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Diagnosis and treatment of multiple personality disorder
B&v. Res. Ther. Vol. 29, No. 2, pp. 207-212, Printed in Great Britain
1991
0005-7967/91 %3.00 + 0.00 Pergamon Press plc
BOOK REVIEWS S.P. SPRINGERand G. DEUTSCH:L.effBrain, Righf Brain, 3rd edn. Freeman, hardback;
f10.95
New York
(1989).
xiii + 394 pp. f19.95
softback.
It must be rather disheartening to write a substantial textbook, see it appear in print, and then have to start all over again, updating it. However, this is exactly what Springer and Deutsch have done twice now. This book was first published in 1981, was then republished in 1985, and now appears in a third edition as its authors attempt to keep its content and scope up to date. They say that in this new edition they have expanded the biological aspects and placed greater emphasis on theoretical models and explanations. These changes reflect more sophisticated brain imaging techniques and more maturity in theoretical debates during the mid 1980s. Although the book is still meant to appeal to a wide range of readers, I feel that in its entirety it might be too dense for early undergraduate students or ‘the intelligent layman’. However, the positive side of this criticism is that it provides excellent coverage of many topics which would be central for a good start in neuropsychology. Apart from learning about brain asymmetry (in brain-damaged and split-brain patients as well as in healthy people), the reader will acquire an understanding of such topics as-the aphasias and alexias, the agnosias, neglect, the apraxias, neuroanatomy (in an Aunendix). as well as descriptions of what EEG, EP, SPECT. PET and NMR techniques are. There are also some broader sweeps across the fields of animal and developmental studies. Altogether, the book provides a wealth of information on a complex subject, and without much over-simplification. I feel that it would be particularly useful to post-graduate students with an interest in clinical work and/or neuropsychology. It is not completely up to date now of course, but I imagine that Springer and Deutsch are once more hard at work at their text?
FRANCESCLEGG
R. ALDRIDGEMORRIS:Multiple Personality-An Exercise in Deception. Erlbaum, F. W. PUTNAM:Diagnosis and Treatment of Multiple Personality Disorder. Guilford
Hove (1989). 129 pp. f14.95. Press, New York (1989). 351 pp. 526.95.
In a rapidly expanding literature of uneven quality, these two books on multiple personality disorder (MPD) stand out as contributions of high quality. However, the authors hold contrasting views on the validity of this controversial but increasingly frequent diagnosis. Aldridge Morris writes from a British viewpoint, where the diagnosis is viewed with a great deal of scepticism, reflected in the rarity with which MPD is diagnosed. The detailed critical reinterpretation of the MPD literature which this volume provides is long overdue. Aldridge Morris’s book begins with a fascinating review of MPD cases, including Thigpen and Cleckley’s Eve and continuing through to the notorious case of the Hillside Strangler, where the enormous problems encountered in diagnosing MPD are highlighted. Other chapters cast a critical eye over the results of neurological and psychological testing in MPD and the roles which childhood sexual abuse and self-hypnosis are likely to play in the aetiology of the disorder. Aldridge Morris concludes that MPD is a rare but grossly overdiagnosed culture specific hysterical state. Putnam does not concern himself with arguing the validity of the diagnosis of MPD, but addresses his book to converted clinicians who are attempting to treat such cases, Putnam holds that MPD is a chronic condition where dissociative symptoms will punctuate the patient’s past and present life. The possibility of iatrogenic creation or exacerbation of MPD by the therapist is too cursorily dismissed. However, the detailed description of a variety of treatment approaches and of the themes encountered in psychotherapy is impressive and indicative of a great depth of clinical experience in treating such cases. Putnam proposes that a central aim of therapy should be to open channels of communication between mutually amnestic personalities and to address conflicts arising from childhood sexual abuse. Hypnosis and abreaction can be useful in uncovering hidden memories and traumatic experiences. Medication has a limited role directed at specific symptoms. The only serious weakness in a book of this sort is the absence of detailed case material demonstrating these interventions in action. Both books are highly recommended although Aldridge Morris’s will be of greater interest to readers seeking an introduction to the topic.
TOMFAHY
M. L. AXEL~~N and D. BRINBERG: A Social-Psychological v + 190 pp. DM 80.
Perspective on Food-Related Behavior. Springer,
New York (1989).
