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Neuropsychiatry
ROOK REVIEWS
194
sections also contain basrc information about btoiogica) systems whtch serve as dependent vat-tables m btofeedback and there is also a guide to the practtcal aspects of conducting biofeedback. These chapters are by no means exhaustive and a novice seriously interested in biofeedback would be advtsed to contmue his basic education by reading. for instance. A. J. Yates’ BiofeedhucL und the Modificurwn oj‘Behurio~ The third section, ‘Clinical Applications of Biofeedback’. comprtses two-thirds of the book. There are eight chapters. five of which are devoted to single disorders (Tension and .Migraine headaches. Raynaud’s Disease. Asthma and Epilepsy). with three further chapters covering Neuromuscular Re-education. Castro-intestinal Disorder and Cardiovascular Disorders. The former chapters follow a general format in which the clinical condition is described wtth the aim of elucidating the mechanism of the disorder. Illustrative case studies of treatment are provided and followed by a summary of the research evidence for the efficacy of the procedure. Finally, the chapter is rounded off wtth a brief consideration of contemporary research problems. The authors have sensibly attempted to place the common treatment procedures in the context of the assumpttons made about the disorder. While this is laudable it is clear that many biofeedback procedures are based on models of the disorder which are not substantially underpinned by research. Furthermore there is little evtdence for specific treatment effects for some conditions, notably headache. The three chapters dealing with clusters of disorders are not so comprehensive. This undoubtedly reflects the amount of research available in the area. These chapters provide more circumscribed reviews of the clinical materiai. This book is a good introduction to the clinical applications of biofeedback. There are good summary tables of the research data and a comprehensive glossary is appended. While the authors are convinced that biofeedback should become a major component in treating psychophysiological disorders (see p. vii). they are by no means evangelistic as so often seems the case in biofeedback. This book can be recommended. S. MORLEY
F. M. TOATES: Animal
Brhurimr-A
S_wems
Approach.
Wiley. Chichester
(1980). x~i + 299 pp. fl7.00.
The title of this book is somewhat misleading, concentrating, as it does. exclusrvely on nonhuman motivation rather than the gamut of behavioural capacities. Although a concern with motivation has played a central role in the development of modern psychology, research in this area has been pursued by a number of relatively independent traditions. Dr Toates concentrates on the theoretical ideas and research generated by the behaviourist and ethological approaches and attempts to provide a synthesis under the rubric of control theory. The book starts out with a simple and clear introduction to the concepts of this systems approach before applying them to the analysis of a variety of motivational systems: hunger, thirst. temperature regulation. sexual behaviour. aggression and fear. exploration and sleep. The presentation is concerned primartly with the causal mechanisms underlying behaviour rather than a functional analysis. although reference is made to recent ideas in behavioural ecology. such as optimality theory. Furthermore. the level of discourse is that of the conceptual model rather than physiological mechanisms; physiologicat evidence is brought to bear where tt can resolve issues between competing conceptual systems. Although this book represents an excellent introductton to animal motivation within its own terms of reference, it must be acknowledged that this brief is very limited. Many recent theoretical and empirical developments, which might be of relevance to those seeking animal models for the processes in psychopathology and therapy, are ignored. The role of learning and developmental processes received little attention while, for instance. Solomon’s opponent-process theory and studies of the affective and motrvational consequences of exposure to unpredictable and uncontrollable environments merit no mention. ANTHONY DICKINSON
M. R. TRIMBLE: ~europs~~~jutr~.
Wiley, Chichester
(1981). xiv + 287 pp. f 13.60.
Dr Trimble has produced an extremely clear and readable account of the overlap between neurology and psychiatry, suitable for psychiatrists and neurologtsts in training. Followmg introductory chapters to the nervous system and psychiatry, he considers the organic brain syndromes. the dementias and head injury, pain, epilepsy and movement disorders. At all stages his descrtptions and arguments are well-referenced and. within the confines of the book title and main-stream psychiatry, comprehensive. The last chapter deals with organic treatments, concentrating upon the effects of psychotropic drugs. I have two criticisms, First is Dr Trimble’s strict adherence to orthodox psychiatry for example. he treats personality primarily as a collection of abnormal states (schizoid personality. explosive personality. borderline personality and so on) instead of commg to grips with the abundant psychological literature on the structure and measurement of personality. Some of the myths of orthodox psychiatry have also been repeated. Here, it is implied that behaviour therapy, in relation to the treatment and removal of hysterical symptoms. “can lead to the emergence of florid psychopathology and occasionally suicide.” Significantly. no references are quoted to substantiate this statement.
