Spirituality, Evolutionary, and Lifespan Psychology

What are Emotions?

Emotions, from a neuropsychological perspective, are defined as a response to environmental issues based upon a person’s individual appraisal of a situation and how they feel, based upon historical or situational events or memories (Andrewes, 2002). This is furthered with the contribution of mood, which is considered to be a temporary influence on how an individual views situations. Emotions can be explained in terms of internal affects, in which subjective feelings are thought but not necessarily expressed, and external affects, in which emotions are displayed to others and not kept inside internally. The external display of emotions can be demonstrated in the form of facial expressions and can be measured in a scientific experimental format when individuals are exposed to positive or negative stimuli (Papa & Bonanno, 2008).

The evolution of the brain from reptilian, to limbic, to neomammalian describes how emotions, which are challenging to measure or identify physiologically, are a part of our “brain blueprint” and differentiate us from primitive species (Andrewes, 2002). This has resulted in our ability to have behavioral responses that can manage fearful situations, protect our young, and induce or inhibit aggressive behaviors when managed by neurotransmitter activity.

Anatomically, the process of an emotional response is characterized first by a stimulus which triggers the appraisal process in the polymodal association area, the medial nucleus of the thalamus, and the inferior colliculus (Andrewes, 2002). This in turn triggers the lateral amygdala which signals the basolateral and basomedial amygdala and the central amygdale. The central amygdala, upon processing the input, initiates an emotional response in the hypothalamus (and then the pituitary gland) or the brain stem. This system of emotional response has been documented in both normal and bipolar patients and, bipolar patients are noted to have increased activity in the amygdala in comparison to non-bipolar patients when experiencing mania (Gruber, Johnson, Oveis, & Keltner, 2008).

Andrewes, D. (2002) Neuropsychology: From theory to practice. New York: Psychology Press.

Gruber, J., Johnson, S. L., Oveis, C., & Keltner, D. (2008). Risk for mania and positive emotional responding: Too much of a good thing? Emotions, 8(1), 23-33.
Papa, A. & Bonanno, G. A. (2008). Smiling in the face of adversity: The interpersonal and intrapersonal functions of smiling. Emotion, 8(1), 1-12. WW


Which quadrant of consciousness are you on?

Modernity, as defined and debated by anthropologists, centers around the change of human behavior from a time in which nonmodern humans were forced to migrate and scavenge to survive versus modern humans who began to bury their dead, used tools, and incorporated symbolism into their daily lives (Henshilwood, 2003). Wilber’s (2000, p.60) conceptualization of pre-modernity and modernity differs in the sense that modernism has resulted in the development of morals, a sense of science, and the application of the arts into daily life. Additionally, Wilber noted that there are ‘dignities’ and ‘disasters’ associated with the evolution into modernity versus premodern times. Some dignities include the increase of technological advances to find scientific truths and artistic freedoms where as some disasters include the fragmentation and alienation of the incorporation of the systems of the body, mind, matter, soul, and spirit (the Great Nest of Being) as a result of scientific systemizations (Wilber, 2000, p. 61). This still evident in our medical systems in which holistic medicine, psychology, and biomedical treatments are all kept separate and are not integrated well (Scherger, 2005).

Wilber (2000, p. 63) noted this disintegration of the Great Nest of Being, which he refers to as scientific reductionism, and he responded by developing the Four Quadrents to not only discuss individual consciousness but to also demonstrate how individual consciousness is a part of a larger collective. The four quadrants are as follows:

I: Intentional: Upper Left Interior-Individual: This quadrant includes traits such as emotions, concepts, symbolism, and impulse.

IT: Behavioral: Upper Right Exterior-Individual: This quadrant includes traits such as brain systems, molecular systems, and atoms.

WE: Cultural: Lower Left Interior-Collective: This quadrant includes traits such as magic, vegetative states, and physical activity.

ITS: Social: Lower Right Exterior-Collective: This quadrant includes traits such as galaxies, family dynamics, and social systems.

four-quadrants-lg.gifI see the awareness of these four quadrants as figuring into individual body/mind/spirit development in the sense that each of them represents some aspect of modern human behavior while incorporating pre-modern driven functions or behaviors such as the reptilian brain stem, vision-logic, foraging, and physical worldviews (Wilber, 2000, p. 68). The incorporation of all the quadrants has the potential of developing modernity in a positive perspective as these quadrants can be applied in a variety of ways with variety of psychological models. Westhearfer (2004) suggested that the four quadrants could allow psychologists to study human behavior in all four contexts (intentional, behavioral, cultural, and social) based upon the situation and the needs of the client. Additionally, a person can utilize all four quadrants in an effort to further their own development in a very broad manner rather than just focusing on intellectual pursuits while ignoring family development or cultural growth (or vice versa).

Henshilwood, C. S. (2003). The origin of modern human behavior. Anthropology, 44(5), 627-651.

Scherger, J. E. (2005). The biopsychosocial model is shrink wrapped, on the shelf, ready to be used, but waiting for a new process of care. Systems & Health, 23(4), 444-447.

Westhearfer, C. (2004). Wilber’s ‘broad science’: A cure for Postmodernism? Australian & New Zealand Journal of Family Therapy, 25(2), 106-112.

Wilber, K. (2000) Integral psychology: consciousness, spirit, psychology, therapy. Shambala Publications, Inc., Boston.


Room for all spiritual beliefs...

Bidwell, a Christian (1999), reflected upon Wilber’s work from a pastoral perspective and he provided both critiques to his work as well as suggestions for the incorporation of his theory into pastoral theology and counseling where appropriate. For example, Bidwell notes that Wilber discussed how the human experience is deeper than just everyday life and experiences, and that the true understanding of complete consciousness is reflective upon theological views of being one with a ‘higher power’ or being ‘whole in spirit’. This can be incorporated into pastoral theology in that a belief in or personal experiences with a higher power (God) and the experience of what many call the Holy Spirit is something that occurs on a very high spiritual level and is consistent with prayer experiences or meditation taught by many churches. Additionally, Wilber’s waves, or levels, demonstrate a journey from the physical world to outer levels including an understanding of the soul (theology) and the spirit (mysticism) which are consistent with a person accepting Jesus Christ as their savior and as a Son of God (2000, p. 6). Some of the main points that Bidwell (1999) noted when he reviewed Wilber’s work included that there are levels of consciousness which can be described rationally but not experienced rationally, that a mystical consciousness can be achieved in which symbolism is nonexistent and in which a person is one with the time and space, and that he (Wilber) desires to expand research in this area with the acknowledgement of prayer and mediation as data sources to document these experiences.

