Strength-Based Mental Health – Reframing “Disorders”

Competence-Hyperdominance: A Salutogenic Reframing of Mental Health Conditions – From Psychopathology to Strength-Based Psychology

Definition: Competence-Hyperdominance is a minimalistic and competence centered salutogenic framework that reconceptualizes psychiatric disorders, mental health conditions, and psychological symptoms as temporary overdominance of essential human competences, abilities, and strengths rather than deficits, illnesses, or pathologies.

This paradigm shift transforms DSM-5-TR and ICD-11 diagnostic categories through positive psychology principles, offering clinicians, therapists, counselors, and mental health professionals a strength-based alternative to the medical model of psychopathology.

Burnout Syndrome (Z73.0) – Occupational Exhaustion and Workplace Stress

Traditional Medical Model – Pathology-Focused View:

Burnout syndrome, occupational burnout, or job burnout manifests as chronic workplace stress syndrome featuring emotional exhaustion, depersonalization, cynicism, reduced professional efficacy, and physical symptoms including fatigue, headaches, and sleep disturbances. ICD-11 recognizes burnout as an occupational phenomenon resulting from unmanaged chronic workplace stress.

Competence-Hyperdominance Salutogenic Reframe:

Hyperdominant Strength: Achievement Excellence and Responsibility Mastery
Burnout represents overdominance of a person’s competence for high achievement, peak performance, perfectionism, and responsibility-taking. This strength-based perspective recognizes burnout as hyperdominant conscientiousness, work ethic, and dedication operating without boundaries, self-care, or recovery periods. The individual’s excellence-drive and helper-syndrome competences function in overdrive mode.

Major Depressive Disorder (F32-F33) – Clinical Depression and Mood Disorders

Traditional Psychiatric Diagnostic Criteria:

Major depression, clinical depression, or unipolar depression involves persistent sad mood, anhedonia (loss of pleasure), hopelessness, worthlessness, guilt, suicidal ideation, plus neurovegetative symptoms: insomnia/hypersomnia, appetite changes, psychomotor retardation/agitation, concentration difficulties, and fatigue.

Competence-Hyperdominance Strength-Based Reconceptualization:

Hyperdominant Competence: Deep Processing and Life Recalibration
Depression represents overdominance of a person’s contemplation, introspection, and meaning-making competences. This salutogenic view sees depressive states as hyperdominant reflection, withdrawal for recalibration, and deep existential processing. The individual’s capacity for profound thinking and life reassessment operates in maximum activation.

Generalized Anxiety Disorder (F41.1) – Chronic Worry and Anxiety States

DSM-5-TR Diagnostic Conceptualization:

GAD involves excessive anxiety, chronic worry, apprehensive expectation, and nervousness about multiple life domains. Physical anxiety symptoms include muscle tension, restlessness, fatigue, irritability, sleep problems, and concentration difficulties persisting over six months.

Positive Psychology Competence-Hyperdominance Reframe:

Overdominant Strength: Future Planning and Comprehensive Risk Assessment
Anxiety disorders reflect hyperdominance of anticipatory competence, future-thinking abilities, and threat-detection skills. This strength includes hypervigilance, careful planning, risk analysis, and preparation mastery. The person’s forecasting and safety-planning competences operate at maximum sensitivity.

Panic Disorder (F41.0) – Panic Attacks and Acute Anxiety

Clinical Psychology Traditional Framework:

Panic disorder features recurrent panic attacks with sudden intense fear, terror, or impending doom. Somatic panic symptoms include palpitations, tachycardia, sweating, trembling, dyspnea, chest pain, nausea, dizziness, derealization, and fear of dying or losing control.

Salutogenic Competence-Hyperdominance Perspective:

Hyperdominant Capability: Survival Mobilization and Emergency Response
Panic represents overdominance of fight-flight-freeze competence, acute stress response, and survival instincts. This strength-based view recognizes panic as hyperdominant emergency mobilization, demonstrating the individual’s powerful life-preservation systems and rapid-response capabilities.

Obsessive-Compulsive Disorder (F42) – OCD Spectrum Conditions

Psychiatric Nosology and Symptomatology:

OCD involves obsessions (intrusive thoughts, images, urges) and compulsions (repetitive behaviors, mental rituals). Common themes include contamination fears, checking behaviors, symmetry needs, forbidden thoughts, and hoarding tendencies causing functional impairment.

Neurodiversity-Affirming Competence-Hyperdominance Model:

Overdominant Mastery: Pattern Recognition and Order Creation
OCD represents hyperdominance of systematizing competence, pattern-detection abilities, and order-creation skills. This includes perfectionism, attention to detail, thoroughness, and certainty-seeking. The person’s quality-control and safety-verification competences function at extraordinary levels.

Post-Traumatic Stress Disorder (F43.1) – Trauma and Stress-Related Conditions

Trauma-Informed Clinical Understanding:

PTSD follows traumatic exposure with intrusion symptoms (flashbacks, nightmares), avoidance behaviors, negative cognitions/mood alterations, and hyperarousal (hypervigilance, startle response). Complex PTSD includes emotional dysregulation and interpersonal difficulties.

