Towards a view of health based on levels of integration and self-fulfilment: An alternative assessment model

Luigi Solano


The paper starts from a criticism of a clinical assessment based on the presence/absence of psychiatric symptoms, typically the DSM. This modality shows strong limits namely in the case of sudden and unexpected violent behaviours, of adhesion to terrorist groups or to criminal regimes, of somatic pathologies, of deficiencies in the development of functions. Utilising psychoanalytic, or psychoanalytically inspired literature, history documents, and clinical examples, a different assessment modality is proposed, both of pathological conditions and of the outcome of treatment: classification of levels of health is based on the degree of connection between different systems of the organism, which are also strongly related to the development of functions, such as dreaming, reflective capacity or affect regulation. Psychic, but also somatic symptoms often appear in this view not as the essence of pathology but as useful alarm signals and forms of communication; at any rate, they should be considered in conjunction with the proposed dimension.


assessment; health; integration; self-fulfilment; development of functions.

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