Bumstabbers

[Batman]

Here is something interesting.

In 1788, the London Monster was a picquerist who went around London pricking women with knife, pin or needle, often in a sexual way.

Macnaughton on Cutbush - It seems, then, highly improbable that the murderer would have suddenly stopped in November '88, and been content to recommence operations by merely prodding a girl behind some 2 years and 4 months afterwards.

Keppel on JtR listed piquerism as a unique and rare feature of JtR.

[Robert]

Cutbush recommenced operations in a fit of picque.

[GUT]

And a full 100 years before Jack???

[Errata]

Jack wasn't a picquerist.

[Batman]

Jack wasn't a picquerist.

I sort of like Keppel's take on this. It makes sense to me. Maybe you have something to add Errata?

[Mayerling]

Jan Bonderson wrote a book on the 1788 case, and accounts of it are in "The Newgate Calendar" and one account was written by William Roughead in his book "Bad Companions". There was an arrest and trial of one Renwick or Rhynwick Willams, who was found guilty and spent time in jail, but there is still some question about whether he did the "Punctures in Pickadilly" as Roughead termed the incident. And Roughead noted that it resembled the more horrific incidents in Whitechapel a century later.

Jeff

[John G]

I sort of like Keppel's take on this. It makes sense to me. Maybe you have something to add Errata?

I am of the same opinion. To my knowledge Keppel's conclusions on this matter have never been challenged by an authoritative source in any respected peer-reviewed publication so, for me, they remain definitive.

[Errata]

I sort of like Keppel's take on this. It makes sense to me. Maybe you have something to add Errata?

A lot actually, but not a lot in terms of "I'm right and someone else is wrong" but more along the lines of "this is actually extremely difficult, and anyone knowingly refusing to address the inherent problems in this little controversy is being dishonest." And it turns out a lot of people don't know, and pronounce with certainty, and without realizing it they just made their life very hard.

Picquerism is a clinical term. And as such any definition of the word comes from shrinks, not criminologists. But it's not that easy. And it's not that common a diagnosis. So to illustrate some problems we are going to use Sadism, because picquerism is a form of sadism. The clinical definition of Sadism is that a person cannot perform sexually without cause pain or harm to their partner. Because most people don't put up with that, a sadist is essentially left only with unwilling partners. Sexual dysfunction causes problems outside of the bedroom, textbook paraphilia. And I sure that definition jives with what you know, mostly. Here's where it starts to slide. Anyone not a shrink or not familiar with the inner workings of paraphilias could be forgiven for assuming that some guy who likes to spank his partners is a sadist. Spanking causes pain right? It's actually completely different.It's not the pain the man is after. Thats a side effect that can be useful to him. What he wants is control and obedience. And he gets off on spanking because it is the one punishment everyone recognizes. It's humiliating, it hurts, and everyone recognizes it as the cost of doing something wrong. Someone with a spanking fetish believes that most control a man can have over a woman (or whatever gender variances) is when he has her turned over his knee and is spanking her. It's not the pain. Many of those with a spanking fetish use tools to either increase or decrease the pain. Is a spanker a Sadist? Maybe. The two can go together, just like someone with Bipolar Disorder can also have an anxiety disorder. But it's not the same thing. Spanking is not inherently sadistic. The two get off on different things.

Which is why we now have dominants and submissives as opposed to sadists and masochists. Dominance and submissiveness is about control and consent. True sadism can never be consented to. Not without breaking a ton of laws, making sadism a paraphilia and dominance merely kink.

