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Learning theory approaches to psychiatry
BOOK REVIEWS
E. R. VALENTINE: Conceptual Issues in Psychology. Allen & Unwin, (Paper).
467
Winchester,
Mass. (1982). 128 pp. $25.00 (Cloth);
$9.95
Behaviour therapists are not normally very interested in conceptual issues, except perhaps for the conditioning vs cognitive factors controversy, but they might find this short and very well-written book not only interesting, but also useful. It deals in a sensible and matter of fact fashion with questions of determinism, the mind-body problem, consciousness, introspection, the problem of the organism, models, theories, and explanations, the relation of physiology to psychology, humanistic psychology and idiographic approaches; all these are ever-recurring problems which psychologists have to take some stance on, even if only to declare them metaphysical and irrelevant! Valentine makes out a good case that they are not irrelevant, and that empirical evidence in many cases suggests possible answers. The writing is clear and often witty; thus Valentine points out that: “Porridge is not a very good model of the brain. How much better is a computer?” Looking at some of the outpourings of existentialists and hermeneutic psychologists I wonder if porridge is not a good model of the brain! Sometimes one wonders about the pronouncements made by Valentine, for instance when she says that “Brains.. are never subject to random error”. I would have thought the opposite. It is certainly incautious to assert a universal negative. But such rather minor matters aside, this is a well-conceived, well-written book that, in spite of its short compass, covers a wide range of questions of concern to psychologists, and which is well worth reading. H. J. EYSENCK
B. B. WOLMAN (Ed.): Psychological Aspects of Obesity: A Handbook. Van Nostrand pp. f20.05.
Reinhold,
New York (1982). xii + 318
Despite the large and growing body of literature in the area of obesity and overeating, there is as yet no up-to-date volume which comprehensively collates the accumulated data. It was therefore disappointing to find the present book to be a rather inadequate attempt at filling the gap. It consists of a collection of papers divided into two sections: the first concerned with the aetiology and symptomatology of obesity, and the second with aspects of treatment. Roughly equal space has tractfully been allocated to behavioural and psychodynamically oriented approaches, with the result that neither is discussed in any depth. Apart from an excellent chapter by Wollersheim which is no less than a detailed manual on how to run weight loss groups using a behavioural/cognitive framework, and an interesting account of the stigma attached to obesity in everyday life by Allon (one of the few chapters to include recent references), the contributions are of variable quality, and views expressed which are likely to appeal to readers of this journal (e.g. Rodin, Leon and Abramson) are less expensively available in other publications. ANITA HAGAN
GRAHAM F. WAGSTAFF: Hypnosis, Compliance and Belief. Harvester
Press,
Brighton,
Sussex (1981). x + 262 pp. f22.50.
For anyone interested in the phenomena of hypnosis and their possible use in psychotherapy or behaviour therapy, this book can be recommended as being interesting, well-written, and containing some novel ideas. Wagstaff does not believe in the existence of a trance state of hypnosis, or ‘altered state of consciousness’. He suggests that it is not a unitary entity, but rather a collection of phenomena. That is possible, and it might agree with my own view that essentially hypnotic phenomena are produced by Pavlovian conditioning using words as conditioned stimuli. Wagstaff does not deal with that hypothesis, only referring to conditioning in relation to hypnotherapy (‘covert conditioning’), but there would be no essential reason for him to deny the possibility that Pavlovian conditioning might be responsible for most if not all of the phenomena discovered. His own tendency is to seek explanations more in line with social psychology, but these ‘explanations’ may beg more questions than they solve. Nevertheless the book is well worth reading, and contains many interesting comments and discussions of the experimental literature. H. J. EYSENCK
J. C. B~ULOUG~URIS (Ed.): Learning Theory Approaches to Psychiatry. Wiley,
Chichester
(1982). xxii + 262 pp. f24.00.
