In the field of physical health and psychological well-being, health psychology specializes in exploring biological, psychological, cultural, societal, and environmental factors of life, and how each of these affects physical health.
There are some who embrace the spiritual or religious aspects to this model, however, traditionally the model includes biological, psychological, and social components. While it may be common knowledge among certain populations to know about the negative effects that a person’s emotional mindset can have on their health, there continues to be a surprising amount of denial about the roles of the interactivity of these aspects in a person’s life. Physical Health can be directly effected by the environment in which we live.
What is Health Psychology?
The central strategy practiced within health psychology is the bio-psycho-social design. The British Health Society explains that health and disease are the effects of a blending of biological, psychological and social factors. Biological determinants consist of genetic conditions and inherited personality traits. Psychological factors are anxiety levels, personality features and lifestyle. Social determinants consist of cultural views, family relationships and support systems.
Health psychologys roots are in the belief that everyone deserves proper medical and psychological care even when daily habits, career, or family life problems contribute to the decrease in physical health and/or psychological well-being. The bio-psycho-social model views health, wellness and illness as being a result of several different inter-related factors effecting a person’s life from biological characteristics, to behavioral and social conditions (Belloc, N. & Breslow, 1972).
Psychological determinants in health have been a focus since the beginning of the 20th century and results explain that people who eat regular meals, maintain a healthy weight, do not smoke, drink little alcohol, receive adequate sleep and exercise regularly are in better health and live longer. Psychologists were also discovering associations between psychological and physiological processes. These include the influence of anxiety on the cardiovascular and immune systems and finding that the functioning of the immune system could be modified by training. There was also a growing awareness of the importance of sound communication skills during office visits.
The American Psychological Associations division 38 is health psychology and they focus on understanding the relationship between health and illness. This division concentrates on examining the psychological determinants that influence health, and they contribute information to the health care policy system. The three areas that relate to health psychology are:
Research: Health psychologists conduct studies on a variety of health-related concerns. For instance, researchers may concentrate on investigating effective preventative measures, explore health promotion techniques, study the causes of health problems, investigate how to motivate people to seek treatment, and how to assist people cope with illness or pain.
Public Policy Work: Health psychologists may work in private or government settings and have a role in making public policy on health related issues. Their business might point to advising executive groups on health care improvement, address disparities in health care, or lobby government agencies.
Clinical Work: In medical and clinical surroundings, health psychologists regularly administer behavioral evaluations, participate in clinical interviews and conduct personality tests. They often participate in managing interventions with individuals or groups which relate to training people about anxiety reduction methods, offer addiction cessation advice and teach people how to refrain from unhealthy ways of life.
Physical Health can be effected by the things that people do, by the way they process information, career choice, family dynamics, life troubles and the environment in which they live. For example, someone living in a damp, mildew infested home has a good chance of developing respiratory or sinus problems and may develop allergies.
Physical Health and Genetics
Research has discovered that people whose parents suffer from certain diseases, such as diabetes, cancer, hypertension, and addictions are predisposed to getting these conditions. Biology certainly plays a central role in the health and well-being of everyone. However, psychological, environmental and cultural factors are also key areas that relate to any illness (Marks, Murray, Evans & Estacio, 2011).
For example, when a mother is diagnosed with breast cancer in her late-thirties or early-forties then most medical professionals would encourage her daughter to obtain a screening regularly once she reaches a certain age. It would not matter, if the daughter kept away from the damaging rays of the sun or if she did not smoke. She is a cancer risk because of the genetic predisposition for the disease that runs in the family history. However, there is no guarantee that daughters of mothers that have breast cancer will suffer the same. It simply means that the DNA (the genetic material that people share with their family) may include a marker that leaves her more susceptible to the disease than someone else who does not have this marker.
Sometimes when people feel sick, tired, or overrun, or when they develop certain diseases, it is not only in response to a virus or bacteria infiltrating the central nervous and immune systems, but rather a response to what is happening within the body, brain and subconscious mind. Catching a cold is only one example. Take heart, I am obviously not leaving out the biological component, meaning the virus that attacked the weakened immune system. Heart related conditions, breathing conditions, muscle and joint pain conditions and various physical ailments are common among people coping with the emotional and psychological stresses of modern day life. The release of the “stress” chemicals in the body weakens the body’s defenses in fighting a physical illness. The more people understand the power of the mind, the more they will realize that physical well-being directly relates to thoughts, feelings and behaviors.
People born from alcoholic parents tend to have more addictive personalities than those whose parents were not alcoholic. Some emotional and mental ailments directly correlate to the abuse endured in childhood others tend to be more genetic in nature. However, psychological, social and environmental factors all play key prominent roles in managing addictions, along with this genetic tendency.