Post-Traumatic Growth Competence-Hyperdominance Frame:

Hyperdominant Strength: Experiential Learning and Protective Memory
PTSD reflects overdominance of trauma-processing competence, threat-learning abilities, and protective vigilance. This salutogenic perspective honors the individual’s powerful memory consolidation, danger-recognition skills, and survival-wisdom acquisition operating at maximum activation.

Social Anxiety Disorder (F40.1) – Social Phobia

Social Psychology Clinical Presentation:

Social anxiety involves intense fear of social evaluation, scrutiny, embarrassment, or humiliation. Performance anxiety, interpersonal fears, and avoidance of social situations impair relationships, education, and career functioning.

Interpersonal Competence-Hyperdominance Reframe:

Overdominant Ability: Social Attunement and Interpersonal Radar
Social anxiety represents hyperdominance of social intelligence, emotional sensitivity, and interpersonal awareness. This includes empathy, social cue detection, and group dynamics comprehension. The person’s social monitoring and approval-seeking competences operate at hypersensitive levels.

Specific Phobias (F40.2) – Focused Fears

Behavioral Psychology Diagnostic Features:

Specific phobias involve marked fear of particular objects/situations: animals (zoophobia), heights (acrophobia), blood/injections (hemophobia), flying (aviophobia), or enclosed spaces (claustrophobia), with avoidance behaviors and functional limitations.

Evolutionary Psychology Competence-Hyperdominance View:

Hyperdominant Survival Skill: Specialized Threat Recognition
Phobias reflect overdominance of specific danger-detection competence and categorical threat-avoidance abilities. This adaptive strength includes rapid fear conditioning, one-trial learning, and protective avoidance mastery focused on particular stimuli.

Bipolar Disorder (F31) – Mood Cycling Conditions

Affective Disorders Clinical Characterization:

Bipolar spectrum includes manic/hypomanic episodes (elevated mood, grandiosity, decreased sleep, racing thoughts, impulsivity) alternating with depressive episodes. Bipolar I features full mania; Bipolar II involves hypomania with major depression.

Creative Competence-Hyperdominance Reconceptualization:

Cyclical Hyperdominance: Creative Expansion and Energy Mobilization
Bipolar patterns represent alternating overdominance between creative-expansive competences (mania) and reflective-processing competences (depression). This includes innovation capacity, divergent thinking, and intense productivity alternating with deep introspection periods.

ADHD (F90) – Attention and Hyperactivity Variations

Neurodevelopmental Disorder Traditional Framing:

ADHD presents with inattention (distractibility, disorganization), hyperactivity (restlessness, fidgeting), and impulsivity (interrupting, difficulty waiting). Subtypes include predominantly inattentive, predominantly hyperactive-impulsive, or combined presentation.

Neurodiversity-Positive Competence-Hyperdominance Model:

Hyperdominant Cognitive Style: Environmental Scanning and Novelty Seeking
ADHD represents overdominance of exploratory competence, divergent attention, and rapid-response abilities. This includes creativity, spontaneity, multitasking skills, and high-energy engagement. The person’s novelty-detection and broad-awareness competences operate in hyperdrive mode.

Autism Spectrum Conditions (F84.0) – Neurodevelopmental Differences

Medical Model Diagnostic Criteria:

Autism involves social communication differences, restricted interests, repetitive behaviors, sensory sensitivities, and need for routine/predictability. The spectrum encompasses diverse presentations from minimal support needs to substantial support requirements.

Neurodiversity-Affirming Competence-Hyperdominance Framework:

Hyperdominant Cognitive Strengths: Systematizing and Detail Processing
Autism represents overdominance of pattern-recognition competence, systematic thinking, and detail-focused processing. This includes specialized interests expertise, logical analysis mastery, and sensory precision. The individual’s analytical and systematizing competences function at exceptional levels.

Body Dysmorphic Disorder (F45.22) – Appearance Preoccupation

Body Image Psychopathology Conceptualization:

BDD involves obsessive preoccupation with imagined appearance defects, repetitive mirror-checking or avoidance, camouflaging behaviors, comparison-making, and reassurance-seeking causing significant distress and impairment.

Self-Improvement Competence-Hyperdominance Perspective:

Overdominant Drive: Aesthetic Perfection and Self-Monitoring
BDD reflects hyperdominance of self-improvement competence, aesthetic awareness, and quality-control abilities applied to physical appearance. This includes attention to detail, high standards, and enhancement-seeking behaviors in overdrive.

Eating Disorders (F50) – Anorexia, Bulimia, Binge Eating

Eating Pathology Clinical Syndrome:

Eating disorders include anorexia nervosa (restriction, low weight, body image disturbance), bulimia nervosa (binge-purge cycles), binge eating disorder, and ARFID (avoidant/restrictive food intake), with medical complications and psychological distress.

Control Mastery Competence-Hyperdominance Reframe:

Hyperdominant Competence: Control Implementation and Resource Management
Eating patterns represent overdominance of control competence, discipline mastery, and resource-regulation abilities. This strength includes willpower, self-regulation, and goal-pursuit focused intensely on food/body domains.

