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Progress in behaviour therapy
114
Book reviews
The Role of Learning in Psychotherapy: A Ciba Foundation Symposium. Edited by RUTH PORTER. J. and A. Churchill, London 1968. pp. 340. 60s.
THE CHAIRMANof this symposium, Prof. N. E. Miller, presumably set the tone for this meeting of people from "diverse backgrounds" by urging, in his opening address, the acceptance of a " . . . spirit of unorthodox courage and tolerance... " It would appear, from even the most cursory inspection of the list of contributors, that the symposium organisers were not prepared to depend entirely upon the spontaneous emergence of this spirit and selected the symposiasts accordingly• Certainly the material in the book avoids contention, even at the considerable risk of failing to draw obvious conclusions at allin some instances. This sidestepping of problem areas is indeed often performed without any show of grace; Krasner's declaration that real differences may exist between psychoanalytic and behaviour therapies, for example, is speedily suffocated by irrelevant references to the onion ( " . . . the difference • . . lies mainly in the number of layers one needs to remove..."), or by somewhat enigmatic replies to questions which have not been asked at all ( " . . . only a small proportion of patients seeking psychiatric help can be investigated in full analytic detail"). However, accepting peaceful coexistence of Freudian and Pavlovian protagonists as a necessary and desirable principle (and even accepting the somewhat dated notions concerning rapprochement of these two systems), it would seem to have resulted in the unfortunate exclusion of several pre-eminent behaviour therapists as participants. Of course it need not be the case that such singular omissions are fatal; but it is clearly not a good beginning. The crucial significance of such ominous exclusions can only be assessed by an examination of the contents of the book, and here one finds that our worst fears have been groundless--although, equally our best hopes remain unrealized. In short, this is much like any other book of its kind, containing good, bad and indifferent contributions. Certain good chapters certainly make the book worth publishing, in spite of the fact that they contain nothing which is particularly novel. However, the inescapable conclusion is that the organisers of the symposium in their anxiety to avoid conflict have failed to capitalise upon a splendid opportunity to bring together proponents of various viewpoints who might well have made a substantial contribution. R. BEECH
Social Psychiatry. Edited by JOSEPH ZUBIN and FRITZ FREYAHN. Grune & Stratton, New York and London 1968. 382 pp. Price $14.50.
BY FAR the best essay in this Symposium is by Barbara Wootton. She is sharply critical and witty, sets a high standard and gives no quarter. Very few of her fellow participants can match these qualities, though several papers are well worth reading. Leighton contributes a brief and clear exposition of his theory. Murphy brings together material from his own transcultural studies in Canada, other epidemiological work, and family investigations, in order to illustrate a possible environmental component in the aetiology of schizophrenia. Elaine Cumming makes some acid, and very pertinent, comments on the "comprehensiveness" of mental health centres that do not include rehabilitation or aftercare among their functions. Dunham reviews critically the various concepts and hypotheses used by social psychiatrists. Nevertheless, the book is disappointing, overall, basically because so many authors attempt to theorise without any basis in fact, and the reader is rarely given any evidence that the "model of social psychiatry" or "models of evaluation" are likely to be useful in practice. J. K. WING
Progress in Behaviour Therapy. Procedings of a Symposium, Bristol. Edited by HUGH FREEMAN. John Wright & Sorts Ltd., 1968.
ThE PUBLICATIONof symposia continues, with uneven results. This short book contains papers presented at the University of Salford in late 1967; quite accurately the editor describes these studies as essentially practical. Evidently the polemicists have finally withdrawn, leaving the field to those who, in Gelder's words, want to find out what works, and the answer of this book appears to be that so far not very much works, but so long as men are willing to devise new treatment techniques without confining themselves to mechanical doctrines, the future is not hopeless. For example Worsky reports
Book reviews
115
success with four obsessionals using pragmatically devised desensitization procedures, and Kraft also reports success with four problem-drinkers after desensitizing both their social anxieties and their dependences on him. Gelder provides a balanced and sensible review of the published results of various behavioral techniques, and Silverstone gives a similarly balanced review of the results with phobics. There are also contributions on the use of aversion techniques with sexual deviations, and Seager rounds off the book with several caveats in his brief discussion. Therapists looking for techniques will find them in this book, but they may be disappointed to find a shortage of "hard" controlled data. The more things change, the more they remain the same. PETER BRAWLEY
Medical Ceramies. A Catalogue of the English and Dutch Collections in the Museum of the Wellcome Institute of the History of Medicine. Wellcome Institute of the History of Medicine, London 1969. p. vii + 304. Price 126 s.
A . K. CRELLIN :
M u c h of our knowledge of man's social, cultural and indeed even personal history, is built on the study of artefacts which have survived. So it is in some respect with medical history. The way our forebears dealt with illness, their concepts of disease and its treatment are illustrated superbly by the appurtenances of the apothecaries shops, the centres for so long, in the days when hospitals hardly existed, of medical practice. The drug jars, pill tiles, bed pans, urinals, posset pots, infant feeding bottles, bleeding bowls, invalid feeding cups--their shapes, their decorative motifs, may reveal to the knowledgeable a great deal of information not obtainable elsewhere. This book deals with all these objects in the Ceramic Collection of the Wellcome Museum of Dutch or English provenance dated from 1600--1900. Profusely and beautifully illustrated as well as carefully documented, it fills a real gap in a literature which to the doctor has been extremely difficult of access. As it becomes more and more difficult for the individual to build up his own collection, the museum collections become even more important, and their descriptions an imperative need. This book will prove one of the Wellcome Institute's most valuable publications. DENIS LEIGH
Book reviews
The Role of Learning in Psychotherapy: A Ciba Foundation Symposium. Edited by RUTH PORTER. J. and A. Churchill, London 1968. pp. 340. 60s.