So what the hell is Picquerism? It's a form of sadism. Just like spanking can be, real beatings always are, burning is usually sadistic though not always, whipping usually is but not always. It's complicated because it's not about the action, it's about the motive. Picquerists want to cause pain, it's the part they get off on. They use needles, pins, nails, bamboo splinters whatever because they don't want to kill, though people do die from this. They also derive great pleasure from dealing serious pain anonymously. Most picquerists today operate in shopping malls. They can stab someone without them knowing. They are no so into blood, which sounds strange but this is a very disturbing art form. If the victim starts gushing blood then you did it wrong. You might get caught. And even those who indulge in the most extreme forms of this still mostly use small instruments, but stakes might be used as well. What all Picquerists have in common is that it is the pain of the act of stabbing that gets them off. Not the blood, not the victims, not even the act of piercing skin. It's the infliction of pain. This is very rare, and it is more often an act they perform on themselves than on others.

But then criminology has a different definition. It's anyone who gets off on piercing flesh. Pin, axes, makes no difference. It also includes people who get off on spilling blood (which is actually hemofetishism), and people who like opening up other people ( which can actually be one of maybe five paraphilias). These are clinical terms for medical problems. The more broad the definition, the more useless it is. About 1/10 of the population would qualify for the criminal definition, and only 1 in 30 actually have paraphilias. It's an attempt to explain what is mostly unexplainable. Why killers get off on stabbing people. But there is no single reason common to all.

And the funny thing is, even the problems with simply defining picquerism isn't the problem. In truth you don't need it to know that Jack was not a picquerist. All you need to know is the definition and frequency of behavior of any paraphiliac. The paraphilia is screwing up their lives so they think about it all the time. But thy can't think about the negative without dwelling on the positive. The average paraphiliac who does not require consenting partners engages in their dysfunctional behavior, whatever it is, at least once a week. And you average paraphiliac has more than one dysfunctional behavior. The average is three. Usually very closely related to each other, but sometimes there is a wild hair. So there is usually the core behavior. And then there is what they do in order to not engage in that behavior, something lesser but in the same vein, sometimes solitary in nature. And then there is the middle behavior. The compromise behavior that is still illegal, problematic, humiliating, etc. but not as bad as the core fantasy. So a necrophiliac might masturbate with an iced hand, and have sex with drunk and unconscious women, all in order to not have sex with a corpse. At least once a week.

Jack's problem was not one that could be dealt with by himself. There are about a dozen things he could be, and none of them don't involve victimizing innocent people in the substitute behaviors. So he is still victimizing women when he is not killing.Probably several times a week. Because thats what out of control paraphiliacs do. And even if he managed to stop killing, he never stopped offending. He couldn't. The appropriate therapy didn't exist back then, and who was he going to turn to to help him substitute behaviors? If Jack had a paraphilia, he offended until the day he died. And he offended likely since he became sexually mature. But Jack didn't. Jack had control. Paraphiliacs don't. There are any number of ways he could have mitigated his obsession, but not to the point where someone didn't die, someone didn't report him, or he killed himself.

We all know that serial killers can stop. Can just walk away. But violent paraphiliacs cannot. Jack could not have been a paraphiliac, therefore he could not have been a picquerist. Doesn't mean something wasn't desperately off about him, but apparently his sex life was not making him kill.

[John G]

Hello Eratta,

I would agree that JtR wasn't a sadist- espeically if your definition of sadism is an interest in pain, rather than, say, domination- but I don't believe that any definition of picquerism necessarily implies any such thing. Thus, Dr Anil Aggrawani, in his book Necrophilia: Forensic and Medico-legal Aspects, 2011, gives us this definition of lust murders:

"Lust murders are homicides in which the offender stabs, cuts, pierces, or mutilates the sexual regions or organs of the victim's body. The sexual mutilation of the victim may include evisceration, picquerism...it also includes activities such as posing and propping of the body, the insertion of objects into the body cavities..."

Now this definition clearly corresponds to Keppel's. Moreover, Dr Aggrawani has specifically defined picquerism as: "sexual gratification through penetration of another person, most commonly by stabbing or cutting the body with sharp objects": see Aggrawani, 2009. It is submitted that this definition is also consistent with Keppel.

However, it must be conceded that "picquerism is currently an ill-defined concept. The DSM, for example, doesn't codify the "condition" but lists it under "paraphilia NOS (Not Otherwise Specified), whereas the ICD doesn't recognize the condition at all.

