An inclusive medical model based on the body-mind-spirit trichotomy / 日本プライマリ・ケア連合学会誌

ABSTRACT

Three questions were provoked by the case of a young female with acute leukemia who died in spite of allogenic stem cell transplantation 1)What is responsible for the widespread belief that bodies are like machines that can be repaired scientifically? 2)Is there a perspective enabling us to view humans and disease holistically? 3)How can clinicians deal with the question “Why do I have such a disease?” Descartes's mind-body dualism and reductionism is the origin of the biomedical model regarding the human body as a machine. Though the biopsychosocial model advocated by Engel supplanted the biomedical model, this article proposes a more holistic medical model based on the body-mind-spirit trichotomy and four relationships “self and others,” “self and the natural environment,” “self and oneself,” and “self and transcender.” These four relationships are modeled here in a “trichotomy-triangular pyramidal model.” We postulate that the true cause of disease may be discordance among these relationships. This model is capable of describing all varieties of healthcare professions, and suggests a future form of a team approach that includes chaplains and complementary/alternative medicine specialists, and may give clinicians a guide to healing the grief of patients who ask, “why me?”