Block 1
Block 1
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BPCG 173 PSYCHOLOGY FOR HEALTH
AND WELL BEING
The course on Psychology for Health and Wellbeing (BPCG 173) is a 6 credits
course offered under Bachelors Degree Programme of IGNOU. The objectives
of this course are to acquaint learners with the spectrum of health and illness,
to identify and manage stress, to learn approaches to enhance well being and
to acquaint learners with strategies to prevent illnesses, promote and manage
health and well being
The course is divided into four blocks. Each of these blocks represents a specific
theme which is discussed in terms of units. The units are arranged in a logical
sequence so as to cover the main aspects of each theme.
Before proceeding to read the units, you are advised to go through instructions
about how to read the course material. Given below is the explanation of the
organization and sequencing of the unit.
Organization and Sequencing of a Unit
The following is the structure of each unit:
1.0 Objectives
1.1 Introduction
1.2 Section (Theme of the section)
1.2.1 Subsection of 1
……………….
Check Your Progress I
1.3 Section (Theme of the section)
1.3.1 Subsection of 2
……………….
Check Your Progress II
Let Us Sum Up
References
Key Words
Answers to Check Your Progress
Unit End Questions
As the scheme suggests, each unit is divided into sections for easy reading and
better comprehension. The numbering and length of each section and subsection
may vary from one unit to the other, depending upon the depth of information
in each unit. Each section is indicated by BOLD CAPITALS and each sub-
section by a relatively smaller but bold typeface. Divisions within the sub-
sections are in relatively smaller bold typeface so as to make it easy for
you to understand. 3
Let us now discuss each section of a unit.
Objectives
We begin each unit with the section Objectives. It tells you briefly about the
objectives of the unit, what you will learn after you study the unit.
Introduction
The section Introduction will mainly focus on introducing the theme of the present
Unit.
Illustration
There are several illustrations in each unit in the form of figures and diagrams.
The main purpose of these illustrations is to make the study comprehensive and
interesting.
Check Your Progress
We have given self-check exercises under the caption Check Your Progress
at the end of main sections. You can provide your answers in the space given
below each question/ exercise. You will be tempted to have a glance of the
main text as soon as you come across an exercise. But we do hope that you
will resist this temptation and turn to the main text only after completing the
answers.
You should read each unit and note the important points in the margin provided
in the course material. This will help in your study. It will also help you to
answer the self-check exercises and the assignment questions, as well as help
in revising your course before appearing for your Term End Examination (TEE).
Let Us Sum Up
This section of each unit under the heading Let Us Sum Up summarises the
whole unit for the purpose of ready reference and recapitulation.
References
We have given a list of references at the end of each unit. This is a list of
books and articles used by the course writers to prepare the units. This reflects
that your course material is based on a wide spectrum of literature available
on a particular theme, related to your course. This also informs you of the wide
literature available in the particular area of study. If interested in widening your
knowledge, you may look for the mentioned references. Each reference mentions
the name of the author, year of publication, title of the book/article, name of
publisher and place of publication.
Suggested readings help you to increase your level of understanding of a
particular theme in each unit.
Key words
The key words explain the basic ideas, technical terms and difficult words.
Answers to Check Your Progress
The answers to check your progress are given here.
4
Unit End Questions
Besides Check Your Progress, we have given Unit End Questions in each Unit.
Practicing these questions will help you in answering assignments and Term End
Examination Question Paper, though the pattern and style of questions asked
may not be similar.
Audio and Video Aids
Some Units have been selected for the audio and video programmes to
supplement the printed material. This will help you to understand the units with
greater clarity.
Apart from this, you may also access IGNOU’s FM radio channel, Gyanvani
(105.6 FM), which is available across many cities in India, for regular
programmes, related to themes on Psychology. You can listen to the live
discussions by faculty and experts on the topic of the day and interact with
them through telephone, email, and through chat mode.
You may also watch Gyandarshan TV channel (free to air educational channel),
for programmes related to topics on Psychology. The schedule of Gyanvani and
Gyandarshan is displayed on www.ignou.ac.in. The radio and TV channels may
also be accessed on Gyandhara, webcast facility for Gyanvani and Gyandarshan,
provided by the University.
