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Lecture 2

Psychology 2036A/B Lecture Notes - Lecture 2: Public Health, Terminal Illness, Cardiovascular Disease

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Doug Hazlewood

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Psych Week 2
What is health?
Common sense: absence of illness
What is illness?
Common sense: happens when the body malfunctions, body is not working
If you don’t have an upset stomach, cancerous tumour, or infection means you
are healthy?
Three implications:
1. Physical illness has physical causes
2. Treat the body, eliminate illness -> health
3. Health and illness are opposites, when one is present, the other is absent
Biomedical model: same as the three implications, physical illness has physical
causes, treat the body, eliminate illness -> health, health and illness are opposite
o Dominant model since the 1600s
Historical Roots of Biomed model
Biomed model can be traced back to the ancient greeks, 500-300 BCE
Hippocrates father of modern medicine
If you become a doctor, you must recite the Hippocratic oath
Prior to Hippocrates: illness stems from “evil spirits” that invaded the body
o How do you get rid of evil spirits?
Trephination: Opening the skull to let the spirit escape
Hippocrates’ view: illness stems from bio processes
o The Humoral Theory: explains why people get sick, 4 body fluids:
Black bile
Yellow Bile
o When the 4 fluids are balanced, we are in good health
o Imbalanced humors = illness
o Influential theory for 2000 years
Galen 130 AD: Surgeon to the gladiators
o 1st to take a hands-on approach to understanding the body
o we can learn about the body by dissecting it
o unsure if he ever dissected a body, but saw a lot of people from the
gladiator ring
o He cut open the body to look at the brain
o Diseases can be localized to certain parts of the body
o Contributed to knowledge about the brain and the circulatory system
because he dissected a lot of animals
o Humoral imbalances can be localized in the body
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Middle Ages (500-1400 AD)
Advances came to a halt about medical knowledge
Roman Catholic Church dominates Europe (including practice of medicine)
People and animals were thought to have souls, dissection was strongly
prohibited (if you mess around with the body, you mess around with the soul)
Illness is God’s punishment for evil, therefore dissection was unnecessary
Priests treat the ill:
o Torture the body to drive out the evil influences
o Prescribe “prayer” and “good deeds”
The Renaissance (1400-1800 AD)
o We see a rebirth of biomed model
1. Descartes (1600’s)
Body works like a physical machine
Soul leave the body at death
Dissection should be acceptable (church now agrees)
Mind and body are separate
2. Other advances: invention of the microscope
Autopsies became more common to determine cause of death
Humoral theory should be replaced with a new theory of cellular pathology
Disease results from disease cells, not humoral imbalances
We must “fix” their body to cure them (biomed model is firmly established)
Without the biomed model, we would not have vaccines, surgical techniques etc
Part 2: Problems with the Biomed Model
Psychological factors can influence physical illness
Sigmund Freud (1856-1939)
Patients with unusual symptoms (suddenly becomes blind or paralyzed)
No physical basis for symptoms
o Ex. Glove anesthesia: patient loses feeling in hand, from wrist down as if
they have on a glove that restricts feeling
o This is physiologically impossible because of how nerves are distributed
o Freud concluded that there must be a psychological basis for this
Unconscious psychological conflicts are “converted” to physical disorders
Mind can influence the body
Dunbar & Alexander (1930s-40s)
Psychological factors can cause real physical disorders (anxiety can cause
The new field of psychosomatic medicine: understanding the link between
psychological factors and somatic processes (the mind and body are linked)
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