195
BOOK REVIEWS
The second criticism is that the book could have paid more attention to therapy. This same criticism can, of course. also be levied at psychiatry and neuropsychology both of which are preoccupied with diagnosis and description. Psychological approaches to the management and treatment of many of the disorders he describes (e.g. aphasia. memory disorder. personality change. epilepsy) could have been documented with some interest to the reader. As it stands. Dr Trimble mentions them in a word or two in passing and only discusses drug treatments more fully. Overall. these two complaints, which to a great extent only reflect the diRering backgrounds of a psychiatrist and clinical psychologist. do not detract from a sound and useful book which will interest and inform the new student, GRAHAM POWELL
JACQUES VAN RILLAER: Les Illtrsions dr Iu Ps~~chana2yse.Pierre
Mardaga. Brussels (1980). 415 pp
The time is long passed when New York was regarded as the Mecca of psychoanalysts; Paris has now supplanted it and altogether psychoanalysis is riding high in the French-speaking countries. However, there have been indications recently that there is a worm in the bud. even there. and this book, written by a well-known Belgian psychoanalyst. reporting his love affair with psychoanalysis, and its sad ending, is indicative of this fact. The book is of great interest. although what it has to say on substantive issues is little more than what would be familiar to most Anglo-American readers of the literature, but would be an eye-opener to French readers. It is a personal account of the author’s experiences of brain-washing, followed by gradual disillusionment and eye-opening. which is so interesting. and his observations from the inside of the attitudes and behaviours of French and Belgian psychoanalysts. The book is well-informed. quoting not only Frenchspeaking sources. but also English. German and Dutch ones. and many of these will be unfamiliar to readers of Behau. Rex 77~. Rillaer is also interesting when he talks about the effects of psychotherapy. the recognition by him and other psychoanalysts that these are essentially non-existent. and the attempts to get out of this impasse. The author makes one additional interesting point, relating to the fact that few psychoanalysts are persuaded by outside critics. but that many are. like himself, persuaded by contacts with reality, As Pascal said: “on se persuade mreux. pour I’ordinaire. par les raisons qu‘on a soi-mime trouvees, que celles qui sont venues dans I’esprit des autres.” This is a book both interesting and important. particularly in the circle of Frenchspeaking psychologists and psychiatrists. and it is bound to have an important influence there. It can also be read with advantage by English and Amertcan readers interested in events in Europe. H. J.
EYSENCK
194
sections also contain basrc information about btoiogica) systems whtch serve as dependent vat-tables m btofeedback and there is also a guide to the practtcal aspects of conducting biofeedback. These chapters are by no means exhaustive and a novice seriously interested in biofeedback would be advtsed to contmue his basic education by reading. for instance. A. J. Yates’ BiofeedhucL und the Modificurwn oj‘Behurio~ The third section, ‘Clinical Applications of Biofeedback’. comprtses two-thirds of the book. There are eight chapters. five of which are devoted to single disorders (Tension and .Migraine headaches. Raynaud’s Disease. Asthma and Epilepsy). with three further chapters covering Neuromuscular Re-education. Castro-intestinal Disorder and Cardiovascular Disorders. The former chapters follow a general format in which the clinical condition is described wtth the aim of elucidating the mechanism of the disorder. Illustrative case studies of treatment are provided and followed by a summary of the research evidence for the efficacy of the procedure. Finally, the chapter is rounded off wtth a brief consideration of contemporary research problems. The authors have sensibly attempted to place the common treatment procedures in the context of the assumpttons made about the disorder. While this is laudable it is clear that many biofeedback procedures are based on models of the disorder which are not substantially underpinned by research. Furthermore there is little evtdence for specific treatment effects for some conditions, notably headache. The three chapters dealing with clusters of disorders are not so comprehensive. This undoubtedly reflects the amount of research available in the area. These chapters provide more circumscribed reviews of the clinical materiai. This book is a good introduction to the clinical applications of biofeedback. There are good summary tables of the research data and a comprehensive glossary is appended. While the authors are convinced that biofeedback should become a major component in treating psychophysiological disorders (see p. vii). they are by no means evangelistic as so often seems the case in biofeedback. This book can be recommended. S. MORLEY
F. M. TOATES: Animal
Brhurimr-A
S_wems
Approach.
Wiley. Chichester
(1980). x~i + 299 pp. fl7.00.
