Biopsychosocial Model

The Bio-Psycho-Social Perspective


We are a unique compilation of biological, psychological, and socio-environmental factors. These factors, together, mold our self-perception and our perception of the world around us.

The Self is a distinct identity that sets us apart from others. It continues to develop & change throughout our lives. It is our conscious, reflective sense of our own identity.

Formation of the Self

“There can be no doubt that the self, like everything else in an organism, develops and changes a great deal in the course of life. Its nucleus appears to be what is experienced as “I” and “me,” as distinguished from everything else that is “not me.” This distinction, whatever its primitive basis, is amplified and strengthened by learning: children find out by investigation that the foot is part of “me” and the favorite toy is not. As time goes on, “myself” assumes a fuller and richer meaning. It is compounded by bodily sensations, feelings, the image of one’s body, the sound of one’s name, the continuity of one’s memories, all leading to the experience of oneself as a unique and separate person having a continuous existence.” (157, 158)

Our overlapping biological, psychological, and socio-environmental elements are the catalysts for our thoughts, feelings, and patterns of behavior.


(1) Biological factors (called primary drives) are many, encompassing such things as our genetics and heredity, our numerous instincts, the basic genetic heritage that all humans share, and even our basic temperament, our innate disposition.

• Genetic Heritage – is responsible for such functions or attributes as height, weight, blood pressure, athletic ability, memory, “intelligence,” mental retardation, anxiety, inhibitions, schizophrenia, among others.

• Heredity – influences on behavior that are transmitted biologically from parent to child.

• Maturation – the unfolding of biologically determined behavior patterns.

Instincts

The roots of all instincts are found in the human driven for personal or species survival. That’s why they are deeply imbedded in us. Instincts are constructed either as proactive or reactive, depending upon the motivation that drives the instinctual response. We are typically unaware of their presence and their impact on our thoughts and behaviors. But because they are, in fact, a part of our thoughts and behaviors and they are bound up in the quest to satisfy human needs, our unconscious instinctual drives contribute greatly to our social traits and social behaviors because they are interacting with the social environments that we are living in.

Our basic instincts include:

• Adaptability; we are able to adapt to new circumstances and surroundings with relative ease; while some can adapt with greater emotional and physical agility, this basic instinct allows all of us to unconsciously focus on surviving and thriving in new environments

• Hunger, thirst, shelter; the motivations to satisfy these needs are fear and deprivation; the deepest motivational level is individual survival
o Depravation is an deeply felt and experienced motivator that causes reactive behaviors meant to satisfy unmet needs

• Pleasure seeking behavior, which includes sex, as well as any behaviors that cause the individual to feel gratification
o Motivations to satisfy these needs include the desire for good physical and emotional feelings, and feelings of deprivation; the deepest motivation level for sexual pleasure is species survival
o The desire for pleasure creates “urges” that can escalate to impulsivity and the emotion-driven need for instant gratification; the instincts’ “tactics” are there to assure that the pleasure is achieved
o The nature of impulsivity is that it is narcissistic, breeding lack of inhibition and curiosity which will lead to risk taking behavior

• The need for community focuses our desire to be a part of groups; this is motivated by fear of harm (fight/flight) or even fear of death

• The need for affiliation affirms as human need the desire to connect to other people in various kinds of relationships; this is motivated by generalized fear (anxiety), pleasure seeking needs, and deprivation

• Aggression is a core human instinct that varies widely in intensity; when a person feels threatened, a fear response triggers a reaction; should the threat and/or sensation intensify, aggression will step up to rage which is so strong an emotion that it triggers multiple biological and instinctual responses leading to a reaction
o People are often not consciously aware of their “fear”
o Aggression can also be tied to the dominance/submission function of instincts, seen primarily in males; the more aggressive members of a group will hold power (dominance), while the more submissive will not; this, interestingly, creates an order in groups which assists with species survival;

• The need for mastery is the person’s ability to influence his or her environment; and the need for competence is the person’s subjective assessment of that ability; this is a deep emotional motivation fueled by individual survival and dominance/submission resolution

o The experience of competence, based on the effectiveness of one’s own activity in dealing with the environment, is a vital root of self-esteem. Behind many acts there is an intention, and it is possible for the individual to perceive very directly whether or not he succeeds in realizing his intention. If he succeeds, the individual not only achieves a goal but senses himself as having been able or competent to achieve it. He has pitted his mind and muscles against obstacles and resistant forces, and he has been able to bring about the change that he intended. This is what we mean by the experience of competence.

