- Email: [email protected]
The denial of stress
HOOK
233
REVIEWS
Important areas. He deals with the psychometric development of the scale, the clmlcal use of the scales, the use of the Wechsler In the assessment of Intellectual difficulties. In the assessment of cerebral pathology, m the assessment of schizophrenia. In the assessment of other psychiatric disorders. in scholastic assessment% and he also discusses the factors which influence the clinical use of subtest patterning. In most of these areas he finds that the Wechsler has not proved its value. and for cllnical psychologists these very detailed and well-referenced discussions are of ihe utmost value. There is one criticism one may make of the rather negative evaluation that Frank gives of the Wechsler subtests and arguments stemming from their interrelatlons. Looking at the factor-analytic studies whtch have been done on the Wechsler. he argues that the subtests do not measure highly unique factors. but, rather. that only two factors define what IS than eleven even relatively unique being assessed by the test. namely the verbal and the non-verbal factors. “Rather functions. the eleven subtests sample only two.” It is true of course that two major factors emerge from factor analysis, but there 1s still a large unique portion for each test, larger mostly than that accounted for by the communality. and thus adequate room for the Individual type of analysis which Frank seems to declare impossible. Of course the fact that there is a possibilltl does not mean that the actual groupings suggested by Wechsler. and particularly Rappaport, work in a meaningful way: I think Frank makes the case that they do not. Thus on the whole, this is a very salutory book which ought to be read by clinical psychologists using the Wechsler and interpreting it in a clinical context. H. .I. EYSMCK
R. R. HAZELWOOD. P. E. DIETZ and XIV + 208 pages. f22.00.
A. W. BURGESS: Autoerotic
Fatalities.
Lexington
Books,
Lexington,
Mass.
(1983).
It is relatively rare for psychology books to carry a health warning. In fact this is the only one I have come across, apart from several psychophysiological textbooks that advise readers not to electrocute their subjects unless equal numbers can be killed off In each group. As the final paragraph of the introduction we find this exhortation: “Do not attempt any of the autoerotic activities described or depicted in this monograph. These activities are inherently dangerous and carry a rusk of death. There is no reason to believe that these activities are pleasurable to the average person. and there is every reason to believe they may prove fatal.” The word ‘depIctIon‘ suggested photos. so having locked my office door (for no real reason other than feeling vaguely furtive). I flicked through the pages. Nothing-so I would have to read the book and use my imagination. On p. 1 I was stopped in my tracks. “Certain embellishments of masturbation sometimes result in death”. it said. I used my imagination: ‘Son. don’t believe them old wives’ tales about hairy palms and blindness, it kills you’. Page 86 told me what not to with a box of Band-Alds. a jar of petroleum jelly, an 11” vibrator and. for heaven’s sake a bottle of nasal spray. The book is a collection of single-case descriptions of how erotic risk-taking can sometimes lead t? accidental (occasionally deliberate) death-sex play incorporating ligatures around the neck. for instance. It is a thorough book, wellreferenced and quite well-written. but too limited in its sample size for real conclusions to be drawn. Anyone (professionally) interested in sexual deviation should read this unique volume. G. POWELL
S. BREZNITZ (Ed. ): 7%~ Dertiol01 Srress. International
Univ. Press. New York (1983). 3 16 pages.
825.00.
Denial 1s an intrtgumg concept. but one that lends itself to multiple meanings. The appearance of a book devoted to this subject is therefore to be welcomed. The present volume is a collection of contributions to an mtemational conference on the subject that was held in 1979. The lengthy delay in publishing these proceedings is regrettable but unexplained. As it turns out. however. comparative]) little of the material describes research findings. and from that point of view. the delay is not too serious. Ciiven the present state of uncertamty about the concept. readers can reasonably hope to obtain from a volume devoted specificall! to denial. some clarification of the concept and an ugto-date account of present knowledge. There is some doubt whether aims of this kind can ever be achieved at conferences in which the participants understandably tend to give accounts of their own thinking and research, rather than address the broader questions involved in a concept (such as denial) or give a comprehensive account of available knowledge. At the present stage. my own preference would be for a book of this kind. preferabl! written with a firm hand by a single author. Some of the contributions to the conference contain valuable information. but none of them satsifactorily cover the range of available knowledge. This flowertng of different opinions has its attractions of course, but the absence of sufficient common agreement on the nature of denial does detract from the contributions made by the participants. There are. of course. difficult philosophtcal problems to be dealt with by anyone usmg the concept of denial. and the problems of the reader can be illustrated by these extracts from the proceedings. On p. 168. Hamilton writes that denial is a statement that a thing 1s not true or existent and that there are different types of negating statements and different levels of negation He argues that all uses of the term ‘demal’ involve negatmg statements applied to objects. events. or persons (p. 1691. B! contrast. on p. 2X? In the editorial comment. it is stated that. “since denial is always without awareness. just as repressjon IS a necessar! facet of an! defence mechanism whatever its nature. so denial of denial is inherent in the concept Itself’ PlaInI>. these two contributors are using the term m totally different ways. The problem could be illustrated by numerous references to the \aryin_p ways m which the participants use the concept. but the point has been made. The reader IS Introduced to a varlet! of posslbilitles. but the arguments for or against any of the many meanings employed are not
argued to a conclusion. Thts produces a further probtem tn that it 1s difficult to integrate the arguments III the diffrrent chapters. deahng as the) do with very different meanin_es of dental. On the question of definitions. II is perhaps to be regretted thar the opportunity was not taken to tackle the difficult philosophical point of how It 1s possible to deny something of which one IS unaware. Scvcral of the parttcipants when faced wtth this difficulty skate around it and then retreat into old-fashIoned Freudian accounts. Hamilton makes an interesting attempt to integrate the concept of denial into hts general explanation for the impairment complex cognitive tasks by high anxiety-,-he argues that ‘anxletv IS itself information’