Unfortunately, as Batman has pointed out, psychology is not a "hard" science. There is no bio-medical proof for the existence of the vast majority of psychological conditions, which is why labelling theory is such an attractive proposition for many, including myself.

Even schizophrenia is an ill-defined condition, and the DSM V has now removed all sub-categories for schizophrenia because of "their limited diagnostic stability, low reliability and poor validity". In fact, I prefer the social defeat hypothesis myself.

As for the clinical concept of paraphilia, perhaps that also needs to be thrown into the nearest waste paper basket: see Ogas, 2012: https://www.psychologytoday.com/blog...s-do-not-exist

[John G]

Edit

I seem to have made a spelling error in my last post, which should, of course, be addressed "Hello Errata". Apologies for the mistake, spelling was never really a strong point of mine!

[Errata]

Hello Eratta,

I would agree that JtR wasn't a sadist- espeically if your definition of sadism is an interest in pain, rather than, say, domination- but I don't believe that any definition of picquerism necessarily implies any such thing. Thus, Dr Anil Aggrawani, in his book Necrophilia: Forensic and Medico-legal Aspects, 2011, gives us this definition of lust murders:

"Lust murders are homicides in which the offender stabs, cuts, pierces, or mutilates the sexual regions or organs of the victim's body. The sexual mutilation of the victim may include evisceration, picquerism...it also includes activities such as posing and propping of the body, the insertion of objects into the body cavities..."

Now this definition clearly corresponds to Keppel's. Moreover, Dr Aggrawani has specifically defined picquerism as: "sexual gratification through penetration of another person, most commonly by stabbing or cutting the body with sharp objects": see Aggrawani, 2009. It is submitted that this definition is also consistent with Keppel.

However, it must be conceded that "picquerism is currently an ill-defined concept. The DSM, for example, doesn't codify the "condition" but lists it under "paraphilia NOS (Not Otherwise Specified), whereas the ICD doesn't recognize the condition at all.

Unfortunately, as Batman has pointed out, psychology is not a "hard" science. There is no bio-medical proof for the existence of the vast majority of psychological conditions, which is why labelling theory is such an attractive proposition for many, including myself.

Even schizophrenia is an ill-defined condition, and the DSM V has now removed all sub-categories for schizophrenia because of "their limited diagnostic stability, low reliability and poor validity". In fact, I prefer the social defeat hypothesis myself.

As for the clinical concept of paraphilia, perhaps that also needs to be thrown into the nearest waste paper basket: see Ogas, 2012: https://www.psychologytoday.com/blog...s-do-not-exist

Well that's a vasty can of worms. Firstly never quote a non psychiatrist about an all around admittedly psychiatric condition. I mean, Ogas is good for almost nothing except for parlaying his PhD as a way to get on TV game shows. The article you referred to was written for the sole purpose of promoting a book about a bunch of things he knows nothing about. I mean, if I was to write a book about sexual proclivities, kink, paraphilias, etc. I would want to know the definitions of those things. He doesn't. Apparently he couldn't find a DSM any younger than the late 60s, so... it's bad. In fact it's legendary bad. It gets referred to in conferences and classes as to how NOT to do a study. And he says he deliberately did not use any scientific method or information specific to any discipline in order to stay the bad boy outsider with street cred or whatever. Hello? Science. He calls it pop psychology but it isn't, it's just really really wrong. But people like reading about other people's turn-ons so it sells. The guy is actually a colossal douchebag, though I suppose that wouldn't be relevant if he was right. Bad reference. No biscuit. Also I gotta say there are very few time you want to reference Psychology Today: The Only Psych Publication No Psychologist Reads. It not that they aren't capable of publishing a consequential paper, they just haven't done it as yet. It's like referencing Readers Digest in a History textbook. Even if for some reason it was right an accurate, you still would never choose to write the way they write.

