Basic point of departure for a biopsychosocial medicine paradigm

Working text: My personal view: Basic point of departure for bio psychosocial medicine paradigm includes also breathing behaviors-physiology as a part of interventional tool box.

In man complex interplay between evolutionary old (spatial – reptilian, mammalian) and (human) new brain is very complex but of crucial importance especially for understanding biopsychosocial medical conditions. Unfortunately is this not well understood both at general and individual levels, which motivate much systems integrating knowledge development efforts as well as clinical cautiousness. But some we do know, e.g. especially that the limbic system often overrides (influence all or parts) of frontal lope activities-behaviors which in an automatic, non-conscious way direct and/or indirect is of high relevance for many lifestyle related medical conditions. Operational and classical conditioning are operating in ways need to be understand more I detail in both assessment (of dysfunctions as well as capacities to influence crucial systems) and biobehavioral interventions.

NB – Learning is regard as a continuously on-going (perceptual) process elaborating complex information in the light of past information processing, e.g. influenced by state dependent learning, and not to be misunderstood as learning in a more formal way. Spatial and sequential interactions can be regarded as systems integrating space-time complex interactions where also time delayed consequences, e.g. in metabolic buffering systems further complicate a general systems understanding.

Old brain activities are mainly automatic, “silent”, non-conscious elaborating external and internal inputs (e.g. internalization, socialization, social learning … as well as mirror neuron perceptions) also in man precognitive, where treat (Zajonc, 1968) also is close associated with mobilization (fight or flight) alternatively “demobilization” of actions and energy (cell metabolism, autonomic nervous systems activities …) where especially the Sympathetic Nervous System (SNS) and Hypothalamic Pituitary-Adrenal play a central role direct and indirect “billiard ball”-effects on biopsychosocial stress – basically old brain activities which “out of it is out of its appropriate context it becomes dysfunctional” (von Scheele & von Scheele, 1999 when discussing hyperventilation as a part of survival behaviors).

Breathing behaviors including its complex physiology influence and is influenced – “both independent and dependent variables (Ley, 1994) depending on where you are positioned” (von Scheele & von Scheele, 1999 p. 177) – “high up” in the complex vertical and horizontal interacting system, e.g. metabolic-chemical and autonomic nervous system motivating breathing training for normalization of observed (if any) dysfunctions as one of the main intervention tools in live with systems theory argument that the independent variable (treatment changes) should be implemented as high up in the systems as possible (Suggested e.g. by Ludwig von Bertalanfyy).

As breathing is critical for basic metabolism functioning as well as ANS interplay individual (habitual and capacity testing) breathing  behaviors are of crucial importance for assessment and treatment of biopsychosocial stress medicine diseases and problems – together with the other tools, e.g. diet, exercise, psychological and social ones, which we – and others – have been using for more than 20 years. As neurological functioning is also dependent on metabolic as well as ANS conditions further development of integration of neuro- and psychophysiology is highly needed for a systems understanding also of mental disorders.

Further notions
In spite of any research founds we have some not published clinical data on effects of breathing on many lifestyle related medical conditions as ADHD, hypertension where we (believe) effects of Breathing with RSA-assisted biofeedback had pronounced effects on hypertension and ADHD. Without having time to review the literature I know that John Gruzelier has done studies on performance comparing HRV-biofeedback with a certain neurofeedback approach.

About the Limbic drive: Following the argument by Robert Zajonc about pre-cognitive appraisal, our version of “emotional Intelligence” is that “historical and present” updating automatic information processing with fast, immediate (in opposite to new brain sequential reasoning) capacity to override conscious behaviors/actions related to a large extent to individual steady state in terms of habitual and direct capacity of their ANS system to cope with limbic drive (direct and/or long-termed – phasic and/or basic). Here SNS-control capacity (can be learned through intense biofeedback training) is important for individual way of coping with life events. Our clinical experiences are that most individuals are prone to learn to increase their capacity to cope with biopsychosocial life events with effects over time where their training result in the development of new effective habits enabling them to basically change their efficacy in their everyday life. For hypertension patients this mean no pills but increased skills as well as for other clinical populations – probably will also be shown with more work in patients suffering from auto-immune diseases.

The reasoning above motivate

  1. Integration of neuro- and biofeedback as well as neuro-psychophysiology knowledge integrating, assessment and empirical studies
  2. Individuals´ learning and tailoring of a biopsychosocial medicine tool box as a main way to “treat” or prevent lifestyle related diseases and problems – see e.g. as a new approach to this problem while waiting for school medicine to change scientific paradigm and practice.

Basic need is

(a)    Biopsychosocial systems integrating knowledge development including also understanding variation within and between individual over situations and time

(b)    Empirical work of the above including not only applied individuals´ complex systems interactions but also still a number of basic research at receptor level AND its complex systems interaction in their context – within and outside its functional context


von Schéele, B.H.C. & von Schéele I.A.M. (1999). The Measurement of Respiratory and Metabolic Parameters Before and After Incremental Exercise on Bicycle of Patients and Control Participants: Supporting the Effort Syndrome Hypothesis? Applied Psychophysiology and Biofeedback, Vol. 24, No 3, 167-177

Zajonc, R. B. (1968). Cognitive theories in social psychology. In G. Lindzey & E. Aronson (Eds.), Handbook of social psychology (2nd ed., Vol. 1, pp. 320–411). Reading, MA: Addison-Wesley

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