At a recent teaching conference, the case of an 18-year-old woman with an eating disorder was presented. She was being treated with behavioral techniques. The resident started his presentation as follows: "This 18-year-old girl became preoccupied with her figure and lost 25 pounds in the three weeks preceding admission." The case discussant stopped the presentation and said it was rare, in her experience, that a patient with an eating disorder would have such an acute weight loss and asked if there was anything else going on. Finally, a nurse noted that a month previously, the patient's father had left home with his secretary, and the patient, at that point, stopped eating and became preoccupied with her weight. Somewhere, the patient's story had gotten lost. What was being treated was a diagnosis and not the patient. What happened here? These were not incompetent clinicians. However, it became clear that in our contemporary psychiatric practice, the patients' stories and the way in which the patients are functioning are not necessary to the diagnostic process. In this case, the symptoms were sought, but not the antecedents or consequences of these symptoms. There are even some recent data that indicate how the symptoms used for the diagnosis color the clinician's perception of the patient's functioning. Roy-Byrne et al. (3) showed that psychiatrists' global ratings of patients' functioning were totally unrelated to detailed nurses' ratings of the same patients' functioning but were highly correlated with their own rating of symptom severity. Halleck (4), in 1988, pointed out that DSM-III seemed to focus the trainee on the diagnostic process and not on the patient. Our view of the patient can become restricted as we are looking for a predetermined set of symptoms. This not only tends to focus our information on what we are looking for, but can allow us to ignore important distinctions between patients. It is important to remember that we are evaluating subjective experiences reported by a patient. Can these self-reported symptoms be effectively evaluated without exploration of their antecedents, consequences, overall context, and fluctuations in intensity over time? Jaspers (5), the great phenomenologist, would say no.