The multiaxial model has been specifically composed to encourage integrative conceptions of the individual's manifest symptoms in terms of the interaction between long-standing coping styles and psychosocial stressors. Our task as clinicians is to recapitulate the above historical progression, so to speak, within the individual person, in order to achieve a conception of each patient's psychopathology that does not merely diagnose or document his or her boils and sneezes, the Axis I disorders, but instead contextualizes these problems in terms of the larger context of the individual's style of perceiving, thinking, feeling, and behaving.

The movement toward integrationism in the conception of disease is both and ideal and an historical fact, illustrated by the evolution of the health sciences through two paradigms shifts.

The series of concentric circles in the figure at right represent revolutions that have occurred in medicine over the past century. In the center, we find Axis I, the so-called clinical syndromes, for example, depression and anxiety. These parallel the state of medicine a hundred or more years ago, when physicians defined their patients' ailments in terms of their manifest symptomatology, that is, their sneezes, coughs,  boils and fevers, labeling these "diseases" with terms such as "consumption," on the basis of the superficial appearance.

In contrast, the outer ring of the figure parallels Axis IV of the DSM. The related medical paradigm shift occurred approximately a century ago when illnesses began to be viewed as the result of intrusive microbes which infect and disrupt the body's normal functions. In time, medicine began to assign diagnostic labels to reflect this new etiology, replacing its old descriptive terms. Dementia paralytica, for example, came to be known as neurosyphilis. 

Fortunately, medicine has progressed in the past decade or two beyond its turn-of-the-century "intrusion disease" model, an advance most striking these last 15 years due to immunological diseases, such as the HIV virus. This progression reflects a growing awareness of the key role of the immune system, the body's intrinsic capacity to contend with the omnipresent multitude of potentially destructive infectious and carcinogenic agents that pervade our physical environment.

Medicine has learned that it is not the symptoms, the sneezes and coughs, nor the intruding infections, the viruses and bacteria, that are the key to health or illness. Instead, health and disease are a function of the competence of the body's own intrinsic defensive capacities. So too, in psychopathology, it is not anxiety or depression, nor the stressors of early childhood or contemporary life, that are the key to psychological well-being. Rather, it is the mind's equivalent of the body's immune system, that structure and style of psychic processes that represents our overall capacity to perceive and to cope with our psychosocial world, in other words, the psychological construct we term personality.

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