UNIT-1

Illness, Health and Well-being

 What is Health
Psychology?
• HEALTH PSYCHOLOGY IS A FIELD THAT DELVES INTO THE INTRICATE RELATIONSHIP
BETWEEN PSYCHOLOGICAL PROCESSES AND OUR PHYSICAL WELL-BEING. IT
EXPLORES HOW OUR THOUGHTS, EMOTIONS, BEHAVIOURS, AND SOCIAL
CONNECTIONS IMPACT OUR HEALTH. AT ITS CORE, HEALTH PSYCHOLOGY
RECOGNIZES THAT HEALTH IS NOT JUST THE ABSENCE OF DISEASE, BUT A
MULTIDIMENSIONAL CONCEPT ENCOMPASSING VARIOUS COMPONENTS.
• Health psychology is the practice of helping motivate people to make health-
conscious decisions like not smoking, eating the right foods, and exercising more
to prevent illness. Health psychology also explores what motivates people and
explores why some people make healthy life decisions and some don’t.
 DIMENSIONS OF HEALTH
• Dimensions of health: physical, mental, emotional, spiritual, and
social. These five (5) dimensions of health provide a full picture of
health as a change in any dimension affects the others. This
interrelationship between the dimensions of health is the key.
1 . PHYSICAL
• Physical fitness is of utmost importance. The body that carries the weight
has to be fit to endure all the other challenges that a person faces in life. A
healthy body not only helps stay away from diseases but also creates
mindfulness.
• Eating right: picking food that makes the body stronger and not that makes
it vulnerable. The selection of proper nutrition and the right amount is
crucial.
• Exercising well: daily exercising in any form is beneficial for maintaining a
healthy weight and for muscles and bones as it brings flexibility and
endurance.
• Ditching certain habits: Alcohol, drugs, and smoking give nothing more than
a kick for that moment. Excessive consumption may create hostile health
conditions that may lead to life-threatening diseases.
• Sleeping enough: Sleep is a necessary human activity that provides rest to
the body and supports crucial functions of the body
2. EMOTIONAL
• Emotional health is about the person's mood or general emotional state. It is our ability to
recognize and express feelings adequately. It relates to your self-esteem as well as your
ability to control your emotions to
• maintain a realistic perspective on situations. The relationship between emotional and
mental health is clear and as such some illnesses relate to both, such as depression and
anxiety.
• Emotional health affects the other dimensions of health as a person with good self-esteem
is more confident in social settings, makes friends quickly and often performs better in
physical activity.
• Fighting stress: Stress suppresses the mental state because it takes away focus and makes a
person emotionally weak.
• Having healthy relations: Having good relations with family, friends, colleagues, and society
keeps a person
• joyful. A happy mind sprouts positive and healthy thoughts.
• Expression of feelings: For an individual, it is vital to communicate feelings. If they face
problems in doing so, they should seek professional help , they have the expertise to open
up troubled souls because keeping thoughts in mind will flush them with negativity
 3. MENTAL
• Intellectual wellness is achieved when a person can do problem-solving, think
creatively, and show an urge to learn more and more and stay abreast with current
affairs.
• Just like physical fitness, even our minds need some exercise. This stimulates and
keeps the brain sharp.

. Along with this, they can:

• take a professional course or self-building workshops.
• learn new skills like languages, software, etc.
• reading newspapers, industry magazines, blogs, web articles, etc.
• appreciate others and learn from their achievements
• connect with people who challenge may intellectually and are a source of
information. People who cherish intellectual growth are good people to keep
company.
 4 . SOCIAL
• The social dimension of health refers to our ability to make and maintain
meaningful relationships with others. Good social health includes not only
having relationships but behaving appropriately within them and
maintaining socially acceptable standards. The basic social unit of
relationships is the family, and these relationships impact a person's life the
most. Other key relationships are close friends, social networks, teachers,
and youth leaders.

• Social health affects the other dimensions of health in many ways. A bad
social life can lead a person to question their purpose in life or feel isolated
and unwanted. Such feelings can demotivate people from physical activity
and lead them towards depression.
 5. SPIRITUAL
• Spiritual wellness is a vast sea of many thoughts. It aims to find the meaning and
purpose of human life without or without following any religion. understand and
appreciate the expanse of life, nature and its forces. the fact that it is better to
find out your meaning and aim in life by self-experiencing rather than relying on
age-old traditions and beliefs of others. This helps a person connect to his inner
self.

