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Iwas minimally “of two minds,” if not actually in some dissociated state, when I agreed to write this review of a book about dissociation and trauma. Having previously read the book for teaching purposes, I was enthusiastic about the depth and breadth of the collection of articles. At the same time, however, I was more aware than ever that understanding exactly what “dissociation” means is no mean task. And then there is the question of how to use the concept in clinical work. What was I taking on? Was I in a dissociated state or just in denial?
Elizabeth F. Howell and Sheldon Itzkowitz have collected and edited an excellent set of 22 articles in their book on a psychoanalytic understanding of dissociation and trauma. After finishing the review I continue to feel that the phenomenon of dissociation is somewhat mysterioso, but this is not the fault of these writers, and the collection clarifies it in many ways. Indeed, what is meant by “dissociation” has vexed the field for decades, and now that it is 2019, we can even say for centuries. Others also are grappling with the topic. When I looked at what else is being published on the topic of dissociation, I found an advertisement for no fewer than 25 “best-selling” books, and that was just on Amazon.
Howell and Itzkowitz have organized the collection in four sections: history of complex trauma and dissociative problems; psychoanalytic orientations and treatment; more specific aspects of treatment; and current research. Each article is rich in its own right, and except for the history articles, some might easily have been placed in different sections, in particular some of those in the second and third sections. Part of this organizational conundrum stems from the fact that the field is
still struggling with exactly what dissociation means, its etiology, and how should it be handled in treatment.
There are several common threads throughout the book, however, that helped organize my own understanding of these issues. One