Der biopsychosoziale Krankheitsbegriff in der Praxis

Many of the recent approaches in diagnostics and therapy, e. g. the behavioral medicine, consider themselves as “holistic” or “multidimensional”. By closer consideration, however, it turns out, that while more or less referring back to the system-theoretically founded “bio-psycho-social model” (Engel, Weiner et al.) its implications are not taken seriously in practice. Presenting a concrete work project (“simultaneous diagnostics”) we will show, how to implement this (theoretically potent) bio-psycho-social conception of disease in clinical practice. It can be clearly seen, that it cannot replace the conventional reductional approach of medicine which focusses on the examination of single processes and structures under simplified conditions. On the contrary, such reductionism remains indispensable, because to be able to grasp any higher (more complex) structure one has to know its elements. Comprehensive explanation of phenomena, however, is not possible in a reductionist way. Therefore, the bio-psycho-social disease model in its operationalization is not a new way of medicine, rather an expanded approach to diagnostical and therapeutic issues.