Most Helpful Customer Reviews
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41 of 42 people found the following review helpful:
5.0 out of 5 stars
Helps Create Awareness of a Common Mental Disorder!, October 15, 2000
Chances are that you will spend time with someone who suffers from dissociation today. Do you know how to help them? Do you even know who they are? If you are like me, the answer was "no" to both questions before reading this excellent, important book. Dissociation is defined by the authors as "a state of fragmented consciousness involving amnesia, a sense of unreality and feeling, of being disconnected from oneself or one's environment." One of the extreme forms that this disorder can take is as someone who exhibits multiple personalities. If you ever saw the movie, Three Faces of Eve, that is what is being described here in extreme form. Most people with this condition are experiencing these personality complexities inside their minds, and the external manifestation can appear to be absent-mindedness or a strange reaction to common occurrences. The actual diagnosis of this mental condition needs to be done by a trained clinician, but there are helpful questionnaires in the book to help you determine whether such a clinician should be sought for you or someone you know. You need to have pretty broad-based and severe symptoms before you have this disorder. Based on broadscale survey research led Dr. Steinberg, it is estimated that 14 percent of the population in North America have this condition. The sufferer usually goes untreated or is treated for a symptom of the disorder, such as depression or panic attacks. The condition is often misdiagnosed, as well, as schizophrenia. Dissociation "is a healthy adaptive defense used almost universally by people in response to overwhelming stress or life-threatening danger." So, if you've experienced some aspects of dissociation, that's good. What's bad is if these characteristics are present all of the time in extreme ways. I thought the questionnaires were unusually good at differentiating normal, healthy dissociation from the qualities of this disorder. The book contains three lengthy case histories that show in detail how the disorder can be manifested, and how difficult it is to diagnose and treat. Many mental health professionals will benefit from reading this book, as encouragement for bringing their knowledge up-to-date. When Dr. Steinberg began her research, it was thought that dissociation was relatively uncommon, yet it is reaching epidemic proportions. The incidence of dissociation is often related to childhood abuse. In relating this information, the authors expose some common myths about childhood abuse. One of the most important is the belief that children would remember such occasions. In fact, the amnesia of dissociation often prevents these memories from surfacing. This abuse most often occurs in alcoholic households. The abuse effects can be complicated by having occurred involving more than one generation in a family. If you are like me and are fascinated by reports of alien abductions, out-of-body experiences, and near-death experiences, you will be interested that the authors point out that these recollections can be manifestations of dissociation. The alien abductions can turn out to be subverted memories of childhood abuse, for example. The authors are open minded, however, and do not attempt to qualify all such memories as being dissociation. Treatment occurs though emphasizing personal comfort, more communication, cooperation, and connection. This requires having the patient employ these resources as well as encouraging those who know the patient to use them. Unlike many extreme treatments used in the past for mental conditions, these are gentle and should be appreciated by anyone. I liked this book for its ability to connect our rapidly-expanding depressed population to a tangible set of causes and treatments. Not every depressed person has dissociation, but many do. Rather than just treat them with drugs, this therapy can provide valuable emotional support and connection to improve the quality of life in other ways. After you have finished reading this book and sharing with people whom you think would benefit from it, think about circumstances where temporary dissociation can be helpful. It would be wrong to deny yourself the benefits of dissociation when you need it. Mental disciplines like meditation are helping you create dissociation in one sense. Decision-making processes are also helping you depersonalize so your rational mind gets a chance to clear away harmful levels of emotion. When you are first injured in a car accident, you will probably not feel much pain. Pain-killing body chemicals are part of that, but dissociation is too. Take control over your mind and your life!
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32 of 34 people found the following review helpful:
5.0 out of 5 stars
Powerhouse of a Book -- a MUST READ!, October 18, 2000
By A Customer
This book blows the lid off of the widespread misunderstanding and misinformation out there about a common disorder that we all share to some degree or another. If you've ever been in an accident, or ever been the victim of any other type of high-stress event, you've experienced dissocation as the defense mechanism that allows you to cope with the attednant trauma. Reading this book will help you identify and understand the symptoms you experienced. Dr. Steinberg's research actually reveals that even the most normal, well-adjusted people dissociate on a regular basis as a defense mechanism. Problems arise only when it is taken to an extreme.Dissociation is simply a protective response hard-wired into our psychological makeup that allows us to cope with high stress situations and events. This book makes it clear that the fact that you dissociate doesn't mean you are turning into Sybil. The self-test included in the book helps you understand this. Based on years of research by an acclaimed figure in the field, the clear and lucid writing make a complex and difficult subject accessible to a general audience. The case histories included in the text make for fascinating reading, and allow the reader to see how therapy actually works in a person's life. It's almost criminal how many people are misled, even by mental health professionals, about the nature and significance of dissociation: it seems that many people being treated for anxiety and depression actually suffer from severe dissociation. This very informative book makes a significant contribution to the general understanding of this subject, and everyone everyone who wants to be in the know about themselves should read it immediately!
