Piquerism

[Ashkenaz]

http://en.wikipedia.org/wiki/Piquerism

http://en.wikipedia.org/wiki/London_Monster

[Cogidubnus]

Hi Ashkenaz

It is usually found only in older offenders who have a history of violence and sexual offending.

Taken from the wikipedia entry you linked to

All the best

Dave

[John Wheat]

How common is Piquerism? I would have thought not particularly common even amongst killers.

[John G]

There is some doubt as to whether picquerism even exists as a mental health condition; it's listed in the DSM under the paraphilia Not otherwise Specified. And, "By virtue of their residual and idiosyncratic nature, cases given the NOS label are by definition outside what is generally accepted by the field as a reliable and valid psychiatric disorder." (Frances and First, 2011). See:

http://www.jaapl.org/content/39/4/555.long

In fact, it's been suggested that "paraphilia as a concept is vulnerable to societal pressures rather than advances in science and so diagnosis may be grounded more in societal norms than in psychiatric health." McManus et al., 2013) see:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769077/

Keenan has also described the "inclusion of paraphilic disorders in DSM-5 as redundant, unscientific and stigmatizing" (ibid).

[Abby Normal]

There is some doubt as to whether picquerism even exists as a mental health condition; it's listed in the DSM under the paraphilia Not otherwise Specified. And, "By virtue of their residual and idiosyncratic nature, cases given the NOS label are by definition outside what is generally accepted by the field as a reliable and valid psychiatric disorder." (Frances and First, 2011). See:

http://www.jaapl.org/content/39/4/555.long

In fact, it's been suggested that "paraphilia as a concept is vulnerable to societal pressures rather than advances in science and so diagnosis may be grounded more in societal norms than in psychiatric health." McManus et al., 2013) see:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769077/

Keenan has also described the "inclusion of paraphilic disorders in DSM-5 as redundant, unscientific and stigmatizing" (ibid).

agree.
the labels are ridiculous psycho babble. and there so specific sometimes as to make them useless. Like the official definition of a necropheliac.

eventhough the ripper, bundy, Dahmer ridgeway had an obvious sexual motivation with dead bodies apparently there not considered necropheliacs as the official definition states one can only be a necropheliac if they acheive sexual satisfaction ONLY with a dead body. what a load of garbage.

Instead of a fancy label that some expert has come up with to justify his existence, for example picuerism to describe the ripper, why not just state that the ripper had a fascination with what his knife could do to the female body? much more useful IMHO.

[John G]

agree.
the labels are ridiculous psycho babble. and there so specific sometimes as to make them useless. Like the official definition of a necropheliac.

eventhough the ripper, bundy, Dahmer ridgeway had an obvious sexual motivation with dead bodies apparently there not considered necropheliacs as the official definition states one can only be a necropheliac if they acheive sexual satisfaction ONLY with a dead body. what a load of garbage.

Instead of a fancy label that some expert has come up with to justify his existence, for example picuerism to describe the ripper, why not just state that the ripper had a fascination with what his knife could do to the female body? much more useful IMHO.

Hi,

Thanks Abby. Allen Frances, who co-wrote the article, was actually the Chair of the DSM IV Task Force. He further pointed out that, "Not otherwise specified diagnoses are meant to be no more than residual wastebaskets provided by DSM IV to encourage research and for the convenience of clinicians when coding patients who do not fit within one of the specified DSM IV categories".

He added, "The problem is that paraphilia NOS has been widely misapplied in SVP hearings to criminals who have no mental disorder by evaluators who have misinterpreted DSM IV."

Necrophilia, which you referred to, also falls under the dubious "Not otherwise specified" category.

[Errata]

Hi,

Thanks Abby. Allen Frances, who co-wrote the article, was actually the Chair of the DSM IV Task Force. He further pointed out that, "Not otherwise specified diagnoses are meant to be no more than residual wastebaskets provided by DSM IV to encourage research and for the convenience of clinicians when coding patients who do not fit within one of the specified DSM IV categories".

He added, "The problem is that paraphilia NOS has been widely misapplied in SVP hearings to criminals who have no mental disorder by evaluators who have misinterpreted DSM IV."

Necrophilia, which you referred to, also falls under the dubious "Not otherwise specified" category.

Remember that every diagnosis has a code, and every code is used for insurance and billing purposes. So there is absolutely no forensic value in any DSM diagnosis arrived at after the fact. There is some value in a diagnosis that precedes an attack, but it's value is in further refining the definition of a disorder.