THE CHAIRMANof this symposium, Prof. N. E. Miller, presumably set the tone for this meeting of people from "diverse backgrounds" by urging, in his opening address, the acceptance of a " . . . spirit of unorthodox courage and tolerance... " It would appear, from even the most cursory inspection of the list of contributors, that the symposium organisers were not prepared to depend entirely upon the spontaneous emergence of this spirit and selected the symposiasts accordingly• Certainly the material in the book avoids contention, even at the considerable risk of failing to draw obvious conclusions at allin some instances. This sidestepping of problem areas is indeed often performed without any show of grace; Krasner's declaration that real differences may exist between psychoanalytic and behaviour therapies, for example, is speedily suffocated by irrelevant references to the onion ( " . . . the difference • . . lies mainly in the number of layers one needs to remove..."), or by somewhat enigmatic replies to questions which have not been asked at all ( " . . . only a small proportion of patients seeking psychiatric help can be investigated in full analytic detail"). However, accepting peaceful coexistence of Freudian and Pavlovian protagonists as a necessary and desirable principle (and even accepting the somewhat dated notions concerning rapprochement of these two systems), it would seem to have resulted in the unfortunate exclusion of several pre-eminent behaviour therapists as participants. Of course it need not be the case that such singular omissions are fatal; but it is clearly not a good beginning. The crucial significance of such ominous exclusions can only be assessed by an examination of the contents of the book, and here one finds that our worst fears have been groundless--although, equally our best hopes remain unrealized. In short, this is much like any other book of its kind, containing good, bad and indifferent contributions. Certain good chapters certainly make the book worth publishing, in spite of the fact that they contain nothing which is particularly novel. However, the inescapable conclusion is that the organisers of the symposium in their anxiety to avoid conflict have failed to capitalise upon a splendid opportunity to bring together proponents of various viewpoints who might well have made a substantial contribution. R. BEECH
Social Psychiatry. Edited by JOSEPH ZUBIN and FRITZ FREYAHN. Grune & Stratton, New York and London 1968. 382 pp. Price $14.50.
BY FAR the best essay in this Symposium is by Barbara Wootton. She is sharply critical and witty, sets a high standard and gives no quarter. Very few of her fellow participants can match these qualities, though several papers are well worth reading. Leighton contributes a brief and clear exposition of his theory. Murphy brings together material from his own transcultural studies in Canada, other epidemiological work, and family investigations, in order to illustrate a possible environmental component in the aetiology of schizophrenia. Elaine Cumming makes some acid, and very pertinent, comments on the "comprehensiveness" of mental health centres that do not include rehabilitation or aftercare among their functions. Dunham reviews critically the various concepts and hypotheses used by social psychiatrists. Nevertheless, the book is disappointing, overall, basically because so many authors attempt to theorise without any basis in fact, and the reader is rarely given any evidence that the "model of social psychiatry" or "models of evaluation" are likely to be useful in practice. J. K. WING
Progress in Behaviour Therapy. Procedings of a Symposium, Bristol. Edited by HUGH FREEMAN. John Wright & Sorts Ltd., 1968.
ThE PUBLICATIONof symposia continues, with uneven results. This short book contains papers presented at the University of Salford in late 1967; quite accurately the editor describes these studies as essentially practical. Evidently the polemicists have finally withdrawn, leaving the field to those who, in Gelder's words, want to find out what works, and the answer of this book appears to be that so far not very much works, but so long as men are willing to devise new treatment techniques without confining themselves to mechanical doctrines, the future is not hopeless. For example Worsky reports
Book reviews
115
success with four obsessionals using pragmatically devised desensitization procedures, and Kraft also reports success with four problem-drinkers after desensitizing both their social anxieties and their dependences on him. Gelder provides a balanced and sensible review of the published results of various behavioral techniques, and Silverstone gives a similarly balanced review of the results with phobics. There are also contributions on the use of aversion techniques with sexual deviations, and Seager rounds off the book with several caveats in his brief discussion. Therapists looking for techniques will find them in this book, but they may be disappointed to find a shortage of "hard" controlled data. The more things change, the more they remain the same. PETER BRAWLEY
Medical Ceramies. A Catalogue of the English and Dutch Collections in the Museum of the Wellcome Institute of the History of Medicine. Wellcome Institute of the History of Medicine, London 1969. p. vii + 304. Price 126 s.
A . K. CRELLIN :
M u c h of our knowledge of man's social, cultural and indeed even personal history, is built on the study of artefacts which have survived. So it is in some respect with medical history. The way our forebears dealt with illness, their concepts of disease and its treatment are illustrated superbly by the appurtenances of the apothecaries shops, the centres for so long, in the days when hospitals hardly existed, of medical practice. The drug jars, pill tiles, bed pans, urinals, posset pots, infant feeding bottles, bleeding bowls, invalid feeding cups--their shapes, their decorative motifs, may reveal to the knowledgeable a great deal of information not obtainable elsewhere. This book deals with all these objects in the Ceramic Collection of the Wellcome Museum of Dutch or English provenance dated from 1600--1900. Profusely and beautifully illustrated as well as carefully documented, it fills a real gap in a literature which to the doctor has been extremely difficult of access. As it becomes more and more difficult for the individual to build up his own collection, the museum collections become even more important, and their descriptions an imperative need. This book will prove one of the Wellcome Institute's most valuable publications. DENIS LEIGH