The encyclopedia of mental disorders known as the Diagnostic and Statistical Manual is built on a principle that many therapists find simplistic: that people's symptoms are the most reliable way to classify their mental troubles.

The manual, often called the D.S.M., does not speculate about internal thoughts or unconscious assumptions, which researchers say are all but impossible to scientifically standardize.

The result, many psychotherapists believe, is a document that is comprehensive but shallow, ultimately too superficial to capture the complexity of human motivation, the depth of emotional pain. Students, clinicians and especially patients yearn for some discussion of these dimensions, they say, some guide to understanding the human stories behind the checklists of symptoms for everything from depression to agoraphobia.

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