Also remember that the point of diagnosing anyone with a mental illness, NOS or otherwise, is to manage the behavior and hopefully treat the sufferer. Picquerism is a set of definitions that allow a person with such a fetish to be diagnosed, treated, and hopefully relieved of destructive tendencies. If a doctor diagnoses a paraphilia, it's because the behavior is a close enough to fit to build treatment on. It may not even be totally right, but it doesn't matter if the diagnosis provides a treatment plan that works. The definition does not exist to retroactively label someone with absolutely no firsthand evidence of fetish or compulsive behavior. So any attempt to do that, especially with things like Picquerism, naturally fails at some point.

Every paraphilia boils down to a single question. Does the paraphilia cause dysfunction? If yes it is treated. In some ways paraphilias are very life Obsessive Compulsive Disorders, in which you can get some pretty bizarre or even seemingly harmless manifestations of the disease, but if they cause dysfunction then they are a disorder that needs to be treated. Hand washing seems pretty benign, but take it to the point where the skin of the hands is stripped off from continued washing and it's clearly a problem. Tapping a pencil until you are crying because you can't stop. Tapping a pencil is nowhere in the DSM, yet clearly for that person it is a manifestation of disordered thinking.

Because breaking laws of the land is considered dysfunctional, there are certain behaviors that are always paraphilias, because to indulge in them is illegal, it harms oneself or others, and until recently anything that was universally condemned by society was considered a paraphilia.Which is how homosexuality was disorder. Necrophilia is illegal. If you engage in it even only rarely, you have a paraphilia. Same with true sadism, and a few of the more rare behaviors involving blood, death, rape, children etc. It is completely possible to have a paraphilia involving say, partners of a different religion, which we see as harmless, but the behavior is compulsive and causes harm. Say, the shame of it leaves you in a constant depressive state. It's how you handle it, or how it handles you that determines if it is causing dysfunction, and therefor a paraphilia. Unless it hurts people who do not or cannot consent to such treatment, and then it's always a paraphilia. And none of these definitions and diagnoses can tell you why someone does what they do. The definitions aren't meant for that, and the reasons vary from person to person, even if some parts of their story fit a theme.

Rewind it a bit, and we have no idea what got Jack's rocks off. People with picquerism usually prey on unwitting people. It's like Frotteurism, but instead of body contact they use a hat pin. It's a signature behavior, and the diagnosis of picquerism rarely comes without that specific behavior. It is unlikely that the pattern of stabbing and cutting seen in the Ripper murders are the work of a picquerist. But that's not to say no paraphilia is at play. It might not have been the stabbing he got off on. It might have been the blood. Or strangulation, or he could have been a partialist. Or it wasn't about sex at all, and was about anger, or a mission, or delusion. There are tiny pieces of these crimes that could fit a lot of different things. I could make probably 5 different arguments. He was unlikely to have five different paraphilias, so they can't all be right.

I have no idea what he was after. The DSM can't help anyone. Not for this. We need more. Like we have with Bundy or Dahmer. But we don't have that. And guessing doesn't help because pinning a diagnosis on this killer still won't tell you why or how. It might explain a surface behavior, but no diagnosis can explain everything he did. Even if he were a violent schizophrenic, that would only explain about a 10th of what he did. There are only two things I can be absolutely sure of. 1: He did what he did because he wanted to. This was a choice, and he consistently made it. Why he made that choice is unknowable. 2: No diagnosis explains all of his behaviors. He was not so insane that he couldn't reason. So any answers we may need aren't going to come from a diagnosis. They can only come from the man himself.

[Abby Normal]

Remember that every diagnosis has a code, and every code is used for insurance and billing purposes. So there is absolutely no forensic value in any DSM diagnosis arrived at after the fact. There is some value in a diagnosis that precedes an attack, but it's value is in further refining the definition of a disorder.

Also remember that the point of diagnosing anyone with a mental illness, NOS or otherwise, is to manage the behavior and hopefully treat the sufferer. Picquerism is a set of definitions that allow a person with such a fetish to be diagnosed, treated, and hopefully relieved of destructive tendencies. If a doctor diagnoses a paraphilia, it's because the behavior is a close enough to fit to build treatment on. It may not even be totally right, but it doesn't matter if the diagnosis provides a treatment plan that works. The definition does not exist to retroactively label someone with absolutely no firsthand evidence of fetish or compulsive behavior. So any attempt to do that, especially with things like Picquerism, naturally fails at some point.