Bidwell (1999) reiterated what Wilber (2000) described regarding the ‘great chain of being’ (also referred to as the great nest) as the manner in which a person graduates through their spiritual development. Bidwell (1999) further discussed the ‘human self’ which, in my opinion, is a reflection upon the three stages which are identification, disidentification, and integration with regard to undergoing the transformations of the different levels (Wilber, 2000, p. 35). Additionally, the developmental model is described by Bidwell (1999) which reflects Wilber’s model of spiritual development from personal to transpersonal experiences. Lastly, Wilber’s model of pathology is reviewed by Bidwell (1999) as mental state in which a person develops anxiety or pathologies associated with the realization that humans are all aware of their impending death and their brief existence on this plane.

The critique provided by Bidwell (1999) noted several reasons for the pastoral communities’ lack of interest in transpersonal theories such as a lack of relevance given to confessions, human discipline, and myths or symbolism associated with faith. Additionally, he noted that the terms that Wilber uses to describe existential psychotherapy are influenced by terms utilized by Buddhists and results in conflicting feelings for Christian theologians. Further, Wilber’s theories are not in alignment with the theory of eternal life nor are his theories reflective of the joyous worship of God and Jesus that is reflected, or preferred, by Christian theologists. spiritual-friendship.jpg

With a clear understanding of the concepts of transpersonal psychology (as were available in 1999) and with a balanced understanding of the resistance of the pastoral community to embrace these ideas, Bidwell is able to clearly acknowledge several reasons in which the pastoral community could benefit by remaining open to further discussions in these areas. Some examples include Wilber’s consistent understanding of God as a creative source, a divine reality, and an understanding that mankind is ever evolving in their relationship with God, spirituality, and transforming throughout his or her life through death (Bidwell, 1999).

Bidwell, D. (1999). Ken Wilber’s Transpersonal Psychology: An Introduction and Preliminary Critique. Pastoral Psychology, 48, 81-90.

Wilber, K. (2000). Integral psychology: Consciousness, spirit, psychology, therapy. Boston: Shambhala.


Moving on Wilber's Spiritual Waves

Wilber is a modern spiritual psychologist who looks at spiritual development in terms of waves in which the individual develops certain characteristics and progresses, in an outwards wave like manner, to the next characteristic all the while building upon and encompassing the prior characteristics (Wilber, 2000, p. 7). He has drawn upon historical references to the understanding of holistic spirituality using ‘the great nest of being’ and he has defined the wave layers into the following categories: A) matter and physics, B) life and biology, C) psychology and mind, D) soul and theology, and E) spirit and mysticism (Wilber, 2000, p. 6 & 12).

The ability for a person to transcend these waves increases his or her spiritual potential. This higher development process is not linear; rather, this occurs in a fluid manner throughout life with the goal of becoming more fully awake and effective in all aspects life (Wilber, 2008). However, these waves do follow a pattern of overall development in which each level, or category, (although independent of each other) must be incorporated into the second level (Wilber, 2000, p. 28). As a person undergoes these transformations the experiences can become a part of the person’s permanent self (conscious) rather than existing only in unconscious holotropic states.

Wilber (2000, p35) further connects consciousness and self with three stages he calls identification, disidentification, and integration with regard to undergoing the transformations of the different levels. The first stage is the identification phase in which the ‘self’ has just encountered a new phase of the ‘great nest’ and identifies with this phase. In the second phase the self transcends, or de-embeds, from the phase and, in the third phase the self includes the phase and integrates it with any other phases that have already gone through this process (Wilber, 2000, p. 35).

great-nest.gifAn example of this process could be moving in a wavelike fashion from psychology and mind to theology and soul (represented in the great nest as moving from A+B+C to A+B+C+D). Once A+B+C have been integrated into one’s self it could be said that a person fully understands his or her relationship with matter and physics, biology and life, with psychology and the mind. This is a very safe integration, in my opinion, as most of these categories (levels) can be scientifically defended and backed up with data. However, when a person decides to move from A+B+C to A+B+C+D they must now assess how they feel regarding the three stages of theology and soul.

Using myself as an example, in the identification phase I am able to acknowledge the existence of the soul and I am able to identify that I have a soul based upon my inability to find logical explanations for many of my feelings and experiences from physics, biology, and/or psychology. In the second phase I feel a sense of loss as I realize that everything that I have been taught in school, specifically Darwin’s theory of evolution, can no longer answer my questions regarding life and I can not find psychological explanations for my experiences either. Therefore, my dependence on A+B+C has, in a way, died (Wilber, 2000, p. 36). The last phase is in which I integrate theology and the soul with the other three phases and I now find this to be my new reality with all of the concepts fitting nicely together. In my case, I find that some things are best explained by physics, biology, psychology, and/ or theology but all things are interrelated in these three four levels.

Wilber, K. (2000). Integral psychology: Consciousness, spirit, psychology, therapy. Boston: Shambhala.

Wilber, K. (2008, January 22). What’s integral? Integral Institute. Retrieved from: www.integralinstitute.org.


Approaches to death and dying

Beliefs about death and dying vary greatly up a person’s culture, religion, social awareness, and transpersonal belief systems. Many people in western society feel threatened by the awareness of death and often cling to cultural values (without deeply investigating the values) in an effort to find an authentic meaning and significance to their eventual death and the importance of their life (Ryan & Deci, 2004). Death used to occurs in a person’s home or a close family member’s house but, due to the advances in medicine and life sustaining procedures that can only be managed in a hospital, most deaths now occur in an unfamiliar and sterile environment (Coppola, 2002). Psychologically this can result in feeling an even greater anxiety or threat surrounding death for the terminally ill patient rather than presenting an environment that facilitates a transpersonal investigation about the meaning of death and a spiritual awareness of the transformation to a different state of being. Sadly, this is not available or discussed in the hospital environment even with the inclusion of chaplains (Coppola, 2002).

Although many people who followed classic psychologists such as Freud had, for the most part, dismissed the incorporation of death into psychological research (although acknowledging it in biological research), Grof (2000, p. 220) has been able to demonstrate an alternative way to understand and investigate the experience of death and dying by researching traditional cultures. Grof (2000, p. 225) noted that traditional cultures have books of the dead, rites of passage (that may or may not include Western traditions such as applying make-up to the deceased), shamanic methods, spiritual practices, and stories surrounding mysteries of death and rebirth.