• Temperament describes each person’s unique, biologically-based, consistent pattern of behavioral responses to people, events and conditions. Everyone shows a degree of response – high, medium, low – to the following behavioral categories influenced by temperament.

o Activity Levels: some people seem always to be in a state of flurry, others seem to exist on a level of permanent calm; most are consistently at various points between these extremes.

o Predominant Frame of Mind (disposition): some people’s glasses are half-full, others’ glasses are half-empty, still others have glasses that are half-empty with a leak

o Intensity of Reactions: whether positive or negative, people express their feelings in degrees – more or less dramatically.

o Rhythmicity: everyone has a degree of regularity or predictability to personal habits; much of this can be attributed to brain functions.

o Approach/Withdrawal: people’s initial perception and response to change ranges from interest and openness to aversion.

o Sensory Threshold: some people’s senses seem that much sharper than others; some seem to get frustrated much easier than others.

o Attention span or Persistence: one person will grab onto an idea or an effort with great intensity; another gives up at the first perceived obstacle or is always turning to new interests.

o Distractibility: whether it is by sight, sound, odor or any other sense, some people immediately turn their attention from what they are doing to pursue the distraction; others continue on the path in which they were originally headed.

- Journal of Developmental
and Behavioral Pediatrics

Maslow’s Hierarchy of Human Need can be viewed from the “bio” of the bio-psycho-social perspective. The bottom three rungs of his triangle, basic needs, safety needs, and belonging and affiliation (or intimacy) needs are rooted in instinctual patterns of behavior.

(2) Socio-Environmental factors (secondary drives) come from society. A society is the largest form of human group, consisting of people who share common culture. Culture is the complex system of meaning and behavior that defines the way of life for a given group or society. It is the totality of learned, socially transmitted customs, knowledge, material objects, and beliefs. There are two types of culture:

o Material Culture consists of the objects created in a given society, which are its buildings, art, tools, and toys, print and broadcast media, and other tangible objects.

o Nonmaterial Culture (also called symbolic culture) includes the norms, laws, customs, ideas, and beliefs of a group of people. It has a strong presence in social behavior.

Culture defines the values, the generalized beliefs of the society, and the norms, the expected behaviors of those who live in the society.

Culture is transmitted to each and every one of us through the agents of socialization. Some of the agents of socialization are the family, peer groups, K-12 education and college, the workforce, sports, religion, clinical psychology, and the media. Each agent “instructs” us in the external workings of the society that we are a part of.

The words “tradition” and “law” are two great example of how agents work.

o Many beliefs and behaviors that families teach their kids are represented as tradition – “the way things are done”, or “what we’ve always believed in”. The clear implication of tradition is that it is the correct way to do something or the correct belief, even ideology, to have. As kids, we integrate tradition into our core beliefs of right/wrong, correct/incorrect feelings and behaviors without realizing that culture is being transmitted to us from the larger social structure.

o Laws are man and woman made statements of allowed behavior within the society. We follow laws because we are socialized to believe it is the morally correct thing to do and we do not wish to suffer punishments.

Success in a society depends upon the individual’s ability to integrate the norms and values into every day life, and to stick to them. Further, it necessitates the ability to embrace self-control when biologically based instincts attempt to overrule societal norms and values. The impulsive leap to instant gratification must become the ability to delay gratification. The desire for pleasure can be realized but only within the norms of social structure. Sexual gratification, for example, becomes boxed in by rules and regulations from culture, law, health class, religion, tradition, whew...



The “experience of competence” (defined on page three) morphs into the experience of social competence.

A great deal of the development of the self, which began within the family circle, occurs through interaction with friends, schoolmates, and friends. Through membership in groups the individual gains new experience with competition and cooperation, testing the suitability of various social roles, while through close friendship he learns a more detailed consideration of others and may in turn achieve a fuller understanding of himself. (159)


And it is social competence that enhances self-esteem (160-173):
The qualities of the person himself, his physique, temperamental traits, mental abilities, special aptitudes, exert a marked influence over his behavior. They affect his evaluation by others and thus his evaluation of himself (looking-glass self).Feelings of Social Competence are built up out of social experiences in which one has found it possible to produce intended effects in other people: to make them respond to you, help you, serve you, love you, accept your love, and learn from you.


