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Ullman, M. (1997). Dreaming and Other Involuntary Mentation: An Essay in Neuropsychiatry: Arthur W. Epstein, M.D., International Universities Press, Madison, CT, 1995, 179 pp.. J. Amer. Acad. Psychoanal., 25(1):183-186.

(1997). Journal of American Academy of Psychoanalysis, 25(1):183-186

Dreaming and Other Involuntary Mentation: An Essay in Neuropsychiatry: Arthur W. Epstein, M.D., International Universities Press, Madison, CT, 1995, 179 pp.

Review by:
Montague Ullman

Over the years Arthur Epstein has brought to our attention a thoughtful integration of neurology and psychoanalysis, particularly with regard to the nature of dreaming. In the current volume he has cast a wider net and has attempted to highlight the common neurophysiological thread linking the manifestations of obligatory mentation in nominal aphasia, epilepsy (in its manifest and latent forms), dreams, fetishism, phobias, and obsessive-compulsive disorder. In this slender volume he has offered a reminder that all is not psychological as he spells out the way the brain, as the substrate of consciousness, exerts a determining influence on the way mentation arises in each of these states. His argument is most cogent in his consideration of the various clinical syndromes he describes. I will consider its application to dreams separately.

The common thread in each of the circumstances noted is the appearance of imperative ideas. Mentation in this form is subserved by neuronal networks which, under certain conditions, reach a state of excitation leading to “neuronal excessive discharge” and a resultant dominance. Ontogenetic influences leading to this include the encoding of an earlier catastrophic event. In childhood particularly an event is more likely to be significantly arousing, and acting on brain tissue of some immaturity, memory of the event achieves vividness and may develop into an imperative idea (p. 139). The author believes this is particularly true of phobic and fetishistic ideas.

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