The Biopsychosocial Model: Treating an Aging Population with Touch

Jodi Scholes

Certified Massage Therapist

In 1977 Dr. George Engel wrote an article entitled, The Need for a New Medical Model: A Challenge for Biomedicine. In this article, he introduced the concept of the Biopsychosocial model. Dr. Engel was concerned about the alarming amount of treatment plans that excluded patient feedback, focused only on data points and lab results. Questions about mental stress or social pressures (family expectations, work deadlines) that could be affecting the patient seemed to be irrelevant. The results of such a singular focus? Treating just one aspect of a disease. Dr. Engel, who enjoyed appointments in the Dept. of Psychiatry and the Dept. of Medicine at the University of Rochester Medical Center, advocated for a more integrated approach: Examine the biology, but also consider the psychology and the social pressures of the patient. Dr. Engel called this the Biopsychosocial Model. It’s standard operating procedure to examine the biology. However, we also have the opportunity to ask questions about the mental state of the patient. Questions like, “Is there any unusual stress in your life?” Here’s the key: then we listen. During the pandemic many dentists caught on to this. Cracked molars indicate new and higher tension levels than normal. Tempromandibular Joint Pain can be a sign of stress related jaw clinching. Yes, a night guard is a good start. But what else is going on? Dr. Abraham Verghese in his TED talk says, “It may be heresy to say this at TED, but I’d like to introduce you to the most important innovation to come in the next 10 years and that is the power of the human hand, to touch, to comfort, to diagnosis and to bring about treatment.” Touch. Let me ask, do you have physical contact with your patients? In treating patients, how can we incorporate Dr. Engel and Dr. Verghese’s point of view? Using a more integrated approach, diagnosing the physical symptoms and being aware of the psychological and behavioral stressors that could be contributing to the condition. A client dealing with increased mental stress may respond well to more intentional directives to relax. Using a hot tub, attending a beginner meditation class, experiencing an all levels yoga class or even recommending a walk in nature…one study tells us.