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Krafft-Ebing Cases @ DSM-IV Codes
Personal Cosmic Game of August 19, 2002
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Codes Beat Cases, 3-0
DSM-IV Code 315.2 (Disorder of Written Expression) Pitches a No-Hitter

Additional Game Notes

Cosmic Games Game Time 2 hours, 33 minutes
Game MCP 315.2 (Disorder of Written Expression)
Umpires Casanova, Don Juan, Messalina,
Official Scorer Havelock Ellis
Attendance Undisclosed
Weather Cloudy & Cool. 62o F.
Simulation: 118v33

A remarkable performance by a condition that affects about five percent of our younger population. Written Expression Disorder pitched an assertive no-hitter and shut down one of the better offenses in the Psychopathology League.


Team Rosters


Krafft-Ebing Cases

NOTE: Page references are to Psychopathia Sexualis by Richard Von Krafft-Ebing. (English translation published 1953 by Wehman Brothers, New York.)

Case 11. Rightfield. (A case of hypersexuality.) P., Caretaker, age 53; married; no evidence of hereditary taint; no epileptic antecedents; moderate drinker; no sign of senior praecox [senility]; appeared, according to the statement of his wife during the whole time of their married life covering a period of 28 years, hypersexual, extremely libidinous, ever potent, in fact insatiable in his marital relations. During coitus, he became quite bestial and wild, trembled all over with excitement and panted heavily. This nauseated the wife who by nature was rather frigid and rendered the discharge of her conjugal duty a heavy burden. He worried her with his jealous behavior, but he himself soon after the marriage seduced his wife's sister, an innocent girl, and had a child by her. In 1873 he took mother and child to his home. He now had two women, but gave preference to the sister-in-law, which the wife tolerated as a lesser evil. As years went by his libido increased, though his potency decreased. He often resorted to masturbation even immediately after coitus, and without in the least minding the presence of the women…At the clinic he was quiet and well behaved. his excuse was hypersexuality. He acknowledged the wrongfulness of his actions, but said he could not help himself. The frigidity of the wife had forced him to commit adultery. There were no disturbances of his mental faculties, but the ethical elements were utterly wanting. He had several epileptic fits but no signs of degeneration.

(pages 71-72)

Case 18. Secondbase. (Vacher the Ripper). Vacher was born of "honorable" parents in 1869. His was a "mentally sound" family. From infancy and childhood he was "vicious, lazy and shy of work." When twenty, Vacher assaulted a small child. Four years later he was discharged from military service "on account of 'psychical disturbances' (confused talk, persecution-mania, threatening language, extreme irritability)." Shortly after his discharge he was sent to an insane asylum and diagnosed as having a "persecution complex." His paranoia resolved he was considered cured and dismissed from the asylum on April 1, 1894. For more then three years, ending with his arrest on August 4, 1897, Vacher committed eleven sadistic lust murders. Typically he would either strangle or cut his victim's throat, disembowel and otherwise mutilate the corpse. Vacher also reportedly had sex with the corpses of his victims. Eventually Vacher was tried in a court of law. Experts testified that Vacher's crimes "are those of an antisocial, sadistic, bloodthirsty being…He is a common criminal and there are no ameliorating circumstances to be found in his favor." Vacher was found mentally sound but morally depraved and he was put to death.

(pages 91-94)

Case 37. Centerfield. (Symbolic Sadism). A man in Vienna regularly visited several prostitutes only to lather their faces and then to remove the lather with a razor, as if he were shaving them. He never hurt the girls, but became sexually excited and ejaculated during the procedure. [Krafft-Ebing writes that if the sadistic impulse is not "overmastering, or if there is yet sufficient moral resistance, it may happen that the perverse inclination is satisfied by an act that is apparently quite senseless and silly, but which has nevertheless a symbolic meaning for the perpetrator."]