Grof (2000, p. 228) found that many traditional cultures practice and experiment with holotropic states so that when they find themselves experiencing death they are better prepared to manage the different realms and inner territories of the psyche. The ignorance, educational suppression, and misinterpretation of holotropic states by Western cultures is considered to be one of the greatest failures of Western society with regard to preparing individuals for the experience of death (Grof, 2000, p. 229). However, there are many reports from people in Western cultures who state they have had spiritual emergencies such as near death experiences. These individuals report that they see their deceased relatives, spirits, alternate universes, or supernatural beings; however, these experiences are often dismissed by the biomedical community as synapses firing irregularly or the presence of hospital lights (Grof, 2000, p. 165).

Death%20Rituals.jpgWestern cultures have systematically removed the rituals that were prevalent in what was considered to be more primitive societies such as specific rites of mourning, the participation in the transfer from the land of the living to the land of the dead, or food and clothing rituals that represent the loss of the loved one but also represent the cycle of death and rebirth (O’Gorman, 1998). However, holistic psychology has brought back interest in the incorporation of death and dying concepts, education, and rituals to modern health and healing perspectives, often with the incorporation of traditional cultures into current religious and health practices (O’Gorman, 1998).

Coppola, K. M. (2002). How is death and dying addressed in introductory psychology textbooks? Death Studies, 26(8), 689-99.

Grof, S. (2000). Psychology of the future: Lessons from modern consciousness research. Albany, NY: SUNY Press.

O’Gorman, S. M. (1998). Death and dying in contemporary society: An evaluation of current attitudes and the rituals associated with death and dying and their relevance to recent understandings of health and healing. Journal of Advanced Nursing, 27(6), 1127-1135.

Ryan, R. M. & Deci, E. L. (2004). Avoiding death or engaging life as accounts of meaning and culture: Comment on pyszczynski el al. Psychological Bulletin, 130(3), 473-477.


In which domain does your problem lie?

Grof identifies and describes three domains of experience (perinatal, biographical and transpersonal). He sees experiences based on the perinatal and transpersonal domains as being almost entirely disregarded by traditional psychiatry. Briefly, outline the underlying assumptions of the three domains, and based on an example from Grof, your personal experience, or clinical work with clients, describe the relationship that you see between either perinatal or transpersonal experiences and individual personal growth and development?

Grof (2000, p.20) notes that traditional academic psychiatry is limited in its ability to describe all the various levels and states associated with human existence and he has described a model in which three major levels, or domains, and be described and researched. The first such domain is biographical. This domain is described by Grof (2000, p.21) as being fairly well exposed in psychological studies in that it focuses on the active memories a person experiences from birth to death. From a holotropic perspective the biographical domain takes on additional characteristics such as a regressive like physical and mental change when a person is experiencing memories from childhood. Additionally, this biographical domain is that physical trauma from the past re-experiences some level of physical suffering. Grof (2000, p.22) used the example of a person reliving a drowning experience who currently experiences whooping cough. He further explains that emotionally charged memories do not occur in just one place in the subconscious; rather, they exist across multiple levels as systems of condensed experience.

perinatal.jpgThe perinatal level of unconscious is described by Grof (2000) as being as life and death struggle in which a fetus is consciously aware of the conditions of life in the uterus and the challenge and fear to escape the same uterus. This theory refutes medical practices that claim the unborn child has no memories of being in utero or going through the drama of birth. This belief is not completely accepted in mainstream as evidenced by the popularity of singing and talking to the unborn child as well as rubbing it’s feet or elbows when the unborn child is kicking inside. Grof (2000, p. 37) describes the perinatal levels of unconsciousness with a Basic Perinatal Matrix (BPM). BPM I is the primal union with the mother which can either be good or based upon the health of the womb, BPM II is the cosmic engulfment and no exit or hell phase which is the phase of labor when the cervix has not opened so the fetus is being pressed upon by the womb, BPM III is the phase in which the child is being birthed, and BPM IV is the death-rebirth experience in which the child is born.

The transpersonal domain of the psyche is referred to by Grof (2000, p. 57) as being an extension beyond what is normally considered to be a personal level of psychological interaction. For example, transpersonal experiences can include intentional psychokinesis such as healing or hexing or yoga, haunting or alien abduction experiences, micro-world experiences such as being conscious of organs or cellular activities, space-time experiences such as parallel universes, past life experiences, or special boundary experiences such as communicating with animals or shared consciousness are all examples of transpersonal experience. My personal experiences with individual growth and development have been transpersonal in nature. For example, when I was younger I experienced several spiritistic phenomena. These experiences led me to believe that there is more out there besides just the traditional “heaven and hell” concepts that I had been taught as a child. I still have experiences that I describe as “gut feelings” or brief and unexpected predictive capabilities that I can not explain. Some people refer to this as “women’s intuition” but now I can refer to it as a transpersonal spontaneous psychoid event which sounds much more serious.

Grof, S. (2000). Psychology of the future: Lessons from modern consciousness research. Albany, NY: SUNY Press.


How do you experience events?

There are several approaches to transpersonal psychotherapy described by Cortright (1997). Ken Wilber’s Spectrum model focuses upon distinctions between consciousness and transpersonal states (p. 65) as well as defining prepersonal, personal, and transpersonal levels of consciousness which desires to bridge the gap between psychology and spirituality (p. 73).

An additional approach to transpersonal psychotherapy discussed by Cortright (1997) is Hameed Ali’s Diamond Approach. This theory consists of the concept of essence and essential qualities which includes using the physical body to sense essence which includes the feelings of truth, compassion and value as well as the essential qualities such as access to real love or wisdom (p. 91-92). Transpersonal%20Psych.jpg

However, Michael Washburn’s contributions and added innovations to Carl Jung’s perspective of psychology is perhaps the most interesting from a Western psychological perspective. Washburn has discussed that the ego has a deeper relationship with the unconscious mind as well as a role in separating itself from the conscious mind by avoiding painful situations (Cortright, 1997, p. 82).

Jung and Washburn discussed that there is a separate self that experiences situations in a more authentic manner versus how the ego experiences events. This model has strengths such as clinical applicability to events such as mid-life crises and the fusion of Western approaches with transpersonal views of the subconsciousness, recognition of archetypes and collective unconsciousness, and that regression can present a great opportunity for research in the ability for a psychotherapist to assess long term psychological wounds (Cortright, 1997, p. 89).

