Heart, Brain and Behaviour: Interactions That Underpin the Biopsychosocial Model of Care

The brain acts as a control centre for a range of human behavioural responses to environmental and social challenges. These responses include eating, drinking, learning, coping with stress, and formation of social bonds. The brain and the heart have a complex but close relationship to each other. They strongly influence, and are influenced by, behaviour (exercise, diet, smoking, sleep, relaxation, risk taking) and behaviour-related factors (anxiety, depression, anger, aggression, risk appraisal, social support, psychological and social stress). The autonomic nervous system provides a two-way connection between the brain and the heart. Ideally, a balance should prevail between the sympathetic and the parasympathetic divisions of the autonomic nervous system. In some conditions, excessive sympathetic activity (or parasympathetic underactivity) results in physical and psychological distress and behavioural problems. The interactions between the brain, the heart and behaviour show that while the mind (‘psyche’) and the body (‘soma’) are not one, they are not two either. These interactions point to the eminence of the discipline that has been known as Psychosomatic Obstetrics and Gynaecology (Psychosocial or Biopsychosocial Obstetrics and Gynaecology in some countries). Knowledge of the interactions between the brain, heart and behaviour mediated by hormones and neurotransmitters underpins the biopsychosocial model of care. It should be an essential part of the undergraduate and postgraduate training in women’s health. Towards that goal, this chapter describes the basic anatomy of the brain, describes role of hormones in the regulation of physiological and social functions by the brain, outlines how cardiac indices could reflect the brain’s regulatory function, and links all of these with human behaviour.