Dissociative Disorders (F44) – Dissociation and Fragmentation

Trauma-Related Psychiatric Conceptualization:

Dissociative disorders include depersonalization/derealization (feeling unreal/detached), dissociative amnesia (memory gaps), and dissociative identity disorder (multiple personality states), typically following severe trauma.

Protective Competence-Hyperdominance Understanding:

Overdominant Survival Strategy: Compartmentalization and Self-Protection
Dissociation reflects hyperdominance of psychological protection competence and compartmentalization abilities. This adaptive strength includes consciousness alteration, experience separation, and trauma-survival skills operating at maximum levels.

Somatic Symptom Disorder (F45.1) – Somatization

Psychosomatic Medicine Traditional View:

Somatic symptom disorder involves distressing physical symptoms with excessive thoughts, feelings, and behaviors related to symptoms. Health anxiety, illness preoccupation, and medical help-seeking characterize the condition.

Body Wisdom Competence-Hyperdominance Frame:

Hyperdominant Awareness: Somatic Intelligence and Body Monitoring
Somatization represents overdominance of body-awareness competence, interoception abilities, and somatic communication. This includes heightened physical sensitivity, body-mind connection, and internal monitoring operating at amplified levels.

Insomnia Disorder (F51.0) – Sleep Difficulties

Sleep Medicine Diagnostic Criteria:

Chronic insomnia involves difficulty initiating sleep (sleep onset insomnia), maintaining sleep (sleep maintenance insomnia), or early morning awakening with daytime fatigue, mood disturbance, and cognitive impairment.

Vigilance Competence-Hyperdominance Perspective:

Overdominant Capability: Alertness Maintenance and Mental Processing
Insomnia reflects hyperdominance of vigilance competence, cognitive processing, and threat-monitoring abilities. The person’s alertness systems and thinking competences remain hyperactivated during rest periods.

Substance Use Disorders (F10-F19) – Addiction Spectrum

Addiction Psychiatry Disease Model:

Substance use disorders involve impaired control, tolerance, withdrawal, craving, and continued use despite consequences. Includes alcohol, cannabis, opioids, stimulants, and behavioral addictions causing neurobiological changes.

Self-Medication Competence-Hyperdominance Reframe:

Hyperdominant Drive: State Optimization and Reward Pursuit
Addiction represents overdominance of self-regulation competence, mood management abilities, and pleasure-seeking drives. This includes the person’s attempts at emotional regulation, pain management, and neurochemical optimization.

Personality Disorders (F60) – Enduring Patterns

Personality Psychopathology Nosology:

Personality disorders represent inflexible, pervasive patterns: borderline (emotional dysregulation), narcissistic (grandiosity), antisocial (rule-breaking), avoidant (social inhibition), obsessive-compulsive (perfectionism), among others.

Adaptive Strategy Competence-Hyperdominance Model:

Hyperdominant Survival Strategies: Specialized Adaptation Patterns
Personality variations reflect overdominance of specific survival competences: emotional intensity (borderline), self-protection through superiority (narcissistic), independence through rule-transcendence (antisocial), safety through avoidance (avoidant).

Adjustment Disorders (F43.2) – Stress Response Syndromes

Stress-Diathesis Clinical Model:

Adjustment disorders involve emotional/behavioral symptoms following identifiable stressors: job loss, divorce, relocation, medical illness. Subtypes include depressed mood, anxiety, or conduct disturbances.

Adaptation Competence-Hyperdominance Understanding:

Overdominant Process: Change Integration and Transition Navigation
Adjustment difficulties represent hyperdominance of adaptation competence and change-processing abilities. The person’s stress-response and life-transition systems operate at heightened activation during challenging periods.

Prolonged Grief Disorder (F43.8) – Complicated Bereavement

Bereavement Psychology Traditional Framework:

Prolonged grief involves persistent yearning, preoccupation with deceased, identity disruption, and difficulty accepting death beyond cultural norms. Includes avoiding reminders or excessive proximity-seeking to deceased.

Attachment Competence-Hyperdominance Reconceptualization:

Hyperdominant Capacity: Love Preservation and Connection Maintenance
Extended grief reflects overdominance of attachment competence, loyalty, and memory-preservation abilities. This represents the person’s profound capacity for enduring love and connection transcending physical presence.

Clinical Integration: From Pathology to Competence Recognition

The Competence-Hyperdominance framework revolutionizes mental health treatment, psychotherapy approaches, and clinical interventions. This salutogenic model transforms the therapeutic relationship from pathology-elimination to strength-recognition and competence-balancing.

Key implications for mental health professionals, therapists, counselors, psychologists, and psychiatrists include: validating hyperdominant strengths, reducing stigma through reframing, enhancing therapeutic alliance via competence-recognition, and shifting treatment goals from symptom-reduction to competence-integration.

This paradigm supports recovery, resilience, post-traumatic growth, and psychological flexibility by recognizing that every psychological presentation represents temporarily oversized human competences seeking balance and integration.