Book Review: Onno van der Hart, Ellert R. S. Nijenhuis, & Kathy Steele, The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization. New York: W. W. Norton, 2006. 418 pp. Cloth: $49.95 (US), ISBN 0393704017

The Haunted Self, written by three experts in the field, develops a theory of clinical dissociation (e.g., lack of integration of psychological processes that are ordinarily integrated; see Cardeña, 1997) based on earlier theories as supported by contemporary research in clinical psychology and the neurosciences. The authors’ “structural theory of dissociation” proposes that as a result of trauma the integrative processes of a personality may be jeopardized. Instead of a unitary personality, what results is either: (1) an “apparently normal part of the personality” (ANP) and an “emotional part of the personality” (EP) (primary structural dissociation); (2) an ANP and more than one EP (secondary structural dissociation); or 3) more than one ANP and one EP (tertiary structural dissociation, including dissociative identity disorder). This part of their theory, based on the work of Charles S. Myers, is supplemented by an update of Pierre Janet’s “psychology of action. ” Janet, whose work spanned the late 19th and early 20th centuries, is arguably the most important pioneer on the study of dissociation and trauma. He proposed that dissociation occurred when vehement emotions could not be integrated because of low mental energy or efficiency. Additionally, Janet argued that non-integrated mental structures are geared towards specific goals (or action tendencies; see also Arnold, 1968). Although the authors’ theory that secondary and structural dissociation may explain severe dissociative conditions is consistent with other models (cf. Putnam, 1989), their proposal that alternate personality parts (i.e., primary dissociation) can explain “simpler” conditions such as posttraumatic stress disorder (PTSD) is more controversial. Alternative models of PTSD (Brewin & Holmes, 2003) maintain that different cognitive schemas may be regnant at different times, without espousing full-fledged alternate personality parts. Also, Van der Hart and collaborators seek to restrict the concept of dissociation to denote non-integrated parts of personality, while seeking to eliminate a different but related notion of dissociation as alterations of consciousness marked by a sense of experiential detachment. Other authors have pointed out the theoretical and clinical usefulness of maintaining both senses of the term (Brown, 2006; Cardeña, 1997). This book has many strengths, especially from a clinical perspective. The authors, who have carried out important research and theoretical work in addition to working as therapists, have refined their theory for a number of years and have amassed an impressive knowledge of the pertinent literature. After a thorough presentation of their theory, Van der Hart, Nijenhuis, and Steele present its application to a three-phase treatment of individuals with post-traumatic psychopathology. The authors emphasize work on the first stage, centered on essential psychological tasks such as reducing phobias and providing more adaptive ways of coping with stressful situations. There are also, however, some areas in which the book could have been improved. Foremost for many of the readers of this journal is the authors’ lack of Book Reviews