Bio-Psycho-Social Model.

Picking up from last week’s blog (where I concluded with some mental health strategies) I now want to offer another tool for our wellbeing.

This particular tool has been developed by the charity BAPAM (British Association for Performing Arts Medicine), who support performing artists across the board, physically and psychologically. This key resource is called the ‘Healthy touring diary’.

The concept is drawn from something called the Bio-psycho-social model of mental health.  This way of looking at our mental health draws upon our biology, psychology and our social world. One core part of this is the ‘social’ aspect, something we know lots about in the music industry. We can have our biological and psychological health sorted but the brutality of the industry can be the ‘social’ factor that pushes us over the edge of mental health struggle. As we know, it’s a difficult industry with artists often receiving little reward, this factor alone is enough to impact all of us despite where our heads are at.

The biopsychosocial model is basically a holistic approach to understanding health and well-being, introduced (by a psychiatrist called George Engel) in the late 1970s. Unlike traditional medical models that focus solely on biological factors, the biopsychosocial model considers three interconnected dimensions: 

Biological Factors: Physical and genetic influences, such as brain chemistry, genetics, or physical health conditions. 

Psychological Factors: Thoughts, emotions, behaviours, coping mechanisms, and mental health conditions like anxiety or depression. 

Social Factors: Social environment, relationships, cultural expectations, financial status, and societal pressures.

This model proposes that health and illness are the result of a complex interaction between these three dimensions and that addressing all of them leads to more effective solutions and self-reflection (I’ll talk more about this next week). For musicians, our mental health is shaped by a unique set of challenges that encompass all of these biological, psychological, and social factors. Applying the bio-psycho-social model provides a wider framework to better understand and address mental health struggles.

Biologically, musicians experience physical and neurological demands that can impact our mental health. Things such as physical strain long hours of practice or performance can lead to repetitive strain injuries, fatigue, or chronic pain, which may contribute to stress or low mood. Substance abuse can also be prevalent in the music industry due to its association with nightlife or as a way of coping with stress. Over time, this can alter brain chemistry, exacerbating mental health issues. Like anyone, us musicians may have a genetic predisposition to mental health conditions like anxiety, depression, or bipolar disorder, which can also be triggered or worsened by the pressures of their career. Interventions targeting the biological aspect could include proper nutrition, exercise, sleep hygiene, physical therapy for injuries, or medical treatment like antidepressants or other medications when needed. In a way I kind of view ADHD as a subset of the biological domain. Perhaps someone can pull me up on this?

The psychological demands of being a musician can also be intense. Many of us grapple with stage fright or performance anxiety, leading to self-doubt, panic attacks, or avoidance behaviours. The pursuit of artistic perfection can lead to feelings of inadequacy and burnout, especially when outcomes (like audience reception or reviews) are beyond our control. Poor coping strategies, such as avoidance or self-criticism, may even worsen mental health.

The social environment surrounding our unique way of life is an additional factor significantly impacting our mental well-being. Financial Precarity being the big one! Many of us musicians face unstable incomes due to inconsistent gigging, low streaming royalties, and the rising costs of living. This financial insecurity can lead to chronic stress, anxiety, and depression. Additionally, touring schedules or long hours in the studio can isolate us from family, friends, or support systems. Paradoxically, even fame can heighten feelings of disconnection. As musicians we can often feel immense pressure to 'make it', which is compounded by the increasing societal undervaluation of art in general. The industry’s competitiveness and social media's constant comparison trap also massively amplify this stress.

Addressing social factors could involve creating better support networks, fostering community among musicians (ahem… the Tonic Rider Peer Support Groups), and advocating for fair compensation in the industry. The Musicians union, ISM, FAC and other organisations can also provide resources to help navigate some of these financial or professional challenges.

In next week’s blog I will introduce the healthy touring diary, a great resource to help us become more reflective within all areas of the bio, psycho and social environments.

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Adam Ficek hosts a monthly show 'Tonic Music' on Totally Wired Radio, where he talks to various guests about music and mental health. You can listen again to any of the previous show on the Tonic Music Mixcloud page.