Biopsychosocial model in contemporary psychiatry: Current validity and future prospects, 2019, Tripathi et al

[Andy]

The biopsychosocial model (BPS) was proposed by George L. Engel in 1977 as a needed medical model to explain psychiatric disorders.[1] Since then, this model had gained wide acceptability across the globe. It systematically explained the complex interplay of three major dimensions (biological, psychological, and social) in the development of psychiatric disorders. It explained that a person does not suffer as isolated organs but rather as a whole. This provided a holistic approach to psychiatric illnesses. The emotional tone of a person, his/her personality, the surrounding environment, and other social parameters do influence the manifestation of illness. The model established a holistic and empathetic approach in psychiatric practice [2] Over the past four decades, many changes happened in our understanding of psychiatric disorders, and hence, there is reluctance in accepting the biopsychosocial model in reality.[3],[4]

Open access, http://www.ijpm.info/article.asp?is...1;issue=6;spage=582;epage=585;aulast=Tripathi

 

[Peter T]

Forgive me if I have failed to miss

The model established a holistic and empathetic approach in psychiatric practice

in the context of the application of this model to ME/CFS.

 

[rvallee]

It systematically explained the complex interplay of three major dimensions (biological, psychological, and social) in the development of psychiatric disorders

I'm sorry but this is straight-up delusional. The model claims those interplays, it does not explain anything, merely states so. It's entirely a turtles-all-the-way-down model, moving the ultimate cause of something one order down to something that itself has no explanation. It's the ultimate hand-wavy explanation, an anti-science approach that has no chance of being remotely useful.

Bonus points for delusion on the "empathic" approach. It explicitly does not, as in ME the BPS approach systematically rejects the very experience of patients and contradicts it entirely in practice, motivated instead by gaslighting onto magical explanations. That's as far as you can get from understanding the other's perspective. You cannot claim to have empathetic understanding of something while rejecting whole the lived experience of the patients.

And I guess "holistic" now means "obsessed with fake psychogenic explanations built entirely on mood and anxiety". It's the narrowest, most reductive model of illness, built on paper-thin caricatures of human behavior and frankly a shockingly bad understanding of human psychology and motivations. Like a blind person insisting they can see better than the seeing people trying to explain them what is out there.

But more importantly the model has no current validity. ME is an example of a disease strictly handled with a BPS model, along with "explanations" that actually explain nothing, and has actually managed to do something that is as unique as it is absurd: to regress an entire field of medicine for 3 decades while stalling all progress. ME serves as prime example of how utterly useless the BPS perspective is by itself.

The BPS model is an abject failure of no value whatsoever. Its promise is valid but its implementation is as disastrous as it is detached from its promise, especially in having encroached way outside of psychiatry and pathologizing normal human behavior as a magical cause of serious illness. Eysenck is another example of how BPS fails, by claiming turtle-based explanations without evidence. Simply saying "BPS" is not evidence of anything. It belongs in the same filing cabinet as humours.

A failure of progress in biomedical research to provide explanations for psychiatric illness does not mean the BPS model is any valid. That's not how any of this works.

In psychiatry, each patient is different.

This is just bizarre. It's not even particular to psychiatry, let alone unique to. I remember from a while ago that brain cancers require an average of 70 hours of preparation by oncology specialists, exactly because of how every case is particular. This is meaningless drivel.

Psychiatry cannot afford to ignore social determinants of health such as poverty, illiteracy, migration, unplanned urbanization, and inequitable distribution of resources as well as personal attributes such as lifestyle choices, personality, motivation, desires, and fantasies in the understanding of illnesses.

BPS has shown no interest in the bolded and the italicized are largely irrelevant. I don't understand the point of making a point that is not even a point because it's aspirational.

Controversial but I don't think medicine should favor delusional ideologies with clearly disastrous outcomes. Maybe that's just me.