Important and common relational conditions, such as severe couple dysfunction and family violence involving child or elder abuse, have been omitted from DSM-IV, the authors believe. They argue that such conditions can exist independently of severe individual psychopathology and that these conditions should be described in relational terms, with specific diagnostic criteria. They outline a classification of relational disorders and propose its addition to axis I of DSM-IV. This classification scheme focuses on severe family dysfunction; problems of living usually treated by couple and family therapists are intentionally omitted. Descriptions of two relational disorders, written in DSM style, are provided. The authors discuss implications for the treatment and rehabilitation of patients, the future training of psychiatrists, and the direction of research.