Emergency psychiatry and diagnostic psychiatry have increasingly become areas of particular concern and growth over the past several years. Consumers and health care providers alike are becoming aware that nowhere in the trajectory of mental health services is skill as great and as diversified required as in the delivery of emergency psychiatric services. Patients presenting in crisis demand skills in rapid and focused interviewing, in the differential diagnosis and diagnosis of disorders of mood, thought and behavior. Psychosocial, biological and existential factors converge to determine the presenting symptoms of even the most biologically based aberrations of behavior and this understanding is used by skillful therapists to manage such disorders [1–3]. Individuals, when threatened by either external stressors or internal physiological decompensation, defend themselves unconsciously in a holistic manner to prevent destruction of the integrity of the personality [4].