Stress management for wellness

Stress management for wellness

I16 Book Reviews Massachusetts General Hospital. Handbook of General Hospital Psychiatry. HACKET-I and N. H. CASSEM. PSG Publishing. Littleton. MA...

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Massachusetts General Hospital. Handbook of General Hospital Psychiatry. HACKET-I and N. H. CASSEM. PSG Publishing. Littleton. MA. 1987.

2nd Edition. Edited by T. P.

THF EDITORS of this book have a special place in the short history of Liaison Psychiatry (or rather what they would call Consultation Psychiatry). Their unit at the Massachusetts General Hospital has been a pioneer in clinical services as well as in establishing academic psychiatric interest in the psychological problems of physical illnesses. most notably heart disease, cancer and dying. Many liaison psychiatrists have trained in their large department and it remains. as it has been from the beginning. a centre of international standing. The hook’s title refers to general hospital psychiatry but the content is principally concerned with consultation and liaison. However. one has to be wary in using any such labels. Dr Hackett has been a vigourous critic of what he sees as the excesses of those who support the term and concepts of liaison. Even so, it must be said that what he sees as consultation is what others are happy to call liaison. The preface to the first edition said it was ‘a handbook for professionals who work with medical and surgical patients. With a few exceptions. the writing is devoted to practical matters of patient care and the conduct of hospital business. Our goal was not to theorise, but rather to set down issues of importance for psychiatrists in the general hospital’. Although this statement is not reiterated in this new edition. it remains a good description of what the book is about. It is not a textbook or an academic review but rather a collection of chapters by the editors and their colleagues. Although wide-ranging. it is not comprehensive. Thus it has chapters upon burns. accidents. spinal cord injuries and chronic renal failure (which presumably represent special interests of the Unit) but there is no attempt to deal with many other important medical and surgical problems. The first edition was quite rightly widely read and widely popular. This edition is not substantially changed. but several chapters have been omitted and replaced by new ones. There is now a chapter whimsically entitled ‘Limbic music’. Suicide is no longer a separate chapter and is now only briefly discussed in a chapter on .Suicide and other disruptive states‘. Hysteria is replaced by a new chapter on ‘Functional somatic states and somatoform disorders‘. In addition, most of the remaining chapters have been rewritten. As a result. it remains a good (if at times idiosyncratic) view of psychiatry in the general hospital. It contains much clinical wisdom; this is a considerable achievement. since few other books attempt to describe the special clinical skills of working in a general hospital. This book remains an important reference for all who are interested in consultation and liaison psychiatry.

RKHARI) MAYOR’ Warneford Hospital Oxford

Stress Management

for Wellness.

W. SCHAFI TV. Holt.

Rinehart

& Winston,

New York.

1987. pp. 351.

THIS HOOK looks. feels and initially reads like a conventional introductory text to a wide vsariety of concepts loosely hung on the peg of ‘stress’. Indeed. it is written primarily for undergraduate students from a variety of disciplines - psychology, business studies. education and so on. It is divided into two parts. The first introduces a variety of theoretical and phenomenological approaches to the experience and study of stress. The author adopts a broadly cognitive-behavioural approach to the explanation of stress, and concepts from cognitivists such as Beck and Meichenbaum, as well as Selye’s physiological model are described. Familiar topics such as the fight-fight response. individual vulnerability to stress. and individual cognitive style are introduced. as well as more idiosyncratic notions, such as the concept of a zone of positive stress. Unfortunately, the author is rather uncritical in his reviews of the effects of stress on health. No hint. for example, is given of the controversy surrounding the concept of type A behaviour. and his review of personality and gastrointestinal disorders is rather dated. The author’s eclectic approach does not provide the reader with any understanding of any ‘pure’ theoretical model of stress. Instead it provides a number of approaches to the understanding of stress that all readers will find coherent and meaningful. This, rather than a purist understanding of stress research and theory, would appear to be the aim of the author. for in part 2 the full richness of the book is revealed, transforming a mere introductory test into a veritable cornucopia of ideas and methods for the identification and alleviation of personal stress. This is the strongest part of the book. It firstly including questionnaires and small self-experiments to the provides a compendium of approaches. assessment of personal stress. including the impact of life events. physiological signs of stress. cognitive style. and stressed behaviour (including anger and type A behaviour). The author then introduces a variety of approaches to the remediation of any identified stressors. Relaxation. meditation. coping.

Book

117

Reviews

self-talk, cognitive challenging and many other techniques for the alleviation of stress are well described. with manageable goals for change suggested in the text. In addition to these psychological techniques. the value of balanced diet and exercise programme are discussed in a lively and comprehensive section. The author’s description of each technique is simple. balanced. lively and excites the reader to. at least. try them out and experiment with different and new ways of coping with stress. Within the confines of a broadly cognitive-behavioural approach. this book provides the undergraduate reader with a powerful armamentum toward the alleviation of personal stress. The jaded or new counsellor too may find fresh exciting ideas and intervention approaches. each of which may be selected and implemented as appropriate. Read and enjoy.

Coronary

Heart

P.\L,I. BEKNF I I Disease Prevjention Programme Selly Oak Hospital. Birmingham