Assignment
You will receive a set of assignments for the whole programme. These are Tutor
Marked Assignments, which are to be submitted to the respective Study Centre
after completion. These assignments will be evaluated by academic counsellor
from your Study Centre. Ensure that you complete all your assignments because
the grades that you get in each of these assignments are included in the final
evaluation of your degree. Before answering the assignments, read all the units
and additional material (if available).
Guidelines for assignments
While working on assignment, kindly ensure the following points,
1) Clearly write your Enrollment number
2) Answer them in your handwriting and in your own words (do not copy
the sentences from the course material or any other source).
3) Write clearly and neatly so that it is easy to read your answers
4) Leave margins on one side of your answer-sheets so that evaluator may
write his/ her comments on your performance.
5) Organise your answers well based on the question asked.
6) You will submit the assignments at your Study Centre on or before the
date mentioned as per the admission cycle. Kindly check the dates from
www.ignou.ac.in or your Regional Centre website.
5
Term End Examination (TEE)
Consider the following points while answering TEE.
1) Questions need to be answered in one’s own words and they need to
be focused based on the question asked.
2) Answer the questions keeping in mind the word limit.
3) Organise answers well based on the question asked and also keep in mind
any bifurcation given in the marks.
4) Ensure that you mention correct question numbers for respective answers.
Preparation of Course Material
The syllabus of course material BPCG-173 is designed by an Expert Committee
(see page 2 of this course) and prepared by Course Preparation Team which
comprises the author(s) of units, content editor(s), language editor, and the course
coordinator. The expert committee selected the themes and sub-themes of the
blocks and units, keeping in view the prescribed syllabi of UGC (CBCS
model).The authors of units have provided their expertise in elaborating them
in the form of the main text of each unit. The content editor has carefully examined
the course contents and has made an attempt to make the material clear and
comprehendible.
For any query or feedback related to the course, you may kindly contact
the course coordinator at,
Prof. Suhas Shetgovekar
Room No. 121, Block-F,
School of Social Sciences
IGNOU, New Delhi
Email: [email protected]
6
Course Contents
BLOCK 1 : INTRODUCTION ............................................................ 11
Unit 1 : Introduction to Health and Wellbeing .......................... 13
Concept and Definition of Health ...................................... 14
Cross-cultural Perspectives of Health ................................. 17
Health-Illness Continuum ..................................................... 19
Unit 2 : Models of Health and Illness ....................................... 24
Medical Model of Health and Illness ................................ 25
Holistic Model of Health .................................................... 27
Biopsychosocial Model ....................................................... 29
Social Model of Health ...................................................... 30
Concept of Wellbeing ......................................................... 31
BLOCK 2 : INTRODUCTION TO STRESS .................................... 37
Unit 3 : Stress: An Introduction ................................................... 39
Concept of Stress .............................................................. 40
Nature of Stress ................................................................. 42
Sources of Stress ............................................................... 45
Measurement of Stress ....................................................... 49
Unit 4 : Factors Contributing to Stress Proneness .................... 53
Factors Contributing to Stress Proneness .......................... 54
Moderators of Stress ......................................................... 52
Unit 5 : Effect of Stress ................................................................ 62
Effect of Stress on Health ................................................. 63
Effect of Stress on Performance and Productivity ............ 66
Effect of Stress on Relationship ......................................... 69
BLOCK 3 : STRESS MANAGEMENT ............................................. 75
Unit 6 : Coping with Stress ........................................................... 77
Definition and Nature of Coping ....................................... 78
Coping Styles ...................................................................... 81
Unit 7 : Stress Management Techniques I ................................. 88
Relaxation Techniques ......................................................... 89
Meditation ........................................................................... 91
Yoga .................................................................................... 93
Mindfulness .......................................................................... 96
7
Biofeedback ........................................................................ 98
Unit 8 : Stress Management Techniques II ............................. 103
Cognitive Restructuring ...................................................... 104
Time Management ............................................................. 107
8
BPCG 173 PSYCHOLOGY FOR HEALTH
AND WELL BEING
Dear Learner,
Psychology for Health and Well Being is a six credits course and the main
objectives of this course are to acquaint learners with the spectrum of health
and illness, to identify and manage stress, to learn approaches to enhance well
being and to acquaint learners with strategies to prevent illnesses, promote and
manage health and well being.
