As a special branch of general philosophy, pathogenesis had never been explored. In my opinion it had never been approached in a strictly scientific fashion--that is to say, objectively, amorally, intellectually.All those who have written on the subject are filled with prejudice. Before searching out and examining the mechanism of causes of disease, they treat of 'disease as such', condemn it as an exceptional and harmful condition, and start out by detailing the thousand and one ways of combating it, disturbing it, destroying it; they define health, for this purpose, as a 'normal' condition that is absolute and immutable.Diseases ARE. We do not make or unmake them at will. We are not their masters. They make us, they form us. They may even have created us. They belong to this state of activity which we call life. They may be its main activity. They are one of the many manifestations of universal matter. They may be the principal manifestation of that matter which we will never be able to study except through the phenomena of relationships and analogies. Diseases are a transitory, intermediary, future state of health. It may be that they are health itself.Coming to a diagnosis is, in a way, casting a physiological horoscope.What convention calls health is, after all, no more than this or that passing aspect of a morbid condition, frozen into an abstraction, a special case already experienced, recognized, defined, finite, extracted and generalized for everybody's use. Just as a word only finds its way into the Dictionary Of The French Academy when it is well worn stripped of the freshness of its popular origin or of the elegance of its poetic value, often more than fifty years after its creation (the last edition of the learned Dictionary is dated 1878), just as the definition given preserves a word, embalms it in its decrepitude, but in a pose which is noble, hypocritical and arbitrary--a pose it never assumed in the days of its vogue, while it was still topical, living and meaningful--so it is that health, recognized as a public Good, is only the sad mimic of some illness which has grown unfashionable, ridiculous and static, a solemnly doddering phenomenon which manages somehow to stand on its feet between the helping hands of its admirers, smiling at them with its false teeth. A commonplace, a physiological cliche, it is a dead thing. And it may be that health is death itself.Epidemics, and even more diseases of the will or collective neuroses, mark off the different epochs of human evolution, just as tellurian cataclysms mark the history of our planet.
Should you operate upon your clients as objects, you risk reducing them to less than human. Following the culture of appropriation and mastery your clients become a kind of extension of yourself, of your ego. In the appropriation and objectification mode, your clients’ well-being and success in treatment reflect well upon you. You “did” something to them, you made them well. You acted upon them and can take the credit for successful therapy or treatment. Conversely, if your clients flounder or regress, that reflects poorly on you. On this side of things the culture of appropriation and mastery says that you are not doing enough. You are not exerting enough influence, technique or therapeutic force. What anxiety this can breed for some clinicians! DBT offers a framework and tools for a treatment that allows clients to retain their full humanity. Through the practice of mindfulness, you can learn to cultivate a fuller presence to the moments of your life, and even with your clients and your work with them. This presence potentiates an encounter between two irreducible human beings, meeting professionally, of course, and meeting humanly. The dialectical framework, which embraces contradictions and gives you a way of seeing that life is pregnant with creative tensions, allows for your discovery of your limits and possibilities, gives you a way of seeing the dynamic nature of reality that is anything but sitting still; shows you that your identity grows from relationship with others, including those you help, that you are an irreducible human being encountering other irreducible human beings who exert influence upon you, even as you exert your own upon them. Even without clinical contrivance.