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Building on Our Own Traditions
"Aap Hindu ho ya Muslim?" (Are you a Hindu or a Muslim?)
It was an innocent question asked by Salma,* a pretty ten-year-old girl studying in a village school in the outskirts of Jaipur. She addressed it to Naren, a young college student and aspiring journalist, who accompanied me to Jaipur as part of our survey of village schools. We talked with the students in this two-room school for a little while and were delighted to have seen fresh, young faces with their enthusiastic questions.
Naren was surprised that he was asked this question. The issue of Religion had not come up even though it appeared from the names that many of the children in the school were Muslim.
"Aap hi bataao, aapko kyaa lagtaa hai?" (You tell me what you think?), parried Naren.
Pat came the answer."Aap zaroor Muslim hoge, kyonki aap ache ho." (You are good; you must be a Muslim.)
This was such an unusual experience for Naren and me that we later raised this incident with Sandeep,* an avowed leftist, who was running the school. I expected Sandeep to be as appalled as we were at the child's comment and interested in talking to the children about it. His answer proved to be even moresurprising to us. He suggested that it would not be secular to teach children about respect for the religious beliefs of others and the fact that good people are found among practitioners of all religions, because it would go against their beliefs.
Pluralism, a Hindu Belief?
Unfortunately, Sandeep does no appear to be unique in having these ideas of secularism. Pratap Bhanu Mehta, criticises a Supreme Court judgment on teaching mutual respect for religions in schools in the following words:
'There is a misplaced sense that toleration requires that citizens respect each other's religions. This stems from confusion…There is something dangerous about thinking that a tolerant society requires respect for people's faiths. Toleration requires a respect for their rights. The test of whether you respect other's rights comes only when you think that they might beup to something fundamentally different or strange.' ("Living with difference", The Hindu, September 14, 2002)
He finally dismisses the idea of pluralism, that multiple paths exist, as a "partisan description of the religious experience, and should not be seen as neutral amongst religions." Some "liberal" Indian intellectuals label presumably teaching about religious pluralism as partisan because it is considered as a "Hindu" belief. Ironically this stance would find good company among right-wing evangelical Christians in America who routinely criticise religious pluralism as a liberal flaw.
The question for us must remain whether we will build a more harmonious, tolerant and just society by teaching all Indian children to respect different religious traditions and the fact that good people are found among adherents of different religions, or is that as Mehta claims instead, "in the long run such beliefs are as damaging as saffronisation."
In this essay, I use "pluralism" and "plural society" as one that accommodates people with different beliefs, and the secular state as one particular system to maintain a plural society. The ideas of a secular state arose in European thought as a result of their experience with religious exclusivism and the close control that the centralised Church maintained on religious and non-religious thought. Religious wars dominated the history of mediaeval Europe. The Roman Catholic Church enshrined the principle of religious exclusivism to the extreme, not only the belief (still held by most Christian denominations) that Jesus was the Only Way, but "Extra Ecclesiam Nulla ("There is no salvation outside the Church"). Anyone promulgating a doctrine other than that approved by the Church could be tried for heresy and executed. As the power of influence of the Roman Catholic Church spread, native pagan traditions, as well as earlier versions of Christianity, such as Celtic Christianity and Arianism, were wiped out.
The Protestant Reformation in the sixteenth century challenged papal authority. This led to a century of religious strife in Europe between Catholics and Protestant denominations when hundreds of thousands of people were killed. The smouldering tip of this conflict can still be seen in the ethnic-religious Catholic-Protestant conflict in Northern Ireland, and the separation of Catholic Ireland from the United Kingdom in 1922. The other end of the conflict of religious exclusivism can be seen vividly in contemporary events across the world where mutually exclusive ideologies are battling for supremacy in what is being described as the "Clash of Civilisations."
The birth of ideas pertaining to religious tolerance in Europe, religious pluralism and ultimately the separation of religion and state arose out of their experience with religious intolerance. This religious intolerance was a natural outgrowth of religious exclusivism – the idea that there is only One Way, and that One Way is controlled or determined by a particular church, tribe or book. Thus, the liberal struggle in the Age of Reason was precisely against the ideas of religious exclusivism and authority, and the resultant foreclosure of free thought and speech in the name of curbing apostasy and heresy.
The European Experience
In the Islamic world, the Shia- Sunni conflicts and the persecution of Sufis, Bahais and Ahmediyas arise from doctrinal exclusivism. The Indic view, by contrast, developed differently. The pluralism of paths and viewpoints is an essential Indic viewpoint, found as far back as the Rig Veda, that states: "Ekam Sat,Vipra Bahuda Vadanti" (Truth is One, the Wise describe it variously)—a principle that was broadly accepted among followers of religions of Indian origin like Hindu, Buddhist, Jains and Sikhs and some others such as the Bahais. This is slowly being understood throughout the world in the Unitarian Church, among some liberal Christians and Muslims, and among humanistic groups such as the United Nations where Kofi Annan used a Rig Veda quote to point to a great and ancient teaching of religious pluralism that can offer succour in the world of religious conflict based on exclusivist doctrines.
A clear exposition of these ideas of pluralism in ancient India is also found in EmperorAshoka's rock edicts from the third century BC.
'Beloved-of-the-Gods, King Piyadasi, honours both ascetics and the householders of all religions, and he honours them with gifts and honours of various kinds. But Beloved-of-the-Gods, King Piyadasi, does not value gifts and honours as much as he values this— that there should be growth in the essentials of all religions. Growth in essentials can be done in different ways, but all of them have as their root restraint in speech, that is, not praising one's own religion, or condemning the religion of others without good cause. And if there is cause for criticism, it should be done in a mild way. But it is better to honour other religions for this reason. By so doing, one's own religion benefits, and so do other religions, while doing otherwise harms one's own religion and the religions of others…
Therefore contact (between religions) is good. One should listen to and respect the doctrines professed by others. Beloved-of the- Gods, King Piyadasi, desires that all should be well-learned in the good doctrines of other religions.'[emphasis added] What a wonderful statement of religious pluralism!
Respect for Diversity
The idea of mutual respect of panths, or paths, became part of Indian philosophical traditions, encapsulated as "Sarva Dharma Sambhava, Sarva Pantha Samadar." (Each one's duty is of equal value, each path worthy of equal respect). This idea did not result in the homogeneity that Mehta dreads. On the contrary, it allowed for tremendous diversity and dialogue, far more than that which existed in Christian Europe or exists in America even today. This diversity confounds us even now when we try a simple exercise like defining what Hinduism is.
This allowance for diversity is what permitted even atheistic schools of philosophy to exist in India without persecution (there are hardly any such examples in Europe in the Christian era, till after the Age of Reason). India also sheltered communities like the Jews, Syrian Christians and Zoroastrians, fleeing from persecution in Christian and Islamic societies, even while they preserved their faiths. This is the same tolerance and quest for Truth that allowed new gurus, teachers and paths to arise in Indian society – such as Buddha, Mahavira and Guru Nanak—without being condemned as heretics and crucified.
