A thought is just as much a biological process as is digestion. Sir William Osler (1849–1919), who has been described as the father of modern medicine, is reported to have said “It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has”. In some ways, it is interesting to consider how the distinction between the biological, the psychological, and the social ever arose. Initial work on PCT began in the 1950s and 1960s (e.g., Powers et al., 1960) with the seminal work on this theory first published in 1973 (Powers, 1973) and a second edition published in 2005 (Powers, 2005). In this paper we will describe Perceptual Control Theory (PCT) which is based on negative feedback and may well be the first biopsychosocial model. The mechanism of negative feedback allows for such a model to be developed. Engel strongly advocated for a biopsychosocial model and seemed to have an astute appreciation of what the advantages of such a model would be, however, his work fell short of providing the model he was proposing. McLaren ( 1998) conducted an extensive review of Engel’s work regarding the biopsychosocial model and concluded that Engel himself never formulated such a model. One of the main problems of the biopsychosocial model is that an actual model that incorporates biological, psychological, and social elements is not currently available. To some extent the limitations have led to questions regarding whether an integrated bio-psycho-social model has ever eventuated (e.g., Read, 2005). Despite the widespread acknowledgment of the importance of biological, psychological, and social factors in contributing to a comprehensive understanding of human life and its problems, there is an increasing awareness that the biopsychosocial model has significant limitations (Pilgrim, 2002 Epstein and Borrell-Carrio, 2005 McLaren, 2007). The biopsychosocial model in psychology (Engel, 1980) was suggested with great promise as a viable and much needed alternative to the prevailing “medical model” in which problems and disorders were considered akin to medical diseases and ailments (Rubinstein and Coelho, 1970 Zucker and Gomberg, 1986). PCT has major implications for both research and practice and, importantly, provides a guide by which fields of research that are currently separated may be integrated to bring about substantial progress in understanding the way in which the brain alters, and is altered by, its behavioral and environmental context. In this paper we outline the working model of PCT and explain how PCT provides an embodied hierarchical neural architecture that utilizes negative feedback to control physiological, psychological, and social variables. Thus, PCT may be the first biopsychosocial model to be articulated in functional terms. Perceptual Control Theory (PCT) describes the way in which negative feedback establishes control at increasing levels of perceptual complexity. Moreover, negative feedback is purported to also govern the activity of all other organisms as well as humans. Negative feedback has been implicated in the regulation of neurotransmitters as well as important psychological and social processes such as emotional regulation and the relationship between a psychotherapist and a client. Negative feedback may be the mechanism that is required. What is needed is a robust mechanism that is equally important to biochemical processes as it is to psychological and social processes. One reason for this might be the absence of an identified mechanism or a functional architecture that is authentically biopsychosocial. Although the biopsychosocial model has been a popular topic of discussion for over four decades it has not had the traction in fields of research that might be expected of such an intuitively appealing idea.
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