The Biopsychosocialspiritual Model of Mental Illness

emotional contagion 3The Biopsychosocialspiritual Model of Mental Illness

A frequently aired criticism of psychiatry is that it places too much emphasis on the role of biological factors as determinants of mental illness. Many people believe that an exclusively biological model of mental illness is a reductionist approach and that mental health problems are caused by a complex range of factors. According to Dr. Lucy Johnstone (as quoted by the Guardian newspaper earlier this week), there is “overwhelming evidence that people break down as a result of a complex mix of social and psychological circumstances – bereavement and loss, poverty and discrimination, trauma and abuse”.

A model of mental illness that is increasingly subscribed to by mental health professionals and academicians is one that acknowledges the contribution and interplay of biological, psychological, and social factors. This is known as the ‘biopsychosocial’ model of mental illness. Whilst the biopsychosocial model appears to provide an encompassing explanation for why mental health problems arise, an important dimension seems to have been overlooked. There is increasing scientific evidence that spirituality plays a significant role in the etiology, maintenance, and treatment of mental health problems. Types of spiritual aptitudes that have been shown to be influential in this regard include (for example) dispositional mindfulness, faith, meditative insight, loving-kindness, compassion, death-awareness, and patience.

The Diagnostic and Statistical Manual of Mental Illness  (DSM) includes ‘Religious or Spiritual Problems’ as a V-code (V62.89). This means that a religious or spiritual problem could be the focus of clinical attention, but should not be confused with a mental illness. The DSM gives examples of religious or spiritual problems as “distressing experiences that involve loss or questioning of faith, problems associated with conversion to a new faith, or questioning of spiritual values that may not necessarily be related to an organized church or religious institution”.

Although the DSM (and mainstream clinical literature more generally) acknowledges that spiritual factors can cause personal conflict, the emphasis is placed on conflict that arises specifically due to loss of faith and/or questioning of spiritual values. Very little consideration is given to the wider role that spiritual factors play in the etiology of diagnosable mental illnesses.

Thus, we would argue that a ‘biopsychosocialspiritual’ model of mental illness – that acknowledges the importance of biological, psychological, social, and spiritual factors as determinants of psychopathology – represents a much more acceptable and inclusive model. This is consistent with the view of a growing number of transpersonal psychologists (and that of most of the world’s spiritual traditions).

From the Buddhist philosophical perspective in particular, a person’s levels of spiritual development (and therefore the risk of them experiencing mental health problems) relates not only to the amount of spiritual insight acquired during this lifetime, but also to the amount acquired during all previous lifetimes. In other words, Buddhism asserts that people are born into this life with a ‘karmic baggage’. This karmic baggage is an additional factor (i.e., in conjunction with the degree of spiritual progress made during this lifetime) that may account for any deficits in spiritual awareness.

We think there is quite a lot of progress to be made before mainstream health disciplines begin to accept that spiritual factors play a central causal role in the onset of mental pathologies. So perhaps now is not the right time to introduce a model of mental illness that requires clinicians not only to assess impairments in spiritual intelligence that relate to this life, but also those that relate to previous lifetimes!


Further Reading

  1. Lukoff, D. From spiritual emergency to spiritual problem: The transpersonal roots of the new DSM-IV-TR category. Journal of Humanistic Psychology 1998;38:21-50 1998
  2. Parks, T. How is your personality formed? The Guardian, 2013, 22nd June.
  3. Shonin E, Van Gordon W, Griffiths MD. Buddhist philosophy for the treatment of problem gambling. Journal of Behavioural Addiction, 2013;2:63-71.
  4. Shonin E, Van Gordon W, Griffiths MD. Meditation Awareness Training (MAT) for improved psychological wellbeing: A qualitative examination of participant experiences. Journal of Religion and Health, 2013; DOI:10.1007/s10943-013-9679-0.
  5. Yang C, Lukoff D. Working with spiritual issues. Psychiatric Annals, 1998;36:168-174.

Ven Edo Shonin and Ven William Van Gordon

Author: Dr Edo Shonin & Ven William Van Gordon

Dr Edo Shonin Dr Edo Shonin is research director of the Awake to Wisdom Centre for Meditation and Mindfulness Research, and a chartered psychologist at the Nottingham Trent University (UK). He sits on the editorial board for the academic journal Mindfulness and the International Journal of Mental Health and Addiction. Edo is internationally recognised as a leading authority in mindfulness practice and research and has over 100 academic publications relating to the scientific study of meditation and Buddhist practice. He is the author of ‘The Mindful Warrior: The Path to Wellbeing, Wisdom and Awareness’ and primary editor of academic volumes on ‘The Buddhist Foundations of Mindfulness’ and ‘Mindfulness and Buddhist-derived Approaches in Mental Health and Addiction’. He has been a Buddhist monk for thirty years and is spiritual director of the international Mahayana Bodhayati School of Buddhism. He has also received the higher ordination in the Theravada Buddhist tradition. Edo regularly receives invitations to give keynote speeches, lectures, retreats and workshops at a range of academic and non-academic venues all over the world. Ven William Van Gordon Ven William Van Gordon has been a Buddhist monk for almost ten years. He is co-founder of the Awake to Wisdom Centre for Meditation, Mindfulness, and Psychological Wellbeing and the Mahayana Bodhayati School of Buddhism. He has been ordained within Hinayana, Mahayana, and Vajrayana Buddhist traditions and has extensive training in all aspects of Buddhist practice, psychology, and philosophy. Prior to becoming a Buddhist monk, Ven William Van Gordon worked for various blue chip companies including Marconi Plc, PepsiCo International, and Aldi Stores Limited where he worked as an Area Manager responsible for a multi-site £28 million portfolio of supermarkets with over 50 employees. Ven William Van Gordon is also a research psychologist and forms part of the Psychological Wellbeing and Mental Health Research Unit, Psychology Division, Nottingham Trent University. His area of research expertise is the study of ‘authentic spiritual transmission’ – within mainstream Buddhism itself as well as within contemporary Buddhist-derived clinical interventions. His current research projects are concerned with evaluating the effectiveness of meditation and mindfulness for the treatment of various health conditions. Ven William Van Gordon has numerous publications relating to the clinical utility of meditative interventions including in leading peer-reviewed psychology journals. As a separate undertaking, William is currently writing-up his doctoral thesis which relates to the effects of meditation on work-related wellbeing and performance. Ven William Van Gordon enjoys fell running, martial arts, DIY, reading and writing poetry, caring for cancer patients, and studying civil litigation. He is a keen mountaineer with some arctic expedition experience.

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