Religious Exclusivism
While free enquiry and debate were encouraged, the idea found in the Ashoka rock edict as well as repeatedly in Indian scriptures is that "speech matters" and it is by no means free. To speak sweetly and to encourage mutual respect will foster harmony. By contrast, speech, education and propaganda thatfosters the spread of religious exclusivism will inevitably cause conflict in society – and this is vouchsafed by even a rudimentary study of the history of the world.
The European struggle for freedom of thought and speech was born in an environment of religious control by a centralised authority. Anyone outside church authority who challenged existing doctrines could be guilty of heresy that could cost them their life. In many ways Indian society evolved beyond this to discover that any sincere quest for Truth needs to be respected and at the same time anyone can be challenged to a debate. This can happen because there is a shared goal— to discover what is true. When there is religious exclusivity and belief that there is only One Way and all others are condemned to hell, there can be no debate – the only option is to convert or kill.
Eroding our Social Contract
Contemporary Indian secular thought, in simply regurgitating Voltaire and other European thinkers, forgets the conditions they faced at the time and which they were fighting against. Instead of building on the traditions of Indian pluralism, as well as our own traditions of active debate and discourse between different paths, they instead decry teaching religious pluralism and mutual respect. This in turn directly or indirectly; supports the growth of religious exclusivism and intolerance. At the very least we have to question why we appear, in many ways, nostalgic for religious harmony and why 50 years of secularism appears to have only widened the cleavage between communities—a cleavage which is considered to be 'spreading' to rural areas.
This must tell us that there was an existing principle and idea, separate from elitist secularism, that allowed for harmony even in rural communities not exposed to secular doctrines. We see this when we understand that Sarva Pantha Samadar – mutual respect for other ways – is not only a statement but also a civil contract that has deep resonance in our society. It is easier for Pat Robertson to get away with calling Prophet Mohammad a terrorist on prime-time television inAmerica than it would be for Togadia to do so here in India. To break this civil contract is to further polarise the society along religious lines. Thus, every time a madrassa teaches that only Muslims are good people and the rest need to be converted; every time a right-wing Christian evangelist in India proclaims their need to "save" the Hindus, Buddhists, Muslims and Sikhs who are living in darkness; and every time a Hindutva proponent points fingers at an allegedly homogenous Indian Muslim community as a Pakistani Trojan horse, we erode our social contract. Similarly, organisations like Sabrang Communications and SAHMAT, that could play a positive role in teaching pluralism, do very little to produce material that would teach the Salma's of India about respect for other paths to help build communal harmony. Instead, they follow arrow partisan agendas geared more to serve or oppose particular political interests and groupings rather than building a harmonious society. In contrast, Mahatma Gandhi's approach was to sing Ishwar, Allah tere naam—an approach that would no doubt be reviled as assimilative by many of the Indian intelligentsia of today.
Assimilation through Violence
Western societies have evolved to a civil understanding of their own kind of secularism, something that was a result of their particular history. In this history, people had become conditioned to accept the ideas of centralised laws (determined by the controlling church) handed down from above. Furthermore, as a result of their Christian histories,Western societies had already been homogenised in beliefs to a far greater extent than India ever was. Their history ofreligious conflict had also brought the idea of tolerating (in the beginning) Christian dissent, and (later) other minorities, as long as doing so did not threaten the foundations of the State. In actual practice, despite the spread of liberal ideas starting from the 18th century, countries in Europe and America underwent a couple of centuries of nationalistic consolidation all the way into the 20th century around the idea of a nation-state – a period in which religious and ethnic minorities were either persecuted or forcefully assimilated till they were no longer perceived as a threat.
Universalism and Pluralism
Ironically, Indian pluralistic and universalistic thought, in the form of translations of the Bhagvad Gita and the Upanishads (first in Persian and then into European languages by the late 18th century), played a positive role in the development of European liberalism. It also influenced a wide range of Western intellectuals in the process of questioning the dominant influence of the religious exclusivism promulgated by organised Christianity. These people ranged from Arthur Schopenhauer and Nietzsche to Tolstoy and Emerson and from Voltaire to T.S. Eliot and Thoreau.
In contrast to European history, India has a much better record ofpluralism. Indian pluralism has involved a civil contract of mutual respect and co-existence between communities, and relied on that principle to build a harmonious and heterogeneous whole. Of course, it had its own problems, such as casteism. However, there is broad intellectual consensus that caste-ism is a problem and there are laws to tackle it. Religious exclusiveism is, however, a different problem that Indian intellectuals have been unwilling to tackle – one that inherently sets communities against other communities based on ideology. Indian pluralism on the other hand worked to harmonise different philosophies at the level of civil society even when intellectual debate continued. By contrast, the secularism proclaimed by many Indian intellectuals, and exemplified by Mehta's article does nothing to directly and positively create a civil or ideological harmony and a common narrative. Instead, it encourages extreme viewpoints and thus relies on the military apparatus of the State and its monopoly of force ("rule of law") to keep from violence the proponents of different ideologies that are, a priori, taken to be intellectually irreconcilable.
Immunity to Reason?
The idea that religious exclusivism must not be challenged is often justified by saying that as a "belief" it is immune from rational challenge. However, if liberals throughout history took the same stand on beliefs, then no one would have challenged Southern Baptists and other Christian sects on slavery and racism and there could be no law passed that made prohibitions on Dalit entry into Hindu temples illegal. The fact of the matter is that religious beliefs have always been subject to challenge and have also been subjectto change as part of negotiation in society.
Just as the prohibition on temple entry (or racism) was challenged on the basis of a belief in the equality of people irrespective of caste boundaries, this is taking the same approach of teaching the equality of people across religious boundaries—and it challenges those that teach otherwise. Also, the realisation that religious exclusivism has been a key reason for religious conflict in the world- is borne out by a study of world history. To refuse to stand up for religious pluralism is to refuse to cherish possibly one of the greatest teachings that India could give to the world —a teaching that may be our best hope for religious harmony.
By refusing to challenge religious exclusivism, the current Indian intellectual approach favours ideological extremists. Since civil compromise and conciliation are not favoured in protecting extreme ideological stances, the self-proclaimed leaders that emerge from this approach are those that hold that the interests of their community are different and unique. Thus representing a community's interests is defined as maintaining separateness and "nonassimilation" into the mainstream and the intellectual opinion provides cover for this. While teaching pluralism still allows considerable leeway in practising one's own way of relating to the divine, it challenges the religious tenets that teach children that relating to the divine is exclusively available only to the members of one community.
What are Our Choices?
