Open Access Open Access  Restricted Access Subscription or Fee Access

A new framework for medicine: the somatosemiotic approach

Lars-Petter Granan


Rationale, aims and objective: Even though the biopsychosocial model is the prevailing framework in modern medicine, it should be abolished due to insufficient explanation of the patients’ reality. The aim of this study is to develop a new and improved framework in medicine.

Method: Clinical examples and abductive reasoning.

Results: Patients’ reality within the prevailing medical framework were successfully deconstructed through the use of 6 clinical examples.

Discussion: Based on the common denominator of the 6 cases, a new framework for medicine is outlined, the somatosemiotic model. This framework takes into account the immense complexity of humans, both as individuals and as interacting agents in Society. Consequently, the understanding, assessment and addressing of a unique individual’s condition(s) must shift.


Biomedicine, biopsychosocial model, Cartesian dualism, chronic pain, clinical examples, determinism, essentialism, evidence-based medicine, person-centered healthcare, somatosemiotic approach

Full Text:



Quintner, J.L., Cohen, M.L., Buchanan, D., Katz, J.D. & Williamson, O.D. (2008). Pain medicine and its models: Helping or hindering? Pain Medicine 9 (7) 824-834.

Ghaemi, S.N. (201). The Biopsychosocial Model in Psychiatry : A Critique. Existenz An Inernational Journal in Philosophy, Religion, Politic and the Arts 6 (1) 1-8.

Sullivan, M.D. & Ballantyne, J.C. (2016). Must we reduce pain intensity to treat chronic pain? Pain 157 (1) 65-69.

Ballantyne, J.C. & Sullivan, M.D. (2015). Intensity of Chronic Pain-The Wrong Metric? New England Journal of Medicine 373 (22) 2098-2099.

Kamper, S.J., Apeldoorn, A.T., Chiarotto, A., Smeets, R.J.E.M., Ostelo, RW.J.G., Guzman, J. & van Tulder, M.W. (2014). Multidisciplinary biopsychosocial rehabilitation for chronic low back pain. Cochrane Database of Systematic Reviews 9, CD000963.

García-Garibay, O.B. & de Lafuente, V. (2015). The Müller-Lyer illusion as seen by an artificial neural network. Frontiers in Computational Neuroscience 9, 21.

Hoffman, D.D. & Prakash, C. (2014). Objects of consciousness. Frontiers in Psychology 5, 1-22.

Hoffman, D.D., Singh, M. & Prakash, C. (2015). The Interface Theory of Perception. Psychonomic Bulletin & Review 22 (6) 1548-1550.

Hoffman, D.D., Singh, M. & Prakash, C. (2015). Probing the interface theory of perception: Reply to commentaries. Psychonomic Bulletin & Review 22 (6) 1551-1576.

Siegrist, J. & Wahrendorf, M. (2009). Quality of work, health, and retirement. Lancet 374 (9705) 1872-1873.

Westerlund, H., Kivimäki, M., Singh-Manoux, A., Melchior, M., Ferrie, J.E., Pentti, J., Jokela, M., Leineweber, C., Goldberg, M., Zins, M.K. & Vahtera, J. (2009). Self-rated health before and after retirement in France (GAZEL): a cohort study. Lancet 374 (9705) 1889-1896.

Kaptchuk, T.J., Friedlander, E., Kelley, J.M., Sanchez, M.N., Kokkotou, E., Singer, J.P., Kowalczykowski, M., Miller, F.G., Kirsch, I. & Lembo, A.J. (2010). Placebos without deception: a randomized controlled trial in irritable bowel syndrome. PLoS One 5 (12) e15591.

Rasmussen, H.N., Scheier, M.F. & Greenhouse, J.B. (2009). Optimism and physical health: a meta-analytic review. Annals of Behavioral Medicine 37 (3) 239-256.

Ronaldson, A., Poole, L., Kidd, T., Leigh, E., Jahangiri, M. & Steptoe, A. (2014). Optimism measured pre-operatively is associated with reduced pain intensity and physical symptom reporting after coronary artery bypass graft surgery. Journal of Psychosomatic Reserch 77 (4) 278-282.

Ronaldson, A., Molloy, G.J., Wikman, A., Poole, L., Kaski, J-C. & Steptoe, A. (2015). Optimism and recovery after acute coronary syndrome: a clinical cohort study. Psychosomatic Medicine 77 (3) 311-318.

Kivimäki, Vahtera, J., Elovainio, M., Helenius, H., Singh-Manoux, A. & Pentti, J. (2005). Optimism and pessimism as predictors of change in health after death or onset of severe illness in family. Health Psychology 24 (4) 413-421.

Peterson, C., Seligman, M.E. & Vaillant, G.E. (1988). Pessimistic explanatory style is a risk factor for physical illness: a thirty-five-year longitudinal study. Journal of Personality and Social Psychology 55 (1) 23-27.

Frankl, V.E. (1992). Man’s Search for Meaning, 3rd ed. Boston MA: Beacon Press.

Dawkins, R. (2015). Essentialism. In: This Idea Must Die: Scientific Theories That Are Blocking Progress, Brockman, J. ed, p. 592. London: Harper Perennial.

Howick, J., Friedemann, C., Tsakok, M., Watson, R., Tsakok, T., Thomas, J., Perera, R., Fleming, S. & Heneghan, C. (2013). Are Treatments More Effective than Placebos? A Systematic Review and Meta-Analysis. PLoS One 8 (5) e62599.

Bingel, U., Wanigasekera, V., Wiech, K., Ni Mhuircheartaigh, R., Lee, M.C., Ploner, M. & Tracey, I. (2011). The effect of treatment expectation on drug efficacy: imaging the analgesic benefit of the opioid remifentanil. Science Translational Medicine 3 (70) 70ra14.

Kahneman, D. (2011). Thinking, Fast and Slow. New York: Farrar, Straus and Giroux.

Thaler, R.H. (2015). Misbehaving: The Making of Behavioral Economics. New York: W.W. Norton & Company.

Kremer, M. & Levy, D. (2008). Peer Effects and Alcohol Use among College Students. Journal of Economic Perspectives 22 (3) 189-206.

Brentari, C. (2015). Jakob von Uexküll: The Discovery of the Umwelt between Biosemiotics and Theoretical Biology. New York: Springer.

Epstein, R.M. & Back, A.L. (2015). Responding to Suffering. Journal of the American Medical Association 314 (24) 2623-2624.

Kirkengen, A.L., Ekeland, T-J., Getz, L., Hetlevik, I., Schei, E., Ulvestad, E. & Vetlesen, A.J. (2015). Medicine’s perception of reality - a split picture: critical reflections on apparent anomalies within the biomedical theory of science. Journal of Evaluation in Clinical Practice 22 (4) 496-501.



  • There are currently no refbacks.