(page 118)

Case 48. Shortstop. (Sadism in Women.) A married man presented himself with numerous scars of cuts on his arms. He told of their origin as follows: When he wished to approach his wife, who was young and somewhat 'nervous,' he first had to make a cut in his arm. The she would suck the wound and during the act become violently excited sexually. [Krafft-Ebing notes that sadism is women is rarer than in men. "Yet sadism occurs in women, and it can only be explained by the primary constituent element-- the general hyper-excitation of the motor sphere. Only two cases have thus far been scientifically studied." (emphasis added). Angela Carter wrote in her 1978 book, The Sadeian Woman, "A free woman in an unfree society will be a monster."]

(page 129)

Case 58. Firstbase.(Masochism in Men, Part 1.) Z. is a 50-year-old government official. He is described as tall, muscular and healthy. His parents were likewise healthy although his father was 30 years older than his mother was. He had a sister, two years older, who suffered from "delusions of persecution." Z. claimed that he never masturbated as a youth and that the act of intercourse seemed "bestial." He was, however, drawn to women. Krafft-Ebing writes, "It was only in the society of beautiful women and girls that he felt well and in his place. He was very gallant without being forward." Instead of masturbation, he had dreams of women sitting on top of him, their weight offering a pleasurable sexual sensation. He felt a need to serve and to be used by women. He became aroused when thinking about how much women enjoyed riding horses. He wished and dreamed of being ridden, like a horse. When he was 32 he met a woman, five years younger, and he had successful if not entirely pleasant sexual intercourse with her. However, their physical relationship broke down. After this, he explored the realization of his dreams and desires with another woman. Krafft-Ebing quotes Z: "Being of tall stature, both hands braced on a chair, I made my back horizontal, and she mounted astride, after the manner of a man. I then did the best I could to imitate the movements of a horse, and loved to have her treat me like a horse, without consideration. She could beat, prick, scold or caress me, just as she felt inclined."

(pages 151-154)

Case 80. Thirdbase.(Masochism in Men, Part 2.) Another Z. was 52 years old, held a high position somewhere and came from a family who "claimed to be untainted." At seven years of age, he saw servants remove their boots in preparation for cleaning the floors. Additionally, this Z. took an interest in reading about cruelty and tortures. Krafft-Ebing writes, "He simply devoured novels dealing with slavery and bondage, and whilst reading them he began masturbation. What excited him most was to imagine that he was the slave of a pretty young lady." Especially he liked to fantasize about kissing the lady's feet (pedes lambere). When Z. was fifteen he let a poodle dog lick his feet. Soon afterward he saw the poodle lick the feet of a young servant girl in his home and it caused him to ejaculate. "He persuaded the girl to let this happen frequently whilst he looked on. After a while he took the place of the poodle and ejaculated every time." Z. was not particularly interested in the female sexual organs and typically, his kissing and licking the dirty feet of his paramours preceded sexual intercourse.

(pages 186-190)

Case 90. Leftfield. (Hand Fetishism.) P.L. is a 28-year-old merchant from Westphalia. . He is described as nervous in temperament. Never a diligent student, P.L. had an interest in music. Along the way, P.L. developed a fetish for "beautifully formed hands. He first sought out psychotherapy in August 1890 when he complained of head and stomach aches. P.L. recalls first becoming sexually aroused at age 7 and masturbated with other boys. He masturbated regularly until his 18th year. As he became more interested in members of the opposite sex his desire to be touched by their hands increased. Hand jobs from women were more pleasurable than sexual intercourse. Krafft-Ebing sums up the situation: "This case of hand-fetishism certainly does not depend on masochism or sadism, but is to be explained simply on the ground of early indulgence in mutual onanism. Neither is there antipathic sexual instinct. Before the sexual appetite was clearly conscious of its object, the hands of schoolfellows were used. As soon as the instinct for the opposite sex became evident, the interest for the hand was transferred to that of woman."

