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Some of my colleagues who read this book may have had experiences in their trauma therapy careers that are similar to ones I have had in working for agencies or institutions where case conferences were weekly occurrences. The scenario may unfold as follows: a clinician presents the case of a patient whose narrative includes beliefs and behaviours that are out of the ordinary. Robust discussion within the group centres on suggestions for diagnosis and work with the patient. Eventually, a member of the group poses the question, “Could this be psychosis?” At this point, there is momentary silence, followed by head-nodding as this is considered. Due to ongoing debate within the mental health field about the nature of psychotic versus non-psychotic presentations, the question has the power to change the entire direction of the patient's healing trajectory. The treatment could go from a focus on trauma and dissociation to a radically different conception of the patient as a person with a brain disease, and for whom medication is the prescribed remedy. The scenario poses several questions for clinicians: is it possible to get beyond the dichotomy of dissociation versus psychosis; are these conditions fundamentally different; and does childhood trauma hold the key?
This book, edited by Andrew Moskowitz, Martin J. Dorahy, and Ingo Schäfer, offers current thoughts, research, and meta-analyses on the dichotomy, from many of the most prolific and trusted writers in the world of trauma treatment and research. From Chris R. Brewin's Foreword from the trauma field, in which he notes disturbing requirements in England's mental health services requiring clinicians to distinguish between “psychotic” and “non-psychotic” conditions, to Brian Martindale's Foreword from the psychosis field, which acknowledges the disturbing non-specificity of many symptoms; this book calls into question some decades-old diagnostic and treatment dilemmas. In so doing, it explores the often-political origin