Westen et al. emphasize that their system is “empirically derived,” unlike the theory-driven tradition-based systems of their predecessors. This is true, up to a point (perhaps as true as possible). There are three inputs to their data: the patients, the clinicians, and the descriptive items. The patients were selected because the treating clinicians view them as having personality problems (generating a “sicker” sample than I would have predicted; one-third of the patients had a previous hospitalization). The clinicians, not the patients themselves, are the real research subjects, and like all clinicians, they are contaminated by the concepts and theories that they bring with them. However, the authors went to great lengths to neutralize this factor by using a wide range of clinicians from a variety of theoretical and professional backgrounds; less than 25% self-identified as “psychodynamic”—the investigators' orientation. The items were assembled over time, largely refined by their psychometric properties and by the consumer responses of the clinicians. The current iteration of the instrument has 200 items, of which 90% have been only minimally revised from the last version. Accepting that the authors are using verbal reports of observations of psychological functioning—one human describing another—this would seem as objective and empirical as one is likely to get. However, inevitably, it sees patients through two lenses—the clinicians' and those of the researcher who selected the items.