One way to describe the basics of health psychology is by exploring the smoking addiction. Part of the smoking habit is the physical component of addiction to nicotine as withdrawal symptoms set in once the process of quitting begins. A typical physician will prescribe medicines to suppress the physical addiction symptoms of withdrawal, treating the smoking addiction as any problem. However, studies show that there is a remarkably strong probability that the individual will just start smoking again. A chain smoker that uses a nicotine patch may have difficulty quitting if they continue to believe that smoking is not harmful, or that smoking helps to relax. In these cases, even with the patch, the smoker may easily return to smoking. The average counselor or physician is only treating the physical withdrawal aspects of smoking. There is a psychological component to the addiction as the smoker stands to gain rewards, no matter how temporary from each cigarette. Smoking may suppress the appetite, offer an opportunity to relax and unwind, or provide a momentary distraction to current stresses. There is also a behavioral aspect to smoking, such as always lighting up when getting in the car, having a cigarette right after dinner, or using a cigarette as a stress reliever.
Every year scientists are discovering new insights into how the brain, body and mind inter-relate and the ways in which they link to each other in harmony. The human brain is one of the most intricate, mysterious, and powerful organs in the entire universe. Science has been able to conjure up ideas in the mind such as, concepts in mathematics and imagine worlds that at this time do not exist. These ideas stem from people wanting to explore the unknown aspects of the mind which has a relationship to the brain and the environment in which they live.
There is a distinctive respect for what the mind is capable of achieving in relation to the brain, medicine and psychology. Science understands much more than even twenty years ago regarding the interaction between emotions and pain, of the thought processes involving healing and the remarkable healing powers of the human body.
Society and Cultural Factors play key roles in physical health
Mokdad et al., 2004 reveal that fifty percent of all deaths in the United States can be associated to ways of life or other risk determinants that are for the most part preventable. Health psychologists work with individuals in hopes of eliminating these risk factors to decrease failing health and improve overall health.
Expectations and gender roles can put a large amount of pressure on someone to behave and act in a distinct fashion. Racism and religious factors often are stressors in people’s lives and over time these pressures have an impact on overall health. For example, white, middle-class people tend to have better overall health than inner-city minorities. Health psychology explores the underlying factors that have a direct and indirect impact on quality of life (Cassileth et al., 1984).
When assisting people develop a healthier lifestyle, career choice is another area that health psychology explore. There is a direct relationship between choices of work and physical and emotional health. The more frustrating the project the more risk people are placing themselves into developing an emotional and/or psychological illness. When someone is under stress, the body produces chemicals and hormones that it does not require and some of these substances may be harmful. The difficult conditions and the release of these substances results in a weakening of the immune system. When an immune system is weak people are more susceptible to physical and mental ailments (Ader, R. & Cohen, N. 1975).
The Bio-Psycho-Social Model as it Applies to Health Psychology
Millions of people around the world are under tremendous amounts of stress as the economy is suffering and unemployment remains high. People who are employed are working more hours and are taking on more responsibilities for less pay. Those that have lost their jobs worry about paying their bills, feeding their families and holding onto what they have worked so hard to achieve in the past and some are wondering if they are normal.
When health psychologists talk about the bio-psycho-social model, behaviors are key ingredients contributing to physical health. Do people smoke? Do they drink alcohol regularly? Do they eat junk food? Have a stressful job? Are finances tough? Do people exercise regularly? How is the family? How is the social life? These are just a few questions that a health psychologist may explore. There are behavioral and social conditions that directly or indirectly relate to the state of overall physical health.
Stress derives from the instinctual nature of the desire to survive and the psychological community labels this concept the ‘fight or flight’ response. When the mind perceives a warning to the body, whether that threat is real or a product of the imagination the brain responds as if in danger. The brain calls for adrenaline to be pumped throughout the body, which allows it to run faster (away from the problem) or fight with a bit more strength than it naturally possesses (face the problem).
The production of adrenaline in association with the flight or fight response is only intended to be for brief periods of time, for survival. When people are facing chronic stress at home or work, the physical body is under constant tension adapting to this “fight or flight response”. As a result, people tend to feel run down and tired more often, they may experience aching joints, muscle aches, lower back pain, headaches and increases in blood pressure. All of which are the common side effects of repeated stress and increases in adrenaline.
While some do not tend to think about stress as being abnormal, it does indeed take a heavy toll on a person, both physically and emotionally. One key factor in lowering stress level is determining how people recognize and respond to stress and how this relates to their behavior. Health Psychologists work in clinical settings promoting behavioral change that relates to the everyday anxieties of life. They inform the public, conduct research, teach at universities and work in the field of sports medicine.
Clinical Health Psychology attempts to provide answers to the following questions:
- What is the relationship between emotional health, physical wellness and illness?
- What is the connection between the body, mind and environment?
- What role does psychology play in relationship to health and disease?
- How should a particular illness be treated?
