Monday, March 10, 2008


Although I got replies to my last blog, I did not get anyone to take a stab at answering the question about the first use of the word/words bio-psycho-social-spiritual. Nevertheless let’s try to define at least what I mean when I use it by coming up with examples.
I consider when I have a manic episode caused by my bipolar illness that I am dealing with a bio or biological phenomenon. Since I consider my bipolar disorder a brain disease, I put it in the bio category. That is not to say that the other three don’t influence or play any part in the manic episode, but the main factor is a malfunctioning body part we call the brain.
When I am depressed it is a bit more complicated. It can be bio, but it can also be mainly psychological. This is sometimes referred to as situational depression. How can I tell the difference? Certainly not by how I feel. However, if I am not so depressed that I can’t do it I can think back to see if something happened that started it. If I can’t identify a reason for it starting then I assume I am in what is commonly referred to as clinically depression which means it is caused by my biological disorder called bipolar. Now to be sure this is not an easy thing to figure out and at times I am both depressed and manic.
A social situation that those of us with a mental illness and our families are very familiar with is stigma. Another one that most of my fellow sojourners deal with is poverty. You put stigma with poverty and you have created a social crisis for the individual.
To understand spirituality does not require you to believe in a soul or God or a life after this one. Let me clearly state I do believe that we have souls which live for eternity and that God created us and all we see around us. However, to get the meaning of the fourth word you do not have to believe as I do. Spirituality does not mean a church or a certain dogma. It means we all have an inner life and much of how well we do on our individual recovery journeys depends on how we learn to deal with our inner life.
For example during a manic episode my actions are more determined by what is deep inside me than from any psychological insights or social morals. My mind is racing and I am acting faster than facts can keep up with. You might say I have to hope my guts will keep the ship on course. From deep within is my only hope.
Now I believe that deep within me is the Creator’s Spirit helping me keep this manic force on some sort of course. You may have a different belief about how you get the help you need when the world seems to over take you, but whatever the view most folks still say they feel it deep inside themselves. In their souls.
We will never get to the place that we can truly be useful to others on their recovery journey until we see them in their complex state as all humans are. We live in a complex yet fragile universe among people who are both complex and fragile. Brave and weak. How would one ever know how majestic an elephant was if they could only see the tail?
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