This model could benefit from research extending from a focus on mid-life crises, exlusive Western philosophy, and further definition of exactly what the Self means with regard to the spiritual or soulful insight other theories discuss. However, Washburn’s theory of repression, retrieval, and regression therapy to manage deep pain as a healing perspective continues to be a foundation for transpersonal psychology (Lev, 2006).

Cortright, B. (1997). Psychotherapy and spirit: Theory and practice in transpersonal psychology. Albany, NY: SUNY Press.

Lev, Shoshana. (2006). Regression in the service of transcendence. Journal of the Sociology of Self-Knowledge, 4(1/2), 207-210.


Finding Your Holotropic State

Grof (2004) discussed what he considers to be non-ordinary states of consciousness as holotropic states.  Grof discussed that consciousness can change and, therefore, although we always are in touch with reality, time, and space, we have experiences that can cause our interpretation of physical spectrums to vary based upon the state the individual is experiencing (Grof, 2000, p.4).  Holotropic states may be induced by means such as psychedelics materials, physical dance, breathing techniques, music techniques, sensory overload or deprevation, or physical means which can vary based upon a person’s culture or available means. These techniques are ancient and global in their foundations. Additionally, these states are often associated with understanding death, birth, and rebirth beliefs in cultures (Grof, 2000, p.11).

lsd.jpgNon-ordinary states play a role in the current practice of psychotherapy relating all the way back to Freud’s belief that free association could assist in psychotherapy to current challenges that holotropic states are pathological in nature (Grof, 2000, p.16).  This concept can be applied in psychotherapy by assessing a person’s awareness as well as their ability to manage their experiences in both conscious and unconscious states (Cortright, 1997, p. 52).  A person may be intellectually aware of an issue that they bring to a psychotherapeutic session; however, often they are unaware of how to treat the problem on a deeper level and inducing a holotropic state has the potential of benefiting a person in this situation.  Additionally, if a therapist is aware of his or her own conscience state he or she is more likely able to contribute to transpersonal psychotherapeutic methods for clients (Cortright, 1997, p. 60).

Cortright, B. (1997). Psychotherapy and spirit: Theory and practice in  transpersonal psychology. Albany, NY: SUNY Press.

Grof, S. (2000). Psychology of the future: Lessons from modern consciousness research. Albany, NY: SUNY Press.  


Finding Holism in Medicine

Holism and humanism are broad terms used to describe theories of medical treatment that differ from traditional biomedical techniques.  Holism can be considered to be either an alternative treatment when no biomedical techniques are incorporated, an integrated treatment when it is purposefully used in conjunction with conventional medicine, or complimentary when it is used alongside a primary biomedical treatment (Barrett, Marchand, Scheder, Plane, Maberry, Appelbaum, Rakel, & Rabago, 2003). 

Humanism is also considered to be a treatment differing from traditional biomedical techniques in that it uses the understanding of psychological self, family systems, goal and value recognition, and intersubjective techniques as therapeutic processes (American Psychological Association Division 32 Task Force for the Development of Practice Recommendations for the Provision of Humanistic Psychosocial Services, 2004). Barret et al. (2003) described complimentary and alternative medicines (CAM) as being more holistic, intuitive, empowering, and individualistic for patients versus conventional medicine which was considered to be more deductive, scientific, general, and more controlling.  Many CAM therapists expressed a feeling that their treatments worked on healing versus repairing and that there was a focus on individual treatment strategies while acknowledging that there is not a regulatory body for these treatment strategies and the field could benefit from an increase in clinical trails that demonstrate effectiveness.  cam.jpg

Health psychologists believe that there are a variety of factors that contribute to why a person seeks a certain type of treatment.  Division 32 of the American Psychological Association was established to address these types of humanistic psychological factors.  Humanistic practitioners, like CAM practitioners, work to develop individual treatment plans for their clients and desire to collaborate with many systems to find the appropriate treatment or preventative strategy for each unique individual (APA, 2004). 

American Psychological Association Division 32 Task Force for the Development of Practice Recommendations for the Provision of Humanistic Psychosocial Services. (2004). Recommended principles and practices for the provision of humanistic psychosocial services: Alternative to mandated practice and treatment guidelines. Humanistic Psychologist, 32(1), 3-75. Retrieved December 3, 2007 from the World Wide Web: http://www.apa.org/divisions/div32/

Barrett, B., Marchand, L., Scheder, J., Plane, M. B., Maberry, R. Appelbaum, D., Rakel, D., & Rabago, D. (2003). Themes of holism, empowerment, access, and legitimacy define complementary, alternative, and integrative medicine in relation to conventional biomedicine. Journal of Alternative and Complementary Medicine, 9(6), 937-947.


How can we confront our friends with disorders?

If I encountered an individual that was suffering an eating disorder I would want to take the time to fully assess their physical state as well as their associated mental challenges. Brannon and Feist (2004) define eating disorders as either the inability to have an appetite because of nervous or physiological illness or the opposite which is a continuous desire to eat. These illnesses are called anorexia nervosa and bulimia respectively. They suggest that a treatment should consist of both individual and group cognitive behavior therapy, hospitalization, learning to eat at home, and teaching parents or significant others strategies on how to get the person suffering to eat in cases of anorexia. so%20very%20sad.jpgIn cases of bulimia it is recommended to manage the intake of sugar as this behavior causes hypoglycemia which causes the person to further crave sweets and continues the cycle of binging and purging (Brannon & Feist, 2004). Antidepressants have been helpful for bulimics; however nutrition and behavior based cognitive psychological programs have shown to be equally effective.

There are great deals of nutritional options for those who suffer from eating disorders. A study cited by Holford (2005) states that a zinc supplement and a placebo supplement were given to equal groups who had anorexia and those who received the zinc supplement had an increase in body weight that was twice that of those who received the placebo. Eades (2000) recommends that upon diagnosis of an eating disorder a diet should consist of regular eating patterns on a schedule that consist of complex carbohydrates and avoid potatoes, wheat, corn syrup, refined sugar, flours and the diet should be rich in fibrous vegetables and fruits. Sugars and refined carbohydrates cause the body’s metabolism to have a drastic swing between highs and lows and this may result in cravings that contribute to binge eating or eating avoidance.

The American Dietetic Association (2001) also recognizes that nutritional intervention is necessary to combat the side effects of eating disorders which include muscle weakness, fatigue, cardiac arrhythmias, dehydration and electrolyte imbalance which can be caused by purging, especially self-induced vomiting, and laxative abuse. They recommend that an interdisciplinary team should be organized to manage the recovery of the nutritional deficiencies and psychological addictions that are associated with these disorders.

