Systems and the structuring of meaning: contributions to a biopsychosocial medicine

The authors discuss the biopsychosocial (systems) model of medicine formulated by George L. Engel. The interaction among systems is explained in terms of selection, negation, and the reduction of the complexity of events. In psychosocial systems, vast possibilities of experience and behavior are selected and negated through structures of meaning. The authors illustrate how meaning organizes the experience and activity of a man suffering a myocardial infarction, a case originally discussed by Engel. The role of meaning in psychosocial systems leads to a discussion of the scientific method for investigating it that is provided by Karl Jaspers' psychology of understanding.