Block 1 is titled Introduction and covers mainly two units, Unit 1 and
2. The first unit is titled Introduction to Health and Wellbeing and this unit will
extensively discuss about the concept and definition of health and cross cultural
perspectives on health. Further, Health-Illness will also be covered in this unit.
The second unit is titled ‘Models of Health and Illness’ and covers the medical
model of health and illness, the holistic model of health and the biopsychosocial
model and social model of health. It also introduces the concept of wellbeing.
Block 2 of this course is divided into three Units; Units 3, 4 and 5. Unit
three is titled ‘Stress: An introduction’ and this unit will serve as a basis to
rest of the units that will be covered in this block. It will cover the concept,
nature, sources and measurement of stress. Discussion on the concept and nature
of stress will provide a fair idea about the term and will set a framework for
comprehension of other topics and subtopics discussed in this block. Sources
of stress mainly focus on frustration, conflict of motives and pressure, that can
be termed as general sources of stress. Measurement of stress is relevant and
necessary for effective diagnosis of stress. There are various ways in which
stress can be measured. Varied methods of measurement like physiological
measures, psychological tests, checklist and interview will be discussed under
this unit.
Unit four mainly focuses on the factors contributing to stress proneness including
Type A personality, hostility, perfectionism, procrastination and learned helplessness/
learned pessimism. Various moderators of stress will also be discussed in this
unit. The moderators play an important role in relationship between the stress
and corresponding reactions. These moderators may lead to individuals experiencing
high or low stress. Various moderators of stress including personality, locus of
control, social support, optimism and pessimism and gender and culture will
be covered in the unit.
Unit five will highlight the effect of stress. Mainly the effect of stress on health,
performance and productivity and on relationships will be covered in this unit.
Block 3 constitutes Units 6, 7 and 8 six. Unit six is related to coping with
stress and covers coping and coping styles. In this unit not only the concept
of coping will be discussed but various coping styles will also be highlighted.
Units seven and eight will cover various stress management techniques. In the
previous block we studied about stress as a concept and in the present block
we will cover how to manage and deal effectively with stress. Unit seven will
cover relaxation techniques, meditation, Yoga, mindfulness and biofeedback and
Unit eight will mainly cover cognitive restructuring and time management.
9
Block 4 focuses on promotion of physical and mental health. This block
is again divided in to four units. Units 9, 10, 11 and 12. Unit nine and
10 deal with physical illness experiences. Unit nine will highlight the illnesses
related to food, diet, obesity. It will also focus on the problems related to sexual
health. And Unit 10 will discuss acute and chronic pain besides chronic illnesses.
Unit 11 discusses mental illness experiences including, depression, anxiety,
psychosomatic illnesses and substance use. The last unit (Unit 12) is related
to the prevention, management and intervention and the topics that are covered
in this unit include cultivating human strengths (intra and inter personal) and
virtues, hope and optimism, gainful employment and work life balance. Further,
the unit will also discuss exercise, nutrition, Yoga and meditation.
Some suggestions and tips to enhance your study of this course are as follows:
1) Ensure that your basic concepts, given in this course, are clear. If you
don’t understand the terms, read again. The first unit is a foundation to
rest of the units, so ensure that you read and learn this unit first.
2) After you read each section, try to attempt the Check Your Progress for
that section and cross check your answers from Answers to Check Your
Progress given in the later section of the unit. This will provide you with
a feedback on what you have learned and what you need to further focus
on and understand.