Werbach (1999) has further recommendations for those suffering with eating disorders which also confirm the suggestions from Eades (2000), Holford (2005), and the American Dietetic Association (2001). Werbach’s suggestions include avoiding sugar, changing the diet to one that is rich in complex carbohydrates and proteins, avoiding alcohol, and supplementing the diet with a good vitamin that has all the B families including folic acid and niacin.

American Dietetic Association (2001). Nutrition intervention in the treatment of anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified (ednos). Journal of American Dietary Association, 101, 810

Brannon, L. & Feist, J. (2004). Health psychology: An introduction to behavior and health (5th Ed.). CA: Wadsworth/Thomson Learning.

Eades, M. D. (2000). The Doctor’s Complete Guide to Vitamins and Minerals. New York: Dell.

Holford, P. (2005). Optimum Nutrition for the Mind. Basic Health Publications

Werbach, Melvyn R. (1999). Nutritional Influences on Mental Illness, (2nd ed.). Tarzana, CA: Third Line Press.


Scientifically speaking, we must have faith and not give up.

Engel (1968) published an article on the giving up-given up complex. In this article he published the conclusions of a study in which he examined the life settings of patients who had fallen ill. Engel (1968) concluded that prior to the onset of illness the patients had displayed psychological disturbances such as a feeling of being unable to cope with life’s circumstances which resulted in biological changes that may have altered the patients’ ability to defend off pathogens resulting in the development of disease. Engel identified five contributing psychological characteristics which were a feeling hopeless or helpless, a decrease in positive self-image, loss of gratification with the roles they play in life with others, blending emotions from the past with the present and projecting them on the future, and focusing on and recalling prior memories of when they had wanted to give up. These symptoms became know as the giving-up-given-up complex. Engel further studied the psychological effects of extreme loss of control and found that individuals who experienced negative powerful events that resulted in a feeling of loss of control and he found a relationship between this experience and the sudden death of patients, usually from myocardial infarction or cerebrovascular stroke ( Lovallo, 2004).


It is not just the cerebrovasular system or the cardiac system that are affected by the effects of extreme loss of control. Animal studies and experiments were being conducted to determine linkage, such as Weiss adjusting the variable of water temperature on the stress levels experienced by rats and Seligman, Maier, and Solomon’s experiments on dogs by distributing shocks by varying their ability to control or manipulate how or if they received the shocks (Lovallo, 2004). In both groups the animals that did not have control experienced a reduction in the central nervous system norepinephrine levels. These findings led to the development of the motor activation deficit model of control by Weiss to explain how animal who experienced extreme loss of control and a reduction in the central nervous system norepinephrine levels also demonstrated lower response rates and decreased motor activity.

This may because the central nervous system uses the noradrenergic cell bodies in the locus ceruleus of the pons, which is located in the dorsal wall of the rostrol pons at the lateral floor of the fourth ventricle, and this area is a major source of storage of norepinephrine which influences the flight or fight response systems (Pinel, 2006). Upon receiving an alert from the amygdale the locus ceruleus increases the rate in which it fires signals and if this area is continuously exposed to excessive firing patterns the levels of noradrenergics depletes and causes a change in the performance of the amygdala, the hippocampus, and the prefrontal cortex ( Gorman, & Sullivan, 2000). Although this information is helpful in substantiating the relationship between feeling extreme loss of control over time and becoming lethargic which is consistent with symptoms of depression, it does not explain how other areas of the brain which manage serotonin areas, such as the raphe nuclei, remain unresponsive and unaffected by the changes in stress levels (Lovallo, 2004).

Engel, G. (1968). A life setting conducive to illness: The giving-up—given-up complex. Annals of Internal Medicine, 69(2).

Gorman, J. M. & Sullivan, G. (2000). Noradrenergic approaches to antidepressant therapy. Journal of Clinical Psychiatry, 61(1), 13-6

Pinel, John P. J. (2006). Biopsychology with “beyond the brain and behavior” (6th ed.). Boston: Allyn and Bacon.

Lovallo, W. (2004). Stress & Health: Biological and Psychological Interactions. Thousand Oaks, CA: Sage Publications


But, why shouldn't I give my husband a lobotomy?

Prefrontal lobes are cited in many articles and text books when the relationship between prefrontal lobe damage or archaic lobotomy procedures were used when discussions regarding social behaviors and higher mental functions were discussed (Kandel & Freed, 1989). The prefrontal lobes are responsible for behaviors that are often considered to be higher functioning brain activities such as intellectual capacity, awareness of self, abstract behavior, foresight, or ethics (Kandel & Freed, 1989).

Lovallo (2004) has discussed the associating between the frontal lobes and the manner in which thoughts and feelings are associated with the stress responses in that there are areas in the prefrontal cortex that manage and help us have feelings about the stressful situation rather than just observing information as data points. These areas of the brain allow us to draw connections between what we observe from the ventromedial prefrontal cortex (which receives connections from the sensory areas and the amygdala and returns axons to the amygdale) and the anterior cingulated gyrus (which relays neural signals between the right and left cerebral hemispheres of the brain) to form a visceral coloration or sensation of ideas and thoughts (Lovallo, 2004).

The prefrontal cortex is very important in social situations as well as higher-order evaluation in that this area of the brain helps to manage emotional content and responses as well as the flow of sensory information which helps us, in stressfully induced responses, to evaluate the validity of our options during the primary and secondary appraisal process (Lovallo, 2004). The frontal lobes allow us to gain meaning into the events that we experience and we are able to critically asses our secondary responses rather than just acting completely in a fight or flight response while still including our emotions in our cognitive thinking.

icepick.gifWhen harm has been done, unintentionally or surgically, to the prefrontal lobes severe consequences are dealt to the person. For example, Pinel (2006) described a situation in which the Nobel Prize was given to Dr. Egas Moniz for developing the surgical procedure of prefrontal lobotomy which was the surgical removal of the connection of the prefrontal lobes from the rest of the brain while leaving them biologically functional in the brain. This surgery, which resulted from supposed positive behavioral changes from observations of a chimpanzee that had a frontal lobe lesion, resulted in minimal therapeutic benefits and also resulted in many unwanted side effects such as emotional unresponsiveness and lack of foresight (Pinel, 2006).

Kandel, E. & Freed, D. (1989). Frontal-lobe dysfunction and antisocial behavior: A review. Journal of Clinical Psychology, 45(3), 404-413

Lovallo, W. (2004). Stress & Health: Biological and Psychological Interactions. Thousand Oaks, CA: Sage Publications

Pinel, John P. J. (2006). Biopsychology with “beyond the brain and behavior” (6th ed.). Boston: Allyn and Bacon.


