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There are other
limitations to the disease-as-abnormality model. It assumes that the biological individual
is the unit of disease - that is, such a view is person-centered. However, if one adopts a
different view, it can be seen that widespread health problems are better understood if
they are considered as a breakdown in function of more complex systems, of which the
individual is only a component. Systems do not stop at the level of the skin, the human
being is an organism that exists in complex levels, constantly exchanging itself with its
physical environment, chemically and energetically, and with its social and psychological
environment through behaviour. A second problem is that the prevailing
model of disease is temporally-bounded. That is, it presents disease as discreet,
time-limited events, which are therefore discontinuous (they have a beginning, middle and
end). However, both phenomenologically and in systems terms, disease events may actually
reflect symptoms of more general systems breakdown, such as family breakdown, which itself
might be seen as a function of economic decline or war. Even within the individual this
view can help: type 2 diabetes, hypercholesteroleamia and vascular disease are
collectively referred to as Metabolic Syndrome (MS). Yet diabetes and the other
“symptoms” of MS are treated as separate diseases, not as symptoms of MS. The cause of
MS is over nutrition and inactivity. The cause of the symptoms of MS as sought in the
blood levels of lipids and insulin resistance.
A third point is that most disease is not limited to specific systemic models
(GI, CNS, CVS), and also tends to be instead either self-limiting (If you treat the
patient, he gets better in a week; if you don’t treat him, he gets better in seven
days), or it is chronic (continuous, fluctuating and, by definition, incurable). Most
disease falls into these two categories. |