Abstract
This is a timely volume, covering a field that has provoked considerable interest and controversy for several centuries. It aims to put dissociation in a more scientific context which is a matter of importance to the field's moving forward. For example, the chapter on the emerging neurobiology of dissociation by Krystal et al. presents a valuable discussion about the sensory integration systems in the brain. In addition, it has been found that the substance ketamine can significantly alter environmental perception through its action on the N-methyl
The provision of a neurobiological model provides a way of organising the clinical observations that this book makes about the nature of dissociative phenomena. Modern psychiatry and particularly, psychotherapy have been deeply interested in dissociative phenomena since the turn of the century. Any serious student of psychopathology should read this book because the initial chapters provide a useful discussion of the various models that have been historically used to explore these phenomena.
Nemia's chapter is of particular interest in this regard. There is also a useful discussion of the relationship between trauma, dissociation and hypnotisability. These questions have relevance to understanding the nature of somatisation and conversion disorders, a group of disorders that have been poorly understood and conceptualised in recent times. Understanding the nature of traumatic memory and the secondary process of dissociation creates a valuable model for the better clinical exploration and management of this continuing conundrum for psychiatry.
This book brings together a group of well respected clinicians and researchers who approach the issue from a variety of different perspectives. It also touches on important developmental issues in terms of the way individuals manage and deal with environmental information. Clearly, a child's capacity to integrate affect, depends upon the attunement of caregivers and their responsiveness to the child's subjective experience. The role of the caregiver in validating the child's identity and assisting the verbalisation of affects is critical to allowing a life with an integrated representation of both inner and outer reality. This is critical to a child's ability to distinguish somatic from psychological experience. This book explores the way in which affective states, if they are not recognised and given the language, can lead to fragmentation of awareness and inner consciousness.
Bremner and Marmar have created a useful volume for researchers and clinicians alike working in this field.