Some academics still firmly believe in the biomedical model. See: http://healthyhealers.blogspot.ca/search?q=biopsychosocial Though arguments to preserve it were lost decades ago, the ultra-conservative agenda continues to surface as "practical" roadblocks to curriculum reform.
"Ultra-conservatives" UCs feel that safe-guarding their profession entails teaching dental & medical students only the sciences required to practice their respective professions. "Soft subjects" must be excluded, because they're: irrelevant, and/or common sense, and/orprivate, personal matters eg ethics, medical humanities, behavioral sciences, spirituality, etc. and "there's not enough time" in the curriculum. Proponents of the biopsychosocial model BPSs feel that sciences need to be balanced with a broad worldview that acknowledges the importance of clinicians (and their future patients) being helped to mature as human beings, along whatever specific direction each chooses. BPSs understand the critical importance of promoting & optimizingstudents' (and thus, future patients') mental, emotional, spiritual and social, as well asbiological, health.
"Many
economists believe that health care costs will continue to rise. Even
more distressing, the Affordable Care Act will likely reinforce current
practice, which dictates surgical and pharmacological interventions that
can be expensive, inappropriate, burdened by side effects and, often,
ineffective.
Forty
years ago, as a researcher at the National Institute of Mental Health, I
began to study inexpensive self-care strategies — then called
“alternative therapies” — that might address the underlying biological
and psychological imbalances that contribute to chronic conditions.
These included nutrition, exercise and “mind-body” techniques like
meditation, guided mental imagery and biofeedback.
Since
then, research has demonstrated that mind-body approaches reduce stress
and improve mood and immunity. They decrease blood pressure in
hypertensives, blood sugar in diabetics and pain. Dietary modification
can play a major role in preventing breast, prostate and colon cancer,
as well as in diabetes and heart disease. And exercise, which can help
prevent all of these, can also alleviate depression.
We
spend about twice as much as many other industrialized nations on
health care, often with inferior outcomes. Three-quarters of that
spending is on chronic conditions, including heart disease, diabetes,
cancer, arthritis, depression and chronic pain — exactly the ones for
which self-care is best suited. Comprehensive programs that offer
self-care in a supportive group are even more promising, for both
treatment and prevention. This approach is also proving effective for
psychological trauma.
What
was unexamined and alternative 40 years ago is now well researched. It
should be fundamental. If we are going to reduce our ruinous costs and improve our declining national health, we must make self-care and group
support central to all care."
"Health promotion supports personal and social development through providing information, education for health, and enhancing life skills. By so doing, it increases the options available to people to exercise more control over their own health and over their environments, and to make choices conducive to health.
Enabling people to learn, throughout life, to prepare themselves for all of its stages and to cope with chronic illness and injuries is essential. This has to be facilitated in school, home, work and community settings. Action is required through educational, professional, commercial and voluntary bodies, and within the institutions themselves."
We health-care professionals must lead by example in developing such personal skills. "Do as I say, not as I do" fails everyone: ourselves, our families, our loved ones, & our patients. See: http://healthyhealers.blogspot.ca/2012/04/capacity.html
Logo created for the First International Conference on Health Promotion held in Ottawa, Canada, 1986.
"the absence
of symptoms of mental disorders does not
assure the presence of positive emotions,
life satisfaction or other indicators of well-being. ... An adequate model
of well-being will require a better understanding of the role of self-transcendence. In contrast to defensiveness and effortful control, an outlook of unity is
expressed in activities such as fluidity in
athletic performance, improvisation in
musical composition, trustful perception
of social support, and generosity in charitable donations, which each activate the
most recently evolved parts of the brain, particularly prefrontal poles. Activation of the anterior prefrontal cortex produces feelings of satisfaction even when
anticipating adversity or when making
meaningful personal sacrifices. ...
Much more work is needed to develop empirical measures that are able to reliably distinguish the different processes that promote healthy personality development and well-being. We need to better understand the crucial role of self-transcendence along with other dimensions of personality in the development of health and happiness. The great deficiency of emerging classifications of mental disorders is that they embody little or no understanding of the science of well-being."
Cloninger CR. Healthy personality development and well-being. World Psychiatry 2012; 11(2): 103-4. "The goal of meditation at its deepest level has been liberation from the egoic self; developing a sense of harmony with the universe; and the ability to increase one's compassion, sensitivity, and service to others. These goals may include, but go beyond, personal self-regulation or self-exploration."
Shapiro DH. Examining the content and context of meditation; A
challenge for psychology in the areas of stress management,
psychotherapy, and religion/values. Journal of Humanistic Psychology
1994; 34(4): 101-135.
Which is preferable, amastery- or a helpless-orientedself-regulation strategy? Every
parent, health-care professional, and all other educators need to
become skilled at fostering an unshakable belief in each individual's
ability to help themselves rise above the many & varied adversities
that are a natural part of life. "Belief in one's efficacy to exercise control is a common pathway through which psychosocial influences affect health functioning. This core belief affects each of the basic processes of personal change - whether people even consider changing their health habits, whether they mobilize the motivation and perseverance needed to succeed should they do so, their ability to recover from setbacks and relapses, and how well they maintain the habit changes they have achieved." Bandura A. Health promotion by social cognitive means. Health Educ Behav 2004; 31(2): 143-64. People who assume that fundamental attributes (such as intelligence or personality) are static traits that are relatively fixed & not subject to personal development are said to be "entity theorists." Those who hold that these human attributes are, instead, dynamic qualities that can be cultivated &can be developed & changed incrementally through personal efforts are referred to as "incremental theorists." Research shows that belief in one or the other of these theories has a major impact "on immediate self-regulatory responses to setbacks, including a) responding to failure, b) coping with dysphoria, c) overcoming negative stereotypes, & d) managing personal conflict in intimate relationships. If attributes are seen as fixed, then success or failure provides diagnostic information about how much of these fixed attributes one possesses (& will ever possess). Therefore, for entity theorists, failure often signifies that abilities are permanently lacking in some way. Following failure, any self-regulation in which these individuals are engaged is thus likely to focus primarily on suppressing the importance of this failure or on coping as best they can with the negative emotional impact. In contrast, if attributes are seen as malleable, then success or failure provides diagnostic information about the level to which these attributes have thus far developed. Therefore, for incremental theorists, failure may signify that their abilities require improvement through further attention and effort. Following failure, any self-regulation in which these individuals are engaged is thus more likely to focus on determining how to bring about this improvement."
Molden DC, Dweck CS. Finding "meaning" in psychology: a lay theories approach to self-regulation, social perception, and social development. Am Psychol 2006; 61(3): 192-203.
