Psychological Insights for Understanding Covid-19 and Health

Robbert Sanderman, Dominika Kwasnicka, Robbert Sanderman, Dominika Kwasnicka

• Publisher: Routledge
• Year: 2020
• ISBN:
  9781000337402
• Edition: 1
• Topic: Psychology
• Subtopic: Applied Psychology
• Index: Psychology

With specially commissioned introductions from international experts, the Psychological Insights for Understanding COVID-19 series draws together previously published chapters on key themes in psychological science that engage with people's unprecedented experience of the pandemic.

In this volume on health, Dominika Kwasnicka and Robbert Sanderman introduce chapters that explore the crucial topics of health behaviour change, wellbeing, stress, and coping. They highlight the key role digital health technologies can play in how we manage health conditions, and how we facilitate change to help individuals manage stressful situations such as physical isolation, job loss, and financial strain during the COVID-19 pandemic. The volume also offers an important overview of environmental and policy-based approaches to health behaviour change and addresses the highly relevant issues of identity and trust and how they shape the health of individuals, communities, and society.

Highlighting theory and research on these key topics germane to the global pandemic, the Psychological Insights for Understanding COVID-19 series offers thought-provoking reading for professionals, students, academics, and policymakers concerned with psychological consequences of COVID-19 for individuals, families, and society.

CHAPTER 1

Emotional Health and Well-Being

This chapter was first published in Health Psychology 3ed and cross-referencing relates to chapters in the original volume. Please visit www.routledge.com/9781138201309 for more information about the book

Chapter outline

Opening Story: Angelita

Section I: Four Models of Well-Being

Section II: Positive Psychology

Section III: Traditional Medicines

Personal Postscript

Questions to Consider

Important Terms

Chapter objectives

After reading this chapter you will be able to:

1. Identify and define four major models of health and well-being.
2. Compare and contrast the concept of well-being in the four models.
3. Define positive psychology.
4. Identify three studies that demonstrate the beneficial effects of positive affect on health.
5. Identify and explain two criticisms of the positive psychology movement.
6. Describe three major types of traditional medicine.
7. Compare and contrast traditional versus modern medicine.

OPENING STORY: ANGELITA

Miguel was getting worried. For the past three months, his wife, Angelita, seemed inexplicably sad. Usually cheerful, talkative, and energetic, Angelita had become increasingly quiet and weepy. She complained of frequent headaches and spent hours alone in her garden. The only activity she seemed to enjoy was cooking. For example, when cooking her favorite foods from her hometown of La Paz, Mexico, Angelita could be heard singing for hours. But during dinner, she would become quiet. She would feel her stomach begin to “churn” and then excuse herself from the table.

Miguel encouraged Angelita to see her doctor. He hoped that a physical exam would uncover the problem. Angelita’s doctor, however, found no viral or bacterial infection and no other physical explanations for the headaches. The doctor believed that Angelita’s symptoms were rooted in emotional problems but was uncertain of the cause. He suggested that she come back in one week if there was no improvement in her condition, and he would refer her to someone who could help address what he suspected were emotional problems.

Angelita decided not to return to her doctor. She believed that because he had no idea what was wrong he could be of no help. Instead, she phoned her mother, Carmen, and told her about her current health problems. Carmen, who still lived in La Paz, convinced her daughter to come to Mexico for a week of rest and relaxation. In truth, Carmen wanted Angelita to see the village curandero, a traditional healer who practiced a form of medicine called curanderismo, found in many Latin American countries. Curanderismo is a holistic approach to health that treats a person’s material, spiritual, and psychic health in addition to his or her physical needs (Trotter, 2001). Carmen believed that curanderismo was preferable to modern health practices, especially when dealing with emotional or other nonphysical health issues.