• Set aside quiet time for contemplation.

• Explore the deeper meaning of your religion.
• Live according to your own principles and values, not just following written rules.
• Pursue activities and beliefs that resonate with your true self.
• Embrace challenges as opportunities for growth and development, without fear
GOALS OF HEALTH
PSYCHOLOGY
• UNDERSTANDING: TO UNDERSTAND HOW PSYCHOLOGICAL FACTORS
CONTRIBUTE TO HEALTH, ILLNESS, AND HEALTHCARE.
• PREVENTION: TO DEVELOP INTERVENTIONS AIMED AT PREVENTING
ILLNESS AND PROMOTING HEALTH BEHAVIOURS.
• TREATMENT: TO ENHANCE THE EFFECTIVENESS OF MEDICAL
TREATMENTS BY ADDRESSING PSYCHOLOGICAL FACTORS THAT MAY
INFLUENCE OUTCOMES.
• IMPROVEMENT: TO IMPROVE THE QUALITY OF LIFE FOR INDIVIDUALS
LIVING WITH CHRONIC ILLNESS OR DISABILITY BY ADDRESSING
PSYCHOLOGICAL AND SOCIAL FACTORS
 Continuum and Models of
Health and Illness
Health-illness continuum model
• Health-illness continuum was introduced by John Travis in the year 1972 and it can be explained as a
graphical representation of wellness. Wellness here is not mere absence of illness but denotes healthy
mental and emotional state.
• As can be seen in the Figure, there are two arrows in the figure that move
in opposite direction with ‘neutral point’ indicating the midpoint. Neutral
point denotes absence of illness as well as wellness.
• As we move towards the left of the figure, that is, towards premature
death, we can see that there are three steps, namely, signs, symptoms
and disability that result in premature death, thus indicating deterioration
of health ultimately leading to premature death.
• On the other hand, as we move towards the right of the figure, the steps
are awareness, education, growth present that result in wellness. Thus,
indicating increasing wellbeing or health of an individual. The figure also
shows treatment paradigm that denotes that if adequate treatment is
given the person can be brought back to neutral point.
• According to the Health-Illness continuum, health is dynamic. Our
health moves back and forth within a continuum, with optimum
health or highest health at one end and death or complete disability
at the other end of this continuum.
• One day you may feel energetic, another might have a headache for
all day long, while on the third day you may feel fine again. These
situations suggest that our health never remains constant and it
changes or fluctuates throughout one’s life.
• According to this model, since our health continuously changes;
therefore, our adaption or response to that change matters most as it
affects our health directly. For the same stressful situation, one
person might respond positively while another person might get
anxious. The person who responded positively will have better health
than the second one.
• For example, if a patient is diagnosed as overweight and has some
conditions such as diabetes that are often associated with being
overweight, this person is in the treatment paradigm. However, the
person's choices have put them on the side of the continuum that
ends in premature death.
 MEDICAL MODEL OF HEALTH AND
ILLNESS

• Since the 19th century, the medical model is the most prevalent model of
health and illness among contemporary healthcare practitioners. The
medical model is also known as “Biomedical model”. The term ‘biomedical’
comes from the Greek word bios (meaning ‘life’) and the Latin word
medicus (meaning ‘healing’). But ironically, healing is not a part of the
practicing medical professionals as it focuses only on the physical aspect of
the disease.

