A Biosemiotic Approach to the Biopsychosocial Understanding of Disease Adjustment
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A Biosemiotic Approach to the Biopsychosocial Understanding of Disease Adjustment Franco Giorgi 1
& Francesco
Tramonti 2,3 & Annibale Fanali 3
Received: 13 May 2020 / Revised: 28 September 2020 / Accepted: 13 October 2020 # Springer Nature B.V. 2020
Abstract The biopsychosocial model was initially proposed to overcome the normative assumption that human diseases are exclusively due to disordered biochemical and/or neurophysiological processes. The model attempts to explain how expectations, thoughts and feelings modify the patient’s motivations to deal with illness and recovery. By considering the physical health in this perspective, healthcare professionals may test the importance of socially and culturally shared principles in alleviating illness experience. The entire biopsychosocial hierarchy may thus appear as a complex network of relationships between the strict logic of scientific explanations and the emotional sustainability with which beliefs may either be defended, changed or even refused. In this paper, we aim at reviewing some of the evidence-based biomedical and psychological findings that provide a unified framework for the biopsychosocial model as a multilevel integrative process. To tackle this objective, we propose to approach the model in biosemiotic terms. It is our contention that the entire biopsychosocial hierarchy could be better understood if approached biosemiotically and the multilevel interconnection of this hierarchy re-examined in the light of a collaborative meaningmaking process. Keywords Biopsychosocial . Meaning-making . Anticipation and beliefs . Sign
relationships * Franco Giorgi [email protected] Francesco Tramonti [email protected] Annibale Fanali [email protected]
1
University of Pisa, Pisa, Italy
2
Azienda USL Toscana Nordovest, Pisa, Italy
3
Istituto di Psicoterapia Relazionale, Pisa, Italy
Giorgi F. et al.
Introduction Human health has been defined as the state of physical, mental and social wellbeing and not merely as the absence of disease or infirmity (WHO 1946). The overall intent of this definition was to take into account how humans interact with their environment at biological, psychological and social levels. In the absence of such a concern, behavioral and medical aberrations run the risk of being interpreted as exclusively due to disordered biochemical and/or neurophysiological processes, and the somatic and mental aspects accounted for as conceptually separate domains. The biopsychosocial model was initially proposed to overcome this normative biomedical assumption (Engel 1977) and with the intent of including such emotionally driven traits as acceptance, expectations and beliefs amongst the patient’s resources. As any other living organism, human beings are deeply embedded in their environment and evolutionarily connected with everything nature and culture have made available on both emotional and rational grounds (Kawade 2009; De Jesus 2016). Rather than considering the human body as the only physical entity contributing to wel
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