Health and Illness: Indian and Western Approach 39 Biopsychosocial Model Given the criticism of Biomedical model, researchers have turned instead to a model of health that embraces biological as well as psychological, social, cultural, individual (personality) factors (Engel,1977; Schwartz,1982). Though, Engel's had proposed that the importance of psychological and social factors in the late 1970's but it could not gain dominance in front of biomedical model. This was due to rapid advancements in technology to deal with health issues. However, recently, the biopsychosocial model had gained recognition within health psychology. Antecedents Forces: Let us venture the evolution of subject matter of Psychology and it's contribution to sensitise the professionals in amalgamating the psychological and social factors within health psychology. Majorly till late nineteenth and early years of twentieth centauries three major schools of psychology emerged as three major forces in Psychology. The first force of Psychology was behaviourism school of psychology. Behaviourism focused on the behaviour of the individual that was mechanically established through stimulus and response. The action was believed to be a complex chain of stimulus and response. Behaviourist took an epiphenomenal view implying that consciousness/ mental processes had no causal efficacy & little interest for science of behaviour. Though, early behaviourist showed little interest in health, but few social learning theorists like Bandura (1977) attempted to contribute the social behaviours , skills and attitude on the health behaviour of the individual. It was a very indirect contribution, yet a significant one in current scenario. In 1960's, Behavioral Medicine and Behavioral Health were two important field that were an extension of behaviourism. They came as a reaction against biomedical model. From behavioursim school, the role of learning and the techniques that maintains and reinforce the positive behavior were derived by psychologists from these two upcoming field. Behavioral medicine focused on treating people who are ill, and behavioural health concentrates on preventing illness and enhancing health. These fields came as interdisciplinary field contributed in proposing the learning techniques based on classical and operant condition in treating health. It also gave importance to the social factors in the environment as element that can predispose, maintain and precipitate the diseases within an individual. Thus psychological factor got broadened to psychosocial factors. The second force of Psychology was Psychoanalytic school of Psychology. Sigmund Freud (1856-1939), who studied under Charcot, got interested in the role of mental phenomena in disease. He proposed the underlying roots of any illness or disease emerges from the anxiety. This anxiety is exhibited as a result of conflicts between unconscious wishes and conscious norms of the society. All wishes, desires that are not acceptable in the society repress in the unconscious mind. There is a constant conflict that all human beings, civilization and cultures undergo. However, when these conflicts get beyond the considerable limits, it affects the bodily functions and might create hormonal imbalance and chemical imbalance within the individual. Later,n Psychology of Health and Welbcig psychoanalyst’ interest in the mind-body relationship led them to develop the re psychosomatic medicine. The work on Psychosomatic disorders was expanded by Alexander(1950) ing Dunbar(1948) work. They believed that illness is primarily a symptom of emotional disorder , rather than a result of disordered cellular functioning. There are Various forms of anxieties. The nature of anxiety will affect the form of illness .Few of thy psychosomatic disease identified were: hypertensions, generic ulcers, bronchial asthma, thyrotoxicosis, celiac disease, neurodermatisis are few disease caused as a result of unresolved conflicts. These two forces became important forces within schoo! of psychology, draw attention on importance of psychological, behavioural and social factors within Health Psychology. In the early 1960's , a movement was developing in American psychology known Humanistic Psychology or the "third force" created to battle with the established forces of behaviorism and psychoanalysis. This school focused mentally healthy, individuals must take personal responsibility for their actions, regardless if those actions are positive or negative. Each person, simply by being, is inherently worthy. While any given action may be negative, these actions do not cancel out their value as a person. The ultimate goal of living is to attain personal growth and understanding, Through constant sel improvement and self-understanding can an individual ever be truly happy. Thus, three schools gave important contributions in an establishment of health psychology. Psychoanalysis or psychosomatic medicine helps us in showing the role of mind as an active agent in contributing to the health and sickness of individuals. Lastly, the humanistic school of psychology paid an important contribution by bringing positive outlook within the field of psychology. First, it demonstrated that psychological interventions are not just necessary for ill patients, but also for healthy people maintain their happiness, optimism and hope in life. This idea broke down the myt! and stigma strongly attached with the field. Thus, the school imparted perspectives that can make an individual positive, self actualized and balanced in his /her life, ev" he/she faces a lot of stressors in life. Postulates: Let us review the underlying principles on which the biopsychoseci! approaches to medicine are based. These are as follows: (2) All physical and mental disorders occurs due to interplay of biolosi*! Psychological and social factors, ie Tee on multiple causal factors that determine the nature and form of disor ae factors are psychological, social and biological factors ite , aintains and precipitate illness within our body. any idan te Multiple aetiology, each disease can be observed OE ; various pq nptoms. Thus, we need to take an in-depth understanding N° Psychological and biological techniques of data collection. (d) The bi i © biopsychosocial approach accepts the continuum of health.Health and Iiness: Indian and Western Approach a (©) Biopsychosocial approach gives due importance to changing pattern in ecology- microsystem, macrosystem, mesosystem, exosystem or cronosystem. It Proposes one of the holistic approach to deal with health problems. (f) The biopsychosocial approach takes monistic view for mind-body relations. They believe that mind and body are interacting with each other in terms of cause and effect. They effect each other bidirectionally. (g) Biopsychosocial approach takes a molar approach to illness and health. They take whole is more than a part and hence total structure of the individual have to be analyzed. Executing Biopsychosocial Approach: Biopsychological takes a molar approach to deal with illness and health. The researchers adopted a system theory approach to health and illness. System theory asserts that “all level of organization in any entity are linked to each other hierarchically and that changes in any one level will effect change in all other levels" Taylor,2006).It is an application of ecological approach proposed by Bonfrenbrenner (1994) where the biological being is core a element that is nested around microsystem, mesosystem, macrosystem, exosystem and cronosystem. These systems work in bidirectional order and therefore are interrelated. For example if'a man gets down with any form of fever, the effect of the will impact psychologically the cognition, emotions and motivation of the individual. At the same time, the fever will also affect social the individual at workplace and home setting, (microsystem) too. If the fever is communicable, it can spread in society or community at larger level. Clinically the diathesis- stress model had been proposed to locate the biological, psychological and social factors within predisposing, precipitating and protective factors of the disease. Achievements of Biopsychosocial model: New discoveries had been observed as a result of biopsychosocial model: (a) People awaiting surgeries often show anxieties before they move to operation theatre. Psychological methods for reducing anxieties had been used for such patients. Through this approach, knowledge on safe sex practices had been imparted to people. This knowledge had helped in reducing risky sex behaviours like HIV Aids and so on. This approach had revived the importance of joint family or close knot family. It is been shown that high degree of social support improves the quality of life of an individual. (4) Heart patients have been trained to deal with depression through psychological and educational training programs. (€) Diathesis stress model had been proposed that shows the impact of stress on the immune system of the body. (b) c