In India we have a choice to base our secularism on the long traditions of Indian pluralism, articulated as far back as thousands of years ago in the Rig Veda and the rock edicts ofAshoka or on the oretical European intellectualism. Secular ideas of tolerance appealed to us and we remained a plural society because of our traditions of pluralism and despite the fact that European intellectual secularism was understood and put in place by only a small English-educated elite inIndia. Other former British colonies, with a similar elite, have not succeeded in remaining secular Nonetheless, we are already seeing the cracks in the elitist secularism as we begin a search for our own expression of a pluralistic system. In doing so we have the choice to look at our own deep traditions of Indian pluralism or continue to apply theoretical eighteenth century European ideas, generally out of context. In the first case, we would actively teach pluralism andIndia. Other former British colonies, with a similar elite, have not succeeded in remaining secular. Nonetheless, we are already seeing the cracks in the elitist secularism as we begin a search for our own expression of a pluralistic system. In doing so we have the choice to look at our own deep traditions of Indian pluralism or continue to apply theoretical eighteenth century European ideas, generally out of context. In the first case, we would actively teach pluralism and mutual respect (the roots of which still exist deeply in us) to all our children and intellectually challenge the ideologies of doctrinal exclusivism that have brought so much grief and conflict to the world. In the latter case, we would continue to insist that the State protect religious exclusivism and we shall provide intellectual cover for it. We will in fact proclaim, as Mehta does, that teaching pluralism is, instead, what is dangerous.
The former approach, where we teach pluralism and challenge exclusivism, has ample room for heterogeneous viewpoints while moving our society towards harmonious co-existence. The latter approach, which aims to protect exclusivism, and denounce mutual respect for religions as insufficiently secular, will naturally and inevitably lead to greater religious exclusivism and polarisation in society. Our only hope will then be to, at some point in the future, develop a military state apparatus strong enough to keep the fighting dogs at bay, or replicate the cycle of European history. In Europe, one or the other creed of religious exclusivism triumphed. We should, if we tread that route, be prepared for the centuries of religious and sectarian warfare that followed it, untill a new model for maintaining harmony in a plural society becomes internalised by the people at large.
Copyright (c) 2002-2010. Sankrant Sanu. All rights reserved.
6 thoughts on "TEACHING PLURALISM AND TOLERANCE"
dental hygienist says:
Pretty nice post. I just stumbled upon your blog and wanted to say that I have really enjoyed browsing your blog posts. In any case I'll be subscribing to your feed and I hope you write again soon!
Occupational Therapy says:
Great site. A lot of useful information here. I'm sending it to some friends!
Personally, I've seen both systems work when people are generally peacefull and have a stress free nervous system. The best solution is to eliminate peoples need to be exclusive which comes from a defensive and fear based belief system.
The Art of Living course is one way people are able to come out of destructive patterns and be stress free and trusting of others.


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CDC to "Reset" Organization Following Criticism Over Failed COVID-19 Response – Did Not "Reliably Meet Expectations"
HealthSocietyU.S. News
By Christopher Boyle On Aug 18, 2022
Director of the U.S. Centers for Disease Control and Prevention (CDC), Dr. Rochelle Walensky, stated Wednesday that they would be conducting a reorganization effort throughout the agency – essentially amounting to a full "reset" – due to the fact they did not "reliably meet expectations."
WASHINGTON, D.C. – Following intense criticism over their somewhat lackluster response to the COVID-19 pandemic, the Director of the U.S. Centers for Disease Control and Prevention (CDC), Dr. Rochelle Walensky, stated Wednesday that they would be conducting a reorganization effort throughout the agency – essentially amounting to a full "reset" – due to the fact they did not "reliably meet expectations."
Walensky announced that the reset would affect nearly every aspect of the CDC's operations, from staffing to procedures followed, in an effort to bolster the agency's responses to health issues and increase transparency with the public after perceived failures to do so during the pandemic.
"For 75 years, CDC and public health have been preparing for COVID-19, and in our big moment, our performance did not reliably meet expectations," she said. "My goal is a new, public health action-oriented culture at CDC that emphasizes accountability, collaboration, communication, and timeliness."
The changes to the CDC were decided internally based on public and media criticism leveled at the agency, and not officially mandated by the Biden Administration or members of the Senate or Congress, according to Walensky.
Early changes to the CDC would be an initial overhaul of their website to make it simpler to locate and access scientific and health reports released to the public, as well as a complete restructuring of their communications office from the ground up. The formation of a new executive council is also slated to take place, which will assist Walensky in creating strategies during health crises and establishing priorities for the CDC.
These moves, among others to be announced, are hoped by agency officials to restore public trust in the CDC, which for some was seriously eroded during the pandemic as conflicting and incorrect information about the coronavirus – that virus that causes COVID-19 – was disseminated to Americans.
For example, experts noted that the CDC failed to realize just how quickly the virus was entering the U.S. from Europe – until it was too late – in addition to poor guidance on mask-wearing, a delay in informing the public that the coronavirus was airborne, and a lackadaisical approach to establishing testing for new COVID-19 variants.
The CDC has also been taken to task for their recent response to the new monkeypox outbreak as well.
"I feel like it's my responsibility to lead this agency to a better place after a really challenging three years," Walensky said.
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Super Bowl IX was an exciting game for the 80,997 that attended on January 12, 1975. This particular Super Bowl was held in New Orleans, Louisiana at Tulane Stadium. The final score of the game was 16-6 with the Pittsburgh Steelers taking home the win over the Minnesota Vikings.
The Steelers really fought to win Super Bowl IX. In fact, the only score the Vikings made during the game was a result of a blocked punt. During this particular game, the Steelers didn't even have some of their best players to help them win. Linebackers Andy Russell and Jack Lambert were both injured and couldn't play in Super Bowl IX. The MVP of Super Bowl IX was Franco Harris, which was a result of his record of 158 yards and a touchdown. People were really excited about Super Bowl IX because it matched two of the best defenses in the NFL. Both teams played hard!
The halftime show of Super Bowl IX was none other than Mercer Ellington and the Grambling State University. The halftime show was a tribute to Duke Ellington. The game was blasted on the NBC network and the announcers of the game were Curt Gowdy, Al DeRogatis, Don Meredith and Charlie Jones.
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Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence
Carmen Adornetto1,
Andrea Suppiger2,
Tina In-Albon3,
Murielle Neuschwander4 &
Silvia Schneider4
Child and Adolescent Psychiatry and Mental Health volume 6, Article number: 40 (2012) Cite this article
16k Accesses
Mental disorders are classified by two major nosological systems, the ICD-10 and the DSM-IV-TR, consisting of different diagnostic criteria. The present study investigated the diagnostic concordance between the two systems for anxiety disorders in childhood and adolescence, in particular for separation anxiety disorder (SAD), specific phobia, social phobia, and generalized anxiety disorder (GAD).
