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Hi merry2e. Although I have shown the hand of my professional life- I too have struggled with the personal. My brother- never satisfactorily diagnosed (had paranoid schizophrenic; schizo-affective disorder; bi-polar and the ever favorite dually diagnosed, died over the summer after ingesting too much cocaine and Fentenyl. Was he lacking "conscience"? Sometimes. Was he too sensitive and in touch with (painful) reality? Sometimes. Did he qualify for a diagnosis that should have meant helpful services might have been his due- much of the time. Yet, the reality (notice the little 'r') is that few who really struggle with severe mental disorder (a term with which I'm a bit more comfortable than "illness") often get even less in terms of care than those who are the "worried well" who want to self- actualize. I still maintain that offer of a relationship in which to engage and try out one's stories in various ways ( and I agree with Anne's implication that they are stories and Paul's that they are changable and not always consistent) is still the ideal way for allowing "treatment" of the disconnect people struggling with difference from the norm often experience. So it almost returns us to the notion that "mental illness" had much more to do with disconnect from the (social) norms than anything else- yet for those of us who have felt the rush into the pit of darkness and apathy, there seems to be more than just social norms. So what does a truly biopsychosocial definition, or an otherwise multifactorial one begin to look like?