REALizing rage: ‘there be monsters…’; actually they’re lyssants

If, as I proclaim, rabidity is a natural part of human behavior that emerges in several situations, then we need a single term to refer to a person or animal affected in this way. I introduce a new word, lyssant, to refer to a person or animal exhibiting rabid behavior. The word is derived from the Greek word, lyssa, which refers to the scientific name for the rabies virus, certain kinds of madness, and is the goddess (daimona, i.e. spirit or demon) of rage, fury, and rabies (ref). The formal name for the rabies virus is Lyssavirus. The Roman equivalent of the goddess Lyssa was variously called Ira, Furor, and Rabies. Although this narrative will continue to use terms such as rabid, vampire, werewolf, intermittent explosive behavior, emotional dysregulation, road rage and others, all refer to a lyssant, a person or animal exhibiting these behaviors. This term also allows us to dissociate temporarily our discussion from a second set of symptoms of rabies, the so-called dumb or paralytic form. Lyssa clearly refers to the rage aspect, i.e., furious rabies, and for now, lyssant does also.

Lyssant behavior is found throughout psychiatry and clinical psychology. However, its appearance is fragmented, inserted piecemeal into a wide array of behavioral disorders. Behaviors that include rage are clustered with Impulse Control Disorders where they are uselessly clumped together with kleptomania and compulsive gambling. Lyssant behavior is couched in a variety of terms including Impulse Control Disorder, Intermittent Explosive Disorder, Conduct Disorder, Emotional Dysregulation, Impulsive Aggression, and others. Lyssants and their behaviors are listed among the myriad of symptoms of broader diseases including Attention Deficit/Hyperactivity Disorder (ADHD), for example ADHD with Conduct Disorder, and in various subclasses of autism spectrum disorders. Disorders such as road rage and domestic violence are shunted into corners of Personality Disorders that have no meaningful therapeutic approaches.

I congratulate all those who put together the newest version of the Diagnostic & Statistical Manual of Mental Disorders, DSM-5. It must be an overwhelming task. I am particularly pleased to see a unified chapter on “Disruptive, Impulse-Control, and Conduct Disorders”. It is a step forward in putting into one place a number of conditions in which rage is prominent. And it is recognition that explosive disorders are fairly common. But then one notices a new disorder, “Disruptive Mood Dysregulation Disorder”, which is…