10
BLOCK 1
INTRODUCTION TO HEALTH AND WELLBEING
11
UNIT 1
Introduction to Health and Wellbeing 13
UNIT 2
Models of Health and Illness 25
12
UNIT 1 INTRODUCTION TO HEALTH
AND WELLBEING*
Structure
1.0 Objectives
1.1 Introduction
1.2 Concept and Definition of Health
1.3 Cross-cultural Perspectives on Health
1.3.1 Western Perspective
1.3.2 Eastern Perspective on Health
1.3.3 Indian Perspective on Health
1.0 OBJECTIVES
After reading this unit, you will be able to:
discuss the concept and definition of health;
explain the perspectives of health; and
describe the Health-Illness continuum.
1.1 INTRODUCTION
Rahul and Samina are a happily married couple in their early 30s. They
both work in a multi national company and are doing very well in their
jobs. But despite of high income and a comfortable lifestyle, Rahul was
recently diagnosed with hypertension and Type II diabetes and Samina is
stressed all the time and has developed sleep problem for which she is
consulting a physician.
Nirav is a ten year old boy and though he has always been on a healthier
side, he has been recently diagnosed as being obese. Doctor has attributed
his obesity to lack of healthy diet, (including fruits and vegetables that
are rich in fibre) and to regular consumption of junk food, soft drink and
sweets.
Arun was a topper throughout his school years and managed to get
admission to one of the best colleges in his cities to pursue a programme
* Dr. Arti Singh, Academic Associate, Discipline of Psychology, SOSS, IGNOU, New Delhi 13
Introduction in management. During this time, he started consuming alcohol and also
started smoking, that soon developed in to a habit and addiction. As a
result not only his studies suffered but his relationship with his family and
friends has also been negatively affected. His parents have now admitted
him to a de-addiction centre to help him recover.
After loosing her mother to a terminal illness, Savita who was once a bubbly
eight year old has now become secluded and lonely. She has stopped
interacting with her friends and refuses to attend school. She is also not
able to eat and sleep adequately. Her family doctor recommended her to
a clinical psychologist who has diagnosed her with having depression.
The above examples, highlight some of the aspects of health. It can be said
that health is one of the most important but most deprived aspect of our life.
Nowadays, our lifestyle has become more leisure oriented, indoor, technology-
centered and dependent on food such as pizza, burger, chips, cold drink, etc.
In all probability, this lifestyle is damaging our health and increasing the burden
of non-communicable diseases on our healthcare system. Moreover, conventional
hospital treatment has been found to be inefficient in treating lifestyle-related
diseases. It is thus important to focus on health and deal with it at multiple
levels not only by making adequate health services available but also by
encouraging healthy lifestyle amongst the individuals.
In the very first unit of this course, we will discuss about the concept and
definition of health. The difference between illness, disease, and sickness will
also be focused on. Further, the conceptualisation of health according to western
and eastern perspectives will also be explained. The Health-Illness continuum
will also be described.
HEALTH
The way in which health is defined or perceived may vary based on culture.
In this sub section of the unit, we will try to understand varied cross cultural
perspectives on health.
Since cultural beliefs are intricately woven into the health beliefs of patients,
therefore to understand any health-related behaviour it is essential to acknowledge
and understand the role of culture and society first. In this section, we will discuss
how western and eastern societies conceptualise health and illness. Before starting
this section, first let’s discuss the concept-Karma. Karma refers to the
metaphysical principle of cause and effect. It is a belief that the accumulated
effects of your deeds of last birth have an effect on the events of present life.
Studies have suggested that in India patients with life-threatening chronic diseases
such as AIDS, heart disease, and cancer tend to attribute the cause to karmic
factors more. Whereas, in western countries very few patients attribute illness
to karmic factors. What do you think, why there is a difference in their causal
attribution? The reason could be ‘cultural differences’ in the conception of the
role of Karma in life-events. This example suggests that cultural notions
significantly affect our conception of health.
1.6 REFERENCES
Bauman, B. (1961). Dversities in the Conception of health and Physical Fitness.
Journal of Health and Human Behaviour, 2, 39-46
20
Benyamini, Y., Leventhal, E. A., & Leventhal, H. (2003). Elderly People’s Introduction to Health
and Well-being
Ratings of the Importance of Health-Related Factors to their Self-assessments
of Health. Social Science & Medicine, 56(8), 1661-1667.