• To understand the medical model, we will discuss some of its major

characteristic
• Cause of Disease: This model considers health as equivalent to a state of
absence of disease and symptoms. The root cause of a disease according to this
model is always some external pathogenic agents like virus, bacteria or some
other physiological problem or cellular abnormalities. (Guttmacher,1979).
Further, it denies any role of emotional and psychological factors in disease.
• Responsibility for disease: This model considers that the cause of illness is not
dependent on the individual. Due to this reason, individuals are not seen as
responsible for their illness. Patients are considered as only victims of some
external factor or internal abnormalities.
• Treatment: Since the focus of the medical model is always on biological or
physical aspect. Therefore, treatment also focuses only on the human body’s
physical aspect. It involves removal of pathogenic agents either through drugs or
through interventional strategies like surgery. The objective of treatment is the
removal of symptom and relief from any type of pain.
• Techno-oriented Model: This is the only model of health which relies heavily on
machines and technologies. From making a generic drug to performing a surgery,
everything here requires technology.
• Practitioner-Physician relationship: This model considers that physicians
possess all the required knowledge, expertise, and skill to treat patients.
The medical model further considers patients as only passive recipiens of
their physician’s expertise and expects patients to only corporate with their
treatment regime. Thus, the model considers practitioners superior to patients.

There is no doubt that the medical model is very effective in critical medical
conditions. Therefore, it is often referred to as “quick fix” approach. It can
provide immediate relief and quickly minimize the symptoms of the disease.
However, many researchers have pointed out a number of limitations of medical
treatment. According to George Engel (1997) and Guttmacher (1979), the
medical model have many drawbacks. Some of the major limitations are as follow
• It has a reductionist approach to human body and views it in the mechanistic
framework. It does not give importance to the concept of ‘mind’ and
considers mind-body dualism.
• It ignores any role of social, emotional, spiritual and psychological factors in
health and illness. Thus, it does not talk about the wellbeing or healing aspect of
the disease.
• It is not always effective in treating many diseases. Specifically, any
psychosomatic diseases, chronic and lifestyle-related diseases.
• The issue of affordability is also associated with this model. Hospital
treatment offers impersonal professional care, leading to a burden on one’s
pocket because of high fees. Its accessibility also depends on one’s socio-
economic status.
 BIO- PSYCHOSOCIAL MODEL
• Biopsychosocial model, as the name suggests, conceptualizes health as
consisting of multiple dimensions. The medical or biomedical model focuses
only on the physical aspect of health, but Engel’s new model includes
psychological and social aspects as well.
• It is based on the idea that “humans are inherently biopsychosocial
organisms in which the biological, psychological, and social dimensions are
inextricably intertwined”. Engel did not completely reject the benefits of the
medical model but emphasized on giving equal importance to psychological
and social factors in the process of treatment. This model suggests that other
than physiological abnormalities, germs and viruses, our behaviors, thoughts,
and feelings may also influence our physical state. Further, Engel also argued
that physicians should also give importance to subjective experiences of their
patients.
• BIOLOGICAL FACTORS: THESE INCLUDE GENETICS, PHYSIOLOGY, AND
PHYSICAL HEALTH CONDITIONS. BIOLOGICAL FACTORS CAN INFLUENCE
SUSCEPTIBILITY TO DISEASE, RESPONSE TO TREATMENT, AND OVERALL
HEALTH OUTCOMES.
• PSYCHOLOGICAL FACTORS: OUR THOUGHTS, EMOTIONS, BELIEFS,
ATTITUDES, AND BEHAVIOURS PLAY A SIGNIFICANT ROLE IN HEALTH
AND ILLNESS. PSYCHOLOGICAL FACTORS CAN IMPACT HOW WE
PERCEIVE AND COPE WITH STRESS, MANAGE CHRONIC CONDITIONS,
AND ENGAGE IN HEALTH-PROMOTING BEHAVIOURS.
• SOCIAL FACTORS: OUR SOCIAL ENVIRONMENT, INCLUDING FAMILY
DYNAMICS, SOCIOECONOMIC STATUS, CULTURAL INFLUENCES, AND
SUPPORT NETWORKS, ALSO SHAPE HEALTH OUTCOMES. SOCIAL
FACTORS CAN INFLUENCE ACCESS TO HEALTHCARE, EXPOSURE TO
STRESSORS, AND ADHERENCE TO TREATMENT PLANS
• THE BIOPSYCHOSOCIAL MODEL EMPHASIZES THE INTERCONNECTEDNESS OF THESE
FACTORS AND THEIR COLLECTIVE INFLUENCE ON HEALTH AND ILLNESS. IT RECOGNIZES
THAT ADDRESSING HEALTH ISSUES REQUIRES A HOLISTIC APPROACH THAT CONSIDERS
THE COMPLEX INTERPLAY OF BIOLOGICAL, PSYCHOLOGICAL, AND SOCIAL
DETERMINANTS.