A structured clinical interview, the Kinder-DIPS, was administered to 210 children and 258 parents. The percentage of agreement, kappa, and Yule's Y coefficients were calculated for all diagnoses. Specific criteria causing discrepancies between the two classification systems were identified.
DSM-IV-TR consistently classified more children than ICD-10 with an anxiety disorder, with a higher concordance between DSM-IV-TR and the ICD-10 child section (F9) than with the adult section (F4) of the ICD-10. This result was found for all four investigated anxiety disorders. The results revealed low to high levels of concordance and poor to good agreement between the classification systems, depending on the anxiety disorder.
The two classification systems identify different children with an anxiety disorder. However, it remains an open question, whether the research results can be generalized to clinical practice since DSM-IV-TR is mainly used in research while ICD-10 is widely established in clinical practice in Europe. Therefore, the population investigated by the DSM (research population) is not identical with the population examined using the ICD (clinical population).
Mental disorders are classified by two major nosological systems, the International Classification of Diseases ICD,[1] and the Diagnostic and Statistical Manual of Mental Disorders DSM,[2]. While the DSM is largely used for research purposes in Europe, European clinicians are mandated to report ICD codes[3]. Despite much effort to reduce the incompatibilities between the two classification systems[4], differences with respect to specific operationalization of many diagnoses still exist between the current versions, the ICD-10[1], last revision in 1993, and the DSM-IV-TR[2], last revision in 2000. A main conceptual difference between the two classification systems is how they differentiate anxiety disorders in adulthood and childhood. The ICD-10 differentiates between anxiety disorders in childhood and in adulthood defining different criteria, whereas for the DSM-IV-TR this separation no longer exists. The subdivision of child-specific anxiety disorders is justified by the authors of the ICD-10 because they argue that emotional disorders in infancy (1) discontinue until adulthood, (2) are rather reinforcements of normal developmental trends as independent, qualitatively unique phenomena, (3) differ from those of anxiety disorders in adulthood, and (4) cannot be clearly divided into more specific units, for instance phobic conditions[5].
Several studies investigated the agreement (percentage of cases with the same diagnosis on both classification systems) between various versions of the ICD and DSM as well as the concordance (percentage of cases with a positive diagnosis by both classification systems out of all cases with a positive diagnosis by either system) of mental disorders. The studies mainly focused on substance use e.g.,[6–8], anxiety disorders, and affective disorders in adulthood e.g.,[9–13]. The results of these studies show moderate to good agreements between the latest versions of ICD and DSM. However, considerable discrepancies nevertheless exist between the two systems.
Focusing on mental disorders in children and adolescents, two studies investigated the agreement between ICD and DSM diagnoses. Steinberger and Schuch[14] examined the diagnostic concordance for 66 children with obsessive-compulsive disorder (OCD) using semi-structured instruments, the International Diagnostic Checklists for DSM-IV and ICD-10 IDCL,[15]. They found evidence of poor agreement between the two classification systems. While DSM-IV identified both children and adolescents with an OCD diagnosis, ICD-10 particularly diagnosed adolescents. Since the ICD-10 displayed an age-dependent concept of OCD, Steinberger and Schuch[14] argued that the DSM-IV criteria diagnosing OCD in childhood are superior to those of the ICD-10. Sorenson, Mors, and Thomsen[16] compared the two systems focusing on major depressive disorder, attention deficit hyperactivity disorder, and oppositional defiant disorder in a sample of 199 child psychiatric patients. The diagnoses were based on a semi-structured interview, the Schedule for Affective Disorders and Schizophrenia for Children-Present and Lifetime version [K-SADS-PL[17]. Sorenson et al.[16] found evidence of moderate agreement between the two systems. More children were diagnosed with a major depressive disorder using the DSM-IV-TR than when the ICD-10 was applied. This discrepancy is mainly due to the fact that ICD-10 requires depressed mood to be largely uninfluenced by circumstances. Also more children were diagnosed with ADHD according to the DSM-IV, because ICD-10 does not offer a diagnosis covering ADHD subtypes such as hyperactive/impulsive or attention. The diagnosis for oppositional defiant disorder was interchangeable between the two systems.
In summary, there is evidence that the concepts of the ICD and DSM differ, resulting in discrepancies in the classification of children. More specifically, results of Sorenson et al.[16] and Steinberger et al.[14] provide preliminary evidence that the DSM diagnoses more children with a mental disorder than the ICD-10. However, to our knowledge, no study focusing on anxiety disorders, apart from OCD, in children and adolescents has been conducted so far. The aim of the present study was therefore to investigate the concordance of anxiety disorders in children and adolescents established by the ICD-10 and the DSM-IV-TR. In addition, discrepancies at the diagnostic and the criterion level were determined for separation anxiety disorder (SAD), specific phobia, social phobia, and generalized anxiety disorder (GAD). Knowledge gained from this study may be essential for subsequent revisions of the ICD-10 and DSM-IV-TR to reduce current differences between the two systems.
Diagnoses were established with the Kinder-DIPS (D iagnostisches I nterview bei P sychischen S törungen des Kindes- und Jugendalters), a structured diagnostic interview that is designed to address both ICD-10 and DSM-IV diagnostic criteria in children and adolescents[18]. The Kinder-DIPS consists of a child and a parent version (i.e., either the mother or father or both together) and assesses all anxiety disorders, depression, attention-deficit hyperactivity disorder, oppositional defiant disorder, sleep disorders, and eating disorders. The Kinder-DIPS shows a good reliability for anxiety disorders (child version: kappa = 0.88; parent version: kappa = 0.85) and other axis I disorders (child version, kappa = 0.48– 0.88, parent version, kappa = 0.85–0.94)[19].
Participants and procedure
We collected data from 468 interviews (210 child and 258 parent interviews), which were conducted by seven psychologists (with a Master's degree) and 28 Master's students of clinical psychology. All interviewers received official standardized training in administering the Kinder-DIPS. Participants were recruited from the patient population at child and adolescent psychiatric clinics (n = 135) and from a research study at the University of Basel (n = 164). Insufficient knowledge of the German language was an exclusion criterion. The participating institutions recruited their patient samples. The patients at the University of Basel took part in a research program for anxiety disorders. Therefore, the recruitment at the University of Basel focussed on children with anxieties, especially on children with separation anxiety disorders. This explains the high prevalence rates of anxiety disorders as described in the result section. The interviewers administered the Kinder-DIPS to 210 children aged 6 to 17 years (M = 10.87, SD = 2.78; 51.4% boys) and to 258 parents of children aged 4 to 17 years (M = 9.77, SD = 3.08; 51.2% boys). The variance in the number of children and parents is a result of the fact that children can only be interviewed from the age of 6, whereas parent interviews can be conducted already when children are 4 years of age. The interview was part of the diagnostic assessment carried out at the participating institutions. Prior to the interview, children and parents were informed about the interview process and gave their written informed consent.
