Seeing through the Psychological Lens
How beliefs, emotions, and past experiences interact with biology and environment
In my work as a psychotherapist—and in my own journey—I often return to the biopsychosocial model. It’s a powerful lens that helps us understand health as something complex and deeply human, not just a checklist of symptoms to “fix.”
As I introduced in the first article of this series, this model asks us to explore the biological, psychological, and social/environmental factors that weave together to shape our health and well-being. In the second article, we zoomed in on biological influences, particularly how hormonal shifts during perimenopause can have profound impacts on mental health.
This week, we turn toward the psychological side of the model. Mental health is health—and our thoughts, emotions, patterns, and inner narratives don’t just influence our minds; they ripple outward, affecting physical and social health, too.
Let me be clear: this isn’t about blame.
It’s about getting curious about how your inner world—your emotions, beliefs, and ways of thinking—interacts with the rest of your life and health, and beginning to find both grace and agency in that understanding.
Here's a list of the big psychological factors:
Emotions - How we experience and interpret the physical sensations of emotions varies based on our biology and our psychology (ex. our attitudes/ beliefs about the expression of difficult emotions like anger/ sadness may influence how/ if we express them at all!). For a review of emotions refer back to this series.
Stress response (and how we manage it) - There is a saying "state predicts story."* Ultimately, our stress state (refer back to my series on stress/ polyvagal), will impact how we perceive and react to what we experience in life.
Response to reward - Some of us (hello, ADHD brains) are wired to be more sensitive to reward. Understanding this can help us build systems that support motivation and consistency.
Temperament - These are innate aspects of our personality, such as being more introverted or extroverted, and they shape how we engage with the world
Self-esteem/ self-worth - Though these terms are often used interchangeably, how we perceive our inherent value (self-worth) vs. how we perceive others value us (self-esteem) are both big factors when it comes to our psychological health and well-being. Nerd out here.
Attitudes/ beliefs - This could include beliefs about yourself, others and even the world and are informed by lived experiences, especially early experiences within your family of origin.
Thoughts/ perceptions - How you perceive the world and how you interpret these perceptions (thoughts) can have a significant impact on how you experience the world and your life.
Social skills - Our ability to connect with others, communicate, and navigate conflict affects both our psychological and relational health (this article in the NY Times is a good review).
Behaviours - Much of our behaviour is learned, shaped by our environments. This is where patterns, habits, and even coping mechanisms are formed and reinforced. Get nerdy here.
Relationships - We are social beings. Relationships are a good part of our lives, as such the safety, quality, and quantity of our relationships (in comparison with our needs) has an impact on our overall health and well-being. This article is older, but gives a great overview of the relationship between...relationships and health.
Trauma - This is a bullet point, but is so much more. Gabor Mate's definition of trauma is the one that speaks most to me "Trauma is not what happens to you; it is what happens inside you as a result of what happens to you." I like it because it acknowledges the role of biology, psychology, and social/environmental factors in how we deal (or struggle to deal) with our traumatic experiences.
Grief - While grief is a universal experience — we will each deal with at some point in lives, the impact can be long-lasting and deeply layered. This article does a great job exploring how grief impacts us - body and mind.
*not sure to whom this should be attributed, if you happen to know, please feel free to comment below (I’d love to know)!
What I hope you notice:
Once again, there are many factors at play (and there are more I haven't listed).
These factors don’t operate in silos — they influence and amplify one another.
I didn't list any diagnoses here. That was intentional. Most diagnoses represent a collection of challenges across these domains. I also don't believe pathologizing mental health is all that helpful in learning to live with/ treat mental health. This does not minimize a diagnosis. Diagnoses can be very helpful in directing us to where we need to explore/ work, but it's also not the end-all be-all. #nuanced
The integrated impact of psychological factors IRL
Take the experience of a woman navigating perimenopause who was raised in a family where emotional expression—especially sadness or anger—was discouraged. Over time, she internalized the belief that struggling emotionally was a sign of weakness or failure. As perimenopause brings unexpected mood swings, anxiety, and tearfulness, her first thoughts might be, “What’s wrong with me?” or “I need to get it together.” These thoughts don’t arise in a vacuum—they reflect long-held beliefs about emotions and control, shaped by her early environment (and the culture at large — more on that in the next article!).
If this woman has also experienced unprocessed grief—perhaps from a past miscarriage, the loss of a parent, or the end of a significant relationship—those emotions may resurface during perimenopause, a phase increasingly recognized as a time of both hormonal upheaval and deep psychological reckoning. Research shows that fluctuating estrogen levels can impair emotion regulation and heighten sensitivity to stress, making it more likely that earlier unresolved grief will be reactivated in this life stage (get nerdy here). This resurgence can feel disorienting, especially for someone who has long coped by suppressing or intellectualizing emotions (psychotherapy speak for thinking your way through an emotion or “making sense” of it instead of just feeling it). When these grief reactions surface alongside the physical and emotional shifts of perimenopause, she may interpret them as a personal failing or unraveling, reinforcing feelings of shame and isolation rather than prompting self-compassion or support-seeking (nerd out here).
This is where a biopsychosocial lens can be powerful: understanding that her current experience is not just about “fluctuating hormones,” (the biology) but also about the stories she's carried, the meanings she’s made, and the wounds she’s lived through (especially if they’re unhealed). Recognizing this complexity opens the door to more compassionate care—care that tends not just to symptoms, but to the full human experience.
Questions to consider:
When you consider your health, what psychological factors are impacting your mental and physical health and well-being?
Can you offer yourself some grace for the factors you cannot control?
Can you get curious about what shifts you might make that are within your ability, and capacity to manipulate?
How does your personal context (social/ environmental factors) support or challenge you to this end?
How does your biology impact your ability to take steps to support your physical and mental health + well-being?
Onward in thriving,
Gillian
PS. In the next article (the last in this series) we'll be diving into social/ environmental factors in more detail. Stay tuned for more!