• THIS MODEL HAS IMPORTANT IMPLICATIONS FOR HEALTHCARE DELIVERY, MEDICAL

EDUCATION, AND RESEARCH. IT UNDERSCORES THE IMPORTANCE OF
INTERDISCIPLINARY COLLABORATION, PATIENT-CENTRED CARE, AND INTERVENTIONS
THAT ADDRESS THE DIVERSE NEEDS OF INDIVIDUALS WITHIN THEIR BROADER SOCIAL
CONTEXT. BY ADOPTING A BIOPSYCHOSOCIAL PERSPECTIVE, HEALTHCARE
PROFESSIONALS CAN BETTER UNDERSTAND AND ADDRESS THE COMPLEX FACTORS
THAT CONTRIBUTE TO HEALTH AND WELL-BEING.
• Broadly, there are three areas in which the biopsychosocial model has
offered new insights:

(1) patient’s subjective experience is as important as objective

biomedical data,
(2) a comprehensive causation can give fuller and deeper
understanding of our health and illness, and
(3) patients should not be treated as passive recipients of the
treatment. They should be given more power in the clinical process.
• The main advantage of this model is that it leads to numerous
development in technology and research. It also contributes to the
diagnoses and effective treatment of varied illnesses. It also leads to
increase in life expectancy and enhancement of life expectancy. Though
the model tends to rely on technology and thus could be cost ineffective
and may not be affordable. The focus of this mode is also more on
treatment than on actual promotion of good health.
 HOLISTIC MODEL OF HEALTH
• The term Holistic medicine was first used by F. H. Hoffmanin 1960 (Derick, 2009). It refers to
conceptualizing health as a ‘whole’. Guttmacher (1979) has suggested that holistic model considers
health as equivalent to “a sense of wellbeing” and disease is not considered as a presence or absence of a
pathogenic agent only. Instead, according to the holistic model, a disharmony between social,
psychological and spiritual dimensions of one's life causes disease. In this way, the holistic model puts
responsibility for ill health on the individual also. This model also gives equal importance to the role of
practitioners and patients. Unlike biomedical model, it considers a practitioner as a mentor and role
model, whose role is to motivate patients to be self-responsible for their health instead of having
blind faith in practitioners’ efficacy.
• In recent times the concept of holism has become quite popular among scholars and health care. As a
result of this, there are many associations that are promoting the concept of holistic health. Some of
these prominent associations include the American Holistic Medical Association, British Holistic Medical
Association, American Holistic Health Association and, American Holistic Nurses Association. According to
one such association; American Holistic Medical Association ,Holistic medicine is “the art and science of
healing that addresses care of the whole person-body, mind, and spirit. The practice of holistic medicine
integrates conventional and complementary therapies to promote optimal health, and prevent and
treat disease by addressing contributing factors”. Based on this definition and earlier discussion we can
conclude following points about the holistic model.
• Holism refers to a complete and comprehensive analysis of health
and illness.
• We need to understand health from multiple perspectives as there is
no single cause of illness.
• A holistic practitioner may treat patients from a wide range of
healthcare options, that is, he/she may use medication along with
alternative therapies.
 SOCIAL MODEL OF HEALTH
• Social model of health finds its roots in the social model of disability and as
such is a reaction to the medical model. In this model various factors that
play an important role in health, like, social, political, economical, cultural and
even environmental are taken in to consideration. For instance,
environmental pollution can lead to detrimental effects on health. This
model can be termed as a community based approach where the focus is
on prevention of the illnesses/diseases. Thus, relevance is given to the
awareness programmes and policies related to health so as to modify the
lifestyle and health related behavior of the individuals so as to promote their
health and wellbeing. Thus, according to this model health can be promoted
by keeping in mind the social, political, economical, cultural and
environmental factors.
• The main characteristics of this model are as follows:
1) Social context in which the individual exists has a significant influence
on the health related experiences, choices and behavior of the individual.
The social context includes class, ethnicity, gender and so on.
2) The human body is social, psychological and biological simultaneously.
3) Cultural variations exist in the way health and illness are perceived.
4) Though, biomedicine and medicine are relevant in the context of
health, there are other aspects as well that play a role.
5) Health and social determinants of health are influences by political