Sanderson, C. (2013). Health Psychology. USA: John Wiley and Sons Inc.
Undén, A. L., & Elofsson, S. (2001). Health from the Patient’s Point of View.
How does it Relate to the Physician’s Judgement? Family Practice, 18(2), 174-
180.
Wikman, A., Marklund, S., & Alexanderson, K. (2005). Illness, Disease, and
Sickness Absence: an Empirical Test of Differences between Concepts of Ill
Health. Journal of Epidemiology & Community Health, 59(6), 450-454.
1.7 KEYWORDS
Disease: Used by doctors or physicians to describe the pathological and
biological aspects of health conditions of his/her patients.
Dualism: Perspective prevalent in western societies, which states that mind and 21
Introduction body are two separate entities and have no connection between them.
Holistic model: This is the model of health and illness majorly followed by
all eastern civilisations.
Sickness: It refers to social role and expectations associated with the patients
and its caregivers.
1) Define Health
b) The basic premise of all eastern civilisation is that health is more than
just an absence of disease or its symptoms.
John Travis
22
Introduction to Health
and Well-being
23
UNIT 2 MODELS OF HEALTH AND
ILLNESS*
Structure
2.0 Objectives
2.1 Introduction
2.2 Medical Model of Health and Illness
2.3 Holistic Model of Health
2.4 Biopsychosocial model
2.5 Social Model of Health
2.6 Concept of wellbeing
2.7 Let Us Sum Up
2.8 References
2.9 Key Words
2.10 Answers to Check Your Progress
2.11 Unit End Questions
2.0 OBJECTIVES
After reading this unit, you will be able to:
discuss the medical model of health and illness;
describe the holistic model of health;
explain the biopsychosocial model;
discuss the social model of health; and
elucidate the concept of wellbeing.
2.1 INTRODUCTION
In recent times many public celebrities like Deepika Padukone (a Bollywood
actress) have become more vocal about their mental illness (Depression in the
case of Deepika Padukone), that was quite positively received. Do you think,
reactions would have been received around 50 years ago if some one had talked
about his or her state of depression? May be not because the probability of
social rejection and taboo were much higher at that time and also, because
of the prevalent health models that labeled and defined an illness. Models provide
a theoretical framework so as to enhance our understanding of the concept,
in this case, health.
So why do we need to study health models? Because the model of the health
and illness adopted by society can have many important implications. It not
only influences the line of treatment but also influences people’s perception,
attitude and cultural beliefs. Another benefit we can gain from studying these
24 * Dr. Arti Singh, Academic Associate, Discipline of Psychology, SOSS, IGNOU, New Delhi
health models is that they can help us in appreciating their role in establishing Models of Health and
Illness
health psychology as a separate branch. Health psychology has been briefly
described in Box 2.1.
In the previous unit we discussed about the concept of health and also focused
on the cross-cultural perspectives of health besides the Health-Illness continuum.
This unit tries to offer an overview of important health models that have played
a vital role in the development of health psychology. Further, the concept of
wellbeing will also be described at the end of the present Unit.
Responsibility for disease: This model considers that the cause of illness is
not dependent on the individual. Due to this reason, individuals are not seen
as responsible for their illness. Patients are considered as only victims of some
external factor or internal abnormalities.
Techno-oriented Model: This is the only model of health which relies heavily
on machines and technologies. From making a generic drug to performing a
surgery, everything here requires technology.
There is no doubt that the medical model is very effective in critical medical
conditions. Therefore, it is often referred to as “quick fix” approach. It can
provide immediate relief and quickly minimise the symptoms of the disease.
However, many researchers have pointed out a number of limitations of medical
treatment. According to George Engel (1997) and Guttmacher (1979), the
medical model have many drawbacks. Some of the major limitations are as
follows:
................................................................................................................
................................................................................................................
................................................................................................................
2) State any one limitation of the medical model of health and illness.
................................................................................................................
................................................................................................................
