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Dreaming and Other Involuntary MentationReview - Dreaming and Other Involuntary Mentation
An Essay in Neuropsychiatry
by Arthur W. Epstein
International Universities Press, 1999
Review by Thomas Cobb, M.D.
Nov 18th 1999 (Volume 3, Issue 46)

Every so often a brilliant idea comes along that falls victim to a less than adequate exploration. Dr. Arthur Epstein’s book, Dreaming and Other Involuntary Mentation: an Essay on Neuropsychiatry, fits this description. Epstein’s valiant attempt to link the fields of neurology and psychodynamic thought lacks the substance to construct the actual bridge between the chasm which separates the fields. Although they are inherently linked by the nature of their common denominator, the brain, Epstein’s assertions force the critical reader to imagine a bridge. While the book was disappointing, the process of generating new ideas and interests has value in itself. Albert Einstein stated, "Imagination is more important than knowledge," and imagination is Epstein’s saving grace.

Based on the concept of neural networks and reinforcing certain pathways in the brain, Epstein extrapolates dream interpretations from the phenomena of seizures. Unfortunately, his approach is self-serving. Being the former President of the Society of Biological Psychiatry as well as former President of the American Academy of Psychoanalysis does not give a scientist, even with the best reputation, permission to make statements of fact without the data to back up his assertions. This is reminiscent of Dr. Susan Vaughan’s work, The Talking Cure: The Science Behind Psychotherapy, (reviewed in Metapsychology April 1999). Her work takes a similar, grasping at straws approach, in trying to link psychoanalytic psychotherapy to neurological mechanisms. Again, while the principles may indeed be true, the data is not available to prove them. This type of reckless approach does a disservice to the field of mental health, which is already handicapped by it’s perceived lack of scientific rigor. Science is not based on anecdotes like, "I once had this patient that had this dream."

Sadly, it seems that Dr. Epstein has neared the end of an illustrious career marked by leadership in the field of psychiatry. This was to be his legacy. Unfortunately, his legacy may be marred by his being too optimistic. Psychiatry in not at the point of a truly integrated approach to the patient, but the field is headed in that direction. As time goes on and more data is collected and properly analyzed, psychiatrists may look back and say, "Dr. Epstein had it right to begin with." That day is a long time in the coming. In the mean time, we will have to be satisfied with the facts at hand.

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