This is a collection of selected articles presented at an International Symposium held in Crete in 1980. Its purpose was to examine theoretical issues regarding the relevance of learning theory to behaviour therapies, and the effectiveness of practical applications to neurotic and behaviour disorders. The views of psychiatrists on the learning theory approach to their discipline and its relationship to treatment procedures would have been of particular interest since they are given far less publicity than those of psychologists, whose views are
468
BOOK REVIEWS
represented in a flow of publications. Although the first section of this book makes some reference to theoretical foundations, it fails to delineate the issues specific to psychiatry or. for that matter, to behaviour therapy in general. Subsequent sections (2-6) deal almost wholly with clinical material at varying levels of sophistication. The opening chapter by Eelen makes an effort to outline recent (but not very new) views on conditioning by referring to contingency analysis, blocking and taste aversion paradigms. The notion of attribution and causal influence is briefly introduced but sketched too lightly to bring out implications for conditioning theory. Marks follows with a lively chapter which mainly restates his views. Wilson reaffirms and reiterates the opinion expressed elsewhere that theoretical developments have lagged behind in the general growth of behaviour therapy. After Teasdale’s thoughtful chapter on what kind of theory might improve treatment (this, like Marks’s, should have provoked dialogue and discussion, but comments made in response to the papers are not included) the book begins to drift comfortably towards clinical research and case histories. This is regrettable, since some of the contributors are well aware of difficult contemporary issues relating to the role of conditioning theory. Barlow, for example, outlines Erwin’s (1978) doubts that behaviour therapy will never be anything more than a technology, but argument and counter-argument remain undeveloped. Subsequent sections deal with phobic. obsessive~ompulsive and sexual disorders, and managemen& of children’s disorders. Assuming a target audience of clinical psychiatrists, this book could provide useful references to forms of treatment such as Gelder’s programmed practice exposure and Herbert’s behaviour modi~cation of hyperactive children, as well as introducing recent research such as the analysis by Foa et al. of failure to habituate in depressed obsessive-compulsives. But there is little real discussion of the issues suggested by the title. Are these chapters of treatment and research examples of how psychiatrists construe the learning theory approach? Whatever the hopes of the organizers of the symposium, this is mostly a collection of papers on clinical research. IRENEMARTIN
Reference
Erwin E. (1978) Behmior Therapy: Srientrjk
Philosophical and Moral Foundations. Cambridge Univ. Press, New York.
G. T. WILSON and C. M. FRANKS(Eds): Contemporary Behmior Therap_bs-Conceptual and Empirica! Foundations.
Guilford
Press, New York (3982). 597 pp. This is a book which the reviewer may perhaps welcome whole-heartedly, in spite of the fact of having himself contributed a chapter to it. Most books on behaviour therapy are either of the cookbook type, or else eschew theoretical considerations like the very devil, and concentrate on description, or history, or evaluation. This book is explicitly devoted to a serious discussion of theoretical issues, different models and methodological strategies. As such it is at the moment almost unique, and the fact that the contributors have been well-chosen, and have for the most part attempted to make a serious contribution, makes the book all the more valuable. There are five parts to the book of which the first is a historical perspective by Leonard Krasner. The second deals with the experimental foundations of behavior therapy, the third with major conceptual approaches (neo-behaviouristic, applied behaviour analysis, co~itive-~haviour therapy and social learning theory). The fourth is concerned with assessment and methodology, and the fifth with outcome and evaluation. Among the more outstanding ~ont~buto~ are D. J. Levis and P. F. Malloy, who write on conditioning; G. E. Schwartz, who writes on psychobiology; D. M. Baer, who writes on applied behaviour analysis; D. Meichenbaum who writes on cognitive-behaviour therapy; T. L. Rosenthal, who writes on social learning theory; F. A. Kanfer, who writes on behaviour assessment; A. E. Kazdin, who writes on methodological strategies in behaviour therapy research; and many more. All, of course, is not sweetness and light, As in any large volume, written by so many people, there are some absurdities. N. Cantor and J. F. Kihlstrom, writing on cognitive and social processes in personality, still take seriously Mischel’s ‘demonstration’ of a correlation of approx. 0.30 between test and non-test manifestations of a trait! Apparently they are unable to understand the absurdity of averaging one good study, giving a correlation of 0.7, and three bad ones, giving a correlation of 0 each! The average, it’s true, would be about 0.30, but this result is achieved by disregarding the fact that one study was based on a good hypothesis, properly executed and analysed, whereas the others were simply shotgun approaches without theory, exemplifying the old addage of “garbage in, garbage out”. Altogether the chapter disregards all biological and genetic factors, in a manner that one would have thought was by now distinctly passe. But apart from this one chapter, although of course the reviewer would not agree with everything that is said, one must regard the contributions as serious efforts to present their case on the basis of empirical evidence, experimental laboratory studies, or at least observational data collected in carefully controlled situations. If there is still a good deal of controversy, that of course is the nature of the beast; as the editors say in their foreword, we are still in a pre-paradi~atic phase, although it may be that this position will resolve itself in the next few years provided only that more clinical psychologists become interested in experimental work centred on the differences between theoretical approaches. To this aim this book has made a very important contribution. H. J.