(pages 226-230)

Case 155. Catcher. (Female Homosexuality). Miss L. is a 55-year-old woman. There is no information about her father's family. Her maternal grandparents have been described as "irascible, capricious and nervous." Her mother was apparently a nymphomaniac and was considered "psychopathic and died at the age of 69 of cerebral disease." Miss L. never had any interest in men. Two years before her first period, when she was 13, Miss L. fell in love with a girlfriend. Her second love was for a girl older than she was . Next, she fell in love with a woman 20 years older and a mother. This third affair lasted 12 years and was not physical in nature. At age 25, Miss L. began to masturbate. At 27 she had a physical relationship with a woman "who denounced abstinence as absurd…[Miss L.] suffered the caresses of the girl, but would not consent to sexual intercourse, as sensuality without love disgusted her." By the age of 38 Miss L. had stopped masturbating and had become involved with a girl, A., who was 19 years old. They practiced mutual masturbation and deeper intimacies. In an autobiographical note, Miss L. writes of an intimate encounter with the beautiful A.: "One day whilst I was asleep Miss A. took occasion to satisfy her lust on me. Although I woke up just in time, I did not have the moral strength to resist her. I was highly excited, intoxicated as it were-- and she prevailed." According To Krafft-Ebing, after Miss L. reached menopause she became "entirely free from sensual worry."

(pages 404-408)

Case 190. Pitcher. (Nymphomania). Mrs. E. was 47 when Krafft-Ebing observed her. She had her first sexual intercourse when she was 10. At 19, she was married . Despite marriage, she had affairs with a number of male friends. In addition to six confinements, she sustained a brain concussion after being thrown from a carriage. Subsequently she became melancholic and paranoid. As she approached menopause, her libido subsided. Krafft-Ebing writes, "Chronic conditions of nymphomania are apt to weaken public morality and lead to offences against decency. Woe unto the man who falls into the meshes of such an insatiable Messalina, whose sexual appetite is never appeased…These unfortunate women disseminate the spirit of lewdness, demoralize their surroundings, become a danger to boys, and are liable to corrupt girls also, for there are homosexual nymphomaniacs as well. By exposing their feminine charms, even by exhibition, they lure men.

(pages 485-487)


Richard Freiherr von Krafft-Ebing was born in Mannheim, Germany on August 14, 1840. He is credited with the development of a lexicon of terms to describe aberrant sexual behavior. "Sadism" and "masochism" are two examples of the words Krafft-Ebing introduced into "scientific" discourse.

Krafft-Ebing, a paradigm of the bourgeois scientist, became a psychiatrist when that field was in its infancy. He became a "pioneering student of sexual psychopathology" and influenced the thought of his day and some interesting thinkers. Carl Jung, under the influence of Krafft-Ebing embarked on a career in psychology. Sigmund Freud built on Krafft-Ebing's work.

Krafft-Ebing's landmark and most famous work is Psychopathia Sexualis. First published in 1886 (11 editions followed) it is a compendium of sexual disorders as viewed from the perspective of the late 19th century. Krafft-Ebing was a pioneer in the field of medicalizing aberrant and in some cases, immoral, behavior. Thomas Szasz, author of The Myth of Mental illness in a recent piece published in the Washington Times writes,

"For millennia, masturbation, homosexuality, and the many other non-heterosexual, non-procreative uses of the genital organs were considered to be grievous sins and were prevented and punished accordingly. Toward the end of the 19th century, they started becoming "mental" diseases. This process played an important part in the transformation of mad-doctoring as quackery into modern psychiatry as a bona fide branch of medicine. Creating diseases by coining disease-sounding terms was raised to the level of a psychiatric art form [by Krafft-Ebing]."
Instead of treating the so-called "pervert" as a criminal, society (led by the psychiatric profession) should treat the pervert as someone who is sick and needs treatment. That seems to be the approach the Catholic Church has taken concerning its problem of pedophile priests.

We have Krafft-Ebing to thank, in part, for this perverse logic.

DSM-IV Codes

Code 301. Rightfield. (Paranoid Personality Disorder). A pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

  • suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her
  • is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates
  • is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her
  • reads hidden demeaning or threatening meanings into benign remarks or events
  • persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights
  • perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack
  • has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner

Does not occur exclusively during the course of Schizophrenia, a Mood Disorder With Psychotic Features, or another Psychotic Disorder and is not due to the direct physiological effects of a general medical condition. Note: If criteria are met prior to the onset of Schizophrenia, add "Premorbid," e.g., "Paranoid Personality Disorder (Premorbid)."

