Dr. Spanos suggests that patients with multiple identities learn to consider themselves as possessing multiple selves, learn to present themselves in terms of this construct, and then learn to reorganize and elaborate on their own biographies so as to make them congruent with their understanding of what it means to have multiple personalities. He believes that patients are actively involved in using available information to create a social impression that is congruent with social and situational demands.

I think there are two fundamental problems with this book. First, Dr. Spanos is a researcher and not a clinician, and, because of this, I think he is seriously limited in his view of the events that he is attempting to understand and explain to us. He does not mention and even seems to discount and minimize childhood histories and unconscious or psychodynamic views of these events; as a result, he presents what I believe is a simplistic view of multiple personality. Second, Dr. Spanos essentially collapses the concept of multiple personality along with what he calls the sexual abuse survivor movement and the development and popularity of incest resolution therapies into one concept, which he then argues against. He talks about multiple personality early in his book, but the real focus and power of his argument is directed at the issue of what is essentially group hysteria in some instances of alleged pervasive sexual abuse, incest, or supposed satanic cult behavior. In these instances, certainly, a very widespread phenomenon involving alleged victims, naive and reactive therapists, lawyers, judges, and other individuals have all participated in creating what is essentially a false event. His apparent outrage is understandable, and many people would agree. The supposed sexual abuse at certain day-care facilities immediately comes to mind.

While reading Dr. Spanos’ book, I was reminded many times of the nineteenth-century novel Extraordinary Popular Delusions and the Madness of CrowdsR341559CHDDEIJH. It seems to me that Dr. Spanos addresses in a more scientific manner the fascinating occurrence of madness and hysteria in group functioning. Group delusions, however, are very different from what we see in multiple personality. This is where I think that Dr. Spanos falls short in this book. If he took out his discussions of multiple personality and left the rest, I think he would have a good book. For him to discuss multiple personality and to discount the important research done by Putnam, Ross, and Kluft, among others, seems to me to be denying an important reality. Dr. Spanos suggests that even these very respected researchers and clinicians are simply participating in the social construction of reality and producing multiple personalities. This seems not only arrogant but reductionistic and simplistic. It is true, of course, that patients who may be dissociative, sexually abused, or incest victims might be unduly influenced by therapists. Of course caution should be taken in how the history is obtained and where the information leads. I think Dr. Spanos doesn’t appreciate that some people become diagnosed as having multiple personality without being led to it by their therapists and that there is more going on here than the simple influence of interpersonal effects.