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Brain damage, behaviour and the mind
Brhur. R.-s. & Thrrup~. Vol 18. pp. 61 10 70 Pcrgzimon Press Ltd 1980. Printed m Great Bnram
BOOK REVIEWS P. L. WACHTEL: Psychoanalysis xv + 315 pp.fl1.25.
and Behavior
Therapy:
Toward
an Integration.
Basic Books, New York, 1977.
This book is full of sane and humane reflections on the process of psychotherapy and should be read by all therapists in training. Having started out as a dynamic psychotherapist, the author now adopts a directive approach, engaging his clients in a working partnership to achieve change outside the consulting room. While not denying the importance of childhood experiences, the archaeological approach to therapy and the primary role of transference are abandoned. He manages to give a fresh and human face to the behavioral approach, as it is practised rather than written about, and in so doing. he does not sidestep any of the common objections to behavior therapy. His discussions of autonomy, manipulation, insight and the role of the therapist as a reinforcing agent, offer new and persuasive arguments for a directive mode of intervention. The virtue of the book is not in its theoretical content, but in the manner in which behavioral concepts are applied sensitively and creatively to all aspects of the therapeutic process. He makes a good case for interpretative methods as an effective way of exposing clients to the conditions that frighten them. Defenses are seen as preventing exposure and hence, impeding extinction and new learning. Behaviour therapists might recoil at this position but, if it is admitted that reinforcement can operate without the person’s conscious awareness of the controlling contingencies, then they have to face the same problems as the analysts of inferring unconscious ‘motives’ (contingencies) with all the attendant difficulties of verification. The author follows Do&d and Miller in utilising the fear conditioning model and he allows thoughts, fantasies and impulses to substitute as conditioned stimuli. Anxiety is made central to neurosis, and so there is nothing new here. This is a pity because anxiety has played the role of convenient intrapsychic fiction for too long. It helped in the initial development of behaviour therapy, but if, as could be argued, it was passed down to us from psychoanalysis, then it should be returned with thanks. The model of neurosis presented in the book is certainly broader than is suggested here and it might be summed up by a quotation. “Much human misery is the result of building life strategies on the basis of a mistaken view of self and world, hedged by fears no longer appropriate to the full-grown person.” (p. 264). The goal of therapy is to help the client to be in-tune with the world and alive to the possibilities it offers him (p. 280). In essence, we have the philosophy of adjustment combined with the possibly contradictory notion of revealing or uncovering a ‘true’ self. In sum the book should have a wholesome and healing effect on the rift between practitioners of psychodynamic and behavioural techniques but it does not provide an integration at a theoretical level. R. S. HALLAM
MOYRA WILLIAMS: Brain Damage,
Behaviour
and
the Mind.
John Wiley, Chichester,
1979. 187 pp. E8.50.
Moyra Williams has, according to the publisher’s notes, “tried to keep technical language to a minimum to enable the book to be read and understood by the non-specialist”. This end she has certainly achieved, and more, for the result is a very fine introductory text-book to neuropsychology that will doubtless form the backbone to many undergraduate courses. There are at least four reasons why the book has succeeded. First, there is a very wide coverage of topics with chapters devoted to disorders of consciousness, mood, memory, visual perception, bodily awareness, motor skill, language, disconnection syndromes, intelligence and personality. This ensures-that the student has some contact with all the major areas of neuropsychology in a single volume. Second, the book is simply written-the writing is fluent, the major points are boldly made, and terms are explained both in the text and by well-drawn diagram. Third is the overall clarity of presentation, in the writing itself and in the organization of the book into many small sub-sections. This clarity is particularly enhanced by the judicious use of single case descriptions and illustrations. The fourth reason why the book has succeeded is, perhaps surprisingly, its brevity. The 166 pages of actual text can be read easily in two or three sittings so that the student without any undue effort can quickly gather a feel of neuropsychology as a whole, without wading through several different books or a huge tome. Further, because of its shortish length, the book is within the price range of many students, even in hard back form. As for more specialist students, or established neuropsychologists, there is little in this book for them (apart from it being a good teaching text) because academic discussion is extremely limited, there is little in-depth exploration of ideas or experiments and virtually none of the ideas are new (indeed, the book is very ‘classic’ in its approach to neuropsychology). All-in-all, complexities and intrigues in the field have been suppressed in order to provide bold, clear statements that can be readily grasped by the student without being side-tracked or confused by too many ‘ifs’ and ‘buts’. 67
68
BOOK REVlEWS
The place of this book, then, is firmly with the undergraduate psychologist, interested undergraduates from other disciplines, and anyone in the medical sphere who is liable to encounter brain damage cases. It is a very welcome book indeed, for there is no other that fills this slot one-half as well. GRAHAM POWELL
DAVID LEWIS: The Secret Laguage of Your Child: How children ralk before they can speak.
