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Obsessive-compulsive disorder—The facts
Behou. Res. The-r. Vol. 31, No. 8, pp. 797-800, Pergamon Press Ltd. Printed in Great Britain
1993
BOOK REVIEWS
P. DE SILVAand S. RACHMAN: Obsessive-Compulsive 121 pp. f13.50 Hardback; E6.99 Paperback.
Disorder-The
Facts. Oxford
University
Press,
Oxford
(1992).
This book is primarily “intended mainly for the sufferers of obsessivecompulsive disorder (OCD), and their families and friends”. It consists of 9 chapters which cover theoretical, clinical, and practical treatment issues of the disorder. The introductory chapter provides excellent phenomenological descriptions of the various facets of the disorder, illustrates gradual transitions from acceptable to unacceptable obsessivecompulsive behaviours and thus highlights a learning perspective in preference to an illness conceptualisation. Although the text sets out to be predominantly psychological, the salient differences between this perspective and a psychiatric approach are not fully explained and might give rise to confusion regarding the differing assumptions and implications of medical and psychological models. In Chap. 2 the authors explore the relationships between OCD and a number of known psychiatric disorders and clarify important differences as well as common misunderstandings. Chapters 3 and 4 provide an in-depth illustrative account of the clinical phenomenon and its potential impact on the sufferer’s lifestyle, with particular emphasis on family, social and professional issues. The use of plenty of graphic examples makes the issues easily understood in terms of patients’ life-styles. Perhaps some more attention could have been given to the impact on marital relationships, which is a commonly observed complication with obsessive-compulsive individuals. Chapters 5 and 6 are concerned with prevalence of OCD and theoretical explanations of OCD. Here, of particular interest are the brief discussions of transcultural issues and explanatory models of various schools of psychotherapy, including psychoanalysis. The remaining chapters are devoted to treatment (Chaps 7 and 9) and evaluation issues (Chap. 8). The essentials of behaviour therapy are explained and advances in cognitive methods pointed out. Established techniques of choice are outlined for the treatment of overt and covert ritualistic behaviours as well as obsessions. The section on self-help should be of particular interest to the sufferer and provides practical advice which is sound and realistic: no quick fixes or miracle solution are offered, instead the reader is taken through a range of options and well-founded advice is offered on how to proceed. This includes possibilities of self-assessment and evaluation of problem behaviours and progress during treatment. An equally useful appendix provides brief instructions for relaxation without discussing the complexities of this further. The most common drugs are also listed and there is a well selected list of recommended further reading. Finally, a number of useful addresses are listed regarding self-help materials and organisations who can provide information about treatment. In conclusion, this is a very readable comprehensive text which covers all the essentials of the disorder and relates them to a human perspective. Obviously, being a short text does not always allow for detailed information and extensive discussion of all aspects of the disorder. To test the usefulness of the text behaviourally, I gave the book to a female patient suffering from OCD and a trainee behaviour therapist. The patient (who happens to be a psychology graduate) describes it as “very informative and useful”. However, she suggests the title is somewhat of a misnomer as “few facts, especially about the cause of the disorder”, are presented. She found the text easy to read, although at times too technical, and expressed some scepticism regarding the suggestions for self-help. On the whole the book compares very favourably with other publications who either tend to make unsubstantiated claims on dramatic improvements or indulge in “voyeurism”. The student of behavioural psychotherapy is equally impressed and describes the book as a very illustrative clinical introduction which gives useful advice in dealing with patients and creates interest for further reading. My own feeling is that the “clinical” chapters are especially useful for patients, whereas some of the theoretical aspects could be rather difficult to follow and appear more suitable for students and interested lay persons who have studied the subject previously.
MICHAELBRUCH
R. VELLEMAN:Cowselling for Alcohol Problems. Sage, London
(1992). x + 159 pp. f9.95
With such an unassuming title such as this book has, it might be assumed that the content is as modest. However, readers of this book will be agreeably surprised. This book is a welcome addition to the existing books on counselling for problem drinkers. It contains, for example, clear sections on the definition of an alcohol problem, with key points in the text being highlighted at the end of the chapter. Case examples are used in the descriptive account but the author has helpfully used the same case history, and the progression of this patient through counselling thus avoiding confusion. The book also remains true to its title. It contains a detailed account of how to counsel patients, including examples of opening statements in counselling. It also encompasses relevant issues such as violence associated in counselling situations. The book does contain a chapter on relapse but it may have been helpful to the reader to know the rate of relapse in problem drinkers. My other criticism concerns the chapter entitled “Myths and Facts About Problem Drinkers”. This chapter in both style and content seems vague and unnecessary. Overall, however, readers of Behaviour Research and Therapy, involved in counselling problem drinkers, will find this book an excellent source of information.
