1: Weaving the Biopsychosocial Braid
Begin by contemplating three of the course's core questions: Why do people get sick? How do people get well? What can we do about it? As a guiding context for the lectures, learn about the biopsychosocial paradigm, which looks at the relationship between the biological, psychological, and social factors in human health.
2: Vital Signs-Defining Health and Illness
What does it mean to be healthy? Here, look at definitions of health, sickness, and disease as multidimensional constructs. Examine how we measure health, both individually and publicly. Review health determinants such as human behavior, geography, the environment, genetics, and economic factors in approaching a more holistic model of health.
3: Fight or Flight vs. Rest and Digest
Begin to look at the biological pathways whereby psychological and social phenomena affect the body. Study the autonomic nervous system, the biology of the "fight or flight" response, and its opposite, the relaxation response. Also learn about the body's stress-response system and the medical consequences of chronic stress.
4: Simmering Soup-The Neuroendocrine System
Here, study the anatomy and function of the endocrine system as it affects the body's stress response. Learn how the endocrine system releases cortisol, the "stress hormone," into the bloodstream, and the physiologic changes that cortisol produces. Review the problems caused by cortisol imbalance and key approaches to controlling stress.
5: Deploying the Troops-Basic Immunology
What is the relation of the mind to the immune system? Study how the immune system fights foreign organisms, destroys altered cells, and heals wounds. Then examine studies showing the effects of stress on front-line immune response, susceptibility to disease, and wound healing. Learn also how meditation can boost immune function.
6: Nature vs. Nurture-Genes, Health, and Disease
Review the basic science of genetics and inheritance as a lead-in to the fascinating field of epigenetics. Grasp how genes are biologically expressed or "turned on" and how our behaviors and environment can alter our genetic material (for better or worse) within our lifetimes-alterations that can be passed on to subsequent generations.
7: Forget Me Not-Cognitive Function
In the first of two lectures on cognition, look at definitions of intelligence and whether intelligence can be changed. Consider the many factors affecting IQ and whether IQ correlates to achievement. Learn about "neurobics" and other ways to improve cognitive functioning, and study the nature of learning and memory.
8: Mind over Matter-Cognition in Everyday Life
Begin this lecture by studying the power of belief and how it can affect our health. Learn about the "dual process" model of thinking and how thinking affects behavior. With reference to cognitive therapy and positive psychology, study reflexive or "automatic" thinking and practical approaches to changing our thinking, emotions, and behavior.
9: Emotions Revealed-Psychology of Emotions
Consider the function of emotions-what they signal and communicate and how we express them, both verbally and in many nonverbal ways. Study their evolutionary purpose, including the role of positive emotions in problem solving and creativity. Review studies of happiness and the specific health effects of different emotional states.
10: Agony and Ecstasy-Biology of Emotion
Learn about the parts of the brain that correlate to emotional experience as they generate emotions and emotion-based memories and regulate our behavior. Note the physiologic "signature" of different emotions-the physical changes emotions produce-and track experiments indicating that altering physical posture and movement changes emotional experience.
11: What's Your EQ, and How Can You Improve It?
This lecture introduces the concept of emotional intelligence: how we perceive, use, understand, and manage emotions. Explore different models of EQ and ways of testing it as they relate to health and the regulation of emotions. Study key strategies for managing negative emotions and for generating positive ones.
12: What's Your Type? Personality and Health
How is personality related to health and disease? Learn about the history of personality testing and the identification of personality "types" based in behavioral traits. Study what these typologies may predict about health matters such as depression and cardiovascular disease, and consider ways to compensate for risk-carrying personality traits.
13: An Apple a Day-Behavior and Disease Prevention
Begin by investigating health-related behaviors, such as smoking, substance abuse, and overeating. In exploring why we behave as we do, look at biological factors, the neuroscience of addiction and habits, and also at psychological and social determinants of behavior such as socioeconomic status, culture, education, and societal pressures.
14: Staying on the Wagon-Making Changes That Last
Here, investigate leading models of behavioral change, including the "stages of change" model and "motivational interviewing," a group of strategies to support people in action taking. In specific examples, study four key elements of successful behavior change, the nature of willpower, and the internal skills of self-regulation.
