Table Of ContentEditor
Girishwar Misra
Psychosocial
Interventions
for Health and
Well-Being
Psychosocial Interventions for Health
and Well-Being
Girishwar Misra
Editor
Psychosocial Interventions
for Health and Well-Being
123
Editor
Girishwar Misra
Mahatma Gandhi Antarrashtriya Hindi
Vishwavidyalaya
Wardha
India
ISBN978-81-322-3780-8 ISBN978-81-322-3782-2 (eBook)
https://doi.org/10.1007/978-81-322-3782-2
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Foreword
Themassofmenleadlivesofquietdesperation.Whatis
calledresignationisconfirmeddesperation…Astereotyped
butunconsciousdespairisconcealedevenunderwhatare
calledgamesofamusementandamusementsofmankind.
Butitisacharacteristicofwisdomnottodo
desperatethings.
HenryDavidThoreau,Walden(August9,1854)
The Conditions for Human Health and Well-Being Reside
in the Psycho-social Contexts of Life ©
Introduction
I call upon the timeless words of Henry David Thoreau, a nineteenth-century
student of Ralph Waldo Emerson (1803–1882), to open this article on the critical
consequences of the sociocultural context for human health and well-being. It is,
perhaps,coincidentalthatthisyearisThoreau’s200thyearanniversary,areminder
of the enduring power of great thoughts and words. Guide me, Sir!
IofferonlyafewlinesofThoreau’swordsasanepigram,insufficienttohonour
the timelessness of his thoughts, but perhaps sufficient to acknowledge his special
sensitivitiestothehumanconditionofhisageandourage.Thoreau’sentireworks
deserve reading. The unfolding industrial age in which he lived, was the source of
problems paralleling the problems of our unfolding socio-technical age.
Icanthinkofnobetterguidetojustifythethoughtsandwordsofthisarticle.In
so many ways, we have forgotten the tragic consequences of the psychosocial
contexts of life for the human condition; we have become infatuated with ‘reduc-
tionism’, a wondrous gift of technological progress, but a distraction from the
realities of human nature.
No one can deny the sheer wonder and glory of our growing knowledge of the
centralnervoussystem(CNS),brain,organsandgenetics.Yet,themagnificenceof
v
vi Foreword
our knowledge must not detract from our understanding the socioenvironmental
determinantsofourlifemilieu.Politicalpowers,controllingfundinghavecalledfor
various national initiatives: ‘Decade of the Brain’.
Similar initiatives, however, for increasing awareness of psychosocial
topics have too hidden agendas (see TV documentary: America’s War on Drugs,
http://www.history.com/Shows/Americas-war-on-drugs). On the surface, they
appear to be noble in their intent, a massive government effort to address the
endemic drug problems, including enhanced criminal prosecution. However, hidden
agendassupportedarmsdeals,racialoppressionanddisguisedforeign-relationspolicies.
Recall, proposals by President Nixon and President Reagan resulted in impris-
onment of vast numbers of African-American offenders, even for minor offenses;
Recall also, billions of dollars generated by illegal drugs funded government
oppression of insurgents in Central America, and kept pro-USA governments in
power. We reap the consequences of these corrupt efforts today in the epidemic
opiate disorders and deaths.
Psychosocial Contexts
KurtLewin(1890–1947),oneofpsychology’sgreatthinkers,contendedbehaviour
isafunctionoftheinteraction oforganismandenvironment(B=O(cid:1)E).Itisthe
interaction of an organism and its milieu which generates behavior, and the prob-
lemsofdiseaseanddisorder.Nothingexistsapartfromitsinnerandoutersingular
milieu. Although physicists may disagree, nothing exists in a vacuum! Life is
connections.
As we become increasingly, and deservedly, awed by reductionist discoveries
and revelations, and as we seek insights, answers, and solutions to major human
problems within reductionist levels, we are failing to address and resolve the
challengesofthepsychosocialcontextofourlives.Thepsychosocialcontextisthe
life context in the behaviour equation. The psychosocial context has critical
implicationsandconsequencesforhealthandwell-being.Itisaformativecauseof
problems, a precipitating, an exacerbating cause and a maintaining cause. The
psychosocial context requires careful attention and understanding in all of the
causal relations (Fig. 1).
