Notes for Experience-Based Medicine: The Disease Origins Permanent Biopsychosocial Changes in the Person

The experience of the disease has a complex structure where there is a biological and a psychosocial moment form a plot. A biological moment, partly conscious (post-infectious immunity and allergy) that marks the whole experience of life, and also partly subconscious: The individual temperament, education, etc., that direct our behaviors. And a psychosocial moment of intra-psychic elaboration of the feeling of illness, where general or basic components intervene (the psychic consequences of the biological or somatic alterations), and the personal ones as the constitution of the individual, the type of illness (acute, where predominate feelings of affliction and threat; or chronic, where the feelings are more biographical), the social-historical situation, sex, race, etc., which are both conscious (changes in the feeling of one’s life: Distress, threat, solitude, and resource), and subconscious (phenomenon of transference), and interpretative (punishment, chance, challenge, test). The fact of contracting a disease is not always pure incomprehensible chance; it influences a conscious and subconscious disposition of a human person in front of his own biography; “The patient does not have a disease, but he does his illness”. Consequently, the disease, both acute and chronic, gives rise to lasting biopsychosocial functional experiences or mutations (immunity and allergy, pathobiographical modification, changes in the feeling of own life and in the way of living). Studies are recommended to evaluate how patients experience a long-term illness to begin to build an experience-based and patient-centered medicine.