And there is no tear to go on with Dr. Aggrawal. He is one of the foremost pathologists in the world, and recognized everywhere as a forensic expert. So having him talk about psych is a little like asking a mechanic for stock tips, but for all I know your mechanic is phenomenal at playing the market. Dr. Aggrawal did a psych rotation in med school. Everyone has to. But thats the last time he practiced psychology or psychiatry. As is evident by the laundry list of shrinks he quotes and thanks in his publications. And he hasn't treated a living patient since 1989. The terms forensic scientists use are criminological, not clinical. Which he acknowledges. Mostly because they never treat anyone ever. So, fair enough. But no shrink gave him this definition of picquerism. So where did he get it? Who knows? It wasn't used before 1995. It was not anyone's standard definition before 2002. It really picked up around 2008. Why? In the "I kid you not" category, because the criminology definition appeared on a Law and Order SVU episode in it's first round of syndication in 2007. It shows up a couple times before that episode aired in syndication, it gets used every few months after. So... there's that.

One thing I think we can all agree on about a diagnosis is that whatever it is, it's the same thing every time. My chicken pox looks like your chicken pox. If someone turns purple and sings incessantly, not chicken pox. Because every disease has diagnostic criteria right? Okay. This is where I whip out my own psychology today article. I have no idea who the author is or what his expertise is, doesn't matter. He's not the important thing here. The stories that he has collected and dutifully referenced are. You'll note that the Law and Order episode is in there, and a more wrong summary of an illness cannot be found. It' on par with babies coming from storks. But read the article, and see how the definition changes. Not just little changes, but really big changes. Everyone attached to psychology or psychiatry will give you the same definition. No two criminologists will. That's a problem. https://www.psychologytoday.com/blog...ife-knife-edge

Let me tell you what sucks the most about my life. Being Bipolar is no picnic, I must confess. But somehow in this day and age being bipolar is the second worst thing that has happened to me. The most worse thing? People. People and bipolar. So I got some guy nattering on at me about how his girlfriend can never order off a menu in a timely manner and he says "God she's just soo bipolar I can't stand it." What I SAY is "You mean she is indecisive, not bipolar". What I THINK is "How ******* dare you compare your little ******* twit of a girlfriend and her general faults to having a disease that I have to deal with every ******* hour of every ******* day for the rest of my ******* life you ignorant piece of ****." And sometimes I imagine beating this guy with a stick to make myself feel better. Nine time out of ten, that guy is being an insensitive douche, and when I correct his language he feels bad about it. But one guy in ten, that's not what happens. Some of these guys think that indecisiveness IS being bipolar, and they are telling me to get advice. Some other of these guys think the same thing, but they don't want advice, they are about to tell me that they dumped her for it and boy did they dodge a bullet. Some of these guys think bipolar is made up so what am I bitching about, some of them somehow thought that I was kidding for all this time, and this is where they figure out that I meant what I said, and the wheels fall off. And when I say the wheels fall off they take several steps back, check their exits, and start talking to me like I'm a toddler mixed with a growling pitbull. Definitions are important. The inability to add to a definition without peer reviewed study with oversight is important. Here's why. I'm bipolar. That has a definition. It is a malfunction in the synthesis absorption or reuptake of seratonin, dopamine, or a combination of both that elicits periods of depression mixed with periods of mania, hypomania, or mixed episodes. That's not hard right? Except that a bunch of people (and I mean a bunch) think that being bipolar makes you unable to exercise self control. And it's hard with mania, I'm not going to lie. Then again most people with Bipolar don't experience full mania ever. A lot of people think that being bipolar means you can't be trusted. Not with money, not with possessions, not with people. And state governments are listening to those people now. A lot of people think that Bipolar people are violent. Almost none of us are. But they "can't take that chance, surely you understand" except I don't, because really it's a lie. But if I say that I'm being unreasonable, and that makes me more scary and sometimes people weep and beg me not to hurt them when I tell them they are offensive or full of ****. SERIOUSLY??? When it comes to declaring people incompetent, judges now listen to psychiatrists less than any other time going back to the early 60s. They don't think they have the luxury of trust. But it's about facts, not trust. But all the facts in the world won't sway you when you are convinced that mentally ill people are dangerous because you saw that one Oprah episode.