Changing perspectives...

Western medicine historically has had a very biological approach in how doctors and nurses treated their patients, whereas the field of psychology had evolved from studying the mental and biological phenomenon of the human mind. These fields remained separate specializations of study in Western and European cultures, yet they had coexisted together in Native American, Latino, and Asia cultures for centuries. Descartes theory of dualism is slowly being dismissed and now there are some Western medical theories in place that incorporate some mental and biological factors that have been promoted by other cultures in the past (Lovallo, 2004). The first is the Psychosocial Theory.

The Psychosocial Theories of disease and treatment evolved from the biomedical approach which had a linear, cause and effect vision as to how the disease process worked (Lovallo, 2004). The biomedical path stated that disease is caused by a pathogenic stimulus, it leads to a physiological and biomechanical reaction, and then the disease state is achieved. The Psychosocial Theory furthered this definition of disease by incorporating concepts such as understanding that the body could have disease as a result of sociocultural malfunctioning, psychophysiological dysfunctions, or physiological dysfunction alone (Lovallo, 2004). The understanding of psychosocial theories is very important to further how the medical field understands the relationship between social networks and support and recovery or prevention rates. For example, a group of 90 patients with traumatic brain injury were studied to assess if there was a relationship between the level of social support they received and their recovery rate (Kendall, 2003). The study did account for the differences in brain damage severity but concluded that there were improved vocational recovery rates in the patients with higher levels of social support.

BPS.bmpHealth psychologists refer to the biopsychosocial model as the conceptual basis for their practice, research, and policy making (Suls and Rothman, 2004). This theory looks at health and illness as a combination of a variety of contributing factors such as genetic predisposition, lifestyle factors, family relationships, social support, and behavior. (Lopez and Jones, 2006; Suls and Rothman, 2004). Engel (1968) concluded that prior to the onset of illness the patients had displayed psychological disturbances such as a feeling of being unable to cope with life’s circumstances which resulted in biological changes that may have altered the patients’ ability to defend off pathogens resulting in the development of disease. George Engel, a medical doctor who some believe is the founder of the biopsychosocial model, identified five contributing psychological characteristics which were a feeling hopeless or helpless, a decrease in positive self-image, loss of gratification with the roles they play in life with others, blending emotions from the past with the present and projecting them on the future, and focusing on and recalling prior memories of when they had wanted to give up. These symptoms became know as the giving-up-given-up complex and became a foundation for the study of the biopsychosocial model and health psychology. People who suffer from these symptoms demonstrated a negative relationship between their biological performances based upon social networks and psychology (Engel, 1968)


The Diathesis-Stress Model is used to help integrate the biological and genetic factors, or nature factors, with the environmental factors, or nurture factors, that are experienced by an individual with the desire to understand why some individuals are more likely to experience stress in a way that contributes to a disease or psychological disorders (Brannon & Feist, 2004). One study by Barrera, Li, and Chassin (1995) used the diathesis-stress model to perform a cross-sectional study on the effects of having an alcoholic parent on two groups of adolescents which were either Hispanic or non-Hispanic Caucasians. The authors had some interesting hypotheses to test such as what effect did being a minority have on stresses assuming that being in a minority group, being in a different culture, or potentially living in a poorer economic group would have in addition to the stress of having an alcoholic parent. The role of family conflict on how stress was absorbed by adolescents was equally important in this study. In their discussion section the authors concluded that Caucasians had more sensitive reactivity to stresses than did their Hispanic counterparts because they were more vulnerable to the life-event of having an alcoholic parent as the Hispanic family culture is more tightly knit in comparison to the Caucasian family and this reduced the Hispanic participants predisposition for stress, when the stress comes from within the family unit.

Of all these models I personally like the biopsychosocial model the best as I feel it incorporates the Psychosocial Theories of Disease and the Diathesis-Stress Model and is the most comprehensive model of the three.

Barrera, M., Li, S. A., & Chassin, L. (1995). Effects of Parental Alcoholism and Life Stress on Hispanic and Non-Hispanic Caucasian Adolescents: A Prospective Study. American Journal of Community Psychology, 23(4), 479+. Retrieved June 7, 2007 from Questia database: http://www.questia.com/PM.qst?a=o&d=5001654936

Brannon, L. & Feist, J. (2004). Health psychology: An introduction to behavior and health (5th Ed.). CA: Wadsworth/Thomson Learning.

Engel, G. (1968). A life setting conducive to illness: The giving-up—given-up complex. Annals of Internal Medicine, 69(2).

Kendall, E. (2003). Predicting vocational adjustment following traumatic brain injury: A test of a psychosocial theory. Journal of Vocational Rehabilitation, 19(1), 31

Lopez, M. & Jones, K. (2006). What a health psychologist does and how to become one. Division Services. Retrieved June 6, 2007 from the American Psychological Association’s Databases.

Lovallo, W. (2004). Stress & Health: Biological and Psychological Interactions. Thousand Oaks, CA: Sage Publications

Suls, J. & Rothman, A. (2004) Evolution of the biopsychosocial model: Prospects and challenges for health psychology. American Psychological Association, Inc. Retrieved June 6, 2007 from Walden University’s Ebsco Database.


Listening to your parents does pay off...just not to tobacco companies

In between 1984 and 1999 a study which included 8,400 students ranging from grades 3 through 10 were presented with a detailed curriculum in their school system which was designed by an anti-smoking prevention project group.  The research question at hand was surrounding if additional prevention strategies could have more impact on deterring smoking with these children versus the control group that taught the standard school district smoking-awareness and prevention programs (Manzo, 2001).  Unfortunately the results showed that there was no difference between the two groups with regards to who smoked and who did not smoke upon reaching 12th grade; both groups had a 29% smoking rate and the study concluded that social factors were more influential than awareness and prevention strategies in determining who smoked and who did not (Manzo, 2001). 

Brannon and Feist (2004) concur that information is not going to be the only strategy that can change behavior or prevent a child or teenager from becoming a smoker.  One procedure they recommend is psychologically inoculating children by exposing them to potential future pressures regarding smoking, from a social standpoint; however there does not seem to be overwhelming evidence that this alone can prevent future smoking. But, if these techniques are incorporated with a family environment in which the child feels great pressure of parental disapproval about the behavior of smoking the child is less likely to smoke (Brown University, 2002).  Additionally, combining advertising programs with parental support and inoculation exposure can reinforce the desired behavior of not smoking (Howe, 1999).  Peer influence and family influence are the best predictors of smoking behavior so, regardless of interaction studies, the responsibility to give children the best fighting chance to avoid addiction lies with the parents (Centers for Disease Control and Prevention, 2030).


