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Psychotherapy with Psychotherapists
BOOK REVIEWS positron emitting isotope. The third section of the text provides a comprehensive review of the increasingly complex area of neuroendocrinology. Discussions of the dexamethasone suppression test and the TSH response to TRH are sophisticated, and include an overview of the regulation and physiology of the hypothalarnic-pituitary-adrenal axis and the hypothalamic-pituitary-thyroid axis. The rapidly expanding field of neuropeptide research is reflected in the discussions of arginine vasopressin, calcitonin, the endogenous opiates, somatostatin, cholecystokinin, and bombesin. The findings in this area anticipate important new directions for research into the psycho- . biology of affective disorders and human behavior. The fourth section, on clinical and neurobiologic models, contains a number of important contributions, such as the chapter on separation in nonhuman primates as a model for components of human psychopathologic states. Data and direction are provided for an integrative approach to understanding the ways in which biologic and social factors interact in detennining behavior. The discussion of hemispheric laterality and disorders of affect is an excellent review of the extensive' varied data base for a functional cerebral anatomy of emotions. The fifth section, on biochemistry of affective illness, focuses on diagnostic and therapeutic implications of alterations in neurotransmitter function, with specific reference to norepinephrine, serotonin, dopamine, acetylcholine, and 'Y-aminobutyric acid. Much of the evidence supporting a role for noradrenergic dysfunction in affective illness is carefully reviewed, S54
especially the studies of 3-methoxy-4hydroxyphenethyleneglycol and receptor characteristics. Of particular interest is the chapter on receptor adaptation in animal models. The review of evidence supporting a role for central serotonergic dysfunction in depressive patients who show a strong tendency toward suicidal behavior highlights an important area of investigation. The sixth and final section, on treatments of affective illness and underlying mechanisms, complements the previous section and addresses all of the major pharmacologic treatment modalities, as well as electroconvulsive therapy. The discussion of antidepressants and neurotransmitter receptors covers the important area of chronic effects of antidepressants. The presentation on the pharmacokinetics of tricyclics is a clear account of therapeutic and investigative issues in a complex area. The three chapters on lithium and carbamazepine in treatment of manic-depressive illness are comprehensive, as well as being creative in addressing implications for future research directions. The final chapter, on pharmacologic response and subgroups of patients with affective illness, provides an appropriate closure to the text. John L. Sullivan. M.D. George Washington University
Psychotherapy with Psychotherapists Edited by Florence W. Kaslow. New York. Hawonh Press. 1984.202 pp. $22.95.
• What happens when the therapist becomes a patient? The title and preface of this book suggest the possibility
of answers to issues such as motivation to seek therapy, complex transference and countertransference problems, inevitable comparisons that the patient makes (between the patient's own and the therapist's professional skills), confidentiality, and when treatment becomes training and vice versa. Unfortunately, this relatively short book is often more tantalizing than satisfying in providing new insights into the intricacies of psychotherapy conducted with a person who is himself/herself a practitioner of psychotherapy. The contributors to this multiauthored book are inconsistent in maintaining the book's goals. Some appear more concerned with touting the value and indications of their specialized form of psychotherapy than in focusing upon the complexities and problems induced by having a professional . therapist in psychotherapy. Two chapters that this reviewer found useful and sophisticated in their concepts are "Treatment of Marital and Family Therapists" (Kaslow) and "Psychotherapy with Women Therapists" (Coche). The book is notably lacking in its superficial treatment of the wealth of clinical experience gathered in the therapies of psychoanalytic candidates. Perhaps this deficiency exists because the contributors are largely from nonmedical disciplines. In summary, the book is uneven in quality, containing some worthwhile contributions. While it is unlikely to be of interest to most medical clinicians, it does have some value to psychotherapists who either treat or are in treatment with another psychotherapist. Charles V. Ford. M.D. Vanderbilt University
PSYCHOSOMATICS
especially the studies of 3-methoxy-4hydroxyphenethyleneglycol and receptor characteristics. Of particular interest is the chapter on receptor adaptation in animal models. The review of evidence supporting a role for central serotonergic dysfunction in depressive patients who show a strong tendency toward suicidal behavior highlights an important area of investigation. The sixth and final section, on treatments of affective illness and underlying mechanisms, complements the previous section and addresses all of the major pharmacologic treatment modalities, as well as electroconvulsive therapy. The discussion of antidepressants and neurotransmitter receptors covers the important area of chronic effects of antidepressants. The presentation on the pharmacokinetics of tricyclics is a clear account of therapeutic and investigative issues in a complex area. The three chapters on lithium and carbamazepine in treatment of manic-depressive illness are comprehensive, as well as being creative in addressing implications for future research directions. The final chapter, on pharmacologic response and subgroups of patients with affective illness, provides an appropriate closure to the text. John L. Sullivan. M.D. George Washington University
Psychotherapy with Psychotherapists Edited by Florence W. Kaslow. New York. Hawonh Press. 1984.202 pp. $22.95.
• What happens when the therapist becomes a patient? The title and preface of this book suggest the possibility
of answers to issues such as motivation to seek therapy, complex transference and countertransference problems, inevitable comparisons that the patient makes (between the patient's own and the therapist's professional skills), confidentiality, and when treatment becomes training and vice versa. Unfortunately, this relatively short book is often more tantalizing than satisfying in providing new insights into the intricacies of psychotherapy conducted with a person who is himself/herself a practitioner of psychotherapy. The contributors to this multiauthored book are inconsistent in maintaining the book's goals. Some appear more concerned with touting the value and indications of their specialized form of psychotherapy than in focusing upon the complexities and problems induced by having a professional . therapist in psychotherapy. Two chapters that this reviewer found useful and sophisticated in their concepts are "Treatment of Marital and Family Therapists" (Kaslow) and "Psychotherapy with Women Therapists" (Coche). The book is notably lacking in its superficial treatment of the wealth of clinical experience gathered in the therapies of psychoanalytic candidates. Perhaps this deficiency exists because the contributors are largely from nonmedical disciplines. In summary, the book is uneven in quality, containing some worthwhile contributions. While it is unlikely to be of interest to most medical clinicians, it does have some value to psychotherapists who either treat or are in treatment with another psychotherapist. Charles V. Ford. M.D. Vanderbilt University
PSYCHOSOMATICS