The three levels of health: biological, psychological and social
April 5, 2018
According to the World Health Organization (WHO), “health is a state of complete physical, mental and social wellbeing, not only the absence of illness or disease.”
Therefore to be “complete”, optimal health must be present at all three levels: the biological or physical level, the psychological or mental level, and the social or relational level.
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Although this definition is clear and has been used for a long time – the WHO published it in 1948 – it was not always seen as valid or accepted. Throughout history, the conception of health has been constantly evolving to reach the level of understanding that we have today.
To summarize, it could be said that we have gone through several phases. For example, biological reductionism emphasized that a person was healthy if he was physically healthy. Later we went to dualism, in which body and mind (or soul) were equally present and interacted with each other. Finally, we arrive at the bio-psycho-social model established by WHO.
We currently know that the three levels of health interact with each other and that this mutual influence can affect the person’s wellbeing.
This is obviously the first one that comes to mind when we think about health. We examine how our body feels, if we have any physical illnesses, if our back hurts or if we have a cold.
Caring about the condition of our body has been present throughout history. Over the years we have seen how important it is to take care of our body.
The development of medicine has provided advances and discoveries that affect the way we now understand daily habits. For example, surely if you ask your grandparents or seniors, many of them will say that they started smoking when they were seven- or eight years old. However, currently in Spain, smoking is prohibited within the workplace and even in bars and restaurants. In addition, packs of cigarettes are plastered with unpleasant images to remind you of the consequences of smoking.
What a change, right?
It must also be said that it has become fashionable to adopt healthy lifestyle habits. Each and every day we see new “healthy” trends and lifestyles like detox shakes and juices, sports and being a “runner,” among many.
It’s great to take care of our body; that’s why they say it’s our temple, but … what about the other levels?
When it comes to assessing our social health, we take into account the importance of having a strong social network that serves as a support in daily life.
Having good friends and good family relationships is becoming increasingly important. If we think about how things were a few years ago, those marriages of friends often come to mind where, once they got married, they neglected their social life with friends or other relatives.
However, today, the maintenance of friendships is encouraged, whether you have a partner or not. The same recommendation applies to all you parents who want to stay in touch with your friends: do it because it will serve you very well. In fact, social support is considered one of the most powerful predictors of health and longevity.
Social networks have definitely helped a lot, too. How many friends do you have on Facebook? And followers on Instagram?
It seems that we really care about the number of online followers we have; it seems very fashionable these days to have a wide social network.
How nice that two of the three levels of health are so trendy at the moment! However, it seems that there is one that is still a bit forgotten …
On a psychological level we all know that we have to be fine, but what does it really mean to be good mentally?
It does not mean not being “crazy.” It means feeling good about ourselves and recognizing thoughts and emotions that make us feel bad.
For example, constantly giving in to the requests of people around us can make us think that our opinion is not cared about or important and, therefore, that we are less valued than others.
Feeling sad or unmotivated daily does not seem very healthy, right?
Remember that emotions, whether pleasant or unpleasant, are adaptive. Sadness and fear help us in certain moments to survive and sometimes even to improve our lives.
However, if these emotions persist and start to loom over our days, we may have to stop to think about what is causing them and how to change them.
What happens when we take into account all three levels?
All levels are necessary to keep our health in balance. It is important to take care of our body, our social network and our psychological state. If one of the levels is weak, it will end up affecting the other two and our general state will no longer be healthy.
A very graphic example is that of the well-known Maslow pyramid. At the base of the pyramid lie your physiological needs (food, respiration, sex …). Then, one step higher are your security needs (housing, employment, protection …). Next, we find the needs of affiliation and then recognition (this includes social relationships, friendship, affection as well as trust and respect …). Finally, once all the previous ones have been covered, you encounter the need for self-realization (important matters such as how you accept the facts of life around you, how you resolve problems, etc.).
Maslow organized these needs in the shape of a pyramid, an order that suggests that you cannot satisfy the needs at the very top without first addressing the more basic ones. Today, however, our conception of health is more dynamic.
The lens we adopt isn’t one of climbing a ladder or completing steps, but rather a more nuanced model where each phases of your life interacts with and modifies the others. In this way, if I am completely healthy – physically – but I feel alone and I am unable to work on my self-esteem, this probably affects my quality of sleep, my energy – that is, it would be affecting my physical condition – and also to how I relate to my friends, that is, it would also affect my social level.
It could also be that you have a very good capacity to accept situations as they occur and that you have a large network of social support but, at the same time, you suffer from a disease that produces chronic pain. Although this disease is always present, your physical condition can improve and the perception of pain will be less if I am strong and healthy on a social and psychological level.
Therefore, although it is very simple to focus on only the observable (how my body is and if I have friends or not, for example), we cannot forget to pay attention to how we feel and think as well.
Health is a long career
After reviewing all the aspects that we have to take care of, reaching a state of complete health sounds like an almost impossible task. Well, it is not about achieving perfection in each of the three levels (bio-psycho-social) – that is simply unattainable.
It is about maintaining a balance between them so that if we begin to feel vulnerable in one, we do not fall into a bottomless pit.
Health is a continuum: at one extreme is sickness and at the other, healthiness. You may not have everything under control but still find yourself closer to the healthy end. You may have a cold or a headache but that does not mean that you are drowning in a disease that takes over your whole life. Even when you’re healthy, there will be issues related to illness or discomfort in your life, since that is simply a part of life.
Take care of every level of your health
Take care of your body. Do not forget that eating healthy and doing physical exercise is very important. Decreasing or eliminating the consumption of harmful substances can also greatly benefit your body.
Also, when you start exercising (in a gym, for example), you get the opportunity to meet new people and your social network expands. What’s more, you will be releasing chemicals in your brain that will make you feel more animated and satisfied.
As you see, every little thing you do to take care of yourself will be benefiting other aspects of your health.
Take care of your social networks. No, we do not mean Facebook, we refer to your friends, partner or family. Learning to relate in a healthy and reciprocal way can avoid many bumps alongs the road. Do not be afraid to meet new people – no matter how it goes, they will be contributing something to your life.
Take care of your emotional well-being Do not assume that feeling unmotivated every day is normal. Do not assume that just because you eat well and have friends “you can’t complain”. If you aren’t feeling emotionally healthy -or not as healthy as you would like to be- do not hesitate to ask for help.
Therapy, in which you express your worries or concerns and think about your future, is long-term training, just like starting a sport. It’s hard to see the changes first, but once you start to reach your goals, they’re visible to yourself and everyone around you.
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