The data were analysed with the Statistical Package for Social Sciences (SPSS) for Windows. We constructed 2x2 tables with the percentage of agreement for interrater reliability and the comparison of ICD-10 (F4/F9) and DSM-IV-TR diagnoses for SAD (F93.0 vs. 309.21), specific phobia, phobic anxiety disorders of childhood, respectively (F40.2/F93.1 vs. 300.29), social phobia (F40.1/F93.2 vs. 300.23), and GAD (F41.1/F93.80 vs. 300.02). Kappa and Yule's Y were calculated since kappa is not informative when base rates are low. Yule's Y, on the other hand, is considered more robust[20]. Yule's Y was calculated[21] for base rates lower than 10%. For cases that were negative on one diagnostic system and positive on the other, specific criteria causing the discrepancy were identified. The level of significance was set to 5%. We omitted the sections of the interview with missing values from further analyses. For the child interviews this resulted in a sample size reduction from 210 to 202 for the analyses of SAD, to 198 for specific phobia, to 186 for social phobia, and to 206 for GAD. For the parent interviews the sample size was reduced from 258 to 257 for the analyses of SAD, to 249 for specific phobia, to 228 for social phobia, and to 248 for GAD. The large sample size reduction for the analyses of social phobia is due to the interview process. We established a separate section for each diagnoses of social phobia (social phobia according to F4 in the ICD-10, social anxiety disorder of childhood according to F9 in the ICD-10, and DSM-IV-TR criteria), since the criteria differ for these three diagnoses. The separation of the three sections ensures an exact assessment of the criteria. If an interviewer did not go through all three sections, because, for example, the criteria were not fulfilled in one section, the comparison could not be made.
Interrater reliability
Differences between ICD-10 and DSM-IV-TR diagnoses can be influenced by the reliability of the diagnoses. Therefore, we initially tested interrater reliability.
Child interviews
The testing included 136 interviews for SAD, 133 interviews for specific phobia, 122 interviews for social phobia, and 138 interviews for GAD. All examined anxiety disorders showed very good interrater reliabilities for ICD-10 as well as for DSM-IV-TR diagnoses: kappa/Yule's Y > 0.81 for SAD, Yule's Y > 0.86 for specific phobia/phobic anxiety disorder, Yule's Y = 1.00 for social phobia, and Yule's Y = 1.00 for GAD. These findings provide a sufficient basis for the research question of this paper.
Parent interviews
We tested 169 interviews for SAD, 159 interviews for specific phobia, 142 interviews for social phobia, and 159 interviews for GAD. All examined anxiety disorders showed very good interrater reliabilities for ICD-10 as well as for DSM-IV-TR diagnoses: kappa > 0.83 for SAD, Yule's Y > 0.88 for specific phobia/phobic anxiety disorder, Yule's Y > 0.85 for social phobia/social anxiety disorder, and Yule's Y = 1.00 for GAD. Again, these findings justify the further study of the research question of this paper.
Comparisons between the ICD-10 and DSM-IV-TR
The following describes the ICD-10 and DSM-IV-TR point prevalence rates as well as the level of concordance for each diagnosis. Further, we present criteria causing disagreements between the systems. A negative case (i.e., no diagnosis of disorders) may be identified, if several criteria are not fulfilled. The results of the comparisons are presented in Table 1. The table shows the cases diagnosed as having no anxiety disorder by both systems (DSM/ICD) (−/−) and those diagnosed with an anxiety disorder by either (−/+, +/−) or both (+/+) systems. Furthermore, the percentage of agreement between the two systems as well as the kappa and Yule's Y coefficients of agreement are displayed.
Table 1 Cross-classification of all anxiety disorders determined by the DSM-IV-TR and ICD-10 for child and parent interviews
Separation anxiety disorder (SAD) ICD-10 F93.0 and DSM-IV-TR 300.21
We found 12.4% prevalence for the ICD-10 and 17.8% for the DSM-IV-TR diagnosis. Thirty-eight children met the criteria for SAD on either classification system with a concordance of 63.9%. Two cases were positive on ICD-10 and negative on DSM-IV-TR. In one case this was due to the fact that the child did not exhibit three or more characteristics of DSM criterion and in the other case because the child did not show clinically significant impairment or distress (DSM criterion D). 16 children received a positive diagnosis with the DSM-IV-TR while the diagnosis based on the ICD-10 was negative: of these, 3 children lacked three or more characteristics of ICD criterion A, and in 13 children the onset of the anxiety was after the age of 6 (ICD criterion C).
The prevalence for the ICD-10 was 29.2% and 36.2% for the DSM-IV-TR. Ninety-seven children were diagnosed with SAD on either classification system with a concordance of 73.2%. Four children were positive on ICD-10 and negative on DSM-IV-TR because they did not show clinically significant impairment or distress (DSM criterion D). 24 children received a positive diagnosis with the DSM-IV-TR diagnosis while the ICD-10 diagnosis was negative. Two of the 24 children lacked three or more characteristics of ICD criterion A while 6 children were diagnosed with a GAD (ICD criterion B). By 16 children the anxiety became evident after the age of 6 (ICD criterion C).
Specific phobia ICD-10 F40.2 and DSM-IV-TR 300.29
The ICD-10 prevalence was 7.1%, the DSM-IV-TR prevalence being 12.1%. Thirty-one children met the criteria for specific phobia on either classification system with a concordance of 22.6%. Eight children received a positive ICD-10 diagnosis while their DSM-IV-TR diagnosis was negative: of these, 2 children almost always never showed a fearful reaction in the phobic situation (DSM criterion B), 5 children did not demonstrate clinically significant impairment or distress (DSM criterion E), and one of the children had experienced fear for less than 6 months (DSM criterion F). For 24 children the DSM-IV-TR diagnosis was positive and the ICD-10 was negative; 11 of the children did not fulfil the essential panic symptoms (ICD criterion B), and 13 children did not have significant emotional distress and insight (ICD criterion C).
Our analysis revealed a prevalence of 6.4% for the ICD-10 and 16.5% for the DSM-IV-TR. Forty-eight children met the criteria for specific phobia on either classification system with a concordance of 18.7%. Seven of the children received a positive diagnosis according to the ICD-10 while their diagnosis based on the DSM-IV-TR negative. Two of the seven children almost always never experienced a fearful reaction in the phobic situation (DSM criterion B) and 5 children had no clinically significant impairment or distress (DSM criterion E). The DSM-IV-TR diagnosis was positive for 43 children while they received a negative diagnosis based on the ICD-10. 19 children of these 43 lacked the essential panic symptoms (ICD criterion B) and 24 children reported that they did not experience significant emotional distress and insight (ICD criterion C).
