Within the depth-psychology corpus, ‘disease’ functions simultaneously as a clinical category, a philosophical problem, and a psychosymbolic event. The tradition refuses any single account. At one pole, the biomedical disease model — endorsed by institutions such as the National Institutes of Health and operationalized in addiction medicine — locates pathology in neurological deviation and cellular disruption; Marc Lewis subjects this model to sustained critique, arguing that brain change may index learning rather than disease proper. At another pole, Thomas Moore and James Hillman read illness as soul-speech, a purposive interruption demanding hermeneutic rather than merely pharmaceutical response. Gabor Maté situates disease within a web of intergenerational trauma, social conditioning, and emotional history, resisting both biological determinism and moral blame. Robert Sardello draws on Bechamp and Steiner to reframe disease as an event of elemental imbalance — a failure of soul-body coherence — rather than external bacterial invasion. Ruth Padel traces the Greek precedent in which illness, pollution, and passion form an inseparable triad. Allan Schore repositions disease as dysregulation of communication networks, integrating psychoanalytic and psychobiological frameworks. Across these voices, a persistent tension obtains: between disease as something one has, something one is, and something one is called by.
Addiction is a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences… The disease of addiction affects both brain and behavior.
Lewis presents, in order to interrogate, the dominant biomedical formulation of addiction as a brain disease, tracing its historical proliferation and institutional authority.
, The Biology of Desire: Why Addiction Is Not a Disease, 2015thesis
if it’s a really bad choice, an obviously bad choice, an illogical, stupid, self-destructive choice, then one can argue that your choice-making mechanism is, well, diseased.
Lewis exposes the circular logic by which the disease model subsumes deviant behaviour — reframing bad choices as symptoms of a diseased choosing-mechanism — thereby questioning the model’s explanatory integrity.
, The Biology of Desire: Why Addiction Is Not a Disease, 2015thesis
Disease is an outcome of generations of suffering, of social conditions, of cultural conditioning, of childhood trauma, of physiology bearing the brunt of people’s stresses and emotional histories.
Maté constructs disease as a multi-causal, relational phenomenon rooted in developmental and social history, explicitly rejecting both self-blame and the model of illness as external attacker.
, The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture, 2022thesis
Bechamp saw that germs do not come from the outside into an innocent body… He found that at most, they are secondary agents.
Sardello marshals Bechamp against Pasteur’s germ theory to argue that disease originates in a prior imbalance of the organism rather than in external biological invasion, opening space for a soul-centred aetiology.
, Facing the World with Soul: The Reimagination of Modern Life, 1992thesis
What meaning has this disease at this moment in the patient’s life? What is going on in the unconscious of the patient and in his environment? What seems to be the purpose of the disease?
Hillman proposes a psychological hermeneutics of disease that supplements aetiological medicine with questions of meaning, purpose, and unconscious context.
, Suicide and the Soul, 1964thesis
We are wounded simply by participating in human life, by being children of Adam and Eve. To think that the proper or natural state is to be without wounds is an illusion.
Moore situates physical and psychic disease within an ontological account of woundedness inherent to the human condition, critiquing medicine’s fantasy of eliminating suffering.
, Care of the Soul Twenty-fifth Anniversary Edition: A Guide, 1992thesis
Illness in the Greek thought-world is inseparable from passion or pollution. Together they make an interlocking set of dangerous intrusions on life and self.
Padel demonstrates that in the Greek imaginal framework disease is structurally linked to erotic obsession and moral pollution, constituting a unified category of dangerous intrusion rather than a discrete biological event.
, In and Out of the Mind Greek Images of the Tragic Self, 1994thesis
The concept of disease has been a particularly difficult problem for psychiatry… illness as an impairment or disorder in communication networks that is characterized by a disturbance in their regulation.
Schore redefines disease in psychobiological terms as a regulatory failure in communication networks, integrating psychoanalytic and neurobiological frameworks to reconceptualise the disease process.
, Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development, 1994thesis
It is changes that are chiefly responsible for disease, especially the greatest changes, the changing seasons. Change happens first in the environment. The prior cause of disease is outside.
Padel reconstructs the Hippocratic environmental aetiology of disease, in which meteorological and seasonal change precedes and precipitates bodily disorder.
, In and Out of the Mind Greek Images of the Tragic Self, 1994supporting
Diseases ‘fall upon’ the body, ‘attack,’ seize, possess, conquer it… Thousands of bitter plagues now roam among human beings. Earth and sea are full of them.
Padel traces the martial and mythological imagery through which Greek medicine figured disease as an autonomous hostile force — a wandering plague released from Pandora’s jar — whose doctor-opponent must combat it militarily.
, In and Out of the Mind Greek Images of the Tragic Self, 1994supporting
The definition of addiction as a disease… may be the most powerful marketing tool there is for the rehab industry… the disease concept is also a useful tool for the insurance industry.
Lewis exposes the institutional and economic interests that sustain the disease model of addiction, showing how its adoption serves rehab, insurance, and family systems as much as it serves patients.
, The Biology of Desire: Why Addiction Is Not a Disease, 2015supporting
The Minnesota Model specifically labelled alcoholism a disease that overcame people physically, mentally, and spiritually… the ‘disease’ terminology began to appear in the literature of twelve-step programs.