And I'm not championing the right of the picquerists here. But the lion's share of picquerists are self harming. Not violent. So while they desperately need help, they don't need to go to jail for having the wrong label. So now this paraphilia is associated with knives and knife murderers. At least according to criminologists. But read that article again. It's not just pins and knives. Now teeth is included. And now it doesn't have to be a sadistic act. It can be about seeing blood (which already has it's own thing thanks.) And if it's about all those things, maybe it doesn't even need blood. Maybe bruising is okay. So beating someone to death is now the same thing. But here's the real problem. It's about blood and it can be teeth so one day in the moment, perhaps startled by something, you accidentally bite down on your SO, and you guys go to the ER because human bites are nasty. Doesn't happen often, but there's a couple hundred cases a year. Except now there's a body in the morgue with the complete works of Shakespeare carved into it, and suddenly you are a suspect because your accidental bite is considered part of this very rare disease. Biting is the same as cutting is the same as blood letting is the same as sadism, and when sadism you always have to throw in dominance for those who didn't get that memo. It has to be specific, and it has to have the same definition every time or that happens. And it does happen. We've only just stop outright arresting dominants within the last 10 years. And we've known they were not clinical sadists since the early 80s. Picquerism is not kink, and is in fact readily separated from kink, except that now it's not. Now it could be kink, it could be something clinical. Which helps no one. It doesn't help law enforcement, it doesn't help the mental health field, it certainly doesn't help anyone with a not quite vanilla sex life, the only people it helps are criminologists, because now they have a word for something and they didn't have to go through the trouble of making one up for themselves. Everyone else, this kind of clinical hijacking hurts.

Did you know that spankers used to get talked to in all sadistic murders? There's an old dominant in New York who kept a list of every investigation he was called in for, and I think the last one was in 1989. So either they figured out that it was two different things, or he got too old to be a suspect. He's like 100.

[John G]

Hello Errata,

Yes, I must say that I struggle with the concept of "lust murders". However, do you see any similarities between and JtR and Jeffrey Dahmer? Of course, Dahmer was clinically diagnosed with paraphilia and several experts testifying at his trial concluded that he was not a sexual sadist. Even Dr Dietz for the prosecution testified: "He [Dahmer ] did not torture and took steps to prevent suffering."

Dahmer, despite his diagnosis, murdered 17 victims over a 13 year period. Therefore, although issues of dominance and control seemed to be prevalent in his thoughts he was still, presumably, able to exercise a high level of self control over his murderous impulses.

However, after conducting further research I have to agree that your criticisms of the criminological approach are well founded. Thus, what exactly is paraphilia? The ICD10, for instance, doesn't even give a definition. The DSM has attempted to define the "disorder", but not without controversy: "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. Keenan in her criticism suggests the inclusion of "paraphilic disorders" in DSM-5 as redundant, unscientific, and stigmatizing..." ( McManus et al, 2013) see: http://f1000.com/prime/reports/m/5/36/#bib-016.

An even more serious difficulty is that picquerism, for example, is categorized as a condition that is NOS (Not otherwise specified). And this as resulted in serious criticisms of the criminological interpretation: "Not otherwise specified disorders are meant to be no more than residual wastepaper baskets provided by DSM- IV to encourage research and for the convenience of clinicians when coding patients who do not fit within one of the specific DSM-1V categories.. 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 the DSM- IV...By virtue of their residual and idiosyncratic nature, cases given the label NOS are by definition outside of 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.