Code 301.4 Secondbase. (Obsessive/Compulsive Disorder). A pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

  • is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost
  • shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met)
  • is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity)
  • is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)
  • is unable to discard worn-out or worthless objects even when they have no sentimental value
  • is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things
  • adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes
  • shows rigidity and stubbornness


Code 301.81 Centerfield. (Narcissistic Personality Disorder). A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  • has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
  • is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  • believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
  • requires excessive admiration
  • has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
  • is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
  • lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
  • is often envious of others or believes that others are envious of him or her
  • shows arrogant, haughty behaviors or attitudes

Code 302.81 Shortstop. (Fetishism). Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the use of nonliving objects (e.g., female undergarments). The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The fetish objects are not limited to articles of female clothing used in cross-dressing (as in Transvestic Fetishism) or devices designed for the purpose of tactile genital stimulation (e.g., a vibrator).

Code 302.82 Firstbase. (Voyeurism). Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the act of observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity. The person has acted on these urges, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.

Code 302.83 Thirdbase. (Sexual Masochism). Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the act (real, not simulated) of being humiliated, beaten, bound, or otherwise made to suffer. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Code 302.84 Leftfield. (Sexual Sadism). Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving acts (real, not simulated) in which the psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person. The person has acted on these urges with a nonconsenting person, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.

Code 312.32 Catcher. (Kleptomania). Recurrent failure to resist impulses to steal objects that are not needed for personal use or for their monetary value. Increasing sense of tension immediately before committing the theft. Pleasure, gratification, or relief at the time of committing the theft. The stealing is not committed to express anger or vengeance and is not in response to a delusion or a hallucination. The stealing is not better accounted for by Conduct Disorder, a Manic Episode, or Antisocial Personality Disorder.

Code 315.2 Pitcher. (Disorder of Written Expression). Writing skills, as measured by individually administered standardized tests (or functional assessments of writing skills), are substantially below those expected given the person's chronological age, measured intelligence, and age-appropriate education. The disturbance significantly interferes with academic achievement or activities of daily living that require the composition of written texts (e.g., writing grammatically correct sentences and organized paragraphs). If a sensory deficit is present, the difficulties in writing skills are in excess of those usually associated with it.


The Diagnostic and Statistical Manual of Mental Disorders (DSM) was first published in 1952 by the American Psychiatric Association (APA) . It was approximately 100 pages. In 1968, DSM-II was published followed by DSM-III in 1980. DSM-IV, the fourth edition, first released in 1994 and since revised, includes over 900 pages. In 2000, a digital version of DSM-IV was available for users of Personal Digital Assistants (PDAs).

The DSM is essentially a taxonomy of mental disorders as defined by the APA. Critics of the manual suggest that the document is not an objective classification of mental disease but a highly polemical tool in the fight for health care dollars and political power. Herb Kutchins and Stuart Kirk in their book, Making Us Crazy: DSM -- The Psychiatric Bible and the Creation of Mental Disorders write,

"DSM oversteps its bounds by defining how we should think about ourselves; how we should respond to stress; how much anxiety or sadness we should feel; and when and how we should sleep, eat, and express ourselves sexually. Although people inevitably base these judgments on personal and social values, the APA tries through the DSM to extend its professional jurisdiction over daily life."
In a letter of resignation from the APA written in 1998 by Loren R. Mosher, a pioneer in establishing programs of psychosocial community care in the field of psychiatry, the point is sharpened:
"[W]hy must the APA pretend to know more than it does? DSM IV is the fabrication upon which psychiatry seeks acceptance by medicine in general. Insiders know it is more a political than scientific document. To its credit, it says so, although its brief apologia is rarely noted. DSM IV has become a bible and a money making best seller - its major failings notwithstanding. It confines and defines practice, some take it seriously, others more realistically. It is the way to get paid. "
The study of mental disorders is an impure endeavor. Psychiatry and psychology are impure sciences. Some of us are "clean freaks." One gets dirty quickly when studying mental disease.

