I t has long been apparent that the nosology used by the mental health professions is ill suited to the psychoanalytic approach to hu man behavior. Psychiatric diagnostic catego ries could not be completely abandoned, how ever, as long as the precise boundaries of malfunction caused by brain disease (whether in the form of tissue pathology or of biochem ical abnormality) were unknown. We may now be on the threshold of being able to distinguish such aorganically'' based disorders through biological measurements instead of having to rely on the clinical tools of descrip tive psychiatry, which can only delimit a va riety of syndromes of heterogeneous origin. Once these advances in psychiatric diagnosis are achieved, the gamut of adaptive disturb ances, including those produced in reaction to diseases of the nervous system, should be
comprehensible within the framework of depth psychology. In other words7 the time has come to begin work on a truly psy
choanalytic schema of psychopathology. In my view (Gedo7 1979a7 p. 5)7 an adequate nosology based on psychoanalytic premises must take into account matters of greater complexity than previously con templated in our models of the mind in disorder. To be sure7 this conviction grew out of my conception of expectable (that is7 more or less normal) psychological development7 which also stresses complex ity. I first attempted to codify these ideas almost 20 years ago7 an effort that culminated in a monograph written in collaboration with Arnold Goldberg (1973)7 Models of the Mind. In that work7 we proposed a hierarchical view of behavior regulation7 founded on the principle of epigenesis7 wherein optimal development produces a repertory of alternative modes of adaptation7 each of which had its origin in differing phases of early life. In accord with such a hierarchical view7 psychopathology would consist of relatively maladaptive resort to modes of behavior regulation of more archaic origin.