According to their hypothesis, mildly disordered behavior of a specific organ or a system may actively serve as an alternative compensation to serious life threatening diseases. An example of active compensation is found in the task of balancing oneself when walking on tight rope. The erratic shaking movements of the arms and hands allow the person to maintain balance, a circumstance that could never happen without the active compensation.

Another area providing multiple examples of adaptive disorder includes the numerous sleep conditions grouped together under the term “parasomnias.” These disturbances of sleep are well known and widely described. Their treatments are numerous and highly variable. Periodic leg movements and enuresis (involuntary bed wetting) are prime examples. Both resist treatment modalities and often are the cause of much dismay to patients, parents and physicians. However, if one considers these conditions in terms of their capacity to restore normal sleep patterns in an individual with dysfunctional sleep patterns, they can be viewed as serving a beneficial function to the entire organism.

As a physician who has read Dr. Golbin’s descriptions of parasomnias in his two prior books, I was delighted to read this recent commentary. It not only clarifies the connection between the various parasomnias, but it explains why patients go into remission. In simple terms, the maladaptive behavior disappears when the organism no longer needs it as a protective mechanism.

Drs Golbin and Umantsev have provided an excellent hypothesis that relates to the individual’s need for and ability to maintain homeostasis. Clearly, although it is theoretically much easier and indeed ideal to live in a state of homeostasis, all living organisms are subject to distractions and intrusions. Under such circumstances, homeostasis may be an unreachable goal, and the resulting mild chaos may be either healthy or health promoting. When this occurs, it may be just what nature orders and wants.

Finally, it should be noted that the Golbin-Umantsev hypothesis might lay a reasonable foundation for changes in the therapy of many disorders, both in terms of a less aggressive approach as well as a lessening of the zeal with which efforts are made to correct the underlying problems.