Souvenir Press,
London, 1978. 288 pp. f4.95. The study of non-verbal ~mmuni~tion and its importance in any social interaction has received considerable attention in recent years, and the work of Argyle and his colleagues has been particuiarIy valuable in demonstrating how such interactions can be measured in an objective and reliabfe way. The present book aims to explain the non-verbal communication of very young children, but, unfortunately, without any of the precision which typifies the work of Argyle. We are told that “For the first time any aduit with an interest in the very young can learn how to observe. understand and make use of the secret language” of children. Apparently, one is meant to believe that without the aid of the author’s advice parents will be unable to respond to the ‘body language’ of their children and will fail to interpret correctly their children’s expressions of insecurity, anger, or frustration etc. It would be a sad day for parents, and children, if this were the case. The book comprises predominantly series of photographs or written descriptions of interactions between children, or children and adults, with the author interpreting these in such a way as to support his own theories and to demonstrate, for the most part, how other adults almost invariably misunderstand their children. However, many of the photographs used in the text are indistinct (the behaviour of one child, for example. is analysed in a series of 10 photographs where we see little more of him than one arm) and the interpretations are often entirely subjective and unsubstantiated. Indeed, the chapter on how to interpret the ‘hidden truth in family snaps’ is about as scientific and objective as a chapter on how to read fortunes in tea leaves might be. The author’s research, we are informed, is based on over eight miles of video recording. There must, surely. be better ways of using expensive video equipment; there are certainly better ways of spending f5 than buying a book of this kind. P.
HOWLIN
and R. I.,. WILLIAMS(Eds.): Phenomenology and Treatment of New York, 1978. 551 pp. f21.00. This book presents the proceedings of a symposium held in Texas in 1976. The contents cover a wide range of approaches to schizophrenia, but with very little mention of behavioural techniques in treatment. Indeed the aim was to bring together biological and psychodynamic approaches to this topic. Areas considered include genetic factors in schizophrenia, psychophysiological studies, psychodynamic approaches, articles on thought and information processing in schizophrenia, the management of schizophrenia and psychopharmacological investigations. The quality of contributions varies hugely; some, like that by Cromwell and Spaulding on how schizophrenics handle information, are worthwhile reviews-others are trivial. There is little attempt to integrate work from the various areas. In view of the rate at which the experimental literature on schizophrenia is growing it would seem preferable to publish these contributions as journal articles, rather than in this expensive volume. W. E. FANN, I. KARACAN.A. D.
POKORNY
Schizophrenia. Spectrum Publications.
0. R. HEM~LEY
E. B. BLANCHARD and L. 218 pp. E4.30.
H. EPSTEIN: A Biofeedback Primer.
Addison-Wesley, Reading, Massachusetts,
1978.
This is an excellent little book. It consists of a review of the biofeedback literature up to 1976. As such, of course, it is out of date, but nevertheless can be recommended as a well-written critical introduction to this rapidly expanding field. There are chapters on all the major physiological systems which have been investigated, apart from electrodermal activity. A few words about the measurement of each variable is followed by a review and discussion of non-clinical research. Clinical applications are then considered, The authors dwell naturally on their own work, a strategy which allows them to discuss some of the problems which arise in biofeedback research at first hand. Of interest to readers of this journal is a chapter on self-management, which suggests, rightly, that since the technology is available, physiological activity can now take its place with motor and cognitive activities as being amenable to self-control. The implications of this could well have been taken further than they are in the final chapter, which does some crystal-balI gazing In summary this book can be highly recommended to all who have an interest in biofeedback and want to learn more. It is a welcome antidote to the rather uncritical popufar books which have jumped on the biof~back bandwagon. WILFRID I. HUME
BOOK REVIEWS P. L. WACHTEL: Psychoanalysis xv + 315 pp.fl1.25.
and Behavior
Therapy:
Toward
an Integration.