decisions
6) The opinions of persons from non-medical background are relevant as
theymay provide a different perspective on health
• Social model thus focuses on the social responsibility in order to
ensure that people have a healthy lifestyle and environment. And
strategies at varied levels, like, economical, political and so on, need
to be developed in order to promote health amongst individuals.
Thus, the social model of health focuses on varied determinants of
health and also strives towards decreasing social inequalities. It
focuses on empowerment of not only individuals but communities as
well.
• Some of the major advantages of this model are that this model
promotes education amongst the individuals and is also cost
effective. It also puts the focus on the individual so that he/ she
develops healthy lifestyle. The model is based on community
approach and seeks involvement of both governmental and non-
governmental agencies. Despite of the advantages, the social model
may also display some issues or disadvantages. Individuals may not be
motivated or may lack awareness regarding health behavior and
lifestyle. Further, brining about change in an individual’s health
related behavior is not easy. This is along term measure and thus
quick results may not be achieved.
CONCEPT OF WELLBEING
• The concept of wellbeing can be termed as broad and finds
application in varied situations like economic, social, psychological
and so on (King, 2007). Accordingto Veenhoven (2004), the term
‘wellbeing’ broadly “denotes that something is in a good state”.
Though the term does not specify what is in the good state and what
constitutes that good state.
• There were mainly two approaches to defining wellbeing. The
hedonic tradition and the eudaimonic tradition. The hedonic tradition
focuses on constructs such as happiness, positive emotions and life
satisfaction. The eudaimonic tradition on the other hand described
wellbeing in terms of effective and positive psychological
functioning and development. Despite of these two different views, as
such wellbeing as a construct is seen as multi-dimensional.
• Lets us now look at various definitions of wellbeing
Shin and Johnson (1978, pg. 478) stated that “wellbeing is a global
assessment of a person’s quality of life according to his own chosen
criteria”.
Shah and Marks (2004, pg. 2) explained that “wellbeing is more than
just happiness. It is feeling satisfied and happy. Wellbeing means
developing as a person, being fulfilled, and making a contribution to the
community’’.
According to Dalal and Misra (2006), the concept of wellbeing is closer
to the concept of mental health, life satisfaction, and happiness. The
concept of wellbeing refers to a subjective feeling, which involves an
evaluation of those affective and cognitive aspects of life which are getting
affected by disease and illness directly or indirectly. Often it involves
evaluation of happiness, sense of contentment, sense of belongingness,
achievement and being without any distress and discomfort.
• Wellbeing can be of two types:
• subjective wellbeing and objective wellbeing.
Subjective wellbeing: It is that part of one’s wellbeing which can be
measured only by asking people directly about three aspects of
wellbeing; evaluative wellbeing (life satisfaction), hedonic wellbeing
(positive emotions such as feelings of happiness, sadness, etc), and
eudemonic wellbeing (sense of purpose and meaning in life).
“Subjective wellbeing consists of three interrelated components: life
satisfaction, pleasant affect, and unpleasant affect. Affect refers to
pleasant and unpleasant moods and emotions, whereas life satisfaction
refers to a cognitive sense of satisfaction with life” (Diener & Suh, 1997,
pg. 200)
• Objective wellbeing: This type of wellbeing has its roots in the discipline of
economics. It can be measured through self-reports as well as by studying
objective measures such as mortality rate, life expectancy etc. This form of Models
of wellbeing measures whether people have basic human needs and rights such as
education, food, water and health facilities.

• Wellbeing can also be categories as emotional wellbeing, physical wellbeing,social

wellbeing, workplace wellbeing and societal wellbeing (Davis, 2019).
• Emotional wellbeing denotes an individuals ability to adequately
manage stress, display resilience and display positive emotions.
• Physical wellbeing is explained in terms of improving one’s bodily
functioning by exercising and eating healthy.
• Social wellbeing is described in terms of effective communication and
ability to develop relationships and having adequate social support.
• Workplace wellbeing is an individuals ability to develop in his/her
profession and pursue one’s interest, values and gain meaning and
happiness.
• Societal wellbeing is about active participation in activities
related to community and environment.