Book: A snapshot of the human system - Operationalizing the biopsychosocial model



PREFACE        7

We know a lot about the world, and about ourselves. The scientific method has slowly but surely dissected our physical, biological, psychological, and social nature. The reductionist agenda has led to the accumulation of vast amounts of ever-detailed discoveries over the last centuries reported in hundreds of thousands of scientific articles. We are made of atoms following physical laws in a 13.7 billion-year-old expanding universe. We have evolved from simple self-replicating molecules by natural selection. A complex network of billions of neurones generates our behaviour and experience, and makes us exquisite observers of nature and of our nature. And, we are cultural beings, standing on the shoulders of our ancestors’ knowledge and forming societies which dominate all other life forms.

Yet, despite all this detailed knowledge, no effective overarching framework to classify, describe, and manage the complexity of human nature exists. Current debates are unnecessarily implicit, unstructured, and incomplete. Not that any human-focused discipline says anything wrong. Each has created a set of fitting and useful descriptions of the specific phenomena they study and treat, but we also need a framework, or a set of tools, that allows us to describe all human processes within a single model. Today, the biopsychosocial “model” tries to fill this gap. Its holistic maxim states: you must consider all three aspects whenever you study humans and their disorders. However, this conceptual framework barely passes as a fundamental and unifying model of humans, but is rather the explicit acknowledgement of the existence of separate biological, psychological, and social processes.

The helping professions should be especially concerned as they often work together in multi-disciplinary teams or are faced with multi-dimensional disorders. A global framework should holistically study human processes and treat disorders.  Students of the human disciplines must work too hard to make sense of the diversity of drivers of human processes in their own field, in which they want to become an expert, and in all other fields, to which they want to be an observer. Patients are even more struggling to build up a simple global picture on what causes and modulates their symptoms and associated handicap. Of course, any area of society would practically benefit from a more effective holistic framework. Not to speak of the intellectual satisfaction to better understand ourselves and our place within the world.

In this book, we propose a conceptual framework on how to construct effective holistic models of the human system. Be patient in the introductory chapters. We do not present the overarching framework ad-hoc, but search for hints to its structure from historical debates, weaknesses of current frameworks, known organising principles of human nature, and requirements imposed on an overarching framework. We then use our framework to derive the simplest non-trivial model of the human system, and apply this four-domain model to all types of human processes such as behaviour, experience, and internal body processes. While we focus on clinical case studies, disorders and psychotherapy, we also show the universal application of the model to all human activity and even extend to other life forms. We then move from the single human perspective to interpersonal relationships and social networks, which we describe with multi-person four-domain models derived from our framework. The models naturally describe the move from natural sciences to social sciences, and provide a clearer perspective on cultural evolution and all other activities of societies including media, politics and economics. We conclude the book with a broader vision on how our framework fits into the scientific world view using an information paradigm.

The book should be especially useful for students of the human disciplines to master the complexity of human nature. Patients can learn how their disorders affect them at different levels. And, seasoned academics and clinicians might see the advantages of re-phrasing what they already know within one single framework. We hope you will find our ideas interesting, and spread them eagerly. Please share your comments with us. Enjoy the book!


