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UNIT 2MIND–BODY
NOTES Structure 2.0 Introduction 2.1 Objectives 2.2 Mind-Body Definition 2.3 Mind–Body Relationship, Functions and Need of Health Psychologists 2.4 Biomedical Model and Biopsychosocial Model of Health 2.5 Illness in Expression of Emotional Needs: The Health Illness Continuum 2.6 Answers to Check Your Progress Questions 2.7 Summary 2.8 Key Words 2.9 Self Assessment Questions and Exercises 2.10 Further Readings
2.0 INTRODUCTION
The mind–body relationship can be defined as the connection between one’s behaviour and thoughts and the effect it has on their physical health. Though it is common understanding that our thoughts affect our bodies, we are starting to realise now that our thoughts may also influence our overall health. As an integral part of holistic medicine–which emphasises to treat a patient as a whole rather than only concentrating on their specific symptoms–the importance of an ideal mind–body relationship is gaining prominence. The biopsychosocial model is a system that considers how various factors and attributes like biology, psychology and one’s socio- environmental surroundings can affect one’s health. This unit will discuss the physiological theories of personal identity. It will also analyze the importance of the mind–body relationship in psychotherapy.
2.1 OBJECTIVES
After going through this unit, you will be able to:
- Understand the mind and body criteria of personal identity
- Analyze the mind–body relationship’s importance in psychotherapy
- Examine the different theories of the mind–body relationship
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- Examine grounded cognition as a framework for psychotherapy
- Compare the differences between the biomedical model and biopsychosocial model of health
- Analyze the health–illness continuum
2.2MIND-BODY DEFINITION
Let us begin with a discussion on body criterion.
Self-Instructional The Mind Criterion It is imperative to understand that ‘mind’ is not the same as the brain. The mind encompasses mental states such as views, beliefs, feelings, attitudes and metaphors. NOTES The brain acts as the hardware that authorises us to experience these mental states. Mental states can be fully ‘conscious or unconscious’. People can react emotionally to the situations without becoming aware of why they are reacting. All mental states have a physiology related to them—a positive or negative effect felt in the physical body. For instance, the mental state of anxiety can release stress hormones. Most of the mind–body therapies emphasise on getting more conscious of mental states and using this amplified cognizance to guide our mental states in an improved and less damaging direction. Check Your Progress
- What is the difference between the mind and the brain?
- What do you understand by the body criterion?
2.3 MIND–BODY RELATIONSHIP, FUNCTIONS AND
NEED OF HEALTH PSYCHOLOGISTS
The cerebellum is responsible for muscular and coordination functions; the brainstem controls body functions such as heart rhythm and body temperature; and the temporal lobe is responsible for comprehension, language, listening and memory learning. It is linked to the oral and written language region of the brain called Wernicke. In the areas of superiority are the areas of human development historically posterior, especially in the frontal lobe: morality, reasoning, personality and others. A systemic conceptualisation of the mind–body relationship leads to a deeper understanding of contradictions between theory and practice of psychotherapy. When the mind–body relationship is conceptualised from a dual or exclusive perspective, a contrast is generated between the phenomenological needs of the present mind and body and the focus on either mind or body according to the therapist’s theoretical assumptions of psychotherapy.
Self-Instructional Fig 2.1: Illustration of the Mind–Body Problem. (Adapted from The Mind–Body Problem by Westphal (2016). Copyright 2016, Massachusetts Institute of Technology.) Monism: This approach posits that there is only one reality, composed only of either physical or non-physical substances. Physicalism: This view assumes that everything existing is physical, including the
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2.4 BIOMEDICAL MODEL AND BIOPSYCHOSOCIAL MODEL OF
HEALTH
Let us first dicuss the biomedical model. NOTES Biomedical Model Health is considered to be the absence of disease in traditional medicine. Disease is exclusively conceptualised as a biological process in this view. According to the biomedical model, ‘disease is a simple, almost mechanistic result of exposure to a specific pathogen, a disease-causing organism’. This model encouraged the development of medicines and clinical technologies to remove the pathogens and cure the diseases. As per this model, health is restored as and when the pathogen is removed from the body. The biomedical model was successful in conquering and controlling illnesses, specifically infectious diseases, that tried to desolate humanity throughout the 20th century. When chronic diseases started replacing infectious diseases and became the leading causes of morbidity, questions were raised regarding the adequacy of the biomedical model. We can better understand the biomedical model of medicine in terms of its answers to the questions given below:
- What causes illness? As per the biomedical model of medicine, diseases enter human body in two ways. They enter from outside the human body, attack the body and result in physical changes within the body, or originate as a result of some internal involuntary physical change. These diseases may be the consequences of various factors such as chemical imbalances, bacterial or viral infection and genetic predisposition.