EYSENCK
E. R. VALENTINE: Conceptual Issues in Psychology. Allen & Unwin, (Paper).
467
Winchester,
Mass. (1982). 128 pp. $25.00 (Cloth);
$9.95
Behaviour therapists are not normally very interested in conceptual issues, except perhaps for the conditioning vs cognitive factors controversy, but they might find this short and very well-written book not only interesting, but also useful. It deals in a sensible and matter of fact fashion with questions of determinism, the mind-body problem, consciousness, introspection, the problem of the organism, models, theories, and explanations, the relation of physiology to psychology, humanistic psychology and idiographic approaches; all these are ever-recurring problems which psychologists have to take some stance on, even if only to declare them metaphysical and irrelevant! Valentine makes out a good case that they are not irrelevant, and that empirical evidence in many cases suggests possible answers. The writing is clear and often witty; thus Valentine points out that: “Porridge is not a very good model of the brain. How much better is a computer?” Looking at some of the outpourings of existentialists and hermeneutic psychologists I wonder if porridge is not a good model of the brain! Sometimes one wonders about the pronouncements made by Valentine, for instance when she says that “Brains.. are never subject to random error”. I would have thought the opposite. It is certainly incautious to assert a universal negative. But such rather minor matters aside, this is a well-conceived, well-written book that, in spite of its short compass, covers a wide range of questions of concern to psychologists, and which is well worth reading. H. J. EYSENCK
B. B. WOLMAN (Ed.): Psychological Aspects of Obesity: A Handbook. Van Nostrand pp. f20.05.
Reinhold,
New York (1982). xii + 318
Despite the large and growing body of literature in the area of obesity and overeating, there is as yet no up-to-date volume which comprehensively collates the accumulated data. It was therefore disappointing to find the present book to be a rather inadequate attempt at filling the gap. It consists of a collection of papers divided into two sections: the first concerned with the aetiology and symptomatology of obesity, and the second with aspects of treatment. Roughly equal space has tractfully been allocated to behavioural and psychodynamically oriented approaches, with the result that neither is discussed in any depth. Apart from an excellent chapter by Wollersheim which is no less than a detailed manual on how to run weight loss groups using a behavioural/cognitive framework, and an interesting account of the stigma attached to obesity in everyday life by Allon (one of the few chapters to include recent references), the contributions are of variable quality, and views expressed which are likely to appeal to readers of this journal (e.g. Rodin, Leon and Abramson) are less expensively available in other publications. ANITA HAGAN
GRAHAM F. WAGSTAFF: Hypnosis, Compliance and Belief. Harvester
Press,
Brighton,
Sussex (1981). x + 262 pp. f22.50.
For anyone interested in the phenomena of hypnosis and their possible use in psychotherapy or behaviour therapy, this book can be recommended as being interesting, well-written, and containing some novel ideas. Wagstaff does not believe in the existence of a trance state of hypnosis, or ‘altered state of consciousness’. He suggests that it is not a unitary entity, but rather a collection of phenomena. That is possible, and it might agree with my own view that essentially hypnotic phenomena are produced by Pavlovian conditioning using words as conditioned stimuli. Wagstaff does not deal with that hypothesis, only referring to conditioning in relation to hypnotherapy (‘covert conditioning’), but there would be no essential reason for him to deny the possibility that Pavlovian conditioning might be responsible for most if not all of the phenomena discovered. His own tendency is to seek explanations more in line with social psychology, but these ‘explanations’ may beg more questions than they solve. Nevertheless the book is well worth reading, and contains many interesting comments and discussions of the experimental literature. H. J. EYSENCK
J. C. B~ULOUG~URIS (Ed.): Learning Theory Approaches to Psychiatry. Wiley,
Chichester
(1982). xxii + 262 pp. f24.00.
