The biopsychosocial model (BPS) is an interdisciplinary approach, which states that ‘interconnection between biology, psychology and socio-environmental factors determine the cause, manifestations and outcome of wellness’1. In this article there is a correlation of homoeopathic aspects and BPS model, which helps in upgrading and widening our vision towards outlook of homoeopathy.
This BPS model specifically examines how biological, psychological and social aspects play a role in health and disease, which helps to understand the intricacies of homoeopathic prescription in preventing diseases and achieving cure.
This model of health and illness was developed by George L Engel. This is a general model or approach which says that biological, psychological and social factors all play a significant role in human functioning. The biopsychosocial model reflects the development of illness through the complex interaction of biological factors (genetic, infections trauma, nutrition, etc.), psychological factors (mood, personality, emotional turmoil, negative thinking etc.) and social factors (cultural, socioeconomic, technological, etc.)1.
For example, a person may have a predisposition for anxiety disorder, but he or she must have social factors such as work stress, family issues and psychological factors such as hurried tendencies in accomplishing given target which all trigger the genetic code for anxiety disorder. So the inference is a person may have a genetic predisposition, but social and psychological factors will trigger the illness.
In Homoeopathy, a case is not merely a combination of symptoms, but an instance of disease, an event and a change in the whole person from his original state of health to his present of sickness. It is the totality of the alterations. It comprises of all the expressions on mental, physical plane and on part(s), which logically form a portrait of the disease2.
Through this definition of a case, one can understand that it is not only about collecting outcomes of the sufferings but also about the causes for the deviation in health, which can be at any aspect like biological, psychological or social. This in turn is no different then biopsychosocial model which imbibes holistic approach towards illness.
Homoeopathic case taking is a unique art of receiving information from a patient as well as from bystanders to define the patient as a person and diagnose the disease2.It should be done with utmost care along with unprejudiced observation to attain success in any case.
While dealing with any case, a keen physician should understand the environment of a patient and he must be capable enough to gather information about what could have been the reason for imbalance of health and at which level (biological, psychological and social) the patient is not able to balance himself and leading towards illness, which is also the aim of BPS model.
After understanding all the above information, it is easier for any beginner to seek the help from great tool called repertory in selecting the rubrics precisely for getting the similimum.
Application of the understanding of BPS model in cases:
A case of 35 years, male patient came with a complaint of skin eruptions over both upper extremities, with intense itching, burning and pricking sensation since 3days, which aggravates in the night time, because of which he was not able to concentrate on his work, by looking at those eruptions and repertorisation with the presenting complaints one can prescribe Rhus tox or any other drug of their choice .On further enquiring about what had happened 3 days back, patient said his father and himself had a fight and he scolded him using bad words in front of his relatives, he felt humiliated and thought that it was an very unfair treatment that his father did and carried anger towards his father . After this incident he noticed these eruptions. On noting this history and going back to repertory, found a rubric
Ailments from, abused; after being, indignation; with3
Carcinosinum was only one remedy for this rubric, prescribed one dose of Carcinosinum 200 and in 2 days the skins eruptions were gone.
From the above case, the impact of psychological affection in acquiring the disease can be understood. This case shows an interplay of psychological and biological factors, which affects the social life also. BPS model also emphasizes the same.
Another case of 45 years, male patient, who was brought by his wife to stop his addiction towards alcohol. Patient was alcoholic since 6 years, he was thrown out of work 5 months back due to his alcoholism. His wife said before 6 years he was not like this, never had alcohol. On asking further wife said 6 years back he lost his mother, to whom he was very much attached and he was not able to overcome this sorrow and started having alcohol. From above narration what we can understand is the patient is in grief, and is an alcoholic. Upon searching for a rubric in repertory, found a rubric
Alcoholism, grief; after3
The only remedy in synthesis repertory for this rubric is Causticum, Prescribed Causticum 200, 3 doses, with placebo for the month time, along with counselling to the patient. Within 3 months he stopped having alcohol.
From this case of we not only understand the scope of homoeopathy in deaddiction, but also one can infer on how psychological factors play the role in adopting certain behaviour and deranging the biological and social life of an individual.
Through these cases, the understanding is, just by considering the totality of presenting complaints might not give cure in all the cases, so complete understanding of environments of the patient in all aspects (biological, psychological and social) will direct us towards similimum and avoids deviation in the way to cure in both acute and chronic cases.
To achieve all these things, there is the need for the case format for the beginners to not miss out any vital information while case taking and case solving by applying biopsychosocial model.
Unawaringly, we all apply biopsychosocial model in our day to day homoeopathic practice, but for the beginners in homoeopathic practice the format is necessary to be built, utilized and master over it for the successful practice.
Here is an attempt to show how one can utilize the various theories and models of health accepted worldwide for simplified scientific explanation of homoeopathic approach towards public health.
- R Munir Ahmed, Handbook of Advanced teaching of fundamentals of homeopathy, Bengaluru: RGUHS; 2017.69-70.
- Tiwari SK, Essentials of Repertorization, New Delhi: B Jain publishers; 2012.50,59.
- Schroyens Frederik .The Essential Synthesis Repertory. New Delhi: B. Jain publishers; 2009. 4, 7.
MD Part 1 -Department of Case Taking and Repertory
Government Homoeopathic Medical College and Hospital