Biopsychosocial Model

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Emotions Are Contagious – Such as, Anxiety.

We are starting a narrative series on discussing where emotions and behaviors come from:

Anxiety bubbled, frothed and infused the air.  Yesenia could barely catch a breath.  Here’s the thing.  Yesenia is not in treatment with me.  Her husband, Rob, is.  Yet it was Yesenia who filled our space.  There was barely room for Rob and I to sit or speak with all that anxiety around.  Rob was breathing faster every moment and his face didn’t have much color.  …Where to start?

Unknown source

(What do you think? think?  think? echo echo echo…)

It was too early in our work together to expect Rob to know this, but emotions are contagious.  Anxiety is very contagious.  To say this another way we could say, the emotion of anxiety around us influences how our genes express themselves.  It is further explained by saying that my “patient” isn’t only Rob.  My patient includes the system he lives in, i.e. his home milieu, wife, kids, work and so forth.  But especially his wife.  Because of Yesenia’s untreated emotional disease, Rob’s emotional disease worsens.  The inverse is true as well and so we go round and round gaining momentum.  Like a big ball of hard packed snow gathering speed and girth as it rolls down the mountain, anxiety grows.  …Where to start?

(What do you think? think?  think? echo echo echo…)

Self-Care Tip #267 – When suffering from emotional illness, remembering that emotions are contagious (no matter who they come from) is useful to your self-care.

Questions:  How have you experienced the contagion of emotions?  or seen it play out in others?  Please tell me your story.

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Patient on Patient Crime – Our Response to Our Own Illness

a "low profile" sole provides a grea...

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Self-Care Tip #238 – Think about your response to your own behaviors and emotions.

Bianca agreed with her husband.  She was too depressed.  She never wanted to go out and cried a lot. Perhaps she even deserved to be cheated on and abandoned because she was so unbearably dull.

Pause button.

We have discussed where behaviors and emotions come from – the brain.  We have identified the brain as human material, matter, biological and as susceptible as anywhere else on the body to illness.  In short, We could say at this point that Bianca is in a Major Depressive Disorder – a medical disease.   There are many medical diseases secondary to design, behaviors or lack of behaviors.  Or for other reasons.  However, I don’t know many medically ill that when the spouse walks out on her, we say,

Well of course!  She had cancer!

Or,

He lost his leg in a car accident, get someone else!

But throw in some aberrant emotions and behaviors for unacceptable time, and the escaping spouse is given running shoes as a gift from their concerned community.

How could he stand her!  Of course he left.  She wasn’t taking care of his needs.

You see the disparity and when written this way, it looks really ugly and I apologize.  I’m not trying to thumb people for biases and prejudice.  Both parties are hurt.  I’m also not trying to say that this happens only in marriage.  It happens in almost any setting.  Emotions and behaviors are just not considered to be symptoms of disease.

Have you ever heard the term, “Women on women crime?”  Well this is something like that.  I’m thinking much of this will improve when we treat ourselves with more insight and understanding consistent with our biopsychosocial model.  If we don’t do this first, who will.  We aren’t responsible for how others treat us, but we are responsible at least for ourselves.

This is one more wonderful way of claiming our right to say, self-care starts and ends with Me!

Questions:  How can we wrap our beliefs around this seemingly enigmous concept that when someone is crotchety, negative, irritable, inattentive or boring – it might not have been because they chose to be that way?  How do you own if in yourself?  Please tell me your story.

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Where to Find Your Council On Self-Care Outside of Yourself

Not sure where to look

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Self-Care Tip #226 – Find your council for self-care outside of yourself with psychiatry.

Many may wonder why a psychiatrist would talk about being a friend to yourself.  People who know psychiatry involves medicine, who think psychiatry excludes psychotherapy, who think self-care is holistic (i.e. holistic they interpret as non-medical) or who don’t bridge the gap that voluntary choices and choices regarding what is involuntary is still self-care – these people may wonder…  It’s no fault or judgment, it just is, as we like to say.

After all, psychiatry has changed a lot in the last thirty-plus years.  This category of people I speak of includes even physicians.  It is not easy to keep up on each other’s specialties.

I make my case for “microphone-time” (taking liberties to speak on this) based on the Biopsychosocial Model.  I boldly say that because Psychiatry flattens the planes between biology, psychology, sociology, then Psychiatry should speak up on self-care.  It is a broad perspective and often with some affecting differences from religion, clergy, laymen, psychology or other therapies by reputation (I’m not speaking about individuals.)

The beautiful bridge linking voluntary behaviors and emotions with the involuntary, and how that relates to our choices, our self-care, our freedom, saying all health begins and ends with Me is an enormous step in friendship with oneself.

Questions:  Where do you find your own opinion on this spectrum of thought?  And why?  What has your experience been with this?  Please tell me your story.

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Where Does Courage Come From?

I want to do that, but I have no idea where I’m going to find the courage!

