| Historical Context and Theory of Health Psychology Daniel M. Burrello �Soul and Body, I suggest, react sympathetically upon each other.� Aristotle To understand the development of Health Psychology as a clearly delineated area of practice and understanding, a proper definition is in order. The University of Utah has three Ph.D. tracks in Health Psychology and defines the field thusly: The �Scientific study of the interrelationship between social, psychological, and behavioral processes with physical health.� Though broad, this seems as proper definition as can be formed. The intangible qualities of Health Psychology have narrowed over the past few years as solid research has been accomplished regarding the mind�s immense power on, and inseparability from, the body�s systems. Any first-year, general psychology textbook will explain the history of psychology as moving away from the philosophy, embraced by many ancient cultures, that disease and mental illnesses were the consequences of either spiritual possession by evil forces or judgment by angry Gods bent on molding free-will into proper obedience. The science of psychology and its subdivisions of health psychology, psychosomatic medicine, and biopsychosocial medicine owe a certain debt to the very beginnings of the attempt to define what it was to be well and unwell. The Greek Humoral school of thought held prominence from around 430 B.C. until nineteenth Century Europe. First posited by Hippocrates and his disciples and reinterpreted by Galen and others this methodology was the first naturalistic theory of human function divorced, as it was almost completely, from the previous, religiously dominated paradigm. However, the supernatural view has stayed alive in various forms for the same period, sometimes underground and sometimes as the dominant non-scientific view. This humoral way of thinking explained things in materialistic cause and effect: �The human body contains blood, phlegm, yellow bile, and black bile. These are the things that make up its constitution and cause its pains and health. Health is primarily a state in which these constituent substances are in the correct proportion to each other, both in strength and quantity, and are well mixed.� (Lloyd, 1978, p. 262) Interesting as an evolutionary step, and the early integration of the body and mind is established. This theory was the dominant one in the west for over two thousand years. With Louis Pasture, Koch, Lister, germ theory, and with help from Descartes dualistic paradigm, physicians began to embrace more scientific models, albeit materialist, and the field became what we know today as modern biomedicine. The enlightenment produced an environment that offered new freedom to understand science without supernatural dictates to consider. However, the idea of the body, and the universe itself, as a machine, separate and unaffected by the systems around it, including the mind, dominated as a reaction to the former restrictions that supernaturally-based paradigms placed on the free inquiry of science. This paradigm separated the mind and body, but brought the scientific method to bear on the problem of disease and causal factors. This �Cartesian� dualistic approach to all the sciences held sway until the early part of the twentieth century and was challenged finally by a slow but steady rise in the understanding of �systems theory�, or a �holistic� approach to the mind and body. At the outset of the last century, after cardiovascular diseases, the leading causes of death were infectious diseases. Here at the beginning of the 21st century most reliable fatal conditions are lifestyle related. The mind-set of the individual is in the forefront of understanding the way certain illnesses progress. Though cardiovascular diseases is still number one, but other causes are competing closely for the top spot: malignant neoplasms, which are environmentally triggered tumors that accelerate due to emotional response suppression, accidents, pulmonary diseases caused by smoking. Among other illnesses and causal factors affected by behavior and mental set are: influenza, pneumonia, suicide, chronic liver diseases and cirrhosis due to drug and alcohol use, and even diabetes mellitus where the individual�s self-management of their behavior strongly affects the outcome of treatments and maintenance programs. Most individuals living in the twenty-first century are faced with a plethora of risk factors including pollution, overcrowding, and lack of proper sleep. Others in the society face additional risks such as: lack of proper health care, dietary inadequacy, substance abuse, financial problems, dangerous sexual practices, and obesity. Today there is a growing recognition in the medical and psychological community of the behavioral components of major disease. More and more research indicates the psychophysiological and behavioral facets of causal factors in disease. This recognition has developed into what we now know as modern health psychology. During the latter part of the twentieth century, certain milestones have marked the progress of the field: During the period between 1974 and 1977, George Engle introduced the world to the term, biopsychosocial, and in 1977 biofeedback was established as a legitimate practice in the field of behavioral medicine. Suls and Rothman (2004) show that during the period between 1974 and 2001 the frequency of use of the term Biomedical in the journals of the abstracting service MEDLINE increased by a factor of only five, whereas the used of biopsychosocial increased by a factor of nearly 60. The establishment of more and more college programs devoted to the practice and research of health psychology demonstrate the academic commitment to the field. And the congressional establishment, in 1993, of the Office of Behavioral and Social Sciences Research at the NIH marks recognition of the importance of the integration behavioral and biomedical knowledge at the highest governmental level. This represents a movement back to the holistic, mind/body synthesis that Aristotle and his peers understood thousand of years ago. References Health psychology: What Will the Future Bring? By: Francis J. Keefe, James A. Blumenthal, Health Psychology, 0278-6133, March 1, 2004, Vol. 23, Issue 2. History of health psychology outline for psych3460. University of Utah psychology website. (Spring 2002). Retrieved June 18, 2004, from the World Wide Web: http://www.psych.utah.edu/psych3460/lecture/overview.html Lipowski, Z.J. (1984) What does the word �psychosomatic� mean? A historical and semantic inquiry. Psychosomatic Medicine, 46, 153-171. Lloyd, G. E. R. (Ed.). (1978). Hippocratic writings. Harmondsworth: Penguin. Sonnanberg, K. (2003). Health Psychology: The Mind-Body Connection. [Article posted on Web site Mental Health Matters]. Retrieved June 10, 2004, from World Wide Web: http://www.mental-health-matters.com/articles/article.php?artID=498 Suls, J. & Rothman, A. (2004). Evolution of the biopsychosocial model: prospects and challenges for health psychology. Health Psychology. 0278-6133, March 1, 2004. Vol. 23 Issue 2. Thagard, P. (1997). The concept of disease: Structure and change [Paper posted in the article section of the University of Waterloo, philosophy department]. Retrieved June, 16, 2004, from the World Wide Web: http://cogsci.uwaterloo.ca/Articles/Pages/Concept.html. |