15: Ease the Burn-Modern-Day Stress and Coping
This lecture discusses stress as an integration of biology, cognition, behavior, and social and emotional factors. Look at stress response and coping as a developmental skill, and explore eight kinds of coping behavior. Then review a menu of stress-management options, both cognitive and behavioral, highlighting mindfulness meditation and the skill of resilience.
16: The Iceberg-Visible and Hidden Identity
Moving to social factors related to health, explore how health is affected by identity. Observe how personal identity is embedded in culture, and study the features of identity formation, using examples of race and gender. Look at the impact of stereotypes and labels as they affect both health and health care.
17: Ties That Bind-Relationships and Health
Now take an in-depth look at relationships and at the kinds of support that social connections can provide. Review the substantial research linking social support to health, in conditions from cardiovascular disease to breast cancer and pregnancy. Finally, use an assessment tool to evaluate the quality of your own social support network.
18: Building Bridges-Intimacy and Relationships
In deepening your look at social factors that affect health, refer to the assessment tool from Lecture 17 and consider ways to strengthen and improve your network of social support. Learn about therapeutic approaches to developing intimacy and resolving conflict in relationships. Also study strategies for managing anger and cultivating empathy.
19: Touched by Grace-Spirituality and Health
Look first at statistics on the prevalence of spirituality, and consider how faith can affect wellness through fostering healthy behaviors, social support, and a sense of meaning. Review studies on the health effects of spirituality, encompassing the physiology of meditation and other faith-based practices, and the significant medical benefits of forgiveness.
20: A Matter of Class-Socioeconomics and Health
Socioeconomic status plays a multilayered role in health. Examine the marked correlation of income to health and the diverse factors that contribute to it. Study evidence on the relation of education level to longevity and to specific medical conditions. Finally, review studies showing surprising connections between social status and susceptibility to disease.
21: A Cog in the Wheel-Occupational Stress
Here, investigate stress in the workplace and the phenomenon of professional burnout. Study research on stress correlated with job category, and the common elements of work-related stress. Learn about ways of measuring individual and organizational stress, links to the onset of medical conditions, and cutting-edge strategies for treating stress.
22: The Power of Place-Communities and Health
Our living environment plays another significant role in health. Assess how neighborhoods affect health, from environmental exposures to the extraordinary benefits of green spaces and contact with nature. Track the effects of our social communities on health-related behaviors, and consider how we can alter our built environments to be healthier.
23: The Master Plan-Public Health and Policy
In a far-reaching look at public health, learn about the field of behavioral economics-its study of the realities of human behavior and how we might use our behavioral tendencies in new ways. Grasp the concept of "choice architecture" as it allows us to make public policy that authentically supports healthier communities.
24: Heart and Soul-Cardiovascular Disease I
Cardiovascular disease shows significant links to psychological and social factors. Study the anatomy and physiology of heart disease as well as the similar pathophysiology of strokes, and review studies revealing startling correlations of stress, personality type, hostility, and depression with cardiovascular function and dysfunction.
25: Heart and Soul-Cardiovascular Disease II
Now look at psychosocial interventions for treating heart disease. Survey the range of behavior change interventions, including diet and exercise, and dramatic evidence that cardiac disease can actually be reversed through lifestyle change. Also track the significant cardiac benefits of stress management, and evaluate the usefulness of treatments for anger and depression.
26: The Big C-Cancer and Mind-Body Medicine
Begin this lecture with a discussion of cancer biology and the range of risk factors for cancer, with emphasis on behavioral and lifestyle-related risk factors. Assess the use of stress management and social support in treating cancer, and investigate whether these and other psychosocial treatments affect cancer outcomes.
27: Bugs, Drugs, and Buddha-Psychoneuroimmunology
Consider the impact of psychosocial factors on the immune system, featuring the correlation of emotional states with wound healing and surgical recovery. Study the effects of behavioral factors and stress management in treating HIV/AIDS and the role of stress in asthma. Finally, look at interventions to improve or recalibrate our immune systems.
