NHR July-September 2018: Biopsychosocial approach: Homoeopathic perspective

Biopsychosocial approach: Homoeopathic perspective


Kanchan Singh*

Postgraduate Trainee, Dept. of Repertory, National Institute of Homoeopathy, Govt. of India

*Correspondence: kanchansingh909@yahoo.in


Abstract

Biopsychosocial approach is a multidimensional approach to any illness and gives physician a broad perspective to every illness for each patient. Every illness manifests with certain signs and symptoms, but each individual never exhibits them for same course of time, with exact similarity and intensity. To elucidate it, the patient’s psychological response to that particular illness and its socio-cultural background also plays a significant role in manifestation of any disease condition. Henceforth, at the practical level, the biopsychosocial model is also a way of understanding the patient’s/ individual’s subjective experiences of illness in order to design therapeutic interventions that modulate the patients’ behavioral or emotional responses, decrease their distress, and improve their medical outcomes. On the other hand, an interesting aspect of homoeopathy is that the prescription is “personalized” or “individualized”. Hence, in this article, an attempt has been made to compare or analyze the importance of biopsychosocial model in relation to homoeopathic perspective.

Keywords

Homoeopathy; Biopsychosocial model

Introduction

Since its inception, homoeopathy has gained little acceptance as a system of medicine among the scientific elite. Homoeopathy is now exclusively disseminated over the different parts of world but strange to say, by none are its doctrine so distorted as by many of its pretended devotees [1]. Homoeopathy treats of both the science and the art of healing by the law of similar and if the art is to remain and progress among man the science must be better understood than at present. Master Hahnemann stated that ‘the pure homoeopathic healing art is the only correct method, the one possible to human art, the straightest way to cure, as certain as that there is but one straight line between two given points’ (§53) [2]. But to apply the art without the science is merely a pretension and such practice should be relegated to the domain of empiricism. To safely practice the art of curing sick people, the homoeopathic physician must know the science [1].

Every science requires some means of investigation, some method of procedure, which is more exact than the mere says so common sense and which can be used over and again by different investigators and under different conditions. This gives a high degree of verification and control to the results once obtained. Conspicuously, in homoeopathy despite being availability of number of laws there seems high degree of variability in results. To elucidate further, the core difficulty in homoeopathic evaluation has been that multiple observers may note different symptoms or interpret signs differently when interviewing the same patient. Hence by acknowledging this, indeed a scientific way should be adopted by homoeopathic physician to walk on that line which leads them to straight way to annihilate disease in its whole extent, in the shortest, most reliable, and most harmless way, on easily comprehensible principles as stated by Master Hahnemann. In summary, the main objective of this article is to discuss about the scientific method that is the Biopsychosocial which can be adopted by the homoeopathic physician to reach the defined goal i.e. individualization without disturbing the doctrine of homoeopathy.

Homoeopathy:

Homoeopathy is a medical discipline whose basis is non-invasive and descriptive form of therapeutics. Hahnemann stressed that human life is not regulated by purely physical laws which operate on inorganic substances. Living matter is regulated by the laws peculiar to vital force alone: they are themselves animated and vitalized just as the whole system is animated and vitalized. The discipline of homoeopathy essentially entails a holistic approach towards the sick person and treats the patient’s disturbances on the emotional, mental and physical levels in an integrated manner. This holistic conceptualization of the organism serves to integrate the materialistic and the ‘vitalistic’ approach to study.

Biomedical model:

On the other hand, the dominant model of disease today is biomedical with molecular biology its basic scientific discipline [3]. Biomedical model exclusively focuses on disease specific approach. It requires that all disease including mental disease, be conceptualized in terms of derangement of underlying physical mechanisms. The biomedical model also encourages so called “magic-bullet” solutions to health problems. These refer to the prevention or treatment measures that cure a condition usually with surgical procedure, new medical technology or medication [3].

Difficulties with biomedical model:

Biomedicine’s successes have been in areas for which the physico-chemical framework is appropriate, leaving other areas neglected. It leaves no room within its framework for the social, psychological and behavioral dimensions of illness. This contemporary model is, in fact, any longer adequate for medicine, much less for psychiatry because a psychiatric disorder may be characterized by the disturbances involving a wide variety of areas in the patient’s life, including the biological, psychological, behavioral, interpersonal and social spheres. Hence, all these dimensions must be considered in psychiatry as well as in homoeopathy but neglected by today’s model. As both the system face same reliability problem:

  • Information variance
  • Criterion variance
  • Observation bias

To exemplify it, the concept driven perception in each clinician who adheres to a prominent contemporary point of view perceives only some of the potentially available phenomena related to particular disease. Although there is overlap, each observer also perceives information that other observer do not notice. Most importantly the theoretical biases of clinicians seem to be related both to the micro cultures of their training programs and to their own personality traits [4].

Henceforth, we are now faced with the necessity and the challenge to broaden the approach to disease to include the psychosocial without sacrificing the enormous advantages of the biomedical approach. Homoeopath indeed seeks a ‘similimum’ which is based on logical totality of the case for which biopsychosocial model could be a good help as it encompasses all the parameters in the form of biological, psychological, emotional and behavioral attributes.

Biopsychosocial model:

The biopsychosocial model provides a framework to include physical-chemical factors and the areas neglected by biomedicine. George Engel (1977) was the first to articulate this approach to guide health researchers and practitioners in research, intervention and practice. The “Biopsychosocial model” refers to the idea that biological, psychological, and social processes are integrally and interactively involved in physical illness and health, medical diagnosis, medical treatment and recovery. [3]

The biological system emphasizes the anatomical, structural and molecular substrate of disease and its effect on the patient’s biological functioning.

The psychological system emphasizes the effect of psychodynamic factors, motivation and personality on the experience of illness and the reaction to it.

