A similar vote decides which newly invented mental illnesses will be included in the latest Diagnostic and Statistical Manual. One psychologist who attended the DSM-III-R hearing remarked sadly:

“The low level of intellectual effort was shocking. Diagnoses were developed by majority vote on the level we would use to choose a restaurant. You feel like Italian, I feel like Chinese, so let’s go to a cafeteria. Then it’s typed into the computer. It may reflect on our naiveté, but it was our belief that there would be an attempt to look at things scientifically.”