This is real folks.  People think this, say this, believe this and behave accordingly.  The other day, a young woman in her forties with a rolled scroll of precious problems including joint disease, extreme morbid obesity, nicotine dependence, depression, anxiety, obstructive sleep apnea, eczema, gastroesophageal reflux disease (GERD), heart palpitations, diabetes, hyperlipidemia and polycystic ovarian disease – this woman told me these words.

I have no idea where I’m going to find the courage!

Where does courage come from?  Is there an odds ratio, statistics, intuition barometer or what?  Where do we find courage?  (I am remembering the dear Lion in The Wizard of Oz.)

I see courage coming from our ability to make decisions.  Being able to decide comes from many paradigms, including my favorites as broken down through the biopsychosocial model (listed in no particular order):

  • Biological – temperament (genes or personality,) mental health/brain health (the brain being the organ we use to make decisions with,) developmental (the neurodevelopment of the brain is different at different ages,) things we put in our body (diet, illicit drugs, alcohol or nicotine,) medical illnesses, sleep issues, exercise, rash, ingrown toe-nail….
  • Psychological – self-control, coping skills, catastrophizing, negative thinking, thoughts, emotions, and behaviors….
  • Sociological – culture (including home, religion, race, gender,) stressors on our body, social support, God, interpersonal relationships (friends, marriage, kids, colleagues,) parenting, unemployment….

(WHEW!  Recovering my breath.)

Where do we find courage?

I drew a picture in the air for her psychological self,

17th century

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I see you 100 pounds lighter, not smoking for the past six months at least, off of six of your twelve medications, your medical problem list shortened down to two or three.  You are able to feel pleasure again.  It is a real option for you.

If you don’t, I see you growing demented, paralyzed and dying from a heart attack.  I can’t say when these things will happen but they will happen if you don’t start taking care of yourself.

Where does courage come from?

For her biological self, I targeted the language of her temperament.  I remembered that we make decisions either through thought or feeling.  She was a “Feeler.”  I drew forth my light saber and went for the emotions.

You can do this!  Think of the gift you’d be giving yourself and to those you love.

For her sociological self, I talked about everyone in the family choosing with her, including husband.  Talking about how this changes the family culture, not to smoke together, setting boundaries with her husband to care for herself and thinking about getting other support networks like starting to go to church again or calling her pastor.

Question:  Where does courage come from for you?  Please tell me your story?

Self-Care Tip – Use your biopsychosocial model, that is to say all of what makes you you, to find your courage.  Be a friend to yourself.

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Get Your Butter Knife Out and Spread Your Biopsychosocial Self Together

Grape Jelly is Spread Over Peanut Butter

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Probably when you have thought about psychiatry in the past, before this blog, you weren’t thinking about self-care.

What do you think of psychiatry?  Would any of you shout out a word, can I have a word, give me a word, any word that shoots to the front of your thoughts?

Psychiatry has changed.

There is a progression of how we view mental health now vs. even thirty years ago.

Back in the day, things went along the lines of poisonous medicines, close the window because sunshine is unhealthy for you, surgery without anesthesia, maggots… drilling holes in people’s heads to let evil spirits out and offering cigarettes to calm the nerves – or cigars as I wonder if any of u would argue.

Truth be told, I’m still learning about psychiatry.  I imagine I will be forever, because I think it is a science that flattens the universe and is unhinged from Time.  I don’t know how big or involved that is, but I’m thinking more than my sum of years can master.

For now, we understand that there is interplay between biological, psychological, and social issues that make us who we are.  We call this the Biopsychosocial Model.  Pretty cool word – biopsychosocial.  It hit me last night when I was working over these thoughts that self-care can also be organized, framed, conceptualized and all that to help it make more sense to us.

What is self-care?  Self-care is a philosophy that everything starts and ends with Me.  And that Me is all of me.  My biological, psychological and social self.

Self-Care is teaming up with our biology.  So where do behaviors and emotions come from?  This to me is one of the most challenging questions to answer from a cultural and moral level.  Can you tall me your gestalt?  Where do our emotions and behaviors come from?  What do they mean about who we are?

Self-Care is Empowerment and not victimization.  This is part of our “psychological” selves.  No one is responsible for our emotions but “Me.”

Self-Care is knowing our Essence. This is part of our “social” selves.  Our Essence is what we find after we get sick, after we change in every way but one, it is our identity, who or what we are.

To understand our essence, knowing our connections helps:

Connection:

  1. God/Love
  2. People
  3. knowledge

When we get sick, our identity, who or what we are – our essence might feel threatened.  Some people call this our “soul” instead of essence.  I found it interesting to think of the soul or essence as part of our “social” selves but it is and it helps me bring it all together better.  My soul is created for connections.  With you in fact.  And my soul has been more connected to the rest of me since you came.

Self-Care is Freedom.  This is another part of our “social” selves.  You may remember that phrase, “To love someone, you have to let them go.”  Freedom brings connection.  Lovely, no?

Now get out our butter knife and let’s smear all this together in a sandwich.  That is who we are.  Without dividers.  That is important if we plan on getting friendly with ourselves.

Self-Care Tip #211 – Whatever is tripping you up when you go, blend it in with the rest of you and things will get more friendly (smoother.)

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