Specific phobia ICD-10 F93.1 (Phobic anxiety disorder of childhood) and DSM-IV-TR 300.29
The results showed a prevalence of 5.1% for the ICD-10 and 12.1% for the DSM-IV-TR. Twenty-eight children met the criteria for specific phobia on either classification system with a concordance of 21.4%. Four children received a positive ICD-10 diagnosis while based on the DSM-IV-TR their diagnosis was negative. Three of these 4 children were positive on ICD-10 and negative on DSM-IV-TR since they almost always never showed a fearful reaction in the phobic situation (DSM criterion B). For one child the duration of the fear was less than 6 months (DSM criterion F). Eighteen children were given a positive diagnosis according to the DSM-IV-TR while their ICD-10 diagnosis was negative. Seventeen of the 18 children were not socially impaired (ICD criterion A) and 1 child was diagnosed with GAD (ICD criterion B).
We found an ICD-10 prevalence of 6.0% and a DSM-IV-TR prevalence of 16.5%. Forty-two children met the criteria for specific phobia on either classification system with a concordance of 33.3%. Only one case was positive on ICD-10 and negative on DSM-IV-TR because the child almost never showed a fearful reaction in the phobic situation (DSM criterion B). Twenty-eight children were granted a positive DSM-IV-TR diagnosis, the ICD-10 diagnosis being negative. Twenty-six of the 28 children did not fulfil the criteria for being socially impaired (ICD criterion A) while 2 children were diagnosed with GAD (ICD criterion B).
Social phobia ICD-10 F40.1 and DSM-IV-TR 300.23
Our results demonstrated an ICD-10 prevalence of 0.5% while prevalence of the DSM-IV-TR was 5.9%. Eleven children met the criteria for social phobia on either classification system with a concordance of 9.1%. None of the children was positive on the ICD-10 and negative on the DSM-IV-TR. Thirteen children received a positive DSM-IV-TR diagnosis while being negative based on the ICD-10. Ten of the children lacked the necessary panic symptoms (ICD criterion B) while 3 children did not have significant emotional distress and insight (ICD criterion C).
The prevalence for the ICD-10 was 1.8% and 13.6% for the DSM-IV-TR. Thirty-two children met the criteria for social phobia on either classification system with a concordance of 9.4%. One child was positive on ICD-10 and negative on DSM-IV-TR because of the lack of clinically significant impairment or distress (DSM criterion E). Positive DSM-IV-TR diagnosis and negative ICD-10 diagnosis was given to 45 children. Twenty-five of them did not demonstrate the necessary panic symptoms (ICD criterion B) and 20 children lacked significant emotional distress and insight (ICD criterion C).
Social phobia ICD-10 F93.2 (Social anxiety disorder of childhood) and DSM-IV-TR 300.23
The prevalence for the DSM-IV-TR was 5.9%. Eleven children met the criteria for social phobia on DSM-IV-TR. None of the children received a positive diagnosis on ICD-10. Twenty-seven children received a positive DSM-IV-TR and a negative ICD-10 diagnosis. Eight children out of the 27 did not meet ICD criterion A, which requires social fear and avoidance, 2 children were not embarrassed or worried about their behaviour toward strangers (ICD criterion B) and 11 children did not have clinically significant impairment or distress (ICD criterion C). One child did not have satisfying relationships with family members and friends (ICD criterion D), and for 5 children the onset of the anxiety was after the age of 6 (ICD criterion E).
ICD-10 had a prevalence of 7.0% for and the DSM-IV-TR of 13.6%. Thirty-six children met the criteria for social phobia on either classification system with a concordance of 30.6%. All five children who were positive on ICD-10 and negative on DSM-IV-TR did not display fear and humiliation (DSM criterion A). Thirty-six children received a positive DSM-IV-TR diagnosis and were diagnosed negative according to ICD-10. From the 36 children, 12 children did not display social fear and avoidance (ICD criterion A), 2 children were not embarrassed or worried about their behaviour toward strangers (ICD criterion B), 16 children did not have clinically significant impairment or distress (ICD criterion C), 2 children did not have satisfying relationships with family members and friends (ICD criterion D), and for 3 children the onset of the anxiety was after the age of 6 (ICD criterion E), while 1 child was diagnosed with GAD (ICD criterion F).
Generalized anxiety disorder (GAD) ICD-10 F41.1 and DSM-IV-TR 300.02
The prevalence for the ICD-10 was 1.5% and for the DSM-IV-TR 4.9%. Eleven children met the criteria for GAD on either classification system with a concordance of 18.2%. One child was positive on ICD-10 and negative on DSM-IV-TR because the child did not exhibit the required symptoms (DSM criterion C). All 8 children, who were positive on DSM-IV-TR and negative on ICD-10, did not display the required symptoms (ICD criterion B).
The prevalences for the ICD-10 and for the DSM-IV-TR were 3.6% and 5.6% respectively. Nineteen children met the criteria for GAD on either classification system with a concordance of 21.1%. Nine children were diagnosed positive on the ICD-10 and negative on the DSM-IV-TR. Two out of the 9 children had no difficulty controlling worry (DSM criterion B), 4 children lacked the required symptoms (DSM criterion C), and 3 children did not have clinically significant impairment or distress (DSM criterion E). All 10 children, who were positive on DSM-IV-TR and negative on ICD-10, did not demonstrate the required symptoms (ICD criterion B).
Generalized anxiety disorder (GAD) ICD-10 F93.80 and DSM-IV-TR 300.02
We found a prevalence of 1.0% for the ICD-10 and 4.9% for the DSM-IV-TR. Ten children met the criteria for GAD on either classification system with a concordance of 20%. Ten children received a positive diagnosis based on the DSM-IV-TR and were diagnosed negative on the ICD-10. Eight out of these 10 children did not display the required symptoms (ICD criterion C) and 2 children did not show worry in at least two situations (ICD criterion D).
The ICD-10 prevalence was 4.4% for and the prevalence for DSM-IV-TR was 5.6%. Fourteen children met the criteria for GAD on either classification system with a concordance of 78.6%. Three children did not exhibit the required physical symptoms (ICD criterion C), while their DSM-IV-TR diagnosis was positive and ICD-10 diagnosis was negative.
The present study describes an investigation of concordance between ICD-10 and DSM-IV-TR diagnoses of anxiety disorders in children and adolescents, specifically for separation anxiety disorder (SAD), specific phobia, social phobia, and generalized anxiety disorder (GAD). The results indicated low to high levels of concordance and poor to good agreement between the classification systems, depending on the anxiety disorder. As seen by the high interrater reliability of the established diagnoses in the present study, the disagreement between the two systems is unlikely to be the result of unreliable diagnostic processes.