CHAPTER ONE: EXPLORING THE COMPLEXITY OF THE HUMAN KALEIDOSCOPE     11

    STUDYING THE IMAGE OF THE HUMAN KALEIDOSCOPE

    INSPIRATION FROM THE MECHANICAL KALEIDOSCOPE

    ENVIRONMENTAL INFLUENCES

    BIOLOGICAL INFLUENCES

    PSYCHOLOGICAL INFLUENCES

    OBSTACLES TO A GLOBAL FRAMEWORK

    BENEFITS OF A SIMPLE GLOBAL FRAMEWORK


CHAPTER TWO: SEARCHING FOR A GLOBAL FRAMEWORK    27

    INTUITIVE FRAMEWORKS AIDED BY THE GODS OF THE GAPS

    SIMPLISTIC FRAMEWORKS WITH MINIMAL USE OF THE GODS OF THE GAPS

    THE SCIENTIFIC WORLD OF INCREASINGLY SPECIALISED FIELDS

    SMOOTHING THE BODY-MIND DICHOTOMY

    THE INFORMATION-PROCESSING AND BIOLOGICAL MEMORY REVOLUTION

    ENGEL’S BIO-PSYCHO-SOCIAL MODEL: THE FIRST EXPLICIT ATTEMPT TO AN OVERARCHING FRAMEWORK

    FRAMEWORKS INSPIRED BY BIOPSYCHOSOCIAL AND EVOLUTIONARY IDEAS


CHAPTER THREE: HOW AN OVERARCHING FRAMEWORK SHOULD LOOK LIKE          38

    WEAKNESSES OF THE BIOPSYCHOSOCIAL AND RELATED APPROACHES

    PROPERTIES OF AN OVERARCHING FRAMEWORK

    REQUIREMENTS OF A GOOD FRAMEWORK


PART II: THE FOUR-DOMAIN MODEL 44

CHAPTER FOUR: DERIVATION OF THE FOUR-DOMAIN MODEL           44

    ONE-DOMAIN MODEL: EVERYTHING IS PHYSICS

    TWO-DOMAIN APPROACH: HUMANS IN AN ENVIRONMENT

    THREE-DOMAIN APPROACH: INFORMATION GATHERING AND UTILISING SYSTEM

    FOUR-DOMAIN APPROACH: DISTINGUISHING ON TRANSPORTABILITY OF HUMAN MEMORY


CHAPTER FIVE: UNDERSTANDING THE FOUR-DOMAIN MODEL         54

    COMMUNICABLE MEMORY: THE REPLICATOR OF CULTURAL EVOLUTION?

