You make an appointment with your doctor knowing there is something that needs attention. You feel terrible and you’re struggling to cope. As you get close to the appointment time you feel a mixture of hopefulness and fear. You hope that your doctor will be sympathetic and caring and really try to find out what’s going on. Maybe this time they’ll find something. But you’re also afraid because so many times before you have felt dismissed, judged and neglected following your appointments. You walk away feeling hopeless, helpless and dejected. Sound familiar?

Those of us who live with fibromyalgia know all too well that the standard medical approach to our condition is woefully inadequate. We also know that the assertion that our condition is psychological is simply wrong, or at least overly simplistic. We know deep within us that our pain is real, that it is serious,  that something must be ‘wrong’ and that we need help.

However, we are continually told that there is nothing ‘wrong’ based on standard lab results, that there is no cure and that pharmaceuticals or psychotherapy are the only options.  But are they the only options? I don’t believe so and I’m going to explore some alternatives by considering the ‘Biopsychosocial‘ model of health and disease.

The model of medicine that is standard practice in most countries around the world is referred to as the Biomedicalmodel. This models focuses on biological factors that can be measured and treated with physical interventions (medications, surgery, diet, exercise, physical therapy). The individual is reduced down to a mechanism of moving parts and the body is considered a separate entity to the mind.

The biomedical model sees disease as isolated physical abnormalities (pathologies) that have known treatments, or not. There are different disciplines within this model to separate and individually treat different systems of the body – gastroenterology for the gut, neurology for the brain and nervous system, physiotherapy for the musculoskeletal system, psychology for the mind and so on. Rarely do these disciplines consider and collaborate with each other.

The biomedical model is based on ‘gold standard’ research that uses mostly ‘Phase III double-blind placebo controlled randomized clinical trials’. If a treatment has not been tested in this way it is highly unlikely to ever be prescribed under the biomedical model. These types of studies are extremely expensive and require funding from governments, private enterprise (mostly pharmaceutical companies) or research institutions (often funded by the former). The nature of this system means that many possible treatments are never funded for quality research. Most often, research is conducted on novel substances that can be patented and sold to the world for incredibility high profits. This is simply the reality of the prevailing modern medical model globally.

The biomedical model of disease is fantastic if you break a leg, get bitten by a snake or require life saving surgery following an serious accident. However, if you are living with fibromyalgia then you probably already know that this model is not able to understand or treat your complex illness. This is because fibromyalgia involves a complex interplay between various body systems (neurology-immune-musculoskeletal-gut and for some people, psychology) and, is different for each individual.

It incorporates the biology, psychology and social influences on an individual. This health philosophy proposes that a human being is more than just a sum of moving parts and that there is a complex interconnection between the different aspect of our lives. 

The model can be used to understand both physical and psychological illness and health.

What is now very well known is that the mind and the body are not separate entities. There is literally no place where one stops and the other starts. Our emotions are felt in the body, the body responds to stress in the environment which impacts the way we think and feel. Our nervous system can be wired into states of chronic stress or trauma which have a very real impact on our physical body and the various body systems that regulate our health.

For example, someone who is being bullied at work and is constantly worried and on edge is likely to have tense muscles, poor ability to digest food and stress chemicals such as cortisol circulating throughout the body for extended periods of time. Our bodies can handle stress like this for a short time but long term it becomes depleting and can contribute to states of disease.

Research shows that people with childhood trauma which can include long term neglect are at an increased risk of various negative health and wellness outcomes throughout life. A 2001 study posited that when children experience chronic stress, trauma, or neglect during critical periods of brain development, their physiological stress response system becomes damaged (Fay, 2015). It is important then to consider these influences when assessing and deciding on appropriate treatments for any disease, including fibromyalgia.

These all contribute to our state of health or illness. The model takes a holistic view of health and is a foundational influence in my work as a holistic fibromyalgia coach. It sees that all aspects of the human experience are interconnected and views the person as a whole rather than a sum of individual and separate parts.

The environments that we live in can have a significant influence on our state of health. Living in a busy noisy metropolitan area can be stressful to come people but not others, contaminates in the local water supply can cause toxicity in the body, mold hidden in houses can ruin a person’s health, exposure to chemicals through food, industry, building, household items and cosmetics can all impact the bodies toxic load. Likewise, weather can impact symptoms (which is quite common in fibromyalgia) and natural disasters can cause stress and long term trauma.

For some people, spirituality is also a major contributing element of wellness or illness. Most traditional cultures from around the world have spiritual philosophies that relate directly to health. Many believe that illness actually begins in the spirit and energy realms before manifesting in the physical. Trauma may be viewed as a loss of spirit and requires a calling back of lost parts in order to return to wholeness and health. Most traditional cultures also have a strong sense of connection and belonging to their land and displacement or desecration of these can create stress and trauma and result in spiritual, psychological and physical illness.

Treatments options under the biopsychosocial model are multi-disciplinary and integrative, drawing on the best from medical science, mental health therapies, alternative therapies, social supports as well as lifestyle and behaviour modifications. I would add environmental changes and spiritual practices if relevant.

Professionals using this model require self-awareness, trust, empathic curiosity, emotional intelligence to foster therapeutic relationships and communication of clinical evidence to foster dialogue with the patient rather than simply applying a predetermined treatment protocol. These qualities are not highly valued within the biomedical model and so it requires a particularly caring and curious physician to cultivate and apply this evolved way of practicing medicine. 

Unfortunately, the prevailing medical paradigm is often tied to insurance or government policies which impose very real time and budget constraints on doctors and the way they can treat patients. Moving beyond these limitations is necessary in order to benefit from the biopsychosocial model. At this time, that usually means patients must pay out of pocket for consultations and treatments offered by integrative doctors. This creates a prejudice against those with low socio-economic means as affordability and access becomes prohibitive and therefore, patients in need are not able to access the care that could truly benefit them.

On the plus side, the model allows individuals to play a larger role in their own health and wellbeing and redistributes some of the power that is handed over to the doctor in the biomedical model. We can all assess the different aspects of our lives and make a start on identifying obvious areas of stress, depletion and toxicity whilst also acknowledging the things that contribute in positive ways to our health, relaxation and sense of wellness. Many influencing aspects are within our control and we can slowly start to make changes that support us in moving towards more wellness and away from illness.

Have a think about one factor outside of your biology that you sense might be having an impact on your fibromyalgia. Is there a way that you could influence that to help ease some of your suffering?

Sometimes it can be hard for us to identify all of our influencing factors because often we don’t know what we don’t know. This is where having supportive professionals and in particular, a health coach can be a fantastic way to assess your situation and set up a plan for wellness improvement. This is a significant part of the process of holistic fibromyalgia coaching and it is very much focused on your individual circumstances, needs and desires.

If you, or anyone you know is feeling impacted by fibromyalgia and are struggling to find understanding medical professionals and treatments that are effective, I invite you to reach out and connect with me.

I applied this model to my own journey with fibromyalgia and I now live almost totally symptom free. I have my life back and now my deepest passion is to help others achieve the same. I would love to connect with you and help you map out the bio-psycho-social-environmental-spiritual influences on your condition. Together we could formulate a plan to help you start to feel better.

If you are interested, I invite you to book in for a complimentary coaching Q&A call here to discuss how coaching may be able to help you

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