Lewis traces the historical consolidation of the disease nomenclature in mid-twentieth-century addiction treatment, from Narcotics Anonymous to Jellinek’s influential medical model.
, The Biology of Desire: Why Addiction Is Not a Disease, 2015supporting
brain change could be interpreted as a consequence of learning rather than disease… when something doesn’t work the way it should, we call it a disease. That’s how the word is used.
Lewis records his debate with Nora Volkow, crystallising the central definitional dispute: whether neurological change indexes disease or the ordinary, if steep, consequences of learning.
, The Biology of Desire: Why Addiction Is Not a Disease, 2015supporting
if I distance myself defensively from the problems my clients bring to me, I force them to carry universal illness while I try to have power over the disease in order to be protected from it.
Moore argues that genuine healing requires the clinician’s intimate rather than defensive relation to disease, dissolving the boundary between treater and sufferer.
, Care of the Soul Twenty-fifth Anniversary Edition: A Guide, 1992supporting
The disease did not skip the parents. These parents may have removed alcohol from the home, but they passed on the disease of alcoholism unintentionally.
The ACA framework extends the disease concept of alcoholism intergenerationally through the mechanism of para-alcoholism, framing family dysfunction itself as transmissible pathology.
, ADULT CHILDREN OF ALCOHOLICS DYSFUNCTIONAL FAMILIES, 2012supporting
Finding in understandings of disease either a conscious or an unconscious metaphor is not a new idea… The Bible portrayed leprosy as a metaphor for sin.
Kurtz historicises the metaphorical function of disease from biblical leprosy through twentieth-century tuberculosis, showing how pathological categories carry embedded moral and social meanings.
, Not God A History of Alcoholics Anonymous, 2010supporting
nearly every common behavioral problem is ‘diseased’ in American culture… It all started less than one hundred years ago with the popularization of alcohol and drug abuse as a ‘disease concept’.
Shaw, arguing from a biblical counselling perspective, critiques the expansive medicalisation of behaviour through the disease concept, reading it as a cultural mechanism for relieving moral culpability.
, The Heart of Addiction: A Biblical Perspective, 2008supporting
there are so many factors involved in the arising of a particular disease — including factors over which we have no control — that we cannot decisively say which one actually caused the disease.
Masters holds a middle position between personal responsibility and determinism, arguing that disease arises from a plurality of interacting factors, many beyond volitional control.
, Spiritual Bypassing When Spirituality Disconnects Us From, 2012supporting
life experience can transmute into organic disease… the basic cause of addiction is predominantly experience dependent during childhood and not substance dependent.
The ACE Study data presented by Lanius demonstrates that early adverse experience is a primary driver of both addictive behaviour and adult biomedical disease, challenging substance-centred aetiologies.
, The impact of early life trauma on health and disease the, 2010supporting
With AIDS these elemental worlds go their own way, so to speak, and without their coherence each of the creative elements of the soul body is subject to every possible malign influence.
Sardello reads AIDS as a disease of elemental disintegration — a dissolution of the soul body’s coherence — rendering it a mirror for the broader evaporation of soul in contemporary culture.
, Facing the World with Soul: The Reimagination of Modern Life, 1992supporting
The debate may hinge on the issue of control. If you don’t have control over your substance use, then you have a disease, and if you do have control (but aren’t using it), then addiction is a choice.
Lewis maps the choice-versus-disease binary onto the question of control, then challenges the assumption that choice is a rational, deliberate faculty separable from desire and neurological habit.
, The Biology of Desire: Why Addiction Is Not a Disease, 2015supporting
Epidemic fever is koinos, ‘common’ to all, because everyone draws in the same pneuma, ‘air, breath.’ But season and ‘situation’ matter, too.
Padel details the Hippocratic pneumatic theory of epidemic disease, in which shared breath transmits shared pathology, linking individual affliction to collective environmental causation.
, In and Out of the Mind Greek Images of the Tragic Self, 1994supporting
According to our concept of the disease, the outcome is not only inherent in the disease itself, but dependent upon many external and internal contingencies.
Bleuler argues that the course of schizophrenic disease cannot be reduced to its intrinsic process alone but is co-determined by psychic predisposition, external circumstances, and traumatic experience.
, Dementia Praecox or the Group of Schizophrenias, 1911supporting
The fundamental notion of nearly all Greek medicine was that health depends on a due balance or proportioned mixture of the ultimate constituents of the body.
Plato’s Timaeus grounds its classification of bodily diseases in the ancient humoural principle of balanced mixture, situating pathology as elemental disproportion.
, Plato’s cosmology the Timaeus of Plato, 1997aside
As B. an affliction of the sacred part, it deserves its name ‘sacred disease’. Acid and saline phlegm is the source of all disorders that occur by defluxion.
The Timaeus commentary connects epilepsy’s designation as the ‘sacred disease’ to its origin in phlegmatic affliction of the brain, illustrating the ancient entanglement of the divine and the physiological in disease aetiology.
, Plato’s cosmology the Timaeus of Plato, 1997aside