The interest that psychologists have had in eating disorders might have been expected to have encouraged considerable attention to the psychological processes relating to feeding. In fact this has not been so; feeding research has been disorganised and spread thinly over many sub-specialities in psychology. Recent developments in nutrition have emphasised the tremendous importance that food selection has in growth, development, health and longevity, and the paucity of basic psychological research is thrown into sharper relief. Good reviews of the literature which draw together the many strands of work would be extremely valuable. 207
1991
0005-7967/91 %3.00 + 0.00 Pergamon Press plc
BOOK REVIEWS S.P. SPRINGERand G. DEUTSCH:L.effBrain, Righf Brain, 3rd edn. Freeman, hardback;
f10.95
New York
(1989).
xiii + 394 pp. f19.95
softback.
It must be rather disheartening to write a substantial textbook, see it appear in print, and then have to start all over again, updating it. However, this is exactly what Springer and Deutsch have done twice now. This book was first published in 1981, was then republished in 1985, and now appears in a third edition as its authors attempt to keep its content and scope up to date. They say that in this new edition they have expanded the biological aspects and placed greater emphasis on theoretical models and explanations. These changes reflect more sophisticated brain imaging techniques and more maturity in theoretical debates during the mid 1980s. Although the book is still meant to appeal to a wide range of readers, I feel that in its entirety it might be too dense for early undergraduate students or ‘the intelligent layman’. However, the positive side of this criticism is that it provides excellent coverage of many topics which would be central for a good start in neuropsychology. Apart from learning about brain asymmetry (in brain-damaged and split-brain patients as well as in healthy people), the reader will acquire an understanding of such topics as-the aphasias and alexias, the agnosias, neglect, the apraxias, neuroanatomy (in an Aunendix). as well as descriptions of what EEG, EP, SPECT. PET and NMR techniques are. There are also some broader sweeps across the fields of animal and developmental studies. Altogether, the book provides a wealth of information on a complex subject, and without much over-simplification. I feel that it would be particularly useful to post-graduate students with an interest in clinical work and/or neuropsychology. It is not completely up to date now of course, but I imagine that Springer and Deutsch are once more hard at work at their text?
FRANCESCLEGG
R. ALDRIDGEMORRIS:Multiple Personality-An Exercise in Deception. Erlbaum, F. W. PUTNAM:Diagnosis and Treatment of Multiple Personality Disorder. Guilford
Hove (1989). 129 pp. f14.95. Press, New York (1989). 351 pp. 526.95.
In a rapidly expanding literature of uneven quality, these two books on multiple personality disorder (MPD) stand out as contributions of high quality. However, the authors hold contrasting views on the validity of this controversial but increasingly frequent diagnosis. Aldridge Morris writes from a British viewpoint, where the diagnosis is viewed with a great deal of scepticism, reflected in the rarity with which MPD is diagnosed. The detailed critical reinterpretation of the MPD literature which this volume provides is long overdue. Aldridge Morris’s book begins with a fascinating review of MPD cases, including Thigpen and Cleckley’s Eve and continuing through to the notorious case of the Hillside Strangler, where the enormous problems encountered in diagnosing MPD are highlighted. Other chapters cast a critical eye over the results of neurological and psychological testing in MPD and the roles which childhood sexual abuse and self-hypnosis are likely to play in the aetiology of the disorder. Aldridge Morris concludes that MPD is a rare but grossly overdiagnosed culture specific hysterical state. Putnam does not concern himself with arguing the validity of the diagnosis of MPD, but addresses his book to converted clinicians who are attempting to treat such cases, Putnam holds that MPD is a chronic condition where dissociative symptoms will punctuate the patient’s past and present life. The possibility of iatrogenic creation or exacerbation of MPD by the therapist is too cursorily dismissed. However, the detailed description of a variety of treatment approaches and of the themes encountered in psychotherapy is impressive and indicative of a great depth of clinical experience in treating such cases. Putnam proposes that a central aim of therapy should be to open channels of communication between mutually amnestic personalities and to address conflicts arising from childhood sexual abuse. Hypnosis and abreaction can be useful in uncovering hidden memories and traumatic experiences. Medication has a limited role directed at specific symptoms. The only serious weakness in a book of this sort is the absence of detailed case material demonstrating these interventions in action. Both books are highly recommended although Aldridge Morris’s will be of greater interest to readers seeking an introduction to the topic.
TOMFAHY
M. L. AXEL~~N and D. BRINBERG: A Social-Psychological v + 190 pp. DM 80.
Perspective on Food-Related Behavior. Springer,
New York (1989).
The interest that psychologists have had in eating disorders might have been expected to have encouraged considerable attention to the psychological processes relating to feeding. In fact this has not been so; feeding research has been disorganised and spread thinly over many sub-specialities in psychology. Recent developments in nutrition have emphasised the tremendous importance that food selection has in growth, development, health and longevity, and the paucity of basic psychological research is thrown into sharper relief. Good reviews of the literature which draw together the many strands of work would be extremely valuable. 207