Psychology, pain and anaesthesia

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Behav. Res. Ther. Vol. 33, No. 3, pp. 357-362, 1995 Elsevier Science Ltd. Printed in Great Britain

Pergamon BOOK REVIEWS

H. B. GIBSON (Ed.): Psychology, Pain and Anaesthesia. Chapman and Hall, London (1994). vii + 314 pp. £17.99. It is refreshing to see attempts to integrate psychology, nursing and anaesthesiology in the treatment of pain. In doing so, this book promotes a common language for interdisciplinary teams at pain centers. There is an emphasis on practical applications. This single volume may not be all it takes to gain proficiency in these applications, but at the very least it is one way of becoming conversant in the most important tools used by clinicians serving pain sufferers. The coverage is sufficiently varied, interesting, and punctuated with references, so that the reader can pursue areas of specialized interest. The chapter by Gibson reviews some of the historical findings on placebos and unorthodox techniques of pain management. Amusing in several parts, it turns out to be far more than a look at medical curiosities, but illustrates some of the basic psychobiological mechanisms of analgesia. A very succinct chapter by Kerry Booker focuses on cognitive-behavioural approaches to rehabilitation of the chronic pain patient. Among its particular merits is the consideration of two often neglected issues in this area: sleep disturbance and anger management. In reviewing behavioural reinforcement principles, the author also takes exceptional care in reminding practitioners of the need to discriminate between instances when pain behaviours are maladaptive vs those when they serve multiple functions. The chapter by Hart and Alden on hypnotic techniques of pain control offers guidelines for preliminary assessment of the pain patient who may be a candidate for hypnosis. Attention is drawn to such issues as the emotional significance of pain to the patient and the patient's expectations about hypnosis. The authors then present some very concrete and compelling examples of how to apply a range of hypnotic techniques, drawing from the broad ideas of Milton Erickson to the specific hypnoanalgesic procedures of Joseph Barber. Psychological factors are not only discussed as moderators of the pain experience (e.g. anxiety, suggestibility and personality variables). They are also examined as concomitants of anaesthesia (e.g. effects on memory, attention). Two chapters by Mewaldt, Ghoneim and Block make sense of the voluminous literature on interactions between types of anaesthesia and stages of information-processing. In general, this is a book that is clear and concise in its description of the practical approaches to pain management. Although not heavily research-oriented, it offers a succinct appraisal of the current status of each approach on the basis of empirical findings. The reader is presented with key concepts and findings without being bogged down in terminology or a melange of data. The material in the text could have been sequenced differently so that the two chapters on back pain are not at opposing ends of the book and the two chapters on post-operative pain follow each other. But that minor point aside, this is an excellent primer for pain specialists, particularly psychologists, nurses and anaesthetists. EPHREM FERNANDEZ

THEO B. SONDEREGGER(Ed.): Psychology and Aging. University of Nebraska Press, Lincoln (1992). xiii + 276 pp. $18.95. This book represents no Jess than the thirty-ninth volume in the series "Current Theory and Research in Motivation." It is published as a selection of contributions to the 39th Nebraska Symposium on Motivation held at the University of Nebraska in 1991, the subject of which was Psychology and Aging. It contains some vigorously researched and well thought out theoretical papers but also some excellent material for the teaching of the psychology of older age and for clinical practice. Hulicka's contribution on the teaching of Aging on Psychology courses provides a number of useful ideas. It gives relevant data and demonstrates the effective presentation of this data. The data is limited to American samples but the guidelines on how to present it are universal and the text benefits from many practical examples of presentation. Storandt's contribution on memory skills in older people provides an application of the principles of memory rehabilitation to the everyday cognitive difficulties of older people. It is a useful summary of some of the empirical work in this area. The rest of the contributions are reviews of some important theoretical issues in aging such as the nature of wisdom in older people, the implications of the slowing of cognitive processes, and the development of personality across the lifespan. The book suffers from the cardinal sin of all symposia--a lack of cohesion of ideas. Highly theoretical papers, those reporting on detailed, empirical research and those tackling clinical and teaching issues, do not usually rest easily next to each other. The technical quality of the contributions is generally excellent, however. Perhaps not the definitive reference on the psychological aspects of aging, but a useful addition to the literature on the subject at an accessible price. STEPHEN DAVIES

K. O'HAGAN: Emotional and Psychological Abuse of Children. Open University Press, Buckingham (1993). vii + 167 pp. £12.99. The author of this book, a social worker, bravely aims to tackle the diffuse and complicated nature of emotional and psychological abuse in children. It aims to enable practitioners to define, identify and intervene in this relatively unexplored yet widespread challenge to the psychological health of children. 357