This influence is exemplified by Engel's use of psychoanalysis in the creation of the internationally known biopsychosocial model of health and disease, which he formulated in 1977. Thaler, who became an important teacher in the medical school, explains the biopsychosocial model and its relation to psychoanalysis. Implied in the model is a hierarchical structure of organisms from the atomic level to the psychological and social levels. Each level is regulated by basic biological principles, such as adaptation, dynamic steady state, and ontogenesis. In addition, each level has its inherent structure and regulatory system.
Psychoanalysis provides a theory of organization at the psychological level.
But even more important than the theory, psychoanalysis is a highly useful method of listening and involving the observer. The history of psychoanalysis in Rochester raises the question of why an institute was never established after a promising, if difficult, beginning. Margolis observes that only those individuals who left Rochester maintained a prime professional identity as psychoanalytic practitioners or educators. Those remaining saw themselves primarily as medical educators, although heavily informed by psychoanalysis. He wonders if analysis could not flourish independently because its viability was too closely linked to a single department of psychiatry with its own set of priorities.