JOAN ACOCELLA: Creating Hysteria: Women and the Myth of Multiple Personality Disorder. Jossey-Bass, San Francisco, CA, 1999, 214 pp., $25.00, ISBN 0-78794794-6. Joan Acocella's expose of the multiple-personality-disorder diagnosis is almost too convincing. There is no room for half tones or uncertainties: Creating Hysteria is an argument rather than a discussion, and Acocella argues with wit and elegance, leaving the battlefield strewn with casualties. Her main targets are the therapists whose public embrace of the MPD diagnosis during the last twenty years created an almost cultlike following, extensive media attention as well as a plethora of publications. Acocella claims that these practitioners knowingly and cynically used the diagnosis to win riches and fame, in the process sacrificing their patients. She is especially scathing about Satanic Ritual Abuse (SRA), the spread of which does defy understanding. (One must be a quick study of acronyms to follow this book.) Yet, unethical therapists are not the sole casualties of Acocella's battle. This is war, and she sweeps away all that clutters her path. As most of the women diagnosed with MPD also reported childhood sexual abuse, Acocella questions the reality of these reports as well as the good faith and suffering of the survivors, thus returning full circle to the Freudian assumption that childhood sexual abuse is a product of female fantasy. The child-protection movement, twelve-step self-help groups, feminism, insight therapy, new age theory, and social constructionism are just a few of the other corpses that litter this field. Acocella also has a disconcerting habit of using one set of beliefs, events or institutions as evidence, then discarding the same set when the next stage of her argument requires it. The media, for example, are transformed from hypocritical traders of truth for ratings in its embrace of MPD to champions of justice when they renounce the diagnosis, instead championing FMSF (the False Memory Syndrome Foundation) (pp. 97-98). Managed care, villainous when it supports the MSD diagnosis, becomes heroic when it balks at financing long-term treatment of MPD or indeed any long-time therapy (pp. 113-116). The DSM, as a diagnostic tool, is alternatively dismissed and used as scientific proof for Acocella's claims. Acocella's argument also depends heavily on clusters of associations. If we agree that most reported cases of SRA defy credibility, we must also doubt the credibility of well-documented cases of disassociative identity disorder (DID) (the new name for multiple personality disorder) (p. 57). Autobiographical accounts of cannibalism and baby sacrifice, which abound in the SRA literature, such as Jenny Walter Harris's Suffer the Child, a ghost-written account of a woman with over four hundred alters who was accosted by legions of demons (p. …
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