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Although erudite, highly informed and cohesive in structure, Howell's book on Dissociative Identity Disorder (DID) presented me with a particular problem that took some time and thought for me to understand. If this book were not about DID and much of the same theoretical material had been brought together with a title of say Dissociative States or even Trauma, I would feel less uneasy and less uncomfortable in recommending it. This would perhaps have allowed me not to directly address the conflicting views within psychoanalytic societies about the diagnosis of DID. Some of the case material also contributed to my unease as I tried to conceptualise how I personally understand the psychiatric diagnosis of DID (or in European terms Multiple Personality Disorder). Perhaps, it is impossible to read these kinds of cases without recognising some link to the Hollywood versions of ‘The Three faces of Eve’ or ‘Sybil’ with the mixture of disbelief and fascination that is inevitably engendered.
I was reminded of a similar personal experience when I first came to live in the UK and took up my psychiatric studies here, having begun them in Australia where a considerable American influence was present. In the early 1990s, the Americans were breaking new ground both theoretically and psychoanalytically in working with the group of patients whom they called ‘borderline’. However, my use of this concept when I first arrived in the UK was to meet with some scepticism and disquiet at the diagnosis. This seems difficult to believe now when Borderline Personality Disorder is such a well-recognised diagnostic entity and I find myself wondering whether DID may also have a similar fate over time. If this might be true then Elizabeth F. Howell's book is likely to play a role in bringing the British on board.
Elizabeth Howell, described on the back cover as a psychoanalyst and traumatologist, provides a detailed, thoughtful and coherent account of a wide range of theoretical issues that deserv