- Who is responsible for illness? Since diseases result from biological changes that are beyond the influence of humans, they are not considered responsible for their diseases. They are seen as victims of the internal changes in the body generating external forces.
- How should illness be treated? Treatments that are aimed to alter the physical state of the body such as vaccination, chemotherapy, surgery and radiotherapy are considered in the biomedical model. 4. Who is responsible for treatment? This model believes that the medical profession is responsible for all sorts of treatment.
- What is the relationship between health and illness?
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Self-Instructional Fig 2.5: Interaction of Risk Factors and Protective Factors Biopsychosocial Model NOTES Bio Physical Biochemical Genetic Psycho Psychology Counselling Psychotherapy Developmental Psychopathology Social Family systems theory Diversity Social justice
Self-Instructional NOTESo^ Personality (characteristic ways of thinking and feeling). Social Components: This category covers the following factors: o Social norms of behaviour (smoking/not smoking);o Pressures to change (peer pressure, expectations, parental pressures); o Social values placed on health (social class); o Ethnicity; o Employment; and o Gender expectations. An individual who has no illness is not sick, but he or she may not be well either. Along with its official definition, the biopsychosocial paradigm is an asset of principles and values that the health psychology discipline has signed up regarding well-being, illness, psychology and cultures. Most of the times health psychologists also argue in favour of the biopsychosocial model and against the medical model (Broome and Llewelyn, 1995). Fig 2.7: Biopsychosocial Model of Disease Fig 2.8: Components of a Biopsychosocial Model Most of the practice of health psychology still ensues in the background of clinical medicine. The United Nations founded the World Health Organization (WHO) in 1946 and wrote a new, western definition in the preamble of its
Self-Instructional constitution. It defined health as ‘a state of complete physical, mental and social well- being and not merely the absence of disease or infirmity.’ This description
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explicitly upholds health to be a positive state and not mere the absence of pathogens. Mental health is known as a condition of psychological and emotional wellbeing, or a lack of a mental disorder. Mental health is also described as an expression of emotion and as a good adaptation to a variety of demands. The WHO describes mental health as ‘a state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community’. Previously, it was reported that there was no official definition of mental health. The manner in which mental health is described affects cultural differences, subjective evaluations and conflicting professional theory. Some of the mental health conditions are common, such as depression and anxiety disorders, and others such as schizophrenia and bipolar disorder, are not common. The WHO evidence shows that almost half of the world’s population suffers from mental illnesses with an influence on their own self-esteem, relations and functioning in everyday lives. An individual’s emotional health can also impact their physical health and poor mental health can lead to problems such as substance abuse. Maintaining good mental health is crucial to living a long and healthy life. Good mental health can enhance one’s life, while poor mental health can prevent someone from living an enriching life. The emotional well-being of a person can also have an effect on physical health and poor mental health may lead to issues such as drug abuse. Maintaining good mental health is the key to a long and stable life. Good mental health can improve one’s personal life, whereas poor mental health can prevent one from living an empowering life. According to Richards, Campania, & Muse- Burke (2010), ‘There is growing evidence that is showing emotional abilities are associated with prosocial behaviours such as stress management and physical health’ (2010). In their study, it was also reported that individuals who lack emotional expression are prone towards anti-social behaviour. These behaviours reflect their mental well-being directly. To combat emotions, self-destructive actions can take place. Drug and alcohol misuse, physical fights or vandalism are some of these acts. Advantages of Biopsychosocial Model The Advantages of the Biopsychosocial model are:
- Health is determined by both microlevel and macrolevel processes(psychological and social factors).
Self-Instructional anxious,’ the individual, might describe ‘a pounding heart, light headedness and difficulty breathing’. He or she might explain exhaustion, lack of energy and sleeping issues instead of voicing feelings of depression. In fact, some individuals may be unable to articulate or explain the emotions they experience in words and may not even recognise those emotions.