The world of health psychology is changing lives one day at a time and with some expert guidance and support people can experience the healthy, vibrant life that they desire, and all it takes is unlocking the secrets of the brain, the body, the mind, and behavior. A simple fact of life is that human beings are extraordinarily complex and an illness can be the result of a myriad of factors. These factors emerge from biological, psychological and environmental facets of everyday life. Most often medications alone will not provide the positive results necessary for people to achieve maximum health. Just because, medicines do not fully aid in recovery or reduce the pain, does not mean that all options for improvement have been exhausted. Health psychology principles clearly have not been fully utilized or recognized at this point in time, by conventional western medicine.
Health Psychology, Pain and Illness
Physical ailments are real, people will say, “they are not in my head.” Some patients and physicians view health psychology concepts as being a personal affront to the gaining knowledge and do not believe that pain relates to overall emotional well-being. Others fear that people working in the health psychology fields will judge them or their pain as being “abnormal.” A few medical professionals, attempt to discredit patient complaints of pain and intimidate people into making them think that the problem simply does not exist and that the pain is all a figment of the imagination. Science is evolving and the problem may simply not be medically understood, or the location of the pain cannot be found in the body at the time. There is a relationship between the brain, the mind and pain.
Health psychologists attempt to assist in the manner of communication between doctors and patients during medical consultations. There are many difficulties in this process, with patients showing a significant lack of comprehension of many medical terms (Boyle, C.M. 1970). One central area of investigation relates to “doctor-centered” consultations, which are directive and involves the one seeking help answer questions and performing less of a part in decision-making. Many people object to the sense of authority or disregard that this spurs and favors patient-centered consultations which focus on the patient’s needs. Patient centered consultations involve listening to the patient completely before reaching a decision and the person seeking help plays an active role in the process of choosing treatment.
Health psychology strives to find strategies to decrease and do away with pain, as well as have knowledge of pain peculiarities such as analgesia, causalgia, neuralgia, and phantom limb pain. Despite the fact that measuring and reporting pain are questionable, the McGill Pain Questionnaire has helped make improvements (Melzack, R. 1975). Treatments for pain are patient-administered analgesia, acupuncture, biofeedback, and cognitive behavior therapy.
Do not be tricked into believing that an illness is a figment of imagination as this belief may cause psychological problems and increase physical symptoms. The above thoughts are generalized examples of what it means when people say healing comes, in part, from the underlying psychological aspects of the mind (thoughts and feelings), behaviors and the brain. Clinical health psychologists identify this way of thinking as being a bio-psycho-social model. The standard encourages a positive shift in the way people think about health, illness, and healing.
Imagine by changing the way people think and cope about a problem in life which can move clients in a direction towards pain-free living or assist in decreasing blood pressure. Patients can achieve this by learning a few techniques. Applying and believing in this theory will increase quality of life. While healing with “health psychology” is certainly much more complicated than just changing a thought or behavior, most people do not believe in this concept and until recently it has been overlooked by those in the medical community.
A difficult task for health psychologists is motivating people to adhere to medical direction and follow the treatment plan. This lack of adherence is possibly do to treatment side effects or life circumstances and some ignore taking medicines or consciously stop. Compliance measures are hard to quantify, however, studies explain that this could improve by tailoring medication schedules to an individual’s daily life.
Health Psychologists have advanced training in a variety of research designs, which allows them to conduct investigations, provide expert consultation or collaborate on research. They conduct research to clarify puzzling questions such as:
- How is anxiety connected to heart disease?
- What are the impacts or influences on healthy eating?
- What are the emotional consequences of genetic testing?
- In what ways can therapists help people reach their goals and change health habits to improve health?
- Health psychologists concentrate on how an illness effects a person’s emotional happiness. Stressors can lead to depression, reduced self-esteem and anxiety.
- Health psychology also concerns itself with improving the lives of those with terminal illness. When there is little hope of recovery, these therapists can improve the quality of life by helping recover thoughts and feelings associated with psychological well-being. These therapists also identify the best ways to provide therapeutic services for the bereaved (O’Brien, J.M.; Forrest, L.M. & Austin, A.E. , 2002).
In conclusion, health psychology is a relatively new sub-category of psychology and is not well known to many people. These clinical psychologists take a more effective approach by exploring the physical, psychological, and behavioral aspects, and consider the problem in a holistic fashion.
The practice of using health psychology principles significantly improves the likelihood of successfully quitting any addiction. Health psychology can help people become more physically fit, assist with decreasing chronic pain, improve the quality of life with those diagnosed with a terminal illness, prevent further complications of any serious physical ailment and assist in learning new ways to cope with the tensions and transitions that govern everyday life. For more information please go to the article, What is Therapy and How to Achieve Success in Counseling.
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Dr. Cheryl MacDonald, RN., Psy’D.
Health Psychology of San Diego