For example in 1973, the APA, in a controversial move, decided to "normalize" homosexuality. The former mental disorder was expunged from DSM-III. Commentators suggest the battle was political and not about science or psychiatric care at all. In an article published by NARTH: The National Association for Research and Therapy of Homosexuality the unidentified author(s) provide the motives behind the APA's removal of homosexuality from the DSM:

"Gay activists had a profound influence on psychiatric thinking. A sincere belief was held by liberal-minded and compassionate psychiatrists that listing homosexuality as a psychiatric disorder supported and reinforced prejudice against homosexuals. Removal of the term from the diagnostic manual was viewed as a humane, progressive act. There was an acceptance of new criteria to define psychiatric conditions. Only those disorders that caused a patient to suffer or that resulted in adjustment problems were thought to be appropriate for inclusion in the Diagnostic and Statistical Manual. "
The DSM disguises the psychiatric profession as healthcare providers. Armed with a new array of psychoactive medicines, the profession will secure its position at the table of power-brokers in the 21st century.


Click an Inning for Detail

08-12-2002 23:25:45 # 1 ---------------


315.2 [Starter]

Case 11 9 . . .

Case 18 2 . . .

Case 37 8 . . .

Inning 1: DSM-IV CODES

Case 190 [Starter]

301 5-3 . . .

301.4 5 . . .

301.81 1B X . .

302.81 3-UN . X .


Case 48 4 . . .

Case 58 8 . . .

Case 80 3-1 . . .

Inning 2: DSM-IV CODES

302.82 K . . .

302.83 K . . .

302.84 5-3 . . .


Case 90 6-3 . . .

Case 155 E-4 X . .

Case 190 3-1 SAC . X .

Case 11 4-3 . . X

Inning 3: DSM-IV CODES

Inning 3- Scoring Summary
312.32 (Kleptomania) Walks
315.2 (Disorder of Written Expression) hits into a force out
315.2 steals second base and advances to third on a throwing error by the catcher (Case 155- Female Homosexuality))
301 (Paranoid Personality Disorder)is called out on strikes
301.4 (Obsessive/Compulsive Disorder)hits an RBI triple
315.2 scores
Codes lead, 1-0.

312.32 BB X . .

315.2 2-4 FO X . .

- 315.2 SB/E-2 . . X

301 K . . X

301.4 3B . . X 1

301.81 K . . X


Case 18 5 . . .

Case 37 7 . . .

Case 48 4-3 . . .

Inning 4: DSM-IV CODES

Inning 4- Scoring Summary
302.82 (Voyeurism) hits a double.
302.83 (Sexual Masochism) hits an RBI double
302.82 scores
Codes lead, 2-0

302.81 6-3 . . .

302.82 2B . X .

302.83 2B . X . 1

302.84 K . X .

312.32 K . X .


Case 58 2 . . .

Case 80 2-3 . . .

Case 90 8 . . .

Inning 5: DSM-IV CODES

315.2 K . . .

301 HBP X . .

301.4 K X . .

301.81 7 X . .


Case 155 6 . . .

Case 190 K . . .

Case 11 6-3 . . .

Inning 6: DSM-IV CODES

302.81 8 . . .

302.82 K . . .

302.83 4-3 . . .


Case 18 8 . . .

Case 37 6-3 . . .

Case 48 9 . . .

Inning 7: DSM-IV CODES

302.84 K . . .

312.32 4-3 . . .

315.2 7 . . .


Case 58 9 . . .

Case 80 4-3 . . .

Case 90 E-3 X . .

Case 155 9 X . .

Inning 8: DSM-IV CODES

Inning 8- Scoring Summary
301.4 (Obsessive/Compulsive Disorder) hits a homerun
Codes lead, 3-0

301 K . . .

301.4 HR . . . 1

301.81 6 . . .

302.81 4-3 . . .


Case 190 K . . .

Case 11 4 . . .

Case 18 6-3 . . .

DSM-IV Codes Win, 3-0

Related Links

BehaveNet® Clinical Capsule™ DSM IV TR Codes

The Medicalization of Homosexuality

Journal of Sex Research: Step Children of Nature

The History of Psychology

Index of Cosmic Games

Personal Cosmic Games


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Game Report: Krafft-Ebing Cases @ DSM-IV Codes
Published: August 19, 2002
Copyright © 2002 by the Cosmic Baseball Association