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Nicholas P. Spanos was killed shortly after completing this book and submitting it for publication. Some revisions to improve readability have been made and introductory material to clarify the relationship between chapters has been added; however, the 371-page book remains largely as Spanos wrote it. Spanos critically examines the nature of memory and defines the relationships among Multiple Personality Disorder (MPD), hypnosis, and the purported recovery of memories of childhood abuse during therapy. The book contains almost 50 pages of references and author and subject indexes.

This book is central to the issues involved in the debate about MPD and memories of childhood abuse. It will likely change the way in which MPD and claims of memories of childhood abuse are understood in the scientific community. Spanos holds that the concept of MPD as a disease entity and/or mental disorder is wrong and argues for the view that the development of the behaviors called MPD are constructed through social interaction. He sees them as developing in a lawful, rule-governed process and then maintained and legitimated by social processes in interpersonal interactions. He delineates and carefully describes the role of mental health professionals who identify, support, and reinforce the behaviors of MPD. He observes how this is done:

The rules for enacting the MPD role conveyed by this and similar interviews are as follows: (a) Behave as if you are two (or more) separate people who inhabit the same body. (b) Act as if the you I have been addressing thus far is one of those people and as if the you I have been talking to is unaware of the other coinhabitants. (c) when I provide a signal for contacting another coinhabitant, act as though you are another person. To the extent that patients behave in terms of these rules, the "classic" symptoms of MPD follow by implication and do not have to be taught through direct instruction or further suggestion (p.239).

The book thoroughly explores the role of hypnosis or hypnotic techniques in the development of MPD actions and false memories. Spanos has continued the work of T. X. Barber showing that hypnosis does not induce some special state of altered consciousness. Rather, hypnosis is a minidrama. Hypnotic responding is context dependent, determined by the willingness of subjects to adopt the hypnotic role and follow expectations of the operator. Subjects use imaginative and cognitive skills to create subjective experiences called for by the suggestions and feedback of the operator. This is the socio-cognitive understanding which Spanos believes is demonstrated by the research evidence.

Spanos maintains there is no good evidence for the claim that childhood abuse causes later development of MPD. He regards psychotherapy and other social factors as the cause of creating a link between confabulated memories of childhood abuse and the behaviors of MPD. The memories are most likely therapist-induced fantasies about events that never happened. Movies, biographies, TV shows, and other cultural sources may also be involved but the strongest social factors are the beliefs and expectations of mental health professionals.

This book is important for all professionals involved in trying to understand the diagnostic category of Multiple Personality Disorder (now labeled Dissociative Identity Disorder, or DID). It is also crucial to anyone dealing with claims of memories of childhood abuse. Attending to the data presented in this book could well result in a significant decline in the frequency of MPD diagnoses and harm done by developing false memories.

Reviewed by Ralph Underwager, Institute for Psychological Therapies, Northfield, Minnesota.