Psychoanalysis and the Concept of Health: Heinz Hartmann. Int. J. Psa., XX, 1939, pp. 308–321.

In his comprehensive paper, Ich-Psychologie und Anpassungsproblem1, Hartmann discussed, among other problems, the conception of 'normality'. In this new paper he continues this discussion. It is very difficult to find a definition for 'psychic health'. Hartmann limits himself to criticisms of definitions, possible and proposed. Psychic mechanisms as such can never be used as criteria for abnormality; normality certainly is not identical with the average; lack of symptoms is not sufficient proof of health; other proposed formulations are not practical. It becomes clear that the conception of health always includes subjective and moral factors. Among the usual definitions of health there are two extremes. Attempts have been made to establish rational behavior and freedom of instincts as the decisive criteria. Both proposals are ambiguous, especially the conception of 'freedom'. Certainly it is not possible to identify 'conflictual' with 'pathological'; 'conflictless' with 'healthy'. Hartmann confesses that he too is unable 'to formulate a concept of mental health in simple unequivocal definite terms', but hopes he has helped discern in which direction his prolegomena to an analytical theory of health need further to be developed.