Self-Instructional They can identify only their physical symptoms, instead. This ailment is called alexithymia by psychiatrists (Sifneos, 1996). A number of physical symptoms are frequently encountered by people with a generalised anxiety disorder (unrealistic or extreme anxiety). These can include shakiness, muscle tension, nausea, anxiety, irritability and insomnia. As they activate the biological suffocation warning system,
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nervous feelings that cause fear can result in shortness of breath, heart palpitations and chest pain. These later symptoms may lead to considerable concern among doctors and patients about the likelihood of a serious cardiac condition. Illness is not a strictly physical or mere phenomenon of emotion. Usually, a person who feels anxious has tense muscles, a rapid pulse, and cold clammy hands. A person who is emotionally depressed is slowed down and feels exhausted, maybe in response to the death of a loved one or the loss of a friendship. Where the individual focuses attention is what matters in deciding whether the person will follow a psychological or somatic perception; the interpretation of what is being felt, and how distress is clarified. Between the peaks of the strictly physical and the purely psychological manifestation of discomfort, most people exhibit something. They could have a sense of emotional discomfort; however, they are unable to express their psychological condition. They may have been conditioned to repress their perceptions and psychological interpretations, and to conceal their emotions from others as in ‘boys don’t cry’. If when they complain of physical illness, just the things they require, such as attention, emotional support, or practical assistance, become inaccessible, the scales will likely be tilted towards physical instead of psychological perceptions of experience. The decision to show physical rather than emotional pain is usually not taken consciously. A depressed patient is likely to be unaware of the emotional explanation of fatigue while seeing a physician complaining of fatigue. Instead, until the true source of the issue is identified, a long period of time can elapse. If the patient is especially good at suppressing (both from themselves and others) signs of psychological distress, the doctor may continue to look for the physical abnormality that explains the subjective feelings of illness of the patient at length, and often in vain. Often needless medicine, care and surgery are given to certain patients in the process. For instance, as per a study, women in a neurological hospital service who expressed their physical distress were more likely at some stage in their lives to have received a hysterectomy than women in a psychiatric service who expressed their distress primarily in psychological terms (52 per cent vs 21 per cent) (Bart, 1968). Research shows that it is not at all unusual to communicate distress with somatic (bodily) vocabulary. No organic problem can be detected in a large proportion of individuals seeking medical attention for somatic complaints, no matter how much research is
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2.6 ANSWERS TO CHECK YOUR PROGRESS
QUESTIONS
- The mind encompasses mental states such as views, beliefs, feelings, attitudesand metaphors. The brain acts as the hardware that authorises us to experience these mental states.
- The body criterion embraces that an individual is identified by the physicalfeatures of the body. It does not presume that our identity, like the individual atoms that make up our body at this exact moment, lies within our particular material substance.
- Idealism uses a metaphysical perspective to sustain that reality is non-physical,and everything is either a mind or depends on the mind to exist. In other words, this view proposes that reality depends on how our minds perceive and make sense of the world. NOTES
- The two key assumptions that support grounded cognition are: (i) Cognition is based on the interaction of the body with the environment;and (ii) These interactions are embodied in the brain.
- According to the biomedical model a disease is a simple, almost mechanisticresult of exposure to a specific pathogen, a disease-causing organism.
- According to the biomedical model, health and illness are perceived to bedifferent qualitatively i.e., either a person can be healthy or ill. There is no continuum between health and illness.
- The biopsychosocial paradigm can be defined as an asset of principles andvalues that the health psychology discipline has signed up regarding wellbeing, illness, psychology and cultures.
- The WHO defines mental health as ‘a state of well-being in which theindividual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community’.
- Alexithymia is a personality trait due to which some individuals may beunable to articulate or explain the emotions they experience in words and may not even recognise those emotions. They can identify only their physical symptoms, instead.
- The term ‘idiopathic’ is used for disorders identified by patients that haveno clear cause. It means arising spontaneously or from an obscure or unknown cause.
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2.7SUMMARY
- The body criterion embraces that an individual is identified by the physical features of the body. It does not presume that our identity, like the individual atoms that make up our body at this exact moment, lies within our particular material substance.
- Crime analysts rely on more advanced physical characteristics that are physical features that we bring with us through life, such as fingerprints, speech patterns, retinal scans and DNA. These features allow law enforcement officers to know if they have the right individual in their custody.
- The mind encompasses mental states such as views, beliefs, feelings, attitudes and metaphors. The brain acts as the hardware that authorises us to experience these mental states.
- All mental states have a physiology related to them—a positive or negative effect felt in the physical body.
- The temporal lobe is responsible for comprehension, language, listening and memory learning. It is linked to the oral and written language region of