I am therefore beginning to wonder if much of Keppel's report should be confined to the "wastepaper basket"! In fact, to be honest I'm not a huge fan of the DSM either, although I understand the practical need to have a codified approach to mental health. The difficulty is that the biomedical model, which could be regarded as reductionist, underpins much of the DSM, despite the lack of scientific support for such an approach: see Deacon, 2013

http://jonabram.web.unc.edu/files/2013/09/Deacon_biomedical_model_2013.pdf

By the way, I'm a great admirer of Allen Frances, the chair of the DSM- 1V task force.: here's another of his reports, which gives an objective and unbiased view of the limitations of the DSM: http://psych.colorado.edu/~willcutt/...ances_2012.pdf.

[Errata]

Hello Errata,

Yes, I must say that I struggle with the concept of "lust murders". However, do you see any similarities between and JtR and Jeffrey Dahmer? Of course, Dahmer was clinically diagnosed with paraphilia and several experts testifying at his trial concluded that he was not a sexual sadist. Even Dr Dietz for the prosecution testified: "He [Dahmer ] did not torture and took steps to prevent suffering."

Dahmer, despite his diagnosis, murdered 17 victims over a 13 year period. Therefore, although issues of dominance and control seemed to be prevalent in his thoughts he was still, presumably, able to exercise a high level of self control over his murderous impulses.

However, after conducting further research I have to agree that your criticisms of the criminological approach are well founded. Thus, what exactly is paraphilia? The ICD10, for instance, doesn't even give a definition. The DSM has attempted to define the "disorder", but not without controversy: "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. Keenan in her criticism suggests the inclusion of "paraphilic disorders" in DSM-5 as redundant, unscientific, and stigmatizing..." ( McManus et al, 2013) see: http://f1000.com/prime/reports/m/5/36/#bib-016.

An even more serious difficulty is that picquerism, for example, is categorized as a condition that is NOS (Not otherwise specified). And this as resulted in serious criticisms of the criminological interpretation: "Not otherwise specified disorders are meant to be no more than residual wastepaper baskets provided by DSM- IV to encourage research and for the convenience of clinicians when coding patients who do not fit within one of the specific DSM-1V categories.. 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 the DSM- IV...By virtue of their residual and idiosyncratic nature, cases given the label NOS are by definition outside of 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.

I am therefore beginning to wonder if much of Keppel's report should be confined to the "wastepaper basket"! In fact, to be honest I'm not a huge fan of the DSM either, although I understand the practical need to have a codified approach to mental health. The difficulty is that the biomedical model, which could be regarded as reductionist, underpins much of the DSM, despite the lack of scientific support for such an approach: see Deacon, 2013

http://jonabram.web.unc.edu/files/2013/09/Deacon_biomedical_model_2013.pdf

By the way, I'm a great admirer of Allen Frances, the chair of the DSM- 1V task force.: here's another of his reports, which gives an objective and unbiased view of the limitations of the DSM: http://psych.colorado.edu/~willcutt/...ances_2012.pdf.

I'm not on board with Keppel. And I think the running definition of sexual sadism is stupid. The only possible reason for anyone to mark or mutilate sex organs is sexual sadism. What? Of COURSE Dahmer wasn't a sexual sadist. Neither was Gein. Nor technically was Bundy because he was a straight sadist.No need to specialize. And I hate I hate I HATE people diagnosing people they never met, and have no intention of treating.

[Errata]

Hello Errata,

Yes, I must say that I struggle with the concept of "lust murders". However, do you see any similarities between and JtR and Jeffrey Dahmer? Of course, Dahmer was clinically diagnosed with paraphilia and several experts testifying at his trial concluded that he was not a sexual sadist. Even Dr Dietz for the prosecution testified: "He [Dahmer ] did not torture and took steps to prevent suffering."

Dahmer, despite his diagnosis, murdered 17 victims over a 13 year period. Therefore, although issues of dominance and control seemed to be prevalent in his thoughts he was still, presumably, able to exercise a high level of self control over his murderous impulses.

