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Brief Therapies
Book Reviews BRIEF THERAPIES. By Harvey H. Barten, M.D. Behavioral Publications, New York, N.Y., 342 pages.
Dr. Barten's introductory statement is that "The brief therapies are certain to become a major treatment modality in the next decade." No one can disagree with this. Like all anthologies, this is "a sampling rather than a compendium," and it cannot provide a unified concept of what brief therapy is or what it means or how it is performed. For example, "brief therapy" may consist of: a) Time-limited therapy, in which a patient is seen as often as necessary over a given period of time, such as in "crisis therapy" for a period of six weeks. b) Session limited therapy, in which the patient is seen for a given number of sessions, the most frequent number given in this book by different authors being six. c) Brief contact thera]JY, in which the patient is seen for a given or for an unlimited number of sessions, each session being brief, for example 1520 minutes. d) Goal limited therapy, in which a specific goal, focus, or sector is chosen and therapy is terminated when that goal is reached. These methods, as applied by the various authors, may be used singly or in any combination, in individual therapy, conjoint therapy, family therapy, or group therapy. Illustrations of all these modalities are given. Throughout the various articles, certain principles of brief therapy recur: a) The therapist should look for patterns of behavior from the past life of the patient. He should not analyze these, but should relate them to the current problem. b) The therapist must have a belief in the basic health and growth potential of the patient, who may be expected to consolidate and perhaps even expand the results of the limited goals that have been obtained. The patient is expected to improve. c) Therapy is strongly focused on the patient's current life situation, the precipitating stresses, the symptoms, and the patient's relationship with his environment. In other words, what is the current problem, what brought it about, and what keeps it going? d) Psychodynamics, the transference, and the unconscious may be recognized but not emphasized. Therapy is focused, and extraneous material is avoided.
206
e) The illness is viewed as a cnsls situation and is treated as such. When the crisis is over, treatment is terminated. f) Treatment is instituted early. g) Treatment programs must be flexible. One point that deserves special attention and questioning is that of the problem of early access to therapy. This is certainly important, but it appears to be offered only in clinics, and I have read elsewhere that waiting lists Ultimately do develop. I would like someone to explain this to me: If a clinic staff is working near capacity, how can it offer immediate service? If it is not operating at near capacity, how are the salaries justified? There are some chapters that deserve special attention: Chapter 13 "Casualty Management," Chapter 24 "Vicious and Virtuous Circles," Chapter 25 "Toward a Specification of Teaching and Learning in Psychotherapy." and the Epilogue by Jay Haley on "The Art of Being a Failure as a Therapist." As in any anthology there is some redundancy, but the reader can always use this for review purposes. This is a thought provoking volume with a lot of meat in it. While it presents few new ideas, it is a good review. It is worth reading. JAMES R. HODGE,
M.D.
Akron, Ohio. SOMA: DiVine Mushroom of Immortality. R. Gordon Wasson, Harcourt Brace Jovanovich, Inc., New York, 1972, $7.50, 381 pp.
Has Gordon Wasson resolved the mystery of Soma at last? Was the Rg Veda potion that "made gods of men" really the fly agaric, Amanita mltScaria? This is a scholarly effort to prove that the white flecked, crimson mushroom which most of us last encountered in Walt Disney's Fantasia was indeed the same Soma that the Vedic poets praised With every superlative available to them. Wasson makes a per~uasive case. The earlier assumptions that Soma was some alcoholic drink, Indian hemp, Afgan grapes, the rhubarb plant, ephedra, sarcostemma or periploca are less convincing than the hypothesis at hand. I remember visiting Gordon Wasson at his office with Morgan & Co. on Wall Street shortly after he rediscovered the psychedelic effects of the Mexican mushroom (]Jsilocybe Mexicana). A more unlikely place to talk about things transcendental can hardly be imagined. Since then he has retired from his Vice-Presidency and now pursues the strange tale of the hallucinogenic mushrooms. Volume XIII
Dr. Barten's introductory statement is that "The brief therapies are certain to become a major treatment modality in the next decade." No one can disagree with this. Like all anthologies, this is "a sampling rather than a compendium," and it cannot provide a unified concept of what brief therapy is or what it means or how it is performed. For example, "brief therapy" may consist of: a) Time-limited therapy, in which a patient is seen as often as necessary over a given period of time, such as in "crisis therapy" for a period of six weeks. b) Session limited therapy, in which the patient is seen for a given number of sessions, the most frequent number given in this book by different authors being six. c) Brief contact thera]JY, in which the patient is seen for a given or for an unlimited number of sessions, each session being brief, for example 1520 minutes. d) Goal limited therapy, in which a specific goal, focus, or sector is chosen and therapy is terminated when that goal is reached. These methods, as applied by the various authors, may be used singly or in any combination, in individual therapy, conjoint therapy, family therapy, or group therapy. Illustrations of all these modalities are given. Throughout the various articles, certain principles of brief therapy recur: a) The therapist should look for patterns of behavior from the past life of the patient. He should not analyze these, but should relate them to the current problem. b) The therapist must have a belief in the basic health and growth potential of the patient, who may be expected to consolidate and perhaps even expand the results of the limited goals that have been obtained. The patient is expected to improve. c) Therapy is strongly focused on the patient's current life situation, the precipitating stresses, the symptoms, and the patient's relationship with his environment. In other words, what is the current problem, what brought it about, and what keeps it going? d) Psychodynamics, the transference, and the unconscious may be recognized but not emphasized. Therapy is focused, and extraneous material is avoided.
206
e) The illness is viewed as a cnsls situation and is treated as such. When the crisis is over, treatment is terminated. f) Treatment is instituted early. g) Treatment programs must be flexible. One point that deserves special attention and questioning is that of the problem of early access to therapy. This is certainly important, but it appears to be offered only in clinics, and I have read elsewhere that waiting lists Ultimately do develop. I would like someone to explain this to me: If a clinic staff is working near capacity, how can it offer immediate service? If it is not operating at near capacity, how are the salaries justified? There are some chapters that deserve special attention: Chapter 13 "Casualty Management," Chapter 24 "Vicious and Virtuous Circles," Chapter 25 "Toward a Specification of Teaching and Learning in Psychotherapy." and the Epilogue by Jay Haley on "The Art of Being a Failure as a Therapist." As in any anthology there is some redundancy, but the reader can always use this for review purposes. This is a thought provoking volume with a lot of meat in it. While it presents few new ideas, it is a good review. It is worth reading. JAMES R. HODGE,
M.D.
Akron, Ohio. SOMA: DiVine Mushroom of Immortality. R. Gordon Wasson, Harcourt Brace Jovanovich, Inc., New York, 1972, $7.50, 381 pp.
Has Gordon Wasson resolved the mystery of Soma at last? Was the Rg Veda potion that "made gods of men" really the fly agaric, Amanita mltScaria? This is a scholarly effort to prove that the white flecked, crimson mushroom which most of us last encountered in Walt Disney's Fantasia was indeed the same Soma that the Vedic poets praised With every superlative available to them. Wasson makes a per~uasive case. The earlier assumptions that Soma was some alcoholic drink, Indian hemp, Afgan grapes, the rhubarb plant, ephedra, sarcostemma or periploca are less convincing than the hypothesis at hand. I remember visiting Gordon Wasson at his office with Morgan & Co. on Wall Street shortly after he rediscovered the psychedelic effects of the Mexican mushroom (]Jsilocybe Mexicana). A more unlikely place to talk about things transcendental can hardly be imagined. Since then he has retired from his Vice-Presidency and now pursues the strange tale of the hallucinogenic mushrooms. Volume XIII