This is a collection of selected articles presented at an International Symposium held in Crete in 1980. Its purpose was to examine theoretical issues regarding the relevance of learning theory to behaviour therapies, and the effectiveness of practical applications to neurotic and behaviour disorders. The views of psychiatrists on the learning theory approach to their discipline and its relationship to treatment procedures would have been of particular interest since they are given far less publicity than those of psychologists, whose views are
468
BOOK REVIEWS
represented in a flow of publications. Although the first section of this book makes some reference to theoretical foundations, it fails to delineate the issues specific to psychiatry or. for that matter, to behaviour therapy in general. Subsequent sections (2-6) deal almost wholly with clinical material at varying levels of sophistication. The opening chapter by Eelen makes an effort to outline recent (but not very new) views on conditioning by referring to contingency analysis, blocking and taste aversion paradigms. The notion of attribution and causal influence is briefly introduced but sketched too lightly to bring out implications for conditioning theory. Marks follows with a lively chapter which mainly restates his views. Wilson reaffirms and reiterates the opinion expressed elsewhere that theoretical developments have lagged behind in the general growth of behaviour therapy. After Teasdale’s thoughtful chapter on what kind of theory might improve treatment (this, like Marks’s, should have provoked dialogue and discussion, but comments made in response to the papers are not included) the book begins to drift comfortably towards clinical research and case histories. This is regrettable, since some of the contributors are well aware of difficult contemporary issues relating to the role of conditioning theory. Barlow, for example, outlines Erwin’s (1978) doubts that behaviour therapy will never be anything more than a technology, but argument and counter-argument remain undeveloped. Subsequent sections deal with phobic. obsessive~ompulsive and sexual disorders, and managemen& of children’s disorders. Assuming a target audience of clinical psychiatrists, this book could provide useful references to forms of treatment such as Gelder’s programmed practice exposure and Herbert’s behaviour modi~cation of hyperactive children, as well as introducing recent research such as the analysis by Foa et al. of failure to habituate in depressed obsessive-compulsives. But there is little real discussion of the issues suggested by the title. Are these chapters of treatment and research examples of how psychiatrists construe the learning theory approach? Whatever the hopes of the organizers of the symposium, this is mostly a collection of papers on clinical research. IRENEMARTIN
Reference
Erwin E. (1978) Behmior Therapy: Srientrjk
Philosophical and Moral Foundations. Cambridge Univ. Press, New York.
G. T. WILSON and C. M. FRANKS(Eds): Contemporary Behmior Therap_bs-Conceptual and Empirica! Foundations.
Guilford
Press, New York (3982). 597 pp. This is a book which the reviewer may perhaps welcome whole-heartedly, in spite of the fact of having himself contributed a chapter to it. Most books on behaviour therapy are either of the cookbook type, or else eschew theoretical considerations like the very devil, and concentrate on description, or history, or evaluation. This book is explicitly devoted to a serious discussion of theoretical issues, different models and methodological strategies. As such it is at the moment almost unique, and the fact that the contributors have been well-chosen, and have for the most part attempted to make a serious contribution, makes the book all the more valuable. There are five parts to the book of which the first is a historical perspective by Leonard Krasner. The second deals with the experimental foundations of behavior therapy, the third with major conceptual approaches (neo-behaviouristic, applied behaviour analysis, co~itive-~haviour therapy and social learning theory). The fourth is concerned with assessment and methodology, and the fifth with outcome and evaluation. Among the more outstanding ~ont~buto~ are D. J. Levis and P. F. Malloy, who write on conditioning; G. E. Schwartz, who writes on psychobiology; D. M. Baer, who writes on applied behaviour analysis; D. Meichenbaum who writes on cognitive-behaviour therapy; T. L. Rosenthal, who writes on social learning theory; F. A. Kanfer, who writes on behaviour assessment; A. E. Kazdin, who writes on methodological strategies in behaviour therapy research; and many more. All, of course, is not sweetness and light, As in any large volume, written by so many people, there are some absurdities. N. Cantor and J. F. Kihlstrom, writing on cognitive and social processes in personality, still take seriously Mischel’s ‘demonstration’ of a correlation of approx. 0.30 between test and non-test manifestations of a trait! Apparently they are unable to understand the absurdity of averaging one good study, giving a correlation of 0.7, and three bad ones, giving a correlation of 0 each! The average, it’s true, would be about 0.30, but this result is achieved by disregarding the fact that one study was based on a good hypothesis, properly executed and analysed, whereas the others were simply shotgun approaches without theory, exemplifying the old addage of “garbage in, garbage out”. Altogether the chapter disregards all biological and genetic factors, in a manner that one would have thought was by now distinctly passe. But apart from this one chapter, although of course the reviewer would not agree with everything that is said, one must regard the contributions as serious efforts to present their case on the basis of empirical evidence, experimental laboratory studies, or at least observational data collected in carefully controlled situations. If there is still a good deal of controversy, that of course is the nature of the beast; as the editors say in their foreword, we are still in a pre-paradi~atic phase, although it may be that this position will resolve itself in the next few years provided only that more clinical psychologists become interested in experimental work centred on the differences between theoretical approaches. To this aim this book has made a very important contribution. H. J.
EYSENCK