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Creating HysteriaReview - Creating Hysteria
Women and Multiple Personality Disorder
by Joan Ross Acocella
Jossey-Bass Publishers, 1999
Review by Peter M. Barach, Ph.D.
Mar 31st 2000 (Volume 4, Issue 13)

Joan Acocella, who is both a dance critic and a co-author of a psychology textbook, apparently drew on both of her interest areas in writing this book. That is, her book contains psychological content, but she dances around the facts. Because she writes smoothly, the average reader floating on the gentle waves of narrative may not be aware that rocks and mud lurk beneath the surface.

Acocella’s book is a diatribe against "recovered memory therapy," which, she hastens to assure readers, is now thoroughly debunked. The book describes the alleged defrauding of thousands of women whom Acocella believes were falsely persuaded by incompetent or greedy therapists that they had multiple personality disorder. The condition formerly known as MPD is now known as Dissociative Identity Disorder, or DID; it is one of the dissociative disorders, a category of mental disorders listed in the standard catalog of psychiatric diagnoses). Most patients with DID recover previously-unknown-to-them memories of sexual abuse. Acocella blames therapists for using suggestive psychotherapy techniques that in her view have caused thousands of patients to falsely remember that they were sexually abused.

Recovered memory therapy, in her view, resulted from feminist therapists whom she describes as believing that all women have been abused, the recovery movement with its focus on "the inner child," and New Age philosophy. She also blames "the breakdown of the family," because, she believes, divorced dads are easier targets for false accusations of abuse, as are stepfathers.

Before I say more about the book, I want to give the reader full disclosure of my own involvement in the issues discussed in the book. I am past president of International Society for the Study of Dissociation (ISSD), an international association of mental health professionals and researchers promoting research and training in the dissociative disorders. Acocella targets ISSD as the Typhoid Mary of the "recovered memory movement," spreading misguided ideas about patients and abuse. She is pleased to quote a fundraising letter that I wrote to ISSD members during a 1998 financial crisis. She notes that ISSD lost half its membership between 1993 and 1998 (true), that ISSD’s official journal ceased publication (true) and that ISSD terminated some of its staff (not true). Had she bothered to contact me or anyone else from ISSD prior to publication of her book, she would have learned that ISSD’s financial crisis was resolved; and that although the journal sponsored by ISSD had ceased publication for reasons unrelated to ISSD’s financial difficulties, ISSD has already started a new journal.

Acocella builds specious arguments with selective data that often come from biased, unrepresentative, and non-authoritative sources. The existence of a "recovered memory movement" is established by quotations from popular psychology books, and bolstered by out-of-context excerpts from clinical reports of difficult cases that Acocella cites as typical treatment. Reports of outrageously suggestive psychotherapy techniques come from plaintiffs in malpractice cases, with no attempt to present the defense side of the story. Cases that were settled out of court are trotted out to attack therapists as if the never-adjudicated allegations of the plaintiffs were accepted fact. Had Acocella made the slightest attempt to be fair, she would have noted that settlements typically include no admission of wrongdoing or stipulation of the facts in the case. She would also have mentioned that malpractice insurance carriers often settle to avoid paying the legal costs of defending against groundless claims.

In general, Acocella uses court cases, statements by attorneys, and popular psychology books to build a picture of how MPD is treated. She quotes plaintiffs’ attorney R. Christopher Barden’s assertion that therapists cooked up the diagnosis of MPD to "increase their market share," while failing to raise the same issue about the motivations of plaintiffs’ attorneys. Acocella uses quotations from popular psychology books to describe the typical "recovered memory therapy," even though the books were written by authors who carry no credentials in the dissociative disorders field. She cites ISSD’s Guidelines for Treating DID in Adults as evidence that the field has retreated to a "mild, conservative" treatment approach. The Guidelines, which have been cited as a standard of care in several court cases, present an expert consensus on successful treatment that bears little resemblance to what the court cases describe. But the Guidelines only look like a retreat to conservatism because Acocella persists in citing malpractice cases as typical.

I can recommend this book only as an example of a polemic that appeals to the emotions. Most readers will never see how much Acocella’s questionable selection of source material has stacked the deck against therapists. She should have discussed the work of Kenneth Pope, Laura Brown, Charles Whitfield, Mike Stanton, and Ross Cheit, all of whom have detailed the distortions of fact and science concerning DID and recovered memory that have been presented to the media. This book demonstrates the result of those distortions and adds to the problem.

 

Peter M. Barach, Ph.D., is a clinical psychologist in Cleveland, Ohio. He is Senior Clinical Instructor in Psychiatry, Case Western Reserve University School of Medicine. Dr. Barach has authored several articles and a book chapter on dissociative disorders, and is Past President of International Society for the Study of Dissociation.

 

To see earlier comments by Peter Barach on Amazon.com, click here. To see a reply to those comments by Joan Acocella, click here.

 

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