilize both psychotherapy and physical therapies for holistic healing.
Self-Care: By employing a variety of stress relieving activities through self-care, a person can strengthen their disease fighting capabilities.

A Few Words from Psychology Fanatic

In conclusion, the biopsychosocial model stands as a testament to the intricate tapestry of human health. It reminds us that wellness is not merely the absence of disease or disorder, but a harmonious balance of biological, psychological, and social factors. As we continue to explore the depths of this model, we uncover the profound interconnectedness of our bodies, minds, and the environments in which we thrive. Let us move forward with the understanding that each individual is a unique confluence of these elements, and that our approach to health care must be as dynamic and multifaceted as the lives we seek to understand and improve. The biopsychosocial model is not just a framework for treatment; it is a call to embrace the complexity of the human condition.

Last Update: August 25, 2025

References:

Bakal, Donald; Coll, Patrick; Schaefer, Jeffrey (2008). Somatic awareness in the clinical care of patients with body distress symptoms. BioPsychoSocial Medicine, 2(1), 1-6. DOI: 10.1186/1751-0759-2-6
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Bolton, Derek; Gillett, Grant (2019). The Biopsychosocial Model of Health and Disease: New Philosophical and Scientific Developments. ‎ Palgrave Pivot; 1st ed. 2019 edition.
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Davis, Kenneth L.; Montag, Christian (2019). Selected Principles of Pankseppian Affective Neuroscience. Frontiers in Neuroscience. DOI: 10.3389/fnins.2018.01025
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Engel, George (1978). The biopsychosocial model and the education of health professional. Annals of the New York Academy of Sciences, 310(1), 169-181. DOI: 10.1111/j.1749-6632.1978.tb22070.x
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Fosha, Diana; Siegel, Daniel J.; and Solomon, Maria D. (2009). The Healing Power of Emotion. Affective Neuroscience, Development & Clinical Practice (Norton Series on Interpersonal Neurobiology). Editors Diana Fosha PhD, Daniel J. Siegel M.D., and Marion F. Solomon Ph.D. W. W. Norton & Company; 1st edition.
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Lightman, Stafford (2005). Can neurobiology explain the relationship between stress and disease? Editor Peter White. In Biopsychosocial Medicine: An Integrated Approach to Understanding Illness. ‎Oxford University Press; 1st edition.
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Sus, Viktoriya (2023). Biopsychosocial Model: Examples, Overview, Criticisms. Helpful Professor. Published: 7-22-2023; Accessed: 7-5-2024.
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Trachman, Susan B. (2023). A Biopsychosocial Approach to Illness. Psychology Today. Published: 8-21-2023; Accessed: 7-5-2024.
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Xiao X, Song H, Sang T, Wu Z, Xie Y and Yang Q (2021) Analysis of Real-World Implementation of the Biopsychosocial Approach to Healthcare: Evidence From a Combination of Qualitative and Quantitative Methods. Frontier Psychiatry 12:725596. DOI: 10.3389/fpsyt.2021.725596
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