Parents, siblings, and community can play a vital role in shaping up one’s socialization patterns in adulthood. From the description of the childhood days of Eduardo, it is apparent that he was not a motivated person and did not receive any academic performance pressures from parents as well as siblings. Eduardo seem to enjoy an extended family set up, with strong bonds among his siblings and engage in frequent interaction among his kith and kin. However, Eduardo has not developed the skill of establishing relationship with colleagues and peers outside home. Cooperativeness and closeness among family members may have passively influenced Eduardo to ignore socialization with the outside world, and contributed to his laggard approach in participating outside social events. Family traditions can create a positive support system during tough times, and Eduardo seems to be receiving support from family. The case indicates that Eduardo has not sought medical help for serious illness, but for mundane symptoms which many normal people have ignored. May be by the pressure from Eduardo’s wife he has consulted the medical experts. However, on close examination only the doctors have identified the risks of developing serious diseases.
Biopsychosocial model is built on the simple premise that the body can influence mind and mind also influences body conditions. Social and psychological factors can cause a biological effect by exposing a person to risk factors, and vice versa. For example, depression by itself do not cause diabetes, but a depressed person may have a sedentary life style and prone to binge eating leading to obesity, and that really produces the risk of diabetes. The patient can probably reduce the risk of diabetes by following an exercise program and keeping oneself active. From a bio-medical approach a person in the risk of diabetes will be prescribed strict diet and internal medicines. On the contrary, biopsychosocial approach takes into consideration what social and psychological factors of the patient triggers the risk of diabetes, and provides solution for it. If Eduardo regularizes his eating pattern and takes up a physical activity with the help of his family members, such as sports or active hobbies, he may have reduced risk of diabetes and recover from problems of shortness of breath, insomnia, etc. Training on social skills such as assertiveness, interpersonal communication, and stress management can also enhance the life of Eduardo, and might get rid of all his crippling symptoms. Such is the power of biopsychosocial approach.
Eduardo belongs to the community of Hispanics, and they have a typical way of life in America. It is reported that ordinary, middle class Hispanic Americans normally avoid competition or activities that will make them stand apart. This phenomenon is clearly evident in the Eduardo’s case; he has been an average student, and did not show any urgency or desire foe career advancement. Probably, if Eduardo overcomes his cultural influence and develop competitive goals, his life might become more prosperous. It is also indicated that children in Hispanic families learn the meaning of deep sense of family duty, inflexible rules of sex roles, unquestioned respect and reverence to the elders, and male domination over women in the family. The case does not mention that Eduardo falls into these cultural generalizations.
Generally, women in Hispanic families take a subordinate and subdued role, and allow males to take up the authoritative position. From childhood, sons would be given more independence to move around and decide for themselves than the daughters. Eduardo’s wife’s fear and helpless confession indicates that she is a typical Hispanic woman who tolerates her spouse’s shortcomings dutifully. There is no indication in the case that Eduardo dominated his wife, instead he has taken steps to overcome his physical debilities by consulting the professionals. In communication terms Hispanics are taciturn, do not show of their feelings, avoid eye contacts, relaxed about punctuality (do not meet deadlines) and are cooperative than competitive. These cultural characteristics of Hispanics perfectly match Eduardo’s behaviors too. Thus biopsychosocial model proposed by George Engel in 1977 is a valuable framework to assess a patient holistically and improving the prognosis.
Rivera, B. D., & Rogers-Adkinson. D. (1997) Culturally sensitive interventions: Social skills training with children and parents from culturally and linguistically diverse backgrounds. Intervention in School and Clinic. 33(2), 75-80.
Engel, George L. (1977). "The need for a new medical model: A challenge for biomedicine". Science 196:129–136.