Regarding the child interviews, the agreement between diagnoses established with the ICD-10 and the DSM-IV-TR was good for SAD (kappa = 0.71), unsatisfactory for specific phobia (F40.2: Yule's Y = 0.52) and for phobic anxiety disorder of childhood (F93.1: Yule's Y = 0.58), and satisfactory for GAD (F41.1: Yule's Y = 0.75). For social phobia (F40.1), social anxiety disorder of childhood (F93.2), and GAD (F93.80) no cases were diagnosed as positive only by the ICD-10.
The results for the parent interviews show very good agreement for SAD (kappa = 0.77), and satisfactory agreement for phobic anxiety disorder of childhood (F93.1: kappa = 0.45) and social anxiety disorder of childhood (F93.2: kappa = 0.41). The agreement was poor for specific phobia (F40.2: kappa = 0.25), and unsatisfactory for social phobia (F40.1: Yule's Y = 0.64) and GAD (F41.1: Yule's Y = 0.62). For GAD (F93.80), no cases were diagnosed as positive only by the ICD-10.
Good agreement between the ICD-10 and DSM-IV-TR was found for all negative diagnoses. Focussing on the positive diagnoses, the DSM-IV-TR consistently classified more children with an anxiety disorder than the ICD-10 for SAD, GAD, social and specific phobia. Results are comparable to previous studies comparing ICD-10 and DSM-IV diagnoses of mental disorders in children and adolescents[14, 16].
The concordance was higher for the DSM-IV-TR and the ICD-10 child section (F9) than for the ICD-10 adult section (F4), especially for the parent interviews. The highest level of concordance was found for SAD (child interviews: 63.9%; parent interviews: 73.2%) and GAD (F93.80; parent interviews: 78.6%). However, there was only a low level of concordance for GAD (F93.80) in the child interviews (20%) and also for GAD (F41.1) in the child and parent interviews (18.2%, 21.1%). This result is due to the stricter criterion C in the ICD-10 than in the DSM-IV-TR requiring three symptoms to be associated with anxiety and worry (e.g., muscle tension, sleep disturbances, restlessness, irritability). However, in DSM-IV-TR only one physical symptom for a diagnosis of GAD in children is required. The revision of the DSM-V (http://www.dsm5.org) points out that there is limited evidence for the threshold of three or more symptoms associated with anxiety and worry. Therefore, it is proposed that, even for adults, one or more associated symptoms should be sufficient for a diagnosis of GAD. A low level of concordance was found for specific phobia (F40.2), phobic anxiety disorder of childhood (F93.1), social phobia (F40.1), and social anxiety disorder of childhood (F93.2) in the child and parent interviews.
Discrepancies on criterion level between the ICD-10 (F4) and the DSM-IV-TR
Regarding discrepancies on criterion level between the ICD-10 (F4) and the DSM-IV-TR, the low concordance for specific and social phobias was particularly due to the ICD-10 criterion requiring significant emotional distress and insight. Thereby, the demand for insight was mainly not fulfilled. When ICD-10 positive cases were negative on the DSM-IV-TR, the main reason was that the DSM-IV-TR criterion requires clinically significant impairment or distress. Some children and parents denied impairment or distress due to the fear or avoidance as defined in the DSM-IV-TR, however, at the same time they indicated significant emotional distress concerning the panic symptoms described in the ICD-10.
Discrepancies in SAD diagnoses were mainly due to ICD-10 criterion B requiring the exclusion of GAD and criterion C requiring onset before the age of 6. For SAD, DSM-IV-TR requires an onset before age 18 years. DSM-V is considering deleting the specifier "early onset before age 6 years" as there is no evidence to justify such a specifier (http://www.dsm5.org). Furthermore, the retrospective NCS-R study showed a median age of onset for SAD at 7 years of age[22] supporting a less strict criterion for SAD in ICD-10.
When the DSM-IV-TR diagnosis was negative, this was mainly due to the criterion D requiring clinically significant impairment or distress. With regard to specific and social phobias, discrepancies were in particular due to the criteria defining the fear and impairment. For specific phobia in the ICD-10, criterion A requires fear with social impairment, whereas the DSM-IV-TR criterion A requires only fear. The type of impairment is more widely defined in the DSM-IV-TR (criterion E; e.g. impairment in social, occupational, or other important areas of functioning). For social phobia, in the ICD-10 social fear and avoidance are required (criterion A), whereas in the DSM-IV-TR social fear and feelings of humiliation are required (criterion A). Further, the feature of impairment is much more clearly defined in the ICD-10 (criterion C) than in the DSM-IV-TR (criterion E). The main reason for a negative DSM-IV-TR diagnosis was criterion A (marked and persistent fear of one or more social or performance situations).
In sum, the low level of concordance is particularly due to the two systems using different definitions of common features. More specifically, the definitions of (specific and social) fear and impairment differ significantly.
Kendell[23] recommends that minor points of difference between the two classification systems should be revised to become identical, and if the differences are substantial, the validity of each system should be assessed. The results of the present study indicate that concordance between the child section (F9) in the ICD-10 and the DSM-IV-TR might be improved by a less strict formulation of the ICD-10 criteria. More specifically, the onset of SAD, the definition of impairment and insight for specific and social phobia, and the required number of essential symptoms associated with anxiety and worry for GAD should be changed in ICD-11. In addition, the conceptualization of GAD (F93.80) in the ICD-10 is an important issue to consider. According to the ICD-10, GAD is conceptualized higher in the hierarchy of anxiety disorders in childhood, since a diagnosis of GAD is an exclusion criterion for other anxiety diagnoses in childhood (F9). However, there are no empirical studies to show that diagnoses of SAD, specific, and social phobia could not be comorbid with GAD. Therefore in ICD-11, it should be possible to assign comorbid anxiety disorders with GAD. However, it has to be acknowledged that the diagnosis of GAD is considered difficult and not reliable, due to high rates of coexisting disorders and the overlap in symptomatology, e.g., depression and other anxiety disorders[24], therefore diagnostic criteria will most likely be changed again for DSM-V. How comorbidity is dealt with by the DSM-IV-TR and the ICD-10 is actually quite similar, since both systems with their descriptive approaches allow multiple diagnoses[2].
The results of the present study support the proposed change in DSM-V to delete the age criteria for SAD. Regarding the discussion to separate functional impairment and diagnoses[25], the good agreement for all negative diagnoses in this study underlines the importance of integrating the criteria of overall impairment and distress in assigning diagnoses.