Carmen notified the curandero, and, as is the custom, the curandero agreed to visit Angelita at home. He came the day after Angelita arrived and spent several hours talking with her. Angelita remembered that the curandero’s father was the village healer when she was a child. It appeared that in the time that had passed, the healing gift, referred to as “el don,” was passed to the son. After talking with Angelita, the curandero gave her an herb tea to drink and rubbed a salve over her temples and forehead. He said he would return to check on Angelita in two days.

On his second visit, the curandero brought more herbs and made another tea. He then asked Angelita about her adjustment to her new home and neighborhood in Nashville, Tennessee. When he learned that Angelita could not find in Nashville the same herbs and spices used for cooking and for teas that she used in Mexico, he gave her extra to take with her when she returned. He also gave her a small pillow filled with strong scents.

Within a week of returning to Nashville, Angelita began feeling better. She seemed happier and appeared more energetic, much like her “old” self. Because she no longer complained of headaches, she was more social and no longer needed long periods of solitude. Angelita called her mother to report the changes, and Carmen immediately relayed the news to the curandero. The curandero replied simply that Angelita needed to reconnect spiritually to her home and culture. He believed that the Mexican herbs he gave Angelita would make her spirit more content while away from her home.

Traditional medicines like curanderismo may have originated several millennia ago, but they are still used throughout the world today. As we saw in the opening story, some people use traditional medicines in addition to or in lieu of Western, medical approaches. Recall that Angelita sought the assistance of the curandero only after seeking assistance from her doctor in Nashville. Her mother, however, preferred to use curanderismo as a first or only option.

Using traditional medicines, the curandero determined (or diagnosed, if you prefer) that Angelita’s physical symptoms were caused largely by spiritual and emotional health problems, a longing for the familiar. Yet Angelita’s doctor in Nashville, who uses Western medical techniques, also concluded that her problem was not physical in origin. In fact, if pressed, the doctor might have suggested that Angelita was suffering from a bout of homesickness, a type of psychosomatic illness with emotional or psychological underlying causes. Thus, both traditional and Western medicinal practitioners concluded that Angelita experienced an emotional health problem, even though they differed somewhat as to the cause. In the opening story we introduce one theme of the current chapter: the contrasting and complementary practices of traditional versus Western medicine. We will explore the similarities and differences between both forms of medicine, focusing specifically on their treatment of emotional health issues.

The opening story also illustrates the effects of emotional factors on overall health outcomes. Specifically, Angelita’s story reminds us that emotions contribute to our physical state. Thus, in this chapter, we also explore the role of emotional health on overall well-being. In the process, we will identify the contributions of health psychologists to understanding emotions as a health determinant.

We begin our exploration of emotional health by examining four models used currently in research and practice in the field of health psychology: the biomedical model, the biopsychosocial model, the wellness model, and the ecological (sometimes called social ecological) model. The models were developed and tested in the 20th century largely in Western cultures and therefore represent a modern day view of health.

In Section II, we explore a new topic called positive psychology. Positive psychology proposes that to understand human outcomes we must identify and examine all contributing factors, positive as well as negative. Included in this concept is a focus on health-enhancing emotional factors that can lead to good health outcomes. According to this view, the positive emotions, experiences, and personal characteristics that contribute to healthy outcomes have been largely overlooked in psychology. Proponents of positive psychology suggest that if we omit the study of “normal” healthy states, we cannot fully understand health.

Finally, in Section III, we explore a sample of traditional medicines, including Chinese traditional medicine, folk medicines that include curanderismo and sangoma, and a brief overview of Native American healing practices. Again, our focus when reviewing traditional medicines is principally to understand the similarities and differences between traditional and Western medicines as well as the relationship between emotions and overall well-being as explained by these two perspectives.

After reading this chapter, you will be able to identify and explain four models of health currently used to diagnose outcomes, to explain the role of emotions on individual health outcomes, to identify the central concepts of positive psychology and its contribution to our understanding of health outcomes, and to compare the treatment of emotional health in Western and traditional medicines.

