(...) 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 ago—and, like so much else, is especially associated with the work of Freud. Thus, the delusions of paranoia were seen by him not as primary but as attempts (however misguided) at restitution, at reconstructing a world reduced by complete chaos. In precisely the same way, Ivy McKenzie wrote:
"The pathological physiology of the Parkinsonian syndrome is the study of an organized chaos, a chaos induced in the first instance by destruction of important integrations, and reorganized on an unstable basis in the process of rehabilitation."
"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 ago—and, like so much else, is especially associated with the work of Freud. Thus, the delusions of paranoia were seen by him not as primary but as attempts (however misguided) at restitution, at reconstructing a world reduced by complete chaos. In precisely the same way, Ivy McKenzie wrote:
"The pathological physiology of the Parkinsonian syndrome is the study of an organized chaos, a chaos induced in the first instance by destruction of important integrations, and reorganized on an unstable basis in the process of rehabilitation."
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