Pearson BTEC National Applied Psychology: Book 2

Changing views of health and ill health A visit to your doctor 40 or so years ago would have been very different from a visit today. It ’ s not just the fashions that have changed, or the technology. Imagine it ’ s 1975 and you are talking to your doctor about some stomach pains you ’ ve been having. He asks you questions about the recent history of the pain and whether stomach problems run in your family. He examines your stomach, takes your blood pressure and temperature and maybe even refers you for some tests. His main interest is in your physical symptoms. Fast forward to today. Now your doctor still asks the same questions and gives you the same examination. But she also wants to know about your lifestyle, your diet, how much you exercise, whether you smoke or drink much alcohol. She is very interested in any stress you ’ ve been under recently. These days, a diagnosis is based on social and psychological factors as well as physical ones. Health and ill health According to the World Health Organization (WHO 1948), health is ‘A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’. Ill health is therefore any deviation from this healthy state. There are two other definitions of health/illness that have dominated conversations and research on health and ill health (illness) – the biomedical and biopsychosocial definitions. Biomedical definition The biomedical definition views health/illness in terms of physical or biological factors. It defines illness as ‘physical disease’ which is diagnosed by a medical professional (doctor) from a person’s symptoms. The illness is treated (often in a hospital) with physical methods (such as drugs or surgery) which aim to address the physical/biological causes. The approach tends to define health as ‘the absence of illness’. A healthy person is therefore someone who is free from disease, pain and disability. When we become ill, the aim of treatment is not really to enhance our health but to return us to our pre-illness condition. The focus is on biological functioning rather than on, for instance, social and psychological causes of illness. The biomedical approach is closely associated with medical science and technological advances (e.g. brain scanning, chemotherapy) and is the dominant view of health/illness in the healthcare systems of Western countries. Biopsychosocial definition George Engel (1977) was one of the first medical practitioners to argue that the biomedical definition does not take into account all of the factors that play a role in health and illness. He proposed a biopsychosocial approach instead. This definition suggests that health/illness is the result of several interacting factors. Biological characteristics (e.g. genes , neurochemistry ) are just one set of factors, alongside psychological/behavioural characteristics (e.g. stress, attitudes) and social environment (e.g. family, culture ). Treatment takes into account all three factors. The approach aims to enhance the person’s health rather than just make them ‘not ill’. It also focuses on prevention. This has led to the development of educational programmes designed to promote healthy lifestyles (e.g. exercising, losing weight, stopping smoking, reducing alcohol intake, etc.). The biopsychosocial approach has been very influential in the treatment of mental disorders. Mental ill health is not just a matter of faulty biological functioning. There is more to treatment than just correcting this fault. Health as a continuum The biomedical approach has tended to dominate our view of health, and therefore, health and ill health have traditionally been viewed as two categories – you are either healthy or you are ill. The biopsychosocial approach has a more complex view. Health exists on a continuum and varies between two extremes. Over time a person can be very healthy, very ill or anywhere in between. This is true of mental health as much as it is of physical health. Extremely good health Good health Average health Poor health Extremely poor health As we have seen, ‘health’ under the biopsychosocial definition includes many social, physical and psychological factors. This means that someone in extremely good health is functioning well in all or most of these areas. Someone with extremely poor health has more than just a physical disease. They could be experiencing great stress and difficulties in their lives at the same time (e.g. relationship issues, facing job redundancy, etc.). Specification terms Health and ill health Health is a positive state, in which we can face the challenges of life, overcome stress, achieve our goals and fulfil our potential. This applies to our whole lives and not just our physical state. Ill health is any deviation from this. Stress A physiological and psychological state of arousal that arises when we believe we do not have the ability to cope with a perceived threat (stressor). Stressor Any feature of the environment that causes a stress response, including factors associated with work, everyday minor hassles and major changes in our lives. Defining health and stress Content area A1: Psychological definition of health, addiction and stress Exercise is an essential part of a healthy lifestyle. 10 Unit 3: Health psychology