Brannon, L. & Feist, J. (2004).  Health psychology: An introduction to behavior and health (5th Ed.).  CA: Wadsworth/Thomson Learning.
Brown University. (2002). Parental disapproval helps prevent smoking. Brown University & Adolescent Behavior Letter, 18(1), 5
Centers for Disease Control and Prevention. (2003). Tobacco use among middle and high school students: New Hampshire, 1995-2001. Morbidity and Mortality Weekly Report, 52(1), 7-9.
Howe, D. K. (1999). Kick butts. American Fitness, 17(3)
Manzo, K. (2001). Study: Social pressures overshadow anti-smoking efforts. Education Week, 20(16)

Reading this is making me sleepy...

There are a couple of sleep theories floating around that try to explain how we, as humans, sleep. Circadian theories support that there is a pattern, or cycle, that dominates how we sleep based upon the passing of time throughout the day. For example, we are cued by light and dark periods for our sleep cycles, some animals function during the night and are cued by daylight for their sleep cycle, but both are based upon a rhythmic pattern (Pinel, 2006).

There is a biological clock that is internalized in most organisms and this rhythmic clock cues us on how to organize our day, how to synchronize ourselves with our external environment, and how to protect ourselves from nocturnal threats and vice versa for animals on a noctural clock (Vitaterna, Takahshi & Turek, 2001). The key take-away from this theory is that a lack of ability for a species to function without a rhythmic pattern would result a demise of mammals because of health issues associated with the deviation from the natural pattern (Vitaterna, Takahshi & Turek, 2001).

asleep.jpgRecuperation theories of sleep propose that the homeostasis of the body is disrupted by being awake and that sleep returns the body to a set-point of physiological stability (Pinel, 2006). I do not believe that this theory is correct for the same reasons that the set-point assumption theory, as discussed in other post, is a theory that fully grasps human evolution and the variability within and between humans. t

Still, I am unable to sleep right now…and if you can’t you may want to read:

Vitaterna, M. H., Takahashi, J. S., & Turek, F. W. (2001). Overview of circadian rhythms. Alcohol Research & Health, 25(2).


Respect for Women from Women

An interesting area of gender issues, sexism, and gender bias for women often comes from women, especially when the topic is being a “stay at home mom” or being a “working mom”. Interestingly I have been in both roles and have seen the benefits and costs associated with both options and for the purpose of this post I am only going to refer to mothers that have an additional income earning partner living in the home.

Socially there is a debate between working mothers and stay at home mothers because the woman’s movement encourages the idea of a successful executive female and yet the role of a woman as the leader of the family is also just as important is supported by those who feel raising children is equal to or greater than any other job (Haralovich, 1992). Women must struggle with how to allocate their time between occupational and domestic goals, both stay at home mothers and working mothers have the same goal of raising a healthy family as well as taking care of their own psychological health, and not allowing these decisions to result in additional discrimination in the workplace is a task all women should undertake (Morehead, 2001).

The role of a woman as a mother and a nurturer is long held and has often resulting in workplace discrimination, decreased opportunities for promotions or overtime earning opportunities, and therefore lower annual incomes than what men receive (Lips, 2003). If a woman chooses to stay at home to raise her children, a basic financial analysis would show that even larger income losses occur as the opportunity to climb the corporate ladder (that women who chose to work aplace children in daycare have) is lost. Financially, deciding to work is also costly. The cost of childcare is expensive and this plays a factor in whether or not a woman returns to work after having a child and this becomes a burden for women psychologically (Stewart, Rondon, Damiani, & Honikman, 2001). I personally believe that society, and women more than men, force feelings of guilt and inadequacy on women regardless of which choice they make.

One concrete action I would propose to help this situation is for community meetings to be held with working and stay at home mothers. The opportunity to share the challenges faced by both groups should be shared in a non-aggressive or sexist manner from women to women. One of the best ways to have this session would be to have these meetings start at a neighborhood level first. All mothers could then network with each other to discuss issues at hand and help each other. For example, stay at home mothers and working mothers equally need a break from family responsibilities so babysitting networks could be developed (one mother watches several other mother’s children once a month and this is rotated between families) or services could be exchanged (mothers who do financial services could do taxes in exchange for other mothers who could attend all the PTA meetings and report out the meeting notes back to the group). Regardless, the sexist attitude that women have towards each other should come to an immediate halt to help women, on a macro level, to progress and achieve equality.

















Somebody must have more ideas?  Please comment...or if you want to read more:

Haralovich, M. B. (1992). Too much guilt is never enough for working mothers: Joan crawford, mildred pierce, and mommie dearest. Velvet Light Trap, 29, 43-52. Retrieved April 19, 2007, from Questia database

Lips, H. M. (2003). The gender pay gap: Concrete indicator of women’s progress toward equality. Analysis of Social Issues and Public Policy, 3, 87-109.

Morehead, A. (2001). Synchronizing Time for Work and Family: Preliminary Insights from Qualitative Research with Mothers. Journal of Sociology, 37(4), 355+. Retrieved April 19, 2007, from Questia database

Stewart, D. E., Rondon, M., Damiani, G., & Honikman, J. (2001). International psychosocial and systemic issues in women’s mental health. Archives of Women’s Mental Health, 4, 13-17.


What part of my brain is best?

The human brain is composed of five major sections which are the myelencephalon, metencephalon, mesencephalon, diencephalon, and telencephalon structures. It is very hard, as a student of psychology, to determine what division of the brain psychologists are most concerned with; I believe that various divisions of psychology would answer this question uniquely.

The diencephalon, which consists of the thalamus and the hypothalamus, manages a variety of functions such as processing signals and delivering them to the sensory cortex and regulating behaviors with hormones (Pinel, 2006). Psychologists interested in anxiety or stress and coping behaviors may find this area to be the most important part of the brain (Feldman, 1999). The mesencephalon manages sensorimotor systems (Pinel, 2006). This area of the brain would be of interest to psychologists that want to focus on the functions of motiviational behavior. The metencephalon contains the cerebellum and is responsible for functions of precision in movement (Pinel, 2006). Psychologists that are interested in occupational therapy and its application to learning in educational systems or those who want to focus on health psychology and motor function rehabilitation may find this area the most important (Thomas, 2006). The myelencephalon is another complex portion of the brain and it manages communication between the mind and the body among other things (Pinel, 2006). Psychologists that are interested in studying attention deficit disorders or sleep disorders may find this to be the most important area of the brain (Thomas, 2006).