However, after conducting further research I have to agree that your criticisms of the criminological approach are well founded. Thus, what exactly is paraphilia? The ICD10, for instance, doesn't even give a definition. The DSM has attempted to define the "disorder", but not without controversy: "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. Keenan in her criticism suggests the inclusion of "paraphilic disorders" in DSM-5 as redundant, unscientific, and stigmatizing..." ( McManus et al, 2013) see: http://f1000.com/prime/reports/m/5/36/#bib-016.

An even more serious difficulty is that picquerism, for example, is categorized as a condition that is NOS (Not otherwise specified). And this as resulted in serious criticisms of the criminological interpretation: "Not otherwise specified disorders are meant to be no more than residual wastepaper baskets provided by DSM- IV to encourage research and for the convenience of clinicians when coding patients who do not fit within one of the specific DSM-1V categories.. 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 the DSM- IV...By virtue of their residual and idiosyncratic nature, cases given the label NOS are by definition outside of 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.

I am therefore beginning to wonder if much of Keppel's report should be confined to the "wastepaper basket"! In fact, to be honest I'm not a huge fan of the DSM either, although I understand the practical need to have a codified approach to mental health. The difficulty is that the biomedical model, which could be regarded as reductionist, underpins much of the DSM, despite the lack of scientific support for such an approach: see Deacon, 2013

http://jonabram.web.unc.edu/files/2013/09/Deacon_biomedical_model_2013.pdf

By the way, I'm a great admirer of Allen Frances, the chair of the DSM- 1V task force.: here's another of his reports, which gives an objective and unbiased view of the limitations of the DSM: http://psych.colorado.edu/~willcutt/...ances_2012.pdf.

Well that was weird. There was more to that post. In case it seemed somewhat blunt.

So here's the thing about Picquerism. It is categorized as a Paraphilia NOS. Thats actually not correct. It is a kind of sadism. Which is it's own broad category. Branding is sadism, breath control leading to death is sadism (it's also something else, but that happens), boneplay is sadism, picquerism is sadism. So it is Sadism NOS if you want to be specific, just sadism if you don't. Which sounds confusing and disorganized and not DSM worthy.

So we all know the problems with the DSM. Every edition reflects the current psychological theory and results from research and of course, those get reversed every five years or so. DSM III to DSM V in thirty years is... not good. We don't get a new version everytime we learn something. That gets put in new printings, not new editions. No, new editions come from when the current DSM is so wrong that it just needs to be scrapped.

But here is the beauty of the DSM. It tells mental health professional how to build a diagnostic procedure, how to categorize and identify the basic kind of problem, and in some cases tells you the best way to treat it. And there is so much neuropsychologists have done in the past 10 years. PET scans can isolate motives for behavior, it can identify the exact chemical malfunction some people experience. We can use pupil dilation and constriction. We can use electrical fields, we can use effing magnets now.. and we can take those results, plug it in to the DSM format and come out with a not only a very detailed description of the behavior, but a solid treatment plan. Te value of the DSM is not that it's complete catalog. It's not. The value is that it tells us how to identify a disorder, distinguish it from a quirk, and figure out if the disorder is chemical or behavioral. People think the Statistical part is the important part. It's not. It's the Diagnostic part. Not just whats in there, but the structure so you can do it yourself when you see something potentially new. The DSM knows it's not complete,and it knows that new stuff happens. It's set up for that.

[Ausgirl]

The guy who attacked Annie Millwood could have gotten off on the act of stabbing. Or maybe she just got away before he could he could finish her off.

Whoever attacked Tabram targetted vital organ regions and hit a few. I'm inclined to call that one a rage attack, and he did not have any intention of her surviving it, obviously.

I'm pretty convinced Emma Smith was attacked by a gang, with one or possibly more members possibly being a true sadist (some sadists just like to watch).

I don't see much evidence for JtR being into piquerism. He was a mutilator, sure, but his victims were likely dead or close to it and unconscious. If he had any "interim" behaviours, I believe he'd try to get access to corpses to mutilate. But somehow, I think he preferred the warm ones.