SUJATAUNNITHAN BRT 31,8--G
797
1993
BOOK REVIEWS
P. DE SILVAand S. RACHMAN: Obsessive-Compulsive 121 pp. f13.50 Hardback; E6.99 Paperback.
Disorder-The
Facts. Oxford
University
Press,
Oxford
(1992).
This book is primarily “intended mainly for the sufferers of obsessivecompulsive disorder (OCD), and their families and friends”. It consists of 9 chapters which cover theoretical, clinical, and practical treatment issues of the disorder. The introductory chapter provides excellent phenomenological descriptions of the various facets of the disorder, illustrates gradual transitions from acceptable to unacceptable obsessivecompulsive behaviours and thus highlights a learning perspective in preference to an illness conceptualisation. Although the text sets out to be predominantly psychological, the salient differences between this perspective and a psychiatric approach are not fully explained and might give rise to confusion regarding the differing assumptions and implications of medical and psychological models. In Chap. 2 the authors explore the relationships between OCD and a number of known psychiatric disorders and clarify important differences as well as common misunderstandings. Chapters 3 and 4 provide an in-depth illustrative account of the clinical phenomenon and its potential impact on the sufferer’s lifestyle, with particular emphasis on family, social and professional issues. The use of plenty of graphic examples makes the issues easily understood in terms of patients’ life-styles. Perhaps some more attention could have been given to the impact on marital relationships, which is a commonly observed complication with obsessive-compulsive individuals. Chapters 5 and 6 are concerned with prevalence of OCD and theoretical explanations of OCD. Here, of particular interest are the brief discussions of transcultural issues and explanatory models of various schools of psychotherapy, including psychoanalysis. The remaining chapters are devoted to treatment (Chaps 7 and 9) and evaluation issues (Chap. 8). The essentials of behaviour therapy are explained and advances in cognitive methods pointed out. Established techniques of choice are outlined for the treatment of overt and covert ritualistic behaviours as well as obsessions. The section on self-help should be of particular interest to the sufferer and provides practical advice which is sound and realistic: no quick fixes or miracle solution are offered, instead the reader is taken through a range of options and well-founded advice is offered on how to proceed. This includes possibilities of self-assessment and evaluation of problem behaviours and progress during treatment. An equally useful appendix provides brief instructions for relaxation without discussing the complexities of this further. The most common drugs are also listed and there is a well selected list of recommended further reading. Finally, a number of useful addresses are listed regarding self-help materials and organisations who can provide information about treatment. In conclusion, this is a very readable comprehensive text which covers all the essentials of the disorder and relates them to a human perspective. Obviously, being a short text does not always allow for detailed information and extensive discussion of all aspects of the disorder. To test the usefulness of the text behaviourally, I gave the book to a female patient suffering from OCD and a trainee behaviour therapist. The patient (who happens to be a psychology graduate) describes it as “very informative and useful”. However, she suggests the title is somewhat of a misnomer as “few facts, especially about the cause of the disorder”, are presented. She found the text easy to read, although at times too technical, and expressed some scepticism regarding the suggestions for self-help. On the whole the book compares very favourably with other publications who either tend to make unsubstantiated claims on dramatic improvements or indulge in “voyeurism”. The student of behavioural psychotherapy is equally impressed and describes the book as a very illustrative clinical introduction which gives useful advice in dealing with patients and creates interest for further reading. My own feeling is that the “clinical” chapters are especially useful for patients, whereas some of the theoretical aspects could be rather difficult to follow and appear more suitable for students and interested lay persons who have studied the subject previously.
MICHAELBRUCH
R. VELLEMAN:Cowselling for Alcohol Problems. Sage, London
(1992). x + 159 pp. f9.95
With such an unassuming title such as this book has, it might be assumed that the content is as modest. However, readers of this book will be agreeably surprised. This book is a welcome addition to the existing books on counselling for problem drinkers. It contains, for example, clear sections on the definition of an alcohol problem, with key points in the text being highlighted at the end of the chapter. Case examples are used in the descriptive account but the author has helpfully used the same case history, and the progression of this patient through counselling thus avoiding confusion. The book also remains true to its title. It contains a detailed account of how to counsel patients, including examples of opening statements in counselling. It also encompasses relevant issues such as violence associated in counselling situations. The book does contain a chapter on relapse but it may have been helpful to the reader to know the rate of relapse in problem drinkers. My other criticism concerns the chapter entitled “Myths and Facts About Problem Drinkers”. This chapter in both style and content seems vague and unnecessary. Overall, however, readers of Behaviour Research and Therapy, involved in counselling problem drinkers, will find this book an excellent source of information.
SUJATAUNNITHAN BRT 31,8--G
797