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Being on the blunt edge, as it were, of psychiatric theory and its 
application in this particular mental health location,
we frequently find it necessary to go beyond DSM III, but certainly 
not as far as DSM V or VI will need to go in order to
capture the essence of current pathology manifest in the presenting
complaints of our client population.

Thus we've been moved to summarize some of our more rare and unusual,
previously unnamed (therefore unclassified) symptom clusters,
syndromes and miscellaneous complaints about life in general, in order
to share our discoveries and insights with the wider mental health
community.


In this article appear a variety of the most exotic and idiosyncratic
diagnoses which are surfacing among the general population now
frequenting (especially) counseling clinics serving HMO organizations,
with the hope that increasing your familiarity with these problems
might allow professionals to be more sensitive toward the troubled 
persons reporting them, and to reduce our "surprise quotient" during
intake interviews.



DSM 007 Diagnoses

These examples are from our last quarterly statistical summary. There
seems to be a marked increase in phobias, for example, as illustrated by
GRACKLEPHOBIA, the fear of the strange wrinkles that appear on your touch-
sensitive areas when you have stayed too long in the pool or hot tub.
Or, FLAGORPHOBIA, a disorder somewhat different in manifestation, that
is experienced when a person fears that a cashier will charge them for
the magazine they have been glancing at in the rack as they wait in 
line at the checkout counter.

A series of housewives report that members of their families, as yet 
unidentified, have serious and chronic cases of LEBBETTPHOBIA, which 
causes them to reach past end slices (lebbetts) of a loaf of bread to
get to the more select, tender slices.  We may need to offer a
support group for these individuals, their siblings and parents.  It
is likely an intergenerational (possibly with heritability) 
phenomenon which will necessitate extended family intervention, 
possibly even multiple-family therapy.  The pervasiveness of this
condition at this time is underappreciated!

Dental hygienists in the area have made several referrals of LUBUPHOBICS
These are persons of all races, creeds and ages who have an
intense fear of lubs (particles of food) becoming lodged in between 
their teeth.  Because there is still some question about whether this
condition is a "covered" disorder under the  ambiguous insurance plans
covering mental health services, most of these clients, especially
those in an acute state, have been referred to a chain drug store 
with a refillable prescription for floss.

Employee assistance counselors who serve the Sheraton, Holiday Inn and
Budget Motel staffs have discovered that among their personnel who
clan rooms there are a number of cases of SOWIEPHOBIA.  This is an 
irrational fear of the dark area under any large piece of furniture. 
The etiology of this disorder is still a puzzle, as thus far no
persons has been able to report any connection to a precipitating 
event, although some element of unanticipated surprise is suspected to
be a component.

The owner/president of a small chain of dry cleaning establishments
throughout the metropolitan area presented himself for systematic
desensitization because of a long-term case of PHLUGOPHOBIA, the dread of
coming in contact with the lint that settles in pockets of clothing,
 which he obviously finds it inconvenient to avoid during his working
hours. He completed the carefully constructed hierarchy of 
anxiety-evoking images paired with relaxation training, and was fitted
with an experimental battery-powered vaccuum unit, which might he the
reader appreciate the innovative integration of high technology into
our intervention strategies.

Staff at our clinic have had some difficulty with two similar
disorders, resulting in late arrivals at work and occasionally missing
an appointment time by anywhere from three to seven-and-a-half
minutes. The first problem being THERMALPHOBIA, or fear of being 
flash-frozen in the shower on a Minnesota winter sub-zero morning.
The second problem being RUMPAPHOBIA, a fear that another may walk 
in on you unexpectedly in a public restroom.  The implications for 
staff morale, cost-effective clinic management and client relations
are self-evident, we hope.

The final phobic reaction to report has shown a remarkable surge with
the dramatic proliferation of fast food establishments in the 
suburbs.  This condition is called FLENPHOBIA, characterized by 
intense concern over touching the black crusty residue (flen) found on
the necks of old ketchup (or catsup) bottles.  Loss of appetite,
occasional sleep disturbance (awaking too early in anticipation of 
interference with the consumption of hashbrowns) and mild mealtime 
agitation often accompany this condition.

An obsessive-compulsive disorder which heretofore went unreported came
to light when an off-duty Maytag repairman asked for an emergency
appointment, quite distraught over unsuccessfully realizing his 
strong desire to achieve his fantasy.  this is known as BULBULAR 
SYNDROME, manifest by an obsession with opening a refrigerator door
quickly enough to catch it with the light off.  He counted 7,482
unsuccessful attempts, then dialled 911 in desperation.  He was 
referred to us by a chiropractor whom he had consulted about neck,
shoulder and arm cramps, plus related eye strain and an inability to 
blink normally.

Law firms and other agencies with high mail volume have sent over a 
growing number of persons whose job performance was impeded by a
condition known as PREMLEMEMBLEMATION, or checking and rechecking to
be certain each letter goes down the mailbox slot. Eighty-nine checks
in three mailings is the highest total reported thus far, but the
reliability of the clients as historians is doubtful because of their
level of anxiety at intake.

Chemical dependency counselors have had several evaluations lately of
persons who happen to have become SQUIMET users and/or dealers. 
SQUIMET are those thin strands on a banana, inside the peeling. They
apparently can be freeze-dried and stored indefinitely. Street value,
addictive biochemistry, and side effects from regular ingestion are
as yet unknown, pending the outcome of a federally funded research 
project in the laboratory at the local metropolitan zoo.  This is to 
be published late next year, hopefully.  It is subject, of course, to
any changes in federal administration policies, with elections also 
pending.

A similar substance abuse problem is STROODLE PSYCHOSIS, typically
induced while dining at any of the many pazza parlor franchises.
STROODLE is the long strand of cheese which just gets longer and 
longer, the more you try to break, stretch, bite or cut it.  
Apparently the STROODLE tolerance threshold in the general population
is more variable than was previously suspected (if, indeed, it ever
was) and can be more easily exceeded than we realized.

This is the end of the case examples of interest.  Should additional
clarification of any disorders discussed herein be sought, you are 
encouraged to, and might just as well, call after hours, as the
answering service and on-call personnel can legitimately deny having 
any knowledge of the above, and have been given strict instructions to
disregard all inquiries, regardless of the title of the caller. 
Nevertheless, as additional similar, fascinating cases are deteed, our
deciphering of them will be published in due time.

Respectfully submitted,


Clinic Archivist

   ADDENDUM:  The first official act of our new clinic administrator 
was to diagnose a true bipolar mood disorder in the corporate 
computer, and if they can catch it in its brief "up" phase (usually
less than a ten minute window of opportunity) there are plans to 
administer a graphite-based lithium placebo.  If that fails, a liquid
form of SQUIMET may be made available for the staff responsible for
computing.  The safest conclusion at which to arrive today is that
only time will tell.



















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Credit and apology to SNIGLETS books

This was inspired when I first read the SNIGLET books because they 
"named" things that needed names, but had thus far been ignored. So,
go out and find SNIGLETS, and buy them up and write your own similar
essay. Have a swell, funny time!!