Self-differentiation as a structural marker of psychopathology: An integrative literature review

This article proposes that self-differentiation – understood as the capacity to maintain identity, emotional regulation, and relational autonomy in the face of interpersonal demands – constitutes a core structural marker for understanding mental illness. While contemporary psychiatric nosology emphasizes symptom-based, largely atheoretical classification systems, it often neglects the underlying intrapsychic, developmental, and relational processes that shape psychopathology. Drawing on an integrative review of classical and contemporary psychoanalytic models of structural development (Freud, Klein, Mahler, Kernberg, Kohut), attachment models, and Bowen’s theory of family differentiation, this article examines how disturbances in the formation and consolidation of the self are foundational to the emergence of mental disorders. Increasing empirical evidence linking low levels of self-differentiation to conditions such as schizophrenia, major depressive disorder, bipolar disorder, eating disorders, and broader patterns of affective dysregulation underscores the clinical significance of this construct. This review argues that assessing self-differentiation offers valuable insight into structural vulnerabilities that transcend diagnostic categories and informs both etiological understanding and psychotherapeutic practice. By reintroducing this construct into psychiatric and psychoanalytic discourse, this article advocates for a more dimensional, subject-centered approach to mental suffering.