Every paraphilia boils down to a single question. Does the paraphilia cause dysfunction? If yes it is treated. In some ways paraphilias are very life Obsessive Compulsive Disorders, in which you can get some pretty bizarre or even seemingly harmless manifestations of the disease, but if they cause dysfunction then they are a disorder that needs to be treated. Hand washing seems pretty benign, but take it to the point where the skin of the hands is stripped off from continued washing and it's clearly a problem. Tapping a pencil until you are crying because you can't stop. Tapping a pencil is nowhere in the DSM, yet clearly for that person it is a manifestation of disordered thinking.

Because breaking laws of the land is considered dysfunctional, there are certain behaviors that are always paraphilias, because to indulge in them is illegal, it harms oneself or others, and until recently anything that was universally condemned by society was considered a paraphilia.Which is how homosexuality was disorder. Necrophilia is illegal. If you engage in it even only rarely, you have a paraphilia. Same with true sadism, and a few of the more rare behaviors involving blood, death, rape, children etc. It is completely possible to have a paraphilia involving say, partners of a different religion, which we see as harmless, but the behavior is compulsive and causes harm. Say, the shame of it leaves you in a constant depressive state. It's how you handle it, or how it handles you that determines if it is causing dysfunction, and therefor a paraphilia. Unless it hurts people who do not or cannot consent to such treatment, and then it's always a paraphilia. And none of these definitions and diagnoses can tell you why someone does what they do. The definitions aren't meant for that, and the reasons vary from person to person, even if some parts of their story fit a theme.

Rewind it a bit, and we have no idea what got Jack's rocks off. People with picquerism usually prey on unwitting people. It's like Frotteurism, but instead of body contact they use a hat pin. It's a signature behavior, and the diagnosis of picquerism rarely comes without that specific behavior. It is unlikely that the pattern of stabbing and cutting seen in the Ripper murders are the work of a picquerist. But that's not to say no paraphilia is at play. It might not have been the stabbing he got off on. It might have been the blood. Or strangulation, or he could have been a partialist. Or it wasn't about sex at all, and was about anger, or a mission, or delusion. There are tiny pieces of these crimes that could fit a lot of different things. I could make probably 5 different arguments. He was unlikely to have five different paraphilias, so they can't all be right.

I have no idea what he was after. The DSM can't help anyone. Not for this. We need more. Like we have with Bundy or Dahmer. But we don't have that. And guessing doesn't help because pinning a diagnosis on this killer still won't tell you why or how. It might explain a surface behavior, but no diagnosis can explain everything he did. Even if he were a violent schizophrenic, that would only explain about a 10th of what he did. There are only two things I can be absolutely sure of. 1: He did what he did because he wanted to. This was a choice, and he consistently made it. Why he made that choice is unknowable. 2: No diagnosis explains all of his behaviors. He was not so insane that he couldn't reason. So any answers we may need aren't going to come from a diagnosis. They can only come from the man himself.

thanks Errata
This was very helpful from the clinical point of view.

I have no idea what he was after

Really? None?

Well I think we could make an educated guess. IMHO from what I know about serial killers and a little bit of common sense I think the ripper was:

Primarily:
Interested in post mortem mutilation-specifically what his sharp knife could do to the female.
And specifically into removing and taking away internal organs, probably as a way of reliving/prolonging the fantasy (which had a sexual component).


Secondary:
Shocking the public
relieving anger/revenge
possibly cannibalism

I think we could also make a good guess he wasn't:
a rapist killer
a torturer/ sadist
a homosexual
suffering from extreme mental disorder that would manifest itself outwardly to the public or so insane he didn't realize what he was doing was wrong.
a pedophile
a mission oriented killer

I know this is armchair whatever but that's how I see it anyway.

[Harry D]

Well I think we could make an educated guess. IMHO from what I know about serial killers and a little bit of common sense I think the ripper was:

Primarily:
Interested in post mortem mutilation-specifically what his sharp knife could do to the female.
And specifically into removing and taking away internal organs, probably as a way of reliving/prolonging the fantasy (which had a sexual component).

I think Errata was referring more to the deeper psychological underpinnings that drove the killer, rather than the surface motivations.

On a side note, I'd love to have a look inside Errata's head, although I am a little scared what I might find in there.

[Abby Normal]

I think Errata was referring more to the deeper psychological underpinnings that drove the killer, rather than the surface motivations.

On a side note, I'd love to have a look inside Errata's head, although I am a little scared what I might find in there.

Hi harry

I think Errata was referring more to the deeper psychological underpinnings that drove the killer, rather than the surface motivations.

well then that's easy enough: he liked it

[Errata]

I think Errata was referring more to the deeper psychological underpinnings that drove the killer, rather than the surface motivations.

