What is the BioPsychoSocial Model of Health?

George Engel was the first medical doctor to propose the Bio-Psycho-Social model of health. In contrast to the classical biological understanding of illness and healing, George Engel suggested that psychological and social factors play sizable role in these processes. A physical injury, for example, is not only physical damage to the body: it also affects one’s thoughts and feelings – sometimes just in the short term. But sometimes this change in thoughts and feelings can persist and affect a person’s lifestyle and daily behaviors in a longer perspective.

Different health conditions have a different BPS profile: some are really dominated by biological factors (such as, for example, genetic diseases), yet others are impacted by psychological and social factors to a greater extent, probably as much as by biological factors. Chronic pain is one of those conditions.

While pain experience is real, we now know that pain is generated in the brain, and that means that we can be more sensitive to it in some situations, and less sensitive in others. Anticipating pain, for example, decreases the intensity of the pain experienced. Fear of pain, on the other hand, tends to increase how much pain we feel. In other words, psychological and social factors impact chronic pain probably as much as does biology.

BPS model of chronic pain: what does it mean for healing?

If chronic pain is affected by all the three BPS factors – and we have established that (also did WHO – ref?) – then pain management should involve interventions on all the tree levels: biological, psychological, and social. And once psychological and social factors are involved, they call for highly individualized treatment, simply because in psychological and social terms each of us is a unique human being.

The BPS model’s biggest strength is that it allows for personalized treatment of chronic pain, something that has never effectively been addressed in the  past. It allows us to go beyond mere physiology and explore factors like past experience, thoughts & feelings, social learning. By addressing the elements that constitute our psychology and sociology, we can achieve steady healing rather than just temporary relief.