For centuries there has been discussion around whether mental events are of physiogenetic (soma, brain) or psychogenetic (psyche, mind) origin, how those comes about, and what the nature is of the relation between those domains. These questions are of critical practical importance in medicine, and especially in psychiatry.
The Oxford Loebel Lectures and Research Programme (OLLRP) seeks to address the shortcomings of a unilinear approach to mental illness that comes from focussing uniquely on the biological, psychological or social contributions, functioning independently.
Instead, the Programme will work towards delineating the nature and magnitude of biopsychosocial interactions in the causation, evaluation and management of mental states, normal and abnormal (e.g. how the gene interacts with the environment), going beyond a simple checklist of contributing factors to arrive at an understanding of how the interactions between factors affect one other, and indeed configure the whole. An approximation to the concept is the image presented by a finely woven tapestry in which the design emerges clearly from a weave whose threads are too fine to be seen unaided.
We will bring the best philosophy to bear on this analysis to clarify concepts and generate hypotheses. Ethics will evaluate potential interventions and management strategies, and beyond to consider the possibilities of functional enhancement.
The end result of this manner of conceptualizing mental illness and indeed illness in general is potentially transformative. The appeal to understand the patient “as a whole” has been heard at least since Hippocrates who aphoristically enjoined us “to understand not the illness the patient has, but the patient the disease has”. This entails the diagnosis and treatment not solely of symptoms but also of propensity and vulnerability, of risk factors, resistance and resilience, and the potential for the attainment not only of recovery from an ailment but the attainment of wellness. Thus, while the reductive or atomistic approach will always continue to be useful it will come to be seen as complementary to the approach proposed by George Engel with the title “Biopsychosocial” (BPS).
OLLRP will examine the BPS approach with a view to incorporating modern findings and hence further develop the concept for the 21st Century.
The project will aim to emulate the manner in which the development of Evidence Based Medicine - a relatively new concept in 90s - has become now a foundation for practice, for research and for policy.