After briefly reviewing the multitude of titles given to modern attempts to capture in a sub-specialty way, a compassionate and competent caregiving approach to the complexities of health and illness in the human being, this talk will present an updated view of Engel’s biopsychosocial model, now over 45 years old and perhaps a forerunner of the many sub-sub fields that have emerged. It will be proposed that while Engel was prescient in his argument, the science of the times was preliminary and not robust in support of the premise, given the evidentiary strength of the traditional Western medical model. While psychiatrists intuited that the biopsychosocial approach had merit, our colleagues in other specialties for the most part turned a blind eye to its usefulness. The argument made here will be that the medical science of today, in no small measure buttressed by recent findings in psychosomatic medicine and neuroimmunology, strengthens the case for a wider and deeper version of the biopsychosocial model. This is potentially of clinical and public health significance given the epidemic of chronic stress related non-communicable diseases and the specter of future viral pandemics we are facing. After brief clinical case examples, an attempt will be made to introduce a model of self-similar hormetic curves that may be used to define the holarchy of every patient we see and may even lend itself to a mathematical scalar formulation that can help define whole person health.
Learning Objectives:
To update evidence for biopsychosocial modeling focusing on specific evidence for the docking points that link together mind-brain and body, and individual and community in a nested hierarchy of top down and bottom up influences on health and wellbeing.
To discuss clinical and public health significance and the potential for CL psychiatry to lead the way in defining an updated model.
.jpg "Gregory L. Fricchione, MD. FACLP (he/him/his) photo")
