The dynamic paradigm of illness in psychopathology

Medical thought oscillates between two representations of ill-ness. According to the first, illness enters or leaves the organism as through a door, by either adding something that should not be there, or removing something that should be there. Infection is the paradigm of illness as a pathogenic addition; haemorrhage is the paradigm of illness as a pathogenic removal of something which is needed. This representation of illness, called “ontologi-cal”1, is to some extent reassuring: what the organism has lost can be restored, and what has entered can be removed.A different representation of illness is called “dynamic”1. Ac-cording to this view, illness is not an accident that arrives from out-side and upsets the state of equilibrium of an otherwise healthy organism. Humans are intrinsically vulnerable beings who fall ill when they respond incongruously to what they perceive as a threat for the unstable and vulnerable equilibrium characterizing their condition. This threat must not necessarily be an objective noxious entity; it is enough that it is subjectively experienced as such.