On a side note, I'd love to have a look inside Errata's head, although I am a little scared what I might find in there.

It's a freak show in here. Not gonna lie

[Abby Normal]

It's a freak show in here. Not gonna lie

Lol!!

[Errata]

Hi harry



well then that's easy enough: he liked it

Not all killers do like it. Some feel driven. Some only like the result, and sort of breeze through the process with no emotional tie. Gein apparently did not enjoy murder. It was a means to an end. Dahmer enjoyed violence to a point, but he was trying to avoid the actual murder by trying to keep his victims submissive but alive. There's a ton of grey area in terms of what these guys get out of it. Never mind the almost universal profound separation these guys achieve between what they want and what they think they want.

Trying to figure out what a killer gets out of killing someone is a lot like trying to figure out which ant in his ant farm is his favorite. Sometimes it's easy. But even if we knew for certain that some sexual fetish is at play here, which we don't, there are HUNDREDS of paraphilias. And we can rule out say, a foot fetish pretty easily because these women were still shod. But the difference between a sexual proclivity for cutting vs. a proclivity for blood vs. a proclivity for the act of taking a life vs a sexual need for one specific body part that happens to be an organ? How can you differentiate without being able to ask the suspect questions? Which ant in his farm of hundreds of identical ants is he watching?

I can think of a lot of things that might be wrong with Jack. Or none at all. But I have no way of picking out one as being more correct than another. More likely in some cases, but paraphilias don't confine themselves to the bedroom. There are other behaviors that are important for a diagnosis, and we have no access to those behaviors. Does he carry a needle on him? Were either of his parents violently killed? Does he seem stricken at the sight of blood? When he talks to women where does his gaze rest? Does he "collect" stories of murders out of the newspaper? Has he been arrested for an assault during a sexual encounter? Does he stand too close to women? Is he socially awkward? All important things we can ask someone suspected of having a paraphilia, but we can't ask Jack. And a guy might have more than one.

And there is a difference between a paraphilia and a compulsion. A paraphilia can be controlled, and usually is. Maybe not perfectly, but a paraphilia is something that a person requires to have a satisfactory sexual encounter. They are perfectly capable of having normal unsatisfactory encounters. Or going without sexual gratification. And they do. With a compulsion there is such profound psychic distress created that a person has little choice but to go through with it. Suicide is usually the other option. So if we are talking about something that MADE him do it, you are looking for a compulsion, which is usually not at all sexual. If you are looking for what kind of sexual payday he got out of it, that's a paraphilia. A paraphilia is always a choice. A paraphilia means you get something where others get nothing, but it does not mean it's in the drivers seat. So even if he had a paraphilia, he didn't have to kill because of it. He had to choose sexual gratification or human life. Everyone can make that choice if they have to. He chose not to. Which is a symptom of a far larger problem that a paraphilia.One that may not even be psychological as we see the science.

But yeah. Don't use the DSM for this stuff. It is meant to diagnose and treat, not to assign motives to killers. Its the only tool we have, but it's still not the right tool for the job. Like, don't use a hammer to chip ice off your windshield, even if it's the only tool you have. Personally I try to describe behaviors and not label them, since there are expectations of other behaviors in a diagnosis that the killer may not have had. For example if you say schizophrenia instead of hallucinations, you are also implying mood lability, flat affect, cognitive disruptions. If the person you are describing has none of those things, he isn't schizophrenic. He might be bipolar, diabetic, even high as hell, but we can't know that unless you describe the behavior and lay off the label. Behaviors are important. Not diagnoses. We aren't trying to bill anyone here.

[SirJohnFalstaff]

Remember that every diagnosis has a code, and every code is used for insurance and billing purposes.

Exactly. This is why C-PTSD has never been included in DSM-IV nor V. Insurance don't want to cover it. Even though a lot of researchers claim it is as real (and different) as PTSD.

[Abby Normal]

Not all killers do like it. Some feel driven. Some only like the result, and sort of breeze through the process with no emotional tie. Gein apparently did not enjoy murder. It was a means to an end. Dahmer enjoyed violence to a point, but he was trying to avoid the actual murder by trying to keep his victims submissive but alive. There's a ton of grey area in terms of what these guys get out of it. Never mind the almost universal profound separation these guys achieve between what they want and what they think they want.

Trying to figure out what a killer gets out of killing someone is a lot like trying to figure out which ant in his ant farm is his favorite. Sometimes it's easy. But even if we knew for certain that some sexual fetish is at play here, which we don't, there are HUNDREDS of paraphilias. And we can rule out say, a foot fetish pretty easily because these women were still shod. But the difference between a sexual proclivity for cutting vs. a proclivity for blood vs. a proclivity for the act of taking a life vs a sexual need for one specific body part that happens to be an organ? How can you differentiate without being able to ask the suspect questions? Which ant in his farm of hundreds of identical ants is he watching?