Freud’s theory of personality can be viewed from the perspective of the “id” energy (represents the “bio”) being socially controlled by the “superego” energy (represents the “socio”). As long as the superego wins the war (after losing a number of battles along the way), the person achieves mastery and competence (from the bio). He also experiences social competence (from the socio). This will create ego-strength and, in layman’s terms, good self-esteem and sense of self-worth.


There are other potential clashes or considerations between bio and socio. Examples would be gender socialization, or a basic temperament that does not match societal expectations. But, typically, a balance needs to be discovered or the socio-environmental influences must trump biological instinctual drives for the good of the society.

Clinical Psychology mirrors a society or culture’s view of what is “abnormal” or deviant behavior. The field serves as a measuring stick for appropriate and inappropriate behavior in society. In this sense, Clinical Psychology serves as a societal agent of socialization and, therefore, is a part of the socio-environmental piece of the bio-psycho-social perspective.

Clinical Psychology publishes a text that is updated about every decade or so. The text The Diagnostic & Statistical Manuel of Mental Disorders defines every “psychiatric diagnosis”, outlining the abnormal behaviors associated with the disorder. Treatment for the disorder is based around the premise that “success” means a return to normal behavior which is in line with the cultural values and norms that are transmitted to the individual through the agents of socialization.

Normal Behavior = Cured or “in remission”

There are a number of biologically based disorders like Schizophrenia and other psychotic disorders that are in the individual’s genetic heritage. Normal or acceptable behavior for these forms of biologically-based mental illnesses can only be achieved through psychotropic or psychoactive medications.

But for disorders that are triggered by socio-environmental events like situational depression, normal or acceptable behavior can be achieved by resolving feelings associated with the trigger event(s). In modern society, psychotropic medications are used for more and more disorders. While advances in modern medicine are significant and important, the pharmaceutical industry is a massive bureaucratic corporation focused on profits. They market many of their drugs for disorders that originate in the socio-environmental realm.

An example is a series of disorders called Adjustment Disorders in the Diagnostic & Statistical Manuel of Mental Disorders. An individual is diagnosed (or labeled) with this psychiatric condition for various reasons –
o Adjustment Disorder with Depressed Mood
o Adjustment Disorder with Anxiety
o Adjustment Disorder with Mixed Anxiety & Depressed Mood
o Adjustment Disorder with Disturbance of Conduct
o Adjustment Disorder with Mixed Disturbance of Emotions & Conduct
o Adjustment Disorder Unspecified

o Acute = less than 6 months & Chronic = over 6 months

What are individuals having trouble adjusting to?
According to the DSM, “The stressor may be a single event (e.g., termination of a romantic relationship), or there may be multiple stressors (e.g., marked business difficulties). Some stressors may accompany specific developmental events (e.g., going to school, leaving the parental home, becoming a parent, failing to attain occupational goals).”

These socio-environmental events are called “Psychosocial”. As defined by Clinical Psychology, they support societal expectations of “normal” and “abnormal”, and they serve as societal social controls as evidence by their ability to tell individuals what behavior is accepted in society and what behavior is not.


(3) Psychological factors are best described as our thoughts (cognition) and our feelings. Together, they define how we will behave. And behavior is what others see, what can be evaluated or measured as normal or abnormal, maladaptive or deviant.

In the bio-psycho-social perspective, psycho refers to the individual’s thoughts and feelings and ensuing behaviors that are a direct result of biological and socio-environmental factors. If, for example, a person feels threatened, his instinctual (primary) drives will advance an aggressive response. The threat itself is coming from the socio-environmental realm. Once the instinctual drive advances, the ensuing feelings and thoughts, and the eventual resolution of the feelings, are all in the psycho realm.

Another example. An eight-year-old boy is shy. Shyness is a part of biologically-based basic temperament. The boy’s shyness is troublesome to his father who envisions his son to be an assertive and outgoing boy. This definition of the boy’s desired behavior comes from society, from gender socialization, from the gender role of who boys are and how they should behave. The clash of bio and socio spark the psycho – feelings and thoughts that will motivate the shy boy’s behavior.