28: Fire in the Belly-The GI System
This lecture explores the important connection between the mind and digestion. Study the anatomy and physiology of the gastrointestinal system, highlighting the remarkable role of our intestinal flora. Learn how stress affects digestion in the examples of ulcers and irritable bowel syndrome, and review effective behavioral and psychological interventions used in treatment.
29: Obesity-America's New Epidemic
Can psychosocial interventions prevent or treat obesity? Investigate the phenomenon of obesity in the United States and the social, environmental, and biological factors that may explain its dramatic increase. From the range of approaches to weight loss and management, and parameters from our lecture on behavior change, consider realistic strategies for success.
30: The Strain in Pain Lies Mainly in the Brain
Mind-body factors play a critical role in both the cause and treatment of chronic pain. Study the physiology of pain and the variability of pain experience with respect to emotions, stress, and phenomena such as placebo and "phantom limb" pain. Review treatments including cognitive and behavioral strategies, acupuncture, mindfulness-based stress reduction, and biofeedback. v
31: Catching Your Zs-Sleep and Health
Learn about the science of sleep, sleep's five stages, and how sleep changes as we age. Study sleep deprivation, with a focus on the widespread problem of insomnia. Track the diverse causes of insomnia and possible treatments, including stimulus control, sleep restriction, relaxation and cognitive therapies, and behavior change.
32: Chasing Zebras-Somatoform Disorders
Explore the intriguing phenomenon of medically unexplained symptoms-symptoms that show no discernible organic cause. Regarding conditions such as chronic fatigue, tension headaches, and lower back pain, look at causes ranging from cognition and emotions to cultural and social factors, and review both psychological and physical approaches to treatment.
33: Seeing the Glass Half Empty-Depression
The biopsychosocial model provides valuable interventions for this all-too-common condition. Define the hallmark symptoms of depression and current medical understanding of depressive disorders. Review a case study of depression, highlighting cognitive restructuring and behavior change treatments, as well as the usefulness of medications, supplements, and shock therapy.
34: Silencing the Scream-Understanding Anxiety
Investigate how fear and anxiety affect your mind and body, and explore the biology and symptoms of anxiety disorders with reference to simple phobias, obsessive-compulsive disorder, social anxiety disorder, and panic disorder. Study effective treatments such as exposure therapy, reality testing, and relaxation therapies and their use in tandem with medications.
35: Lingering Wounds-Trauma, Resilience, Growth
This lecture discusses treatments for trauma, with a focus on post-traumatic stress disorder. Learn about the psychobiology of PTSD, and follow a case study featuring highly effective interventions based in emotional reprocessing and unlearning fear-based cognitions. Consider how to promote resilience, growth, and meaning following trauma.
36: Tomorrow's Biopsychosocial Medicine
In concluding, reflect on the promise of new medical technologies, a more interdisciplinary and personalized approach to health care, and new directions in medical training. Contemplate changes in clinical practice between 1970 and what we may expect in 2030, and what the health care team of the future may look like.
Doing a comprehensive course on mind-body medicine has been a lifelong dream. We can all manage our health and alter our environments. Next up: cognitive therapy tools that can improve health and wellness. Onward and upward!
About Jason M. Satterfield
Professor Jason M. Satterfield is Professor of Clinical Medicine, Director of Social and Behavioral Sciences, and Director of Behavioral Medicine in the Division of General Internal Medicine at the University of California, San Francisco (UCSF). He earned his B.S. in Brain Sciences from the Massachusetts Institute of Technology and his Ph.D. in Clinical Psychology from the University of Pennsylvania. He currently directs the UCSF Behavioral Medicine Unit, which integrates mental and behavioral health services into adult primary care. Professor Satterfield’s book, A Cognitive-Behavioral Approach to the Beginning of the End of Life: Minding the Body, was recognized as a Self-Help Book of Merit by the Association for Behavioral and Cognitive Therapies. He served on the Behavioral and Social Science Subcommittee that revised the Medical College Admission Test-work that was recently featured in the New England Journal of Medicine and The New York Times. Professor Satterfield is also part of a core interdisciplinary team that is writing a medical textbook based on the biopsychosocial model. He has been nominated for multiple teaching awards at UCSF, and he is often competitively selected to teach at national conferences for a wide variety of health professionals, including physicians, nurses, social workers, and psychologists.