(...) But it must be said from the outset that a disease is never a mere loss or excess— that there is always a reaction, on the part of the affected organism or individual, to restore, to replace, to compensate for and to preserve its identity, however strange the means may be: and to study or influence these means, no less than the primary insult to the nervous system, is an essential part of our role as physicians. This was powerfully stated by Ivy McKenzie: "For what is it that constitutes a ‘disease entity’ or a ‘new disease’? The physician is concerned not, like the naturalist, with a wide range of different organisms theoretically adapted in an average way to an average environment, but with a single organism, the human subject, striving to preserve its identity in adverse circumstances. " This dynamic, this ‘striving to preserve identity’, however strange the means or effects of such striving, was recognized in psychiatry long ...
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