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24 of 25 people found the following review helpful:
4.0 out of 5 stars
Flawed Yet Still Invaluable, July 13, 2003
Dr. Steinberg's book has significant flaws but is still an invaluable resource for therapists and their clients who wish to understand and recover from trauma-based dissociation. She defines dissociation as "a state of fragmented consciousness involving amnesia, a sense of unreality, and feelings of being disconnected from oneself and one's environment." Aimed at the general reader, Steinberg's and co-author Schnall's prose is lucid, compassionate and contains much practical insight. She provides many self-help suggestions for communicating with and nurturing the dissociated parts of oneself. The book also includes a screening instrument to help identify the presence and potential need for further assessment of what Steinberg considers the five core dissociative symptoms: amnesia, depersonalization, derealization, identity confusion, and identity alteration. She stresses that dissociation may be mild, moderate or severe; normal or abnormal; adaptive (healthy, promoting adjustment) or maladaptive (unhealthy and interfering with adjustment, growth and stability) and that having one or more dissociative experiences does not automatically mean one has a dissociative disorder. One chapter even bears the title "A Healthy Defense Gone Wrong." Transient dissociation may occur in response to heightened stress. Dissociative disorders, such as dissociative identity disorder (formerly known as multiple personality) develop in response to overwhelming (or traumatic) stress, such as childhood sexual abuse. Dissociation is often overlooked in typical psychiatric assessments. This is due to various factors. For one, there seems to be an ever-increasing reliance on medication as the primary (if not sole) treatment for emotional and mental health problems; there is often ignorance of dissociation, and sometimes even derision and disdain masquerading as skepticism vis-à-vis dissociative disorders. How refreshing, then, is Dr. Steinberg's distinguishing surface and hidden symptoms. She contends that many cases of depression, bipolar mood disorder, anxiety, attention deficit and even ostensible schizophrenia (often popularly confused with multiple personality) are outward manifestations of inward dissociative processes that can be treated with the therapeutic techniques she advocates. She states: " . . . we can prevent the tragic waste of life of many creative people with [severe dissociative disorders] by teaching them how to communicate with their different sides and integrate them instead of trying to suppress them with drugs alone. Research has shown that people spend seven to ten years or more in ineffective treatment, often shunted haplessly from one therapist to another until their dissociative disorders are correctly diagnosed." (p. 297). She has developed a tool for diagnosing dissociative disorders, a structured interview called the SCID-D. At times, The Stranger in the Mirror reads as if it were an infomercial for the SCID-D, and Steinberg seems to imply that there has been no other comparable instrument. Thankfully, that is not so; yet having another objective measurement of this controversial condition may contribute to silencing some of the skeptics. Steinberg's lack of historical perspective is surprising but forgivable, considering that the book has considerable therapeutic value otherwise and that providing a literature review was clearly not its primary purpose. (Those readers wishing for an extensive review of over 100 years of literature on dissociation should consult Colin A. Ross' Dissociative Identity Disorder) Still, her flat assertion that in 1981 "dissociation . . . was a relatively new concept" (p. ix) is simply not true. Writing in 1934, C. G. Jung credited Janet and Prince before him "for our knowledge today of the extreme dissociability of consciousness," and he said that "fundamentally there is no difference in principle between a fragmentary personality and a complex." He also referred to what he termed autonomous feeling-toned complexes as "splinter psyches." Another criticism of the book is in her treatment of the paranormal. Although she, like Jung before her, sees dissociation as normal and not necessarily pathological, she is rather quick to conclude that out-of-body-experiences (OOBE's) past-life memories, near death experiences (NDE's) and other such borderland phenomena are "most likely, not events that actually happened, but yet another example of the power of the human mind to protect itself by creating imaginative metaphorical symbols for memories of unthinkable childhood trauma." (p. 293). This may often be so, and her caution is a welcome alternative to either wide-eyed credulity or knee-jerk skepticism, but she by no means accounts for all the data. For example, although the literature on OOBE's contains many accounts of experiences precipitated by shock or trauma, there are also innumerable exceptions. Still, no one who accepts the possibility of an OOBE would deny that, by definition, a type of dissociation is involved. Religion writer Alan Spragget in 1967 even referred to OOBE's as "somatic dissociation." Also, evidently Steinberg is unaware of Dr. Ian Stevenson's studies of children who spontaneously report verifiable past life recollections. Whether these cases prove reincarnation is a separate matter, but they hardly seem reducible to "screen memories" of past abuse. The one work on past life therapy she cites is Brian Weiss' Many Lives, Many Masters. She argues plausibly that the patient portrayed in that book had a dissociative identity disorder rather than recollection of literal past lives. She attributes what progress that patient made to the fact that Weiss' therapy "acknowledged and worked with her hidden parts and did not discount them" (p. 290) but sees Weiss' not recognizing an underlying dissociative disorder as prohibiting the patient's further integration. Should she read another work in this vein, Steinberg would do well to choose Roger Woolger's Other Lives Other Selves. His approach to past lives amounts to an elaboration and extension of Jung's theory of complexes, and, as with more conventional forms of trauma therapy, stresses that the literalness of the memories is less significant than their symbolic resonance with the patient's core conflicts. In spite of the above criticisms, I have enthusiastically recommended The Stranger in the Mirror to colleagues and clients and will continue to do so.
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