Basic Books, New York, 1977.
This book is full of sane and humane reflections on the process of psychotherapy and should be read by all therapists in training. Having started out as a dynamic psychotherapist, the author now adopts a directive approach, engaging his clients in a working partnership to achieve change outside the consulting room. While not denying the importance of childhood experiences, the archaeological approach to therapy and the primary role of transference are abandoned. He manages to give a fresh and human face to the behavioral approach, as it is practised rather than written about, and in so doing. he does not sidestep any of the common objections to behavior therapy. His discussions of autonomy, manipulation, insight and the role of the therapist as a reinforcing agent, offer new and persuasive arguments for a directive mode of intervention. The virtue of the book is not in its theoretical content, but in the manner in which behavioral concepts are applied sensitively and creatively to all aspects of the therapeutic process. He makes a good case for interpretative methods as an effective way of exposing clients to the conditions that frighten them. Defenses are seen as preventing exposure and hence, impeding extinction and new learning. Behaviour therapists might recoil at this position but, if it is admitted that reinforcement can operate without the person’s conscious awareness of the controlling contingencies, then they have to face the same problems as the analysts of inferring unconscious ‘motives’ (contingencies) with all the attendant difficulties of verification. The author follows Do&d and Miller in utilising the fear conditioning model and he allows thoughts, fantasies and impulses to substitute as conditioned stimuli. Anxiety is made central to neurosis, and so there is nothing new here. This is a pity because anxiety has played the role of convenient intrapsychic fiction for too long. It helped in the initial development of behaviour therapy, but if, as could be argued, it was passed down to us from psychoanalysis, then it should be returned with thanks. The model of neurosis presented in the book is certainly broader than is suggested here and it might be summed up by a quotation. “Much human misery is the result of building life strategies on the basis of a mistaken view of self and world, hedged by fears no longer appropriate to the full-grown person.” (p. 264). The goal of therapy is to help the client to be in-tune with the world and alive to the possibilities it offers him (p. 280). In essence, we have the philosophy of adjustment combined with the possibly contradictory notion of revealing or uncovering a ‘true’ self. In sum the book should have a wholesome and healing effect on the rift between practitioners of psychodynamic and behavioural techniques but it does not provide an integration at a theoretical level. R. S. HALLAM
MOYRA WILLIAMS: Brain Damage,
Behaviour
and
the Mind.
John Wiley, Chichester,
1979. 187 pp. E8.50.
Moyra Williams has, according to the publisher’s notes, “tried to keep technical language to a minimum to enable the book to be read and understood by the non-specialist”. This end she has certainly achieved, and more, for the result is a very fine introductory text-book to neuropsychology that will doubtless form the backbone to many undergraduate courses. There are at least four reasons why the book has succeeded. First, there is a very wide coverage of topics with chapters devoted to disorders of consciousness, mood, memory, visual perception, bodily awareness, motor skill, language, disconnection syndromes, intelligence and personality. This ensures-that the student has some contact with all the major areas of neuropsychology in a single volume. Second, the book is simply written-the writing is fluent, the major points are boldly made, and terms are explained both in the text and by well-drawn diagram. Third is the overall clarity of presentation, in the writing itself and in the organization of the book into many small sub-sections. This clarity is particularly enhanced by the judicious use of single case descriptions and illustrations. The fourth reason why the book has succeeded is, perhaps surprisingly, its brevity. The 166 pages of actual text can be read easily in two or three sittings so that the student without any undue effort can quickly gather a feel of neuropsychology as a whole, without wading through several different books or a huge tome. Further, because of its shortish length, the book is within the price range of many students, even in hard back form. As for more specialist students, or established neuropsychologists, there is little in this book for them (apart from it being a good teaching text) because academic discussion is extremely limited, there is little in-depth exploration of ideas or experiments and virtually none of the ideas are new (indeed, the book is very ‘classic’ in its approach to neuropsychology). All-in-all, complexities and intrigues in the field have been suppressed in order to provide bold, clear statements that can be readily grasped by the student without being side-tracked or confused by too many ‘ifs’ and ‘buts’. 67
68
BOOK REVlEWS
The place of this book, then, is firmly with the undergraduate psychologist, interested undergraduates from other disciplines, and anyone in the medical sphere who is liable to encounter brain damage cases. It is a very welcome book indeed, for there is no other that fills this slot one-half as well. GRAHAM POWELL
DAVID LEWIS: The Secret Laguage of Your Child: How children ralk before they can speak.