The title of this book is somewhat misleading, concentrating, as it does. exclusrvely on nonhuman motivation rather than the gamut of behavioural capacities. Although a concern with motivation has played a central role in the development of modern psychology, research in this area has been pursued by a number of relatively independent traditions. Dr Toates concentrates on the theoretical ideas and research generated by the behaviourist and ethological approaches and attempts to provide a synthesis under the rubric of control theory. The book starts out with a simple and clear introduction to the concepts of this systems approach before applying them to the analysis of a variety of motivational systems: hunger, thirst. temperature regulation. sexual behaviour. aggression and fear. exploration and sleep. The presentation is concerned primartly with the causal mechanisms underlying behaviour rather than a functional analysis. although reference is made to recent ideas in behavioural ecology. such as optimality theory. Furthermore. the level of discourse is that of the conceptual model rather than physiological mechanisms; physiologicat evidence is brought to bear where tt can resolve issues between competing conceptual systems. Although this book represents an excellent introductton to animal motivation within its own terms of reference, it must be acknowledged that this brief is very limited. Many recent theoretical and empirical developments, which might be of relevance to those seeking animal models for the processes in psychopathology and therapy, are ignored. The role of learning and developmental processes received little attention while, for instance. Solomon’s opponent-process theory and studies of the affective and motrvational consequences of exposure to unpredictable and uncontrollable environments merit no mention. ANTHONY DICKINSON
M. R. TRIMBLE: ~europs~~~jutr~.
Wiley, Chichester
(1981). xiv + 287 pp. f 13.60.
Dr Trimble has produced an extremely clear and readable account of the overlap between neurology and psychiatry, suitable for psychiatrists and neurologtsts in training. Followmg introductory chapters to the nervous system and psychiatry, he considers the organic brain syndromes. the dementias and head injury, pain, epilepsy and movement disorders. At all stages his descrtptions and arguments are well-referenced and. within the confines of the book title and main-stream psychiatry, comprehensive. The last chapter deals with organic treatments, concentrating upon the effects of psychotropic drugs. I have two criticisms, First is Dr Trimble’s strict adherence to orthodox psychiatry for example. he treats personality primarily as a collection of abnormal states (schizoid personality. explosive personality. borderline personality and so on) instead of commg to grips with the abundant psychological literature on the structure and measurement of personality. Some of the myths of orthodox psychiatry have also been repeated. Here, it is implied that behaviour therapy, in relation to the treatment and removal of hysterical symptoms. “can lead to the emergence of florid psychopathology and occasionally suicide.” Significantly. no references are quoted to substantiate this statement.
195
BOOK REVIEWS
The second criticism is that the book could have paid more attention to therapy. This same criticism can, of course. also be levied at psychiatry and neuropsychology both of which are preoccupied with diagnosis and description. Psychological approaches to the management and treatment of many of the disorders he describes (e.g. aphasia. memory disorder. personality change. epilepsy) could have been documented with some interest to the reader. As it stands. Dr Trimble mentions them in a word or two in passing and only discusses drug treatments more fully. Overall. these two complaints, which to a great extent only reflect the diRering backgrounds of a psychiatrist and clinical psychologist. do not detract from a sound and useful book which will interest and inform the new student, GRAHAM POWELL
JACQUES VAN RILLAER: Les Illtrsions dr Iu Ps~~chana2yse.Pierre
Mardaga. Brussels (1980). 415 pp
The time is long passed when New York was regarded as the Mecca of psychoanalysts; Paris has now supplanted it and altogether psychoanalysis is riding high in the French-speaking countries. However, there have been indications recently that there is a worm in the bud. even there. and this book, written by a well-known Belgian psychoanalyst. reporting his love affair with psychoanalysis, and its sad ending, is indicative of this fact. The book is of great interest. although what it has to say on substantive issues is little more than what would be familiar to most Anglo-American readers of the literature, but would be an eye-opener to French readers. It is a personal account of the author’s experiences of brain-washing, followed by gradual disillusionment and eye-opening. which is so interesting. and his observations from the inside of the attitudes and behaviours of French and Belgian psychoanalysts. The book is well-informed. quoting not only Frenchspeaking sources. but also English. German and Dutch ones. and many of these will be unfamiliar to readers of Behau. Rex 77~. Rillaer is also interesting when he talks about the effects of psychotherapy. the recognition by him and other psychoanalysts that these are essentially non-existent. and the attempts to get out of this impasse. The author makes one additional interesting point, relating to the fact that few psychoanalysts are persuaded by outside critics. but that many are. like himself, persuaded by contacts with reality, As Pascal said: “on se persuade mreux. pour I’ordinaire. par les raisons qu‘on a soi-mime trouvees, que celles qui sont venues dans I’esprit des autres.” This is a book both interesting and important. particularly in the circle of Frenchspeaking psychologists and psychiatrists. and it is bound to have an important influence there. It can also be read with advantage by English and Amertcan readers interested in events in Europe. H. J.
EYSENCK