    OUR CULTURAL CONTENT AS A LIST OF MEMES

    CONFINED MEMORIES ARE A.M.E.S

    THOUSANDS OF ELEMENTS IN EACH OF THE FOUR DOMAINS

    OPERATIONALISING THE FOUR-DOMAIN MODEL

    EXAMPLES


PART III: UNDERSTANDING HUMAN BEHAVIOUR AND EXPERIENCE: A STATE VIEW             66

CHAPTER SIX: WHAT DRIVES ORDINARY BEHAVIOUR?           66

    A GIRL EATS ICE CREAM ON A RIVER BOAT

    A HIGH SCHOOL STUDENT SITTING HIS FINAL EXAM

    A TEENAGE GIRL READS A BOOK

    A MAN EATS CHOCOLATE AT NIGHT DESPITE BEING ON A DIET

    THE EXECUTIONER STARTS THE FIRE OF THE STAKE WITH A SHACKING HAND

    A RUSSIAN SPY BETRAYS ATOMIC WEAPON SECRETS

    THE CLOWN JUGGLES IN THE CIRCUS

    A VIOLENT TEENAGER

    A MAN KILLS HIS WIFE AND TWO DAUGHTERS

    A SORROWING WIDOW


CHAPTER SEVEN: WHAT DRIVES A DISORDER?            76

    ENGEL’S MYOCARDIAL INFARCTION PATIENT

    DIFFERENCE BETWEEN ENGEL’S APPROACH AND THE FOUR-DOMAIN MODEL

    STUTTERING

    LIVING WITH ADDICTION

    STRESS-RELATED DISORDER IN RESPONSE TO BULLYING

    CANCER


CHAPTER EIGHT: AN ALTERNATIVE DISORDER FRAMEWORK            85

    CLASSIFICATION OF DISORDERS

    LACK OF A GENERIC DISORDER FRAMEWORK

    THE BALANCE BETWEEN SHARED AND UNIQUE ELEMENTS

    FROM INDIVIDUALS’ STATES TO A GENERIC DISORDER-SPECIFIC MODEL

    EVOLUTION OF A DISORDER OVER TIME


PART IV: INTERVENING IN HUMAN BEHAVIOUR & EXPERIENCE: A STATE VIEW     91

CHAPTER NINE: CHOOSING THE APPROPRIATE STATE FOR A DESIRED PROCESS   91

    TOWN COUNCIL TRYING TO FIGHT GRAFFITI

    COACHING A YOUNG SPORTS TALENT

    INVESTMENT BANKS MOULDING YOUNG GRADUATES

    MOVING A CENTRALISED ECONOMY TOWARDS A MARKET ECONOMY

    SELF-MANAGEMENT AND SELF-REALISATION

    TREATING STRESS: MULTI-DIMENSIONAL APPROACH

    TREATING CLAUSTROPHOBIA: ONE-DIMENSIONAL APPROACH


CHAPTER TEN: HOW INTERVENTION TECHNIQUES CHANGE THE STATE    98

    GRADUAL DESENSITISATION

    SOCRATIC DIALOGUE

    TIME OUT

    FREE ASSOCIATION

    ACTIVE LISTENING

    ENACTMENT OR ROLE PLAY

    SUPPORT GROUP

    MEDITATION AND RELAXATION

    HYPNOSIS

    PSYCHOTHERAPY INTERVENTIONS AS PROCESSES CHANGING THE INFORMATIONAL STATE


CHAPTER ELEVEN: GENERIC PSYCHOTHERAPY FRAMEWORK           107

    HOW PSYCHOTHERAPY SCHOOLS INTERVENE TO MOVE THE SAME ELEPHANT

    ANALYTIC THERAPY

    BEHAVIOURAL THERAPY

    COGNITIVE THERAPY

    SYSTEMIC THERAPY

    GESTALT THERAPY


CHAPTER TWELVE: GENERIC TARGET-ORIENTED INTERVENTION FRAMEWORK  112

    DIAGNOSIS

    TARGET

    PRIORITISING INTERVENTION

    ANALYSING THE IDENTIFIED STATES FROM DIFFERENT PERSPECTIVES

    INTERVENTION

    CONCLUSION


PART V: MULTI-PERSON MODELS        119

CHAPTER THIRTEEN: TWO-PERSON MODEL                119

    CHARACTERISTICS OF INTERPERSONAL RELATIONSHIPS AND INTERACTIONS

    EXAMPLES OF INTERPERSONAL RELATIONSHIPS AND INTERACTIONS

    THERAPEUTIC PROCESS AND THE THERAPIST-CLIENT RELATIONSHIP

    TREATING AN INTERPERSONAL RELATIONSHIP


CHAPTER FOURTEEN: CULTURE          126

    THE CULTURE WITHIN US

    CULTURAL EVOLUTION OR THE SPREADING OF MEMES

    THE DYNAMICS BEHIND MEMES


CHAPTER FIFTEEN: MULTI-PERSON MODEL FOR SOCIAL GROUPS   132

    SOCIAL NETWORKS AND AGENT-BASED MODELLING

    GROUP BEHAVIOURS

    EXAMPLES OF SOCIAL GROUP PHENOMENA

    TREATING SOCIAL GROUPS


PART VI: ENDING ON A WIDER PERSPECTIVE              138

CHAPTER SIXTEEN: REVIEWING THE FRAMEWORK 138


CHAPTER SEVENTEEN: TAKING A WIDER PERSPECTIVE       149

    THE TOWER OF INFORMATION

    LIFE, ANIMALS, CHILD DEVELOPMENT, TWINS

    HUMAN DISCIPLINES FROM AN INFORMATION PERSPECTIVE

    SHIFTING TO A MEME PERSPECTIVE

    A FRESH LOOK AT INTERESTING TOPICS


CHAPTER EIGHTEEN: SPREADING THE MEME             160

    INFORMATION-DRIVEN FRAMEWORK WILL PREVAIL

    MAKING PEOPLE USE THE FRAMEWORK


REFERENCES   163