The social system emphasizes cultural, environmental, and familial influences on the expression and the experience of illness. Engel postulated that each system affects and is affected by every other system. [5]

We should not misunderstand biopsychosocial model (BPS) as “model”. The term model here is blurred and creates confusion among researchers. Basically, the BPS model is a perspective and an approach to clinical practice rather than an empirically verifiable theory, a coherent philosophy, a clinical decision making model or a clinical method. BPS is not and cannot be a model (or a formula) of clinical practice, precisely because the major contribution of the original BPS model proposed by the Engel involves a humanistic look at the patient, and it is not possible to design models that show clinicians how to make clinical decisions in every single case: this concerns essentially something really inherent in the human being: individuality and subjectivity [6].

But this approach can give a paradigm for homoeopath to elicit the totality in each case in a logical way. To elucidate it more, if homoeopaths starts perceiving each case from biological [physical generals], psychological [psychological response/ mental generals], socio-cultural aspect then the totality could erect in more logical and scientific way. As with the help of this approach the questioning will be precise, insightful and knowledgeable so that in a short time homeopath will come up with handful of peculiar symptoms.

Similarities between homoeopathy and Biopsychosocial model:

  • In homoeopathy the emphasis on whichever disease one may be treating is on the holistic approach to the sick individual and not just only to the so called disease label that is appended. Biopsychosocial model also offered holistic approach with consideration of psychosocial with biological system.
  • In homoeopathy the individual in all his mental and physical ramifications, with the plethora of interactions within, and between him and the exterior of the universe is carefully studied.

As long ago, master Hahnemann said that totality of the symptoms must be the principle, indeed the only thing the physician has to take note of in every case of disease for individualization. He also stated that the cure would be unnatural, that is unhomoeopathic, unless we noted also the symptomatic changes of mind and temperament, occurring in every case even of acute diseases (§ 213) [7]. The state of patient’s mind and temperament is often of most decisive importance in the homoeopathic selection of a remedy as it is the sign possessing a distinct peculiarity (§ 211) [2]. The concept given by master Hahnemann years back is now acknowledging today through the clinical experience and research that illness variables such as severity, chronicity, organ involvement cannot predict individual’s response to any given medical illness. Rather, it is in the realm of the individual’s subjective experience of an illness that one can begin to understand his or her emotional and behavioral responses [8].

Henceforth, in order to achieve or establish ‘homoeopathicity’ [1] the biopsychosocial approach could be of immense help.

Conclusion:

Ostensibly, through this analogy, what master Hahnemann said years ago in his teachings can be found in biopsychosocial model. The reason of emphasizing on this new paradigm is that as today Master Hahnemann’s doctrine must be taken out of its dogmatic context and interpreted from the viewpoint of modern understanding, so that art of homoeopathy by homoeopath can be practiced in a uniform, logical and scientific manner. As, in today’s scientific era where every field is evolving with further improvement in its implementations giving an alarm to all the stagnant areas including homoeopathy where nothing new has been evolved/ discovered after the death of its progenitor. As, thinking in new perspective in a calculated and justifiable manner without disturbing the underlying basic principle can never hinder the growth of anything rather it shows new paradigms. The best example of this one can see that the biopsychosocial model which underwent many criticisms in the past has been incorporated now as multi-axial classification version in the ICD- 10 which is entirely based on dominant biomedical model. Nowadays in medical field latest work has been start progressing in the direction of making a more holistic, biopsychosocial assessment of an individual patient. [9] Henceforth, thinking in this perspective in homoeopathy could give valuable scientific outcome.

 

Acknowledgement

Dr. Ashok Sharma, Chief Medical Officer (SAG); I/C, IHBAS Unit, Institute of Human Behavior and Allied Sciences, Tertiary Care Psychiatric Hospital GNCT, Delhi & Vivek Vihar Disp., Dir. of AYUSH, GNCT Delhi.

References

  1. Kent JT. Preface. Lectures on Homoeopathic Philosophy. 11th New Delhi: B. Jain Publishers; 2012.
  2. Hahnemann CFS. Organon of Medicine. Translated by Dudgeon RE. 5th edition. New Delhi: B Jain Publishers; 2009.
  3. Suls JM, Luger T, Martin. R. The Biopsychosocial Model and the use of theory in health psychology, Jerry M. Suls, Karina W. Davidson, Robert M. Kaplan. Handbook of Health psychology and behavioral medicine. New York: Guilford press; 2010: p. 17-18.
  4. Yager J, Gitlin MJ. Clinical manifestations of psychiatric disorders. Sadock BJ, Sadock VA. Comprehensive textbook of psychiatry.7th edition, Philadelphia, USA: Lippincott Williams & Wilkins; 2000; p. 793-794
  5. The doctor patient relationship and interviewing techniques. Kaplan and Sadock Synopsis of Psychiatry behavioral science and clinical psychology, 10th, Lipincott William and Wilkin; 2007.
  6. Alvarez AS, Pagani M, Meucci P. The clinical application of the biopsychosocial model in mental health: a research critique.Am J Phys Med Rehabil. 2012; 91(suppl): S173-S180.
  7. C. Introduction. Analytical repertory of the symptoms of mind. 2nd ed., Philadelphia: J. M. Stoddart; 1881: p. 11-22.
  8. MS, Muskin PR. Psychological response to illness. Levenson JL. Textbook of psychosomatic medicine. 2nd ed., Washington D.C. and London, UK: American Psychiatric Publishing; 2005: p. 67-90.
  9. Diagnosis and classification in psychiatry. Ahuja. N. A short textbook of psychiatry. 7th edition, New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2011. P4-5.
Cite this article as: Singh K. Biopsychosocial approach: Homoeopathic perspective. National Homoeo Recorder 2018;14(3):na.

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