................................................................................................................
................................................................................................................
In this section, we will discuss the most famous holistic model, Biopsychosocial
model. Between the 1960s and 1980s, George Engel published a series of papers
criticising medical model and advocating the need for a new model of health
and illness. He proposed that,
‘‘........the existing biomedical model does not suffice. To provide a basis for
understanding the determinants of disease and arriving at rational treatments and
patterns of health care, a medical model must also take into account the patient,
the social context in which he [sic] lives, and the complementary system devised
by society to deal with the disruptive effects of illness, that is, the physician
role and the health care system. This requires a biopsychosocial model’’ (Engel
1977, pg. 132)
Biopsychosocial model, as the name suggests, conceptualises health as consisting
of multiple dimensions. The medical or biomedical model focuses only on the
physical aspect of health, but Engel’s new model includes psychological and
social aspects as well. It is based on the idea that “humans are inherently
biopsychosocial organisms in which the biological, psychological, and social
dimensions are inextricably intertwined” (Melchert, 2007, pg. 37). Engel did
not completely reject the benefits of the medical model but emphasised on giving
equal importance to psychological and social factors in the process of treatment.
This model suggests that other than physiological abnormalities, germs and
viruses, our behaviours, thoughts, and feelings may also influence our physical
state. Further, Engel also argued that physicians should also give importance
to subjective experiences of their patients.
Broadly, there are three areas in which the biopsychosocial model has offered
new insights: (1) patient’s subjective experience is as important as objective
biomedical data, (2) a comprehensive causation can give fuller and deeper
understanding of our health and illness, and (3) patients should not be treated
as passive recipients of the treatment. They should be given more power in
the clinical process.
The main advantage of this model is that it leads to numerous development
in technology and research. It also contributes to the diagnoses and effective
treatment of varied illnesses. It also leads to increase in life expectancy and
enhancement of life expectancy. Though the model tends to rely on technology
and thus could be cost ineffective and may not be affordable. The focus of
this mode is also more on treatment than on actual promotion of good health.
Check Your Progress III
1) What are the three areas in which the biopsychosocial model has offered
new insights?
...............................................................................................................
...............................................................................................................
...............................................................................................................
...............................................................................................................
............................................................................................................... 29
Introduction
2.5 SOCIAL MODEL OF HEALTH
Social model of health finds its roots in the social model of disability and as
such is a reaction to the medical model. In this model various factors that play
an important role in health, like, social, political, economical, cultural and even
environmental are taken in to consideration. For instance, environmental pollution
can lead to detrimental effects on health. This model can be termed as a
community based approach where the focus is on prevention of the illnesses/
diseases. Thus, relevance is given to the awareness programmes and policies
related to health so as to modify the lifestyle and health related behaviour of
the individuals so as to promote their health and wellbeing. Thus, according
to this model health can be promoted by keeping in mind the social, political,
economical, cultural and environmental factors.
The main characteristics of this model are as follows (Yuill, Crinson and
Duncan, 2010):
3) Cultural variations exist in the way health and illness are perceived.
Social model thus focuses on the social responsibility in order to ensure that
people have a healthy lifestyle and environment. And strategies at varied
levels, like, economical, political and so on, need to be developed in order
to promote health amongst individuals. Thus, the social model of health focuses
on varied determinants of health and also strives towards decreasing social
inequalities. It focuses on empowerment of not only individuals but communities
as well.
Some of the major advantages of this model are that this model promotes
education amongst the individuals and is also cost effective. It also puts the
onus on the individual so that he/ she develops healthy lifestyle. The model is
based on community approach and seeks involvement of both governmental and
non-governmental agencies. Despite of the advantages, the social model may
also display some issues or disadvantages. Individuals may not be motivated
or may lack awareness regarding health behaviour and lifestyle. Further, brining
about change in an individual’s health related behaviour is not easy. This is a
long term measure and thus quick results may not be achieved.
30
Check Your Progress IV Models of Health and
Illness
1) State any one characteristic of social model of health.
................................................................................................................
................................................................................................................
................................................................................................................
35
36