The classic 1977 paper by Engel that introduced the now famous biopsychosocial model of healthcare

PainSci » bibliography » Engel 1977
updated May 26, 2023

Six pages on PainSci cite Engel 1977: 1. The Complete Guide to Low Back Pain 2. Your Back Is Not Out of Alignment 3. Cognitive Behavioural Therapy for Chronic Pain 4. What Works for Chronic Pain? 5. BPS-ing badly! How the biopsychosocial model fails pain patients (Member Post) 6. Does BPS-ified pain treatment work?

Photo of a female patient holding her neck and talking to a older male doctor in the foreground.

BPS in a nutshell: treat patients like (complicated) people.

PainSci commentary on Engel 1977: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.

This paper is the origin of the now famous biopsychosocial model of healthcare, advocating for a kinder, more nuanced and artful medicine, as opposed to the rather cold, clinical, and technical profession it had become in the middle of the 20^th Century thanks to its immense science-powered successes.

Engel argued that the dominant biomedical model inappropriately reduced too many complex health concerns to biology and pathology alone (reductionist), excessively separated body and mind (dualist), and left “no room within its framework for the social, psychological, and behavioral dimensions of illness.” In short, he believed medicine had become dehumanizing, excluding the patient and their “…attributes as a person, a human being.”

Engel proposed that the BPS model could provide a “…blueprint for research, a framework for teaching, and a design for action in the real world of health care.”

Ever since publication of this landmark paper, the BPS model has been extensively interpreted and misinterpreted, used and abused and co-opted and perverted. Cormack et al describe many of the problems that emerged over the years, and I explored that topic in detail, see: BPS-ing badly! How the biopsychosocial model fails pain patients.

~ Paul Ingraham

original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

The dominant model of disease today is biomedical, and it leaves no room within tis framework for the social, psychological, and behavioral dimensions of illness. A biopsychosocial model is proposed that provides a blueprint for research, a framework for teaching, and a design for action in the real world of health care.

original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

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