Abstract
The biopsychosocial (BPS) model proposed by George Engel posited that a disease developed through a complex interaction of biological, psychological and social factors. This popular model, despite its limitations, continues to influence the practice and treatment of illness and service delivery worldwide. We propose the networked computer metaphor as a novel and pragmatic tool to help psychiatric trainees appreciate and enhance the utility of the BPS model as it pertains to psychiatric disorders. We also propose that the application of this metaphor would help provide some clues to answer the question of achieving the goal envisioned by Engel of providing holistic and comprehensive patient-centered care. We also discuss the utility of this metaphor from trainee, teacher and patient perspectives and describe various examples of the application of this metaphor so as to deepen our understanding of the BPS model. We discuss the criticisms of this model, summarize the applications of this metaphor and outline future directions for research.
Highlights
The biopsychosocial (BPS) model proposed by George Engel posited that a disease developed through a complex interaction of biological, psychological and social factors
We propose the networked computer metaphor as a novel and pragmatic tool to help psychiatric trainees appreciate and enhance the utility of the BPS model as it pertains to psychiatric disorders
We propose that a device such as a metaphor could provide more nuance and rethinking with a goal to improve the application of the BPS model by early psychiatric trainees with regards to diagnosis, conceptualization and treatment of psychiatric disorders
Summary
One can use the "hardware" analogy to discuss about subtle aspects of cognition such as information processing deficits noted in illnesses such as schizophrenia and propose “hardware” solutions to patients This could include measures such as engaging in dietary modifications, pharmacotherapy and other somatic treatments [such as electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS)]. These networks afford more healthy and reciprocal interactions predicated on maintaining the patient’s sobriety as in the case of substance use disorders and promote illness recovery Application of this metaphor could be a good tool for academic psychiatrists to teach the BPS model to trainees in general and BPS formulation in particular. The networked computer metaphor might help identify and reduce the biological bias and help providers become more attuned to the psychological and social perspectives in the treatment of psychiatric illness
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