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Psychosomatic medicine: Theory, physiology and practice
116
Book Reviews
This book is easy for someone with the very m i n i m u m of psychology theory to follow. It examines experimental evidence in a logical and critical manner. For anyone who has more than a passing interest in psychological treatments (and that should mean most psychiatrists) I would unhesitatingly recommend this book. DR C. VASSILAS Lecturer in Mental Health University of Bristol
Psychosomatic Medicine: Theory, Physiology and Practice. STANLEY CHEREN. Madison, Connecticut: International Universities Press Inc, 1989. pp. 977. Price $40 each (2 volumes). THIS ambitious text sets itself the stiff goal of presenting an integrated, in-depth and wide review of recent developments in psychosomatics; however, Dr Cheren immediately limits the scope of his task by restricting his contributors to three areas--psychodynamic psychiatry, psychophysiology and biobehavioural approaches--his reasons being that these disciplines share demonstrable theoretical power, explanatory force, clinical utility and scientific method. The book is in two volumes: volume one is subdivided into theoretical considerations and psychophysiology while volume two covers clinical issues with sections on psychosomatic disorders and clinical practice. Seventeen of the 21 chapters have North American authorship, the remainder emanating from Chile, West Germany, France and Finland. The comprehensive name and subject indexes are located at the end of volume two. The text is well organized and accurately referenced so that this reader found his way around from topic to topic with ease. Further, Dr Cheren's editing ensures none of the irritating repetitiousness that often mars multi-author textbooks. Another delight is the quality of the contributions which are of a uniformly high standard. So why can 1 not recommend this book wholeheartedly? There are three reasons, the first of which may be readily dismissed as a reflection of my chauvinism in that I find it unsettling to read comprehensive reviews upon topics where British contributions with which I am familiar don't rate a mention. I jotted down the names of eight leading and relevant British workers to find only one of them (Greer) included--and this in a 3000 plus names' index. More serious is the age of m u c h of the material, Most work cited is 1 2 decades old and with a few exceptions the latest reference is 1982/83. Particularly in the sections upon psychophysiology and psychosomatic conditions, the reviews are by no stretch of the imagination conceivable as contemporary. Thirdly, Dr Cheren's introduction explaining the selection and synthesis of so m a n y disparate topics in a single text which he regards as a comprehensive compilation rings a bit hollow. A major overview which contains next to nothing upon issues like pain, hyperventilation, somatization, family issues (other than genetics) and drug treatments compared with 57 pages on the medical aspects of obesity and half a dozen chapters upon psychoanalytical case work has, in my view, a lack of balance and completeness. I would not recommend this book as a basic textbook to the individual reader. Because of the quality of the contributions it is worth considering for the departmental library as a collection of essays and reviews, but you'd better be quick for I doubt its sell-by date can be that far off. GEORGE MASTERTON Department of Psychological Medicine Royal Infirmary of Edinburgh
Emotiogenic Structures of the Brain and Cardiac Activity. I. I. VAINSHTEINand P. V. SIMENOV. New Delhi: Oxonian Press Prt. Ltd., 1987. pp. 108. Price: $30 hard cover outside U.S.A. $15 hard cover inside U.S.A. WILLIAM Sargant's descriptions of the effects of stress upon behaviour in war-time clinched for me m a n y of the clinical impressions and beliefs I had formed when I learned about cardiac rehabilitation. That experience has made it impossible for me to see the heart as a prime mover in m a n y patients with function disorders and coronary heart disease: for me it became a subordinate member of a brain-heart couplet. This book provides reinforcement. It is fascinating to read how its authors, coming from a country that is strange to us, drawing upon a largely unfamiliar list of references, but sharing Sargant's devotion to I. P. Pavlov, have arrived at conclusions that are close to our own hypotheses. Their clinical and laboratory studies enable them to be comfortable with the opinion that acute emotional distress can overtax a diseased heart and put it into failure. They regard the passively defensive