The challenge of first grasping a causal pattern and then of disentangling its
patternforinterventionisdifficult,andservesasadeterrenteventowell-intentioned
socialandpoliticalactivistsandofficials.Howmucheasierisittosimplyturntoa
pill to change a brain?
Wemaybeexcessivelyconcernedandpreoccupiedwiththephysicalaspectsof
our being, even to the extent of dividing solutions into medical specialties,
sub-specialties, and sub-sub specialties. We journey across limb, organ, cell, gene,
atom and molecular space; this journey has proven miraculous for many diseases
and disorders. However, this journey alone cannot address nor resolve the tolls
Foreword vii
Maintaining
Causes
Exacerbating
Causes
Formative ______ Precipitation
Causes Causes
Fig.1 Multi-dimensionalcausality:thecomplexecologyofcausalrelations
exacted on human health and well-being forged and sustained within the psy-
chosocial contexts of our lives.
There are many empirical and theoretical reasons concluding many diseases,
disorders, dysfunctions, deviancies, and distress arise from the psychosocial con-
texts of our life than from our body alone. Indeed, the experiences forged and
sustainedinthepsychosocialcontextsshapeandgeneratemanyofthesetragic‘D’
words as the body and mind become war zones for survival struggles—lives of
‘quiet desperation’.
Today, humans seek respite and relief from ‘desperation’ in prescription pills,
illegal drugs and substances, and/or both. Pills and substances are often temporary
palliatives, unable to treat and heal the broader destructive contexts of human life,
located in the ‘isms’, poverty, violence, war and oppression.
There can be no doubt pills and substances alter behaviour via neurochemistry
and anatomical structure. However, seeking solutions to the determinants of
problems requires solutions appropriate to the level generating them and their
consequences. Tragically, psychosocial contexts, though obvious, are too often
ignored.Thesearebigproblems!Toooftenlocal,nationalandinternationalleaders
yield to the preferences of the wealthy, powerful and positioned. The result is the
‘medicalization’ofsocietyandhumanexistence.Abuseofpowerbythoseinpower
is history’s story! It is said it is inevitable. The phrase ‘Absolute power corrupts,
absolutely is well known’, and is now visibly apparent.
Many noble minds and hearts sought to awaken humanity to the psychosocial
sources of their problems (e.g., Gandhi, Martin Luther King, Jr., Cesar Chavez,
NelsonMandela,PresidentJohnFitzgeraldKennedy),butthoseinpower,continue
todominate,‘tossingbonesofsolace’toreachinghands.Todaytheworldisgifted
by many new heroic stalwarts, who are advancing peace and social justice (e.g.,
Mairead McGuire, Michael Knox, Antonio de Rosa, Glenn Paige and numerous
others). The struggle, however, is endless, and requires a person become a social
andpoliticalactivist.Ashasbeensuggestedbymany,today’ssituationrequiresus
to merge personal, occupational and civic lives; there must be a fusion or a
viii Foreword
VIOLENCE &
AGGRESSION
Breeds:
ABUSE Fear, Anxiety, Dread DISTRUST
Breeds: Breeds:
Trauma, Sorrow, Suspicion, Paranoia,
Suffering, Retaliation Isolation
INEQUITY HUMILIATION
Breeds: Breeds:
Resentment, Anger, Revenge, Reprisal,
Contempt Resentment
PSYCHO-SOCIAL
CONTEXTS
and
HEALTH &
WELL-BEING
RACISM, SEXISM,
OPPRESSION AGEISM, CLASSISM
Breeds: Restricts:
Resentment, Anger, Choice, Opportunity
Violence
Punishes: Status
CULTURAL
DESTRUCTION
POWERLESSNESS
Breeds:
Breeds:
Confusion, Conflict,
Fear, POVERTY Hopelessness,
Uncertainty, Despair
Uncertainty Breeds:
Illness, Disease,
Death, Grief,
Suffering
Fig.2 Psychosocialcontextsforhealthandwell-being
gathering of ‘self’. In two previous publications with the Transcend Media
Service,1 I suggested a number of psychosocial contexts determining health and
well-being.Theseconditionsandcontexts,aswellasothers,aredisplayedinFig.2
and Table 1, along with suggestions of the human responses and conditions they
breed and nurture.
