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Book Forum: Stress   |    
The Stranger in the Mirror: Dissociation—The Hidden Epidemic
LEAH J. DICKSTEIN, M.D.
Am J Psychiatry 2001;158:1178-a-1179. doi:10.1176/appi.ajp.158.7.1178-a
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By Marlene Steinberg, M.D., and Maxine Schnall. New York, Cliff Street Books (HarperCollins), 2000, 308 pp., $25.00.

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Targeted at the general public, The Stranger in the Mirror should be read by all psychiatry residents as well as all mental health professionals heretofore skeptical of the diagnosis of dissociative identity disorder.

This is an extraordinarily well-written compilation of descriptions of the disorder, in all its forms and degrees of severity, together with sections of the Structured Clinical Interview for DSM-IV Dissociative Disorders—Revised for the five core symptoms. The symptoms are presented in separate chapters with vivid case examples.

Dr. Steinberg, the first researcher to receive National Institute of Mental Health grant support to conduct field research in dissociation, vividly and thoughtfully shares her professional expertise to inform the reader about this major mental illness.

The book is divided into four sections: Dissociation—What It Is and Is Not, Recognizing the Signs and Rating Your Symptoms, Inside Stories (three case studies), and Befriending the Stranger. The last section, dedicated to treatment goals and techniques, is very useful, summarizing symptoms such as feeling numb, suicidality, depression, time loss, self-mutilation, out-of-body experience, amnesia, derealization, depersonalization, identity alteration, and identity confusion and then describing what Dr. Steinberg calls the four Cs of therapy: comfort, communication, cooperation, and connection.

Having known and later been supervised by Sybil’s psychiatrist, Cornelia Burwell Wilbur, when she was at the University of Kentucky and in practice in Lexington, and having diagnosed and treated bright adult trauma victims with dissociative identity disorder, I found this book thorough, interesting, and sensitive. It is an excellent reference book, as Dr. Steinberg indicates, for the general public and patients as well as all health sciences students and trainees. All readers will gain understanding about a very treatable yet seemingly misunderstood and misdiagnosed condition.

After a careful study of this book, the reader should no longer be confused or in doubt but, instead, ready and willing to help traumatized patients with dissociative identity disorder regain healthy self-esteem and a good life through psychotherapy. Finally, the references section offers further case studies as well as numerous refereed and other scientific publications.

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