Book Reviews
This book is easy for someone with the very m i n i m u m of psychology theory to follow. It examines experimental evidence in a logical and critical manner. For anyone who has more than a passing interest in psychological treatments (and that should mean most psychiatrists) I would unhesitatingly recommend this book. DR C. VASSILAS Lecturer in Mental Health University of Bristol
Psychosomatic Medicine: Theory, Physiology and Practice. STANLEY CHEREN. Madison, Connecticut: International Universities Press Inc, 1989. pp. 977. Price $40 each (2 volumes). THIS ambitious text sets itself the stiff goal of presenting an integrated, in-depth and wide review of recent developments in psychosomatics; however, Dr Cheren immediately limits the scope of his task by restricting his contributors to three areas--psychodynamic psychiatry, psychophysiology and biobehavioural approaches--his reasons being that these disciplines share demonstrable theoretical power, explanatory force, clinical utility and scientific method. The book is in two volumes: volume one is subdivided into theoretical considerations and psychophysiology while volume two covers clinical issues with sections on psychosomatic disorders and clinical practice. Seventeen of the 21 chapters have North American authorship, the remainder emanating from Chile, West Germany, France and Finland. The comprehensive name and subject indexes are located at the end of volume two. The text is well organized and accurately referenced so that this reader found his way around from topic to topic with ease. Further, Dr Cheren's editing ensures none of the irritating repetitiousness that often mars multi-author textbooks. Another delight is the quality of the contributions which are of a uniformly high standard. So why can 1 not recommend this book wholeheartedly? There are three reasons, the first of which may be readily dismissed as a reflection of my chauvinism in that I find it unsettling to read comprehensive reviews upon topics where British contributions with which I am familiar don't rate a mention. I jotted down the names of eight leading and relevant British workers to find only one of them (Greer) included--and this in a 3000 plus names' index. More serious is the age of m u c h of the material, Most work cited is 1 2 decades old and with a few exceptions the latest reference is 1982/83. Particularly in the sections upon psychophysiology and psychosomatic conditions, the reviews are by no stretch of the imagination conceivable as contemporary. Thirdly, Dr Cheren's introduction explaining the selection and synthesis of so m a n y disparate topics in a single text which he regards as a comprehensive compilation rings a bit hollow. A major overview which contains next to nothing upon issues like pain, hyperventilation, somatization, family issues (other than genetics) and drug treatments compared with 57 pages on the medical aspects of obesity and half a dozen chapters upon psychoanalytical case work has, in my view, a lack of balance and completeness. I would not recommend this book as a basic textbook to the individual reader. Because of the quality of the contributions it is worth considering for the departmental library as a collection of essays and reviews, but you'd better be quick for I doubt its sell-by date can be that far off. GEORGE MASTERTON Department of Psychological Medicine Royal Infirmary of Edinburgh
Emotiogenic Structures of the Brain and Cardiac Activity. I. I. VAINSHTEINand P. V. SIMENOV. New Delhi: Oxonian Press Prt. Ltd., 1987. pp. 108. Price: $30 hard cover outside U.S.A. $15 hard cover inside U.S.A. WILLIAM Sargant's descriptions of the effects of stress upon behaviour in war-time clinched for me m a n y of the clinical impressions and beliefs I had formed when I learned about cardiac rehabilitation. That experience has made it impossible for me to see the heart as a prime mover in m a n y patients with function disorders and coronary heart disease: for me it became a subordinate member of a brain-heart couplet. This book provides reinforcement. It is fascinating to read how its authors, coming from a country that is strange to us, drawing upon a largely unfamiliar list of references, but sharing Sargant's devotion to I. P. Pavlov, have arrived at conclusions that are close to our own hypotheses. Their clinical and laboratory studies enable them to be comfortable with the opinion that acute emotional distress can overtax a diseased heart and put it into failure. They regard the passively defensive