I can think of a lot of things that might be wrong with Jack. Or none at all. But I have no way of picking out one as being more correct than another. More likely in some cases, but paraphilias don't confine themselves to the bedroom. There are other behaviors that are important for a diagnosis, and we have no access to those behaviors. Does he carry a needle on him? Were either of his parents violently killed? Does he seem stricken at the sight of blood? When he talks to women where does his gaze rest? Does he "collect" stories of murders out of the newspaper? Has he been arrested for an assault during a sexual encounter? Does he stand too close to women? Is he socially awkward? All important things we can ask someone suspected of having a paraphilia, but we can't ask Jack. And a guy might have more than one.

And there is a difference between a paraphilia and a compulsion. A paraphilia can be controlled, and usually is. Maybe not perfectly, but a paraphilia is something that a person requires to have a satisfactory sexual encounter. They are perfectly capable of having normal unsatisfactory encounters. Or going without sexual gratification. And they do. With a compulsion there is such profound psychic distress created that a person has little choice but to go through with it. Suicide is usually the other option. So if we are talking about something that MADE him do it, you are looking for a compulsion, which is usually not at all sexual. If you are looking for what kind of sexual payday he got out of it, that's a paraphilia. A paraphilia is always a choice. A paraphilia means you get something where others get nothing, but it does not mean it's in the drivers seat. So even if he had a paraphilia, he didn't have to kill because of it. He had to choose sexual gratification or human life. Everyone can make that choice if they have to. He chose not to. Which is a symptom of a far larger problem that a paraphilia.One that may not even be psychological as we see the science.

But yeah. Don't use the DSM for this stuff. It is meant to diagnose and treat, not to assign motives to killers. Its the only tool we have, but it's still not the right tool for the job. Like, don't use a hammer to chip ice off your windshield, even if it's the only tool you have. Personally I try to describe behaviors and not label them, since there are expectations of other behaviors in a diagnosis that the killer may not have had. For example if you say schizophrenia instead of hallucinations, you are also implying mood lability, flat affect, cognitive disruptions. If the person you are describing has none of those things, he isn't schizophrenic. He might be bipolar, diabetic, even high as hell, but we can't know that unless you describe the behavior and lay off the label. Behaviors are important. Not diagnoses. We aren't trying to bill anyone here.

"Driven. Means to an end. No emotional ties." is that really any difference than simply that they like it. Or some aspect of it at least?

Let me give you an example.

Sometimes I like to have a few drinks.
Why?
Because I like to.
I like the feeling.
Sometimes because I feel compelled.
Sometimes because I'm stressed from a hard weeks work.
Sometimes because I'm bored
Sometimes because it's in a social situation
Or some or all the above
Bottom line-because I like to.

Sometimes the next morning I feel rejuvenated because my stress has been wiped clean, and or had a great time.
Sometimes I feel a bit of guilt or remorse and wish I hadn't drank the night before. Not necessarily because anything bad happened or I have a hangover, but maybe just the mood I'm in the next morning.

But bottom line in all of this is that I drink sometimes because I want to and I like it, regardless of all the other stuff. Even if sometimes I feel a little guilty the next day. It doesn't stop me from wanting to do it again.

Same as serial killers. Regardless of all the other stuff you talk about the bottom line is that they like it, or some aspect of it.

Now if you ask me why they like it, then that's a question I don't think anyone knows.

"behaviors are important"

Exactly. Which is the reason for my previous post. Because I think from the crime scenes we can discern the behaviors and the motivation behind those behaviors.

Using my drinking analogy. Even if you had no knowledge of what I said earlier in this post for why I drink, I think you could figure it out from my crime scene.

If you visited my house and could look around. See my fridge and my liquor cabinet, how much booze, what kind of alcohol, when and how much empties you find around or in the trash etc. I think you could easily determine, I'm not an alcoholic, nor am I only a one or two glasses of wine with evry dinner type, or a binge drinker, or mainly a collecter .I think it you you could easily determine that I'm an occasional drinker sometimes to pleasant excess. That I drink mainly on Friday nights so stress relief from work is probably a reason.That I don't drink because I like the taste (which is why don't drink a couple very night with dinner).im not drinking for the bar scene/hooking up as i mainly drink at home,etc. etc.

Are you feeling any of this of what I'm trying to say?