Souvenir Press,
London, 1978. 288 pp. f4.95. The study of non-verbal ~mmuni~tion and its importance in any social interaction has received considerable attention in recent years, and the work of Argyle and his colleagues has been particuiarIy valuable in demonstrating how such interactions can be measured in an objective and reliabfe way. The present book aims to explain the non-verbal communication of very young children, but, unfortunately, without any of the precision which typifies the work of Argyle. We are told that “For the first time any aduit with an interest in the very young can learn how to observe. understand and make use of the secret language” of children. Apparently, one is meant to believe that without the aid of the author’s advice parents will be unable to respond to the ‘body language’ of their children and will fail to interpret correctly their children’s expressions of insecurity, anger, or frustration etc. It would be a sad day for parents, and children, if this were the case. The book comprises predominantly series of photographs or written descriptions of interactions between children, or children and adults, with the author interpreting these in such a way as to support his own theories and to demonstrate, for the most part, how other adults almost invariably misunderstand their children. However, many of the photographs used in the text are indistinct (the behaviour of one child, for example. is analysed in a series of 10 photographs where we see little more of him than one arm) and the interpretations are often entirely subjective and unsubstantiated. Indeed, the chapter on how to interpret the ‘hidden truth in family snaps’ is about as scientific and objective as a chapter on how to read fortunes in tea leaves might be. The author’s research, we are informed, is based on over eight miles of video recording. There must, surely. be better ways of using expensive video equipment; there are certainly better ways of spending f5 than buying a book of this kind. P.
HOWLIN
and R. I.,. WILLIAMS(Eds.): Phenomenology and Treatment of New York, 1978. 551 pp. f21.00. This book presents the proceedings of a symposium held in Texas in 1976. The contents cover a wide range of approaches to schizophrenia, but with very little mention of behavioural techniques in treatment. Indeed the aim was to bring together biological and psychodynamic approaches to this topic. Areas considered include genetic factors in schizophrenia, psychophysiological studies, psychodynamic approaches, articles on thought and information processing in schizophrenia, the management of schizophrenia and psychopharmacological investigations. The quality of contributions varies hugely; some, like that by Cromwell and Spaulding on how schizophrenics handle information, are worthwhile reviews-others are trivial. There is little attempt to integrate work from the various areas. In view of the rate at which the experimental literature on schizophrenia is growing it would seem preferable to publish these contributions as journal articles, rather than in this expensive volume. W. E. FANN, I. KARACAN.A. D.
POKORNY
Schizophrenia. Spectrum Publications.
0. R. HEM~LEY
E. B. BLANCHARD and L. 218 pp. E4.30.
H. EPSTEIN: A Biofeedback Primer.
Addison-Wesley, Reading, Massachusetts,
1978.
This is an excellent little book. It consists of a review of the biofeedback literature up to 1976. As such, of course, it is out of date, but nevertheless can be recommended as a well-written critical introduction to this rapidly expanding field. There are chapters on all the major physiological systems which have been investigated, apart from electrodermal activity. A few words about the measurement of each variable is followed by a review and discussion of non-clinical research. Clinical applications are then considered, The authors dwell naturally on their own work, a strategy which allows them to discuss some of the problems which arise in biofeedback research at first hand. Of interest to readers of this journal is a chapter on self-management, which suggests, rightly, that since the technology is available, physiological activity can now take its place with motor and cognitive activities as being amenable to self-control. The implications of this could well have been taken further than they are in the final chapter, which does some crystal-balI gazing In summary this book can be highly recommended to all who have an interest in biofeedback and want to learn more. It is a welcome antidote to the rather uncritical popufar books which have jumped on the biof~back bandwagon. WILFRID I. HUME