To answer the question specifically I would say that the telencephalon, which is the largest portion of the brain and controls cognitive processes, voluntary movement, and complex processes, is the division of the brain most psychologist are most concerned with (Pinel, 2006). I believe this because this division is also responsible for memory and emotions which leaves a huge window of opportunity for research, discovery, and experimentation for psychologists in general (Thomas, 2006).


Feldman, R. S. (1999). Health psychology: Stress, coping, and health. Understanding Psychology. Retrieved March 21, 2007 from PsyCafe.

Pinel, John P. J. (2006). Biopsychology with “beyond the brain and behavior” (6th ed.). Boston: Allyn and Bacon.

Thomas, M. (2006). Biological psychology: Neuroanatomy. Retrieved March 21, 2007 from the University of Washington’s databases.


We need friends.

What makes a social relationship “meaningful”?  It is getting even harder for people in my generation to establish any relationships at all, let alone ones that are meaningful.

Duke University (2006) conducted a study and concluded that Americans have decreased the amount of ties they have with people outside of their immediate family. The study compared ten years of data and found that the number of confidants that Americans have has dropped by one third since 1985 (about three confidants to only two).

With the increase in technology many people are working out of the home instead of in the office, friends are being made on MySpace, and classmates e-mail each other and often lose touch at the end of class. All these examples support how it has gotten harder to make and maintain a long term network of social support.

Duke University. (2006). Americans have fewer friends outside the family, duke study shows. Duke University: News & Communications. Retrieved April 6, 2007 from Duke News Communications.



Social support...gosh, I guess I should invite my family over more often...

Social support is an integral part of the biopsychosocial model and a key component to understanding how physiologically individuals respond differently to stress (Brannon & Feist, 2004). This support can act as a buffer for the patient to the day to day challenges and psychological coping that takes place when a patient suffers from chronic illnesses as well as playing a role in helping the patient manage their affective responses to the illness (Cox, Roberts, Shannon, & Wells, 1994). Social support often takes place in the form of leisurely activities and therefore social leisure helps relieve the stress that may be experienced by a person who is suffering an illness (Coleman, Seppo, & Iso-Ahola, 1993).

Individuals who experience psychosocial stresses related to illness often retreat away from society and this has shown to have a relationship to the onset of depression and poor psychological coping skills (Bozzette, Collins, Crystal, Fleishman, Hays, Kelly, Marshall, Shapiro, & Sherbourne, 2000). Depression and isolation have also shown to decrease or lengthen the time to recovery from illness; therefore depression related to a lack of a social network is an effect that health psychologists want patients to avoid (Brannon & Feist, 2004). Additionally, positive social support in the form of positive emotional support (versus educational or informational support) about the illness has proven to reduce depressive symptoms in patients as they are influenced (be it subconsciously or consciously) in how they perceive their illness from their peers and the emotional support they receive (Ali & Toner, 1996). An example of this type of relationship between health and social support has been seen specifically in HIV patients as the perception of the disease has changed socially since its onset (Bozzette, Collins, Crystal, Fleishman, Hays, Kelly, Marshall, Shapiro, & Sherbourne, 2000).



Here is some reading material for the family get together…

Ali, A., & Toner, B. B. (1996). Gender Differences in Depressive Response: The Role of Social Support. Sex Roles: A Journal of Research, 35(5-6), 281+.

Coleman, D., & Iso-Ahola, S. E. (1993). Leisure and Health: The Role of Social Support and Self-Determination. Journal of Leisure Research, 25(2), 111+. Retrieved April 4, 2007, from Questia database: http://www.questia.com/PM.qst?a=o&d=5000177026

Fleishman, J. A., Sherbourne, C. D., Crystal, S., Collins, R. L., Marshall, G. N., Kelly, M., et al. (2000). Coping, Conflictual Social Interactions Social Support, and Mood among HIV-Infected Persons [1]. American Journal of Community Psychology, 28(4), 421. Retrieved April 4, 2007, from Questia database: http://www.questia.com/PM.qst?a=o&d=5001075077

Roberts, C. S., Cox, C. E., Shannon, V. J., & Wells, N. L. (1994). A Closer Look at Social Support as a Moderator of Stress in Breast Cancer. Health and Social Work, 19(3), 157+. Retrieved April 4, 2007, from Questia database: http://www.questia.com/PM.qst?a=o&d=5001663389


It "pains" me to understand this theory...

The specificity theory of pain originated in the 1600s, with a limited understanding of how the mind and body worked together, and it suggested that psychological factors did not play in role in the manner in which the mind and body communicated pain (Brannon & Feist, 2004).  Practitioners of the specificity theory believed that any type of pain should be resolved by surgery or medicine as they felt there was a direct relationship between the intensity of the pain and the amount of the body that was injured (Dannenbaum, 2006).  Descartes believed that there were nerves or “cords” that were extended from the part of the body that was experiencing pain directly to the brain and that was how pain was signaled (Duncan, 2000). Therefore, patients who suffered from chronic pain did not find relief in the treatment provided by the specificity theory of pain and often were left feeling frustrated, humiliated, and hopeless (Sieppert, 1996).

In 1965 Melzack and Wall developed the gate control theory which explained that pain is not driven from point A to point B; rather there are gates (central control triggers) which control the flow of information about the intensity, severity, and the perception of the pain (Brannon & Feist, 2004). The gate control theory proposes that messages from receptors travel along nerve fibers to the spinal cord, they then come to “gates” that are either opened to transmit pain messages or closed to suppress pain messages (Kodish, 2001).  This theory is more popular with those who practice the biopsychosocial model of medicine in that it incorporates not only the biological occurrence of injury but also the psychological and social implications of the severity of the pain (Brannon & Fiest, 2004; Sieppert, 1996).


I have a painful desire to read more:

Dannenbaum, S. E. (2006). The evolving theory of pain management. Details. 

Duncan, G. (2000). Mind-body dualism and the biopsychosocial model of pain: What did descartes really say? Journal of Medicine and Philosophy, 25(4), 485-513.

Kodish, B. I. (2001). The pain in sprain . ETC.: A Review of General Semantics, 58(2), 138.
Sieppert, J. D. (1996). attitudes toward and knowledge of chronic pain: A survey of medical social workers. Health and Social Work, 21(2), 122+.