The author discusses the disruption of psychiatric theory and practice, exposed by two paradigms: the DST and the DSM-III. The former means the introduction of an alienating screen between psychiatrist and patient. The latter is discussed on its merit, which appears as an apparatus for statistical research, the purpose for which it was designed. The use of the DSM-III as the basis for nosological and structural reasoning leads however to a further fragmentation of psychiatry and the practitioner's reflection upon it. The author's proposition is a nosological thought to be developed on the basis of psychoanalytical concepts.