ThematerialinFig.2isalsoofferedintabularforminBox1.Readersmayuse
eitherorbothforpurposesofteachingandotheractivities.Box1offersafewmore
assertions than Fig. 1 because of space limitations.
1See A.J. Marsella September 17, 2012: www.http://transcend.org/…/the-conditions-for-human-
health-and-well-being-reside-in-the-psychosocial-contexts-of-life/; and A.J. Marsella, July 17,
2017: www.http://transcend.org/…/the conditions for human health and well-being reside in the
psycho-social-contextsoflife/.
Foreword ix
Box 1: Psychosocial Contexts for Health and Wellbeing
Wecannothavehealthandwell-beingwherethereisculturaldestruction,for
this breeds confusion, conflict, fear, and uncertainty;
We cannot have health and well-being where there is oppression, for this
breeds resentment, anger and violence;
We cannot have health and well-being where there is powerlessness, for
this breeds hopelessness, uncertainty and despair;
We cannot have health and well-being where there is poverty, for this
breeds illness, death, grief, suffering;
Wecannothavehealthandwell-beingwherethereisdenigration,disdain,
and contempt for others, for this breeds low self-esteem, worthlessness,
identity confusion;
We cannot have health and well-being where there is violence and
aggression, for this breeds fear, anxiety and dread;
We cannot have health and well-being where there is distrust, for this
breeds paranoia, suspicion and isolation;
We cannot have health and well-being where there is inequity and
inequality, for this breeds resentment, anger, contempt;
Wecannothavehealthandwell-beingwherethereishumiliation,forthis
breeds revenge, resentment, and reprisal;
We cannot have health and well-being where there are environmental
toxins(e.g.,lead,mercury,radiation),forthisbreedsdisease,disorderand
death;
We cannot have health and well-being where there are tolerated and
accepted power asymmetries and physical abuses (e.g., bulling, rape,
familialviolence),forthisbreedsfear,injustice,hopelessness,andsuicide;
Wecannothavehealthandwell-beingwherethereisasymmetricpolitical
partisanship,forthiscorruptslegalandmorallocal,regionalandnational
governmental processes.
We cannot have health and well-being where there is government cor-
porate and military corruption, cronyism, favoritism, nepotism, for this
breeds societal collapse, citizen and terrorism.
Complexity, Interactions, Potentiation
There are many more items warranting inclusion, as ‘interactions’ foster new
contexts and complexity. Amidst this challenging ‘matrix’, it is easy to become
pessimistic, to give up on solutions, and to accept forces and fates as destiny. Do
not!
x Foreword
As the struggles appear overwhelming, find inspiration and hope from those
aboutyou,especiallyatthelocallevels,makingcontributionstopeace,justiceand
dignity. They are the new heroes of our times. Turn to them, model them; release
your own heroic impulses, kept too often restrained, as Thoreau notes in the epi-
graph quoted above, by indifference, fear, and comfort.
Therewillonlybeoneofyouinthislifetime.Smallcontributionsatlocallevels
canescalatetolargercontributionsasinstitutionsrespond.Whileeffortstoaddress
social conditions and contexts are often met with resistance and delays by local
officials, sometimes because of political graft and corruption, there are many
options for activism.
Gandhi’slifeanditsconsequencesofferastrikingexampleofthedetermination
of one person to address inequities and injustices of an imperial age. Gandhi’s
non-violencecoursewasnoteasy,andmanydiedinthestruggletofreeIndiafrom
Britishdomination.Today,therearemanyoptionsforactivism.Therearelettersto
editors,petitions,peacefulprotests,communityorganization,educationalmaterials,
newsletters, listservs, speaker bureaus, silent presence at community and govern-
mentmeetings,meetingswithgovernmentofficials,datacollectionofpsychosocial
consequences, involvement of teachers, doctors, lawyers and others in key posi-
tions. Move beyond ‘quiet desperation’. Imagine it! Do it!
Honolulu, USA Anthony J. Marsella, Ph.D.
2017 Member, TRANSCEND Network for Peace
Development and Environment
Past President Psychologists for Social Responsibility
Emeritus Professor of Psychology
University of Hawaii’s Manoa Campus in Honolulu Hawaii; and
Past Director, World Health Organization
Psychiatric Research Center