Consider two important points before proceeding. First, you will notice that some of the health models use the term well-being to characterize an individual’s overall state of health. As noted in Chapter 1, An Interdisciplinary View of Health, well-being describes the state of the body (physical), the mind (psychological), the spirit, and social relations (emotions). It offers a holistic view of health similar to the ecological model, with one distinction. The ecological model does not specifically address spiritual health. It does, however, include physical environmental factors as well as health systems and health policy determinants. Because well-being incorporates many of the same determinants found in the biopsychosocial model, we will use this term rather than health to characterize a person’s overall condition (physical, psychological, emotional, and social). When applicable, we will add to this concept the effects of the physical and psychological environment, health systems, and health policy on health outcomes to explain the ecological model.

Second, and equally as important, by using the term well-being we are reminded that a thorough study of health integrates the emotional and psychological states of an individual. It further supports the inclusion of health psychologists into the practice of and research on health.

SECTION I. FOUR MODELS OF WELL-BEING

Biomedical Model

The first formal, Western model of well-being, here meaning a model supported by scientific inquiry and empirical study, is the biomedical model. In favor since the early 20th century, the biomedical model proposed that health is the absence of disease or dysfunction. Using this definition as a starting point, disease was defined as an abnormality, specifically a dysfunction of or deviation in a body organ or other body structure (Engel, 2002; Wade & Halligan, 2004). Thus, according to the biomedical model, a person who is in good health will be free of any abnormal biological changes in or functions of the body, whereas someone in “bad” or ill health will experience a change in the body system or functions. Furthermore, when diseases occur, this model suggests that locating and eradicating the illness will restore a person to good health.

As we saw in Chapter 1, An Interdisciplinary View of Health, a wholly physiologically based concept of health is consistent with some earlier beliefs. For example, the Cnidians in 500 BCE in Greece and the Roman philosopher and physician Galen in 200 CE believed that physical maladies determined an individual’s health status. Research suggests that the early views were enhanced and supported by later studies performed in the 1880s by Robert Koch of Germany and by Louis Pasteur of France (Cantor, 2000; Checkland et al., 2008).

In separate, some say rival, studies, Koch established that “invisible germs carried contagions.” In support of that assertion, Koch identified specific microorganisms that caused diseases such as anthrax and tuberculosis (Tan & Berman, 2008). The irrefutable association between a specific organism and a specific disease convinced many Western scientists that illnesses were indeed caused only by microorganisms.

Pasteur’s work, which pioneered the use of vaccines to prevent infectious diseases (see Chapter 3, Global Communicable and Chronic Disease) (Pasteur, Chamberlain, & Roux, 2002), further supported the germ theory of disease. Thus, it appeared that Koch’s discovery of the relationship between microorganisms and disease and Pasteur’s discovery of vaccines that protect individuals from such microorganisms (thereby ensuring good health) explained the origins of illness. These two seminal studies appear to have led to the development of the biomedical model of health (Checkland et al., 2008).

LIMITATIONS OF THE BIOMEDICAL MODEL To be certain, science supports the association between microorganisms and disease, the central tenet of the biomedical model. Unfortunately, the assertion that only physical agents cause illnesses is also a limitation of the model. Other limitations include a problem-oriented approach to health and wellness and a broad, perhaps overbroad, definition of illness. We review each limitation briefly here.

The belief that only physiological determinants cause illness presents, as Engel (2002) suggests, a “culturally specific perspective about diseases,” somewhat like a Western-culture ver...

Table of contents

• Cover
• Half Title
• Series Page
• Title Page
• Copyright Page
• Contents
• List of contributors
• Introduction
• 1 Emotional Health and Well-Being
• 2 Stress and coping: On being well in yourself
• 3 Opportunities of technology to promote health and well-being
• 4 The lived experience of digital health
• 5 Environment- and policy-based approaches to health behavior change
• 6 Self-as-Doer Identity and Health Behavior Change Within Non-Clinical Populations
• 7 Trust and health: The road to wellness?