What Makes Up A Person?

When meeting a patient for the first time, I find myself thinking a lot of a model I use to assess  a new patient.  Put simply, I think of the mind as a table with four legs, with each leg important to the understanding of the construction of the person in front of me.

The first leg is biologic.  There is little doubt that many people are more prone to certain problems that carry a genetic or physical component: anxiety, depression, alcohol use, etc.  Some individuals are inherently at higher risk than others.  Using what is called the stress-diathesis model, children who have a family history of depression are generally more vulnerable to developing a depressive disorder themselves.

The second is developmental.  What kind of experiences did the patient have when growing up?  How did he or she learn how to cope?  What kind of parents did he or she have? Siblings?

Extended family? Friends?  What is the ethnicity of the patient, and where did the person grow up?  Was college part of the experience?

Third is environmental.  What does the patient eat, smoke, or drink?  What does he or she look at online?  What kind of job does the patient have?  Living conditions?  What is the daily or nightly routine? Married, single, divorced, in a relationship or not, etc.

Last is the spiritual.  This cannot be dismissed, as devout Catholics or Jews have less than half the suicide rate of those with no religious affiliation.  It is a necessary part of the initial evaluation.

All these factors are taken into consideration during an initial evaluation and are reassessed continuously during treatment.  Using this as a template is helpful in figuring out an appropriate treatment plan and helping patients move forward in the betterment of their lives.