It is important to note that the ICD is used in clinical practice in Europe, whereas the DSM is the most frequently used system for research purposes[26]. The differences between the two systems lead to different diagnoses in clinical practice and research. Knowledge gained from research may therefore not be directly applicable to clinical practice. If the population investigated by the DSM (research population) is not identical with the population examined by the ICD (clinical population), it is open to question whether the results from research can be directly applicable to clinical practice. This is an important issue considering the fact that psychotherapy and psychopharmacology treatment research is usually based on DSM diagnoses. The ICD-10 differentiation between anxiety disorders in adulthood and childhood leads to diagnostic problems in clinical practice; for instance it is unclear which diagnoses a 17-year old adolescent, who fulfils criteria for both specific phobias (F4 and F9), should receive. In addition, the argument of discontinuing disorders of ICD-10 is not empirically supported. On the contrary, several studies indicate that anxiety disorders in childhood are a major risk factor for the development of further mental disorders[27–29]. Suggesting that ICD-10 classifies fewer children with anxiety disorders than DSM-IV-TR, indicates that these children are not recognized, and therefore they remain untreated and are at risk to develop further mental disorders.
Some shortcomings of the present study have to be acknowledged. The small sample size, with rare positive diagnoses, especially for social phobia and GAD, should be mentioned as a limitation. The sample size may have been too small to detect rarely occurring discrepancies. To confirm the reported results, studies with a larger sample size including more positive diagnoses are necessary. The focus of the present study was on concordance and discrepancies on the criterion level and no conclusions about the validity of the diagnoses were drawn. It would be useful for future research to examine diagnostic validity, in particular for diagnostic categories with low concordance.
In sum, the low level of concordance is due to substantial differences in criteria for anxiety disorders between the classification systems. The two systems contain different concepts, and therefore classify different children. This is problematic, as children with significant problems and impairments may remain undiagnosed and therefore untreated. Consequently, the goal for both DSM-V and ICD-11 should be to diagnose children as adequately as possible, get them into treatment and so reduce further distress. Therefore, each diagnostic criterion should be empirically investigated. In addition, comparable diagnostic criteria would lead to consistent prevalence rates regardless of the classification system used.
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This study was funded by the Swiss National Science Foundation (SNF) (project no. PP001-68701; 105311-116517/1). The Article processing charge (APC) of this manuscript has been funded by the Deutsche Forschungsgemeinschaft (DFG).
Child- and Adolescent Psychiatry, University of Basel, Basel, Switzerland
Carmen Adornetto
Department of Psychology, Clinical Psychology and Psychotherapy, University of Basel, Basel, Switzerland
Andrea Suppiger
Clinical Child and Adolescent Psychology, Universität Koblenz-Landau, Koblenz-Landau, Germany
Tina In-Albon
Clinical Child and Adolescent Psychology, Ruhr-Universität Bochum, Universitätsstraße 150, Bochum, 44780, Germany
Murielle Neuschwander & Silvia Schneider
Murielle Neuschwander
Silvia Schneider
Correspondence to Silvia Schneider.
CA carried out interviews, the analyses, and drafted the manuscript. AS has made substantial contribution to acquisition of data. TI contributed to acquisition of data, the drafting and revising of the manuscript. MN participated in the interpretation of the data and revising the manuscript. SS made substantial contributions to the design of the study, the interpretation of the data, drafting and revising the manuscript. All authors read and approved the final manuscript.
Adornetto, C., Suppiger, A., In-Albon, T. et al. Concordances and discrepancies between ICD-10 and DSM-IV criteria for anxiety disorders in childhood and adolescence. Child Adolesc Psychiatry Ment Health 6, 40 (2012). https://doi.org/10.1186/1753-2000-6-40
DOI: https://doi.org/10.1186/1753-2000-6-40
DSM-IV-TR
Specific phobia
Diagnostic criteria


Chuck Boiler is the U.S. Systems Engineer Manager for JMP, a business unit of SAS. Since joining SAS in 1997, he has held management roles with JMP and helped develop solutions for conducting many types of analysis, including design of experiments for the semiconductor industry, quality control for pharmaceutical manufacturing, and marketing applications for survey analysis using JMP. Boiler currently works with customers and U.S. field engineering staff to help them solve business problems and discover hidden opportunities in data. Earlier in his career he worked for Abacus Concepts, makers of StatView software, as technical services manager and software quality assurance manager. A member of the American Society of Quality, Boiler received a bachelor's degree in education from the University of Oregon and has done graduate work in ancient philosophy at the Graduate Theological Union in Berkeley, California. He is a graduate of Gallup University's Great Manager Program.


text:
A Queen of People's Hearts
I watched "The Queen" at the Odeon last night. I had wanted to see it for awhile, and was disappointed that I missed it when it played there last year. I was living in England before coming to Florence in 1997. Before heading down to Italy, I went to Lyon, France for a friend's wedding. I had to then take a train back to Paris before taking the TGV to Florence. I took a taxi through the tunnel where Princess Diana's fatal car accident had occurred only less than 24 hours earlier. And, the next morning when I had to take another taxi to go back to the Gare de Lyon, I was taken yet again past the accident site.
I couldn't help but look at the pillar where the car struck. Both times, it sent shivers up my spine. When I looked back at the tunnel, I saw the "Flamme de la Liberté" (The Flame of Liberty), which is a replica of the flame on the Statue of Liberty, with flowers at its base.
I couldn't bring myself to buy a newspaper to read about the accident because I had so many feelings going through me that it would've just been overwhelming.
When my train left Paris, the sun had just risen. I settled into my seat and set my notebook in front of me with a pen on top of it. I stared at my notebook for a long time before I wrote anything. I wanted to make sense of what I was feeling, but because I had so many feelings going through me, I was confused as to what to write.
I had strange feelings about my future on that train ride to Italy. I realized how Princess Diana left England and died in France, and how she would never return to England alive. I thought about how I had left England a few days earlier, and realized that I would never return either. I hadn't even arrived in Florence, but I had a feeling that I was experiencing a different type of death. That I was at the end of a leg of my journey.
Before a voice came on the loudspeaker in the train and announced that we had just passed the border between France and Italy, I felt as if something had just been lifted off my shoulders. I felt a lightness that I hadn't felt in a long time. It felt like someone was cuddling my heart and filling me with hope.
After arriving in Florence, I was still mourning Princess Diana's death each day. I couldn't really talk to anyone about it, so I just kept writing. In the apartment where I was living, the family put the TV on during dinner, so news presenters discussed her passing every night in depth. I didn't understand much, but just seeing the photos and seeing people's reactions was enough to have an affect on me. I didn't unleash my tears until I was in my room, even though it was hard at times to swallow my food much of the time.
Before Dave and I moved to Italy in 2004, we went to England and visited Princess Diana's Memorial Fountain. I had made a point of going there because I felt a bond with her in my own way. Here I was about to go to Italy again.
In the movie, they showed the BBC interview in which Princess Diana had said, "I don't go by a rule book, because I lead from the heart, not the head, and albeit that's got me into trouble in my work, I understand that. But someone's got to go out there and love people and show it.". She also said, "I'd like to be a queen of people's hearts." And, I believe that she has succeeded because each time I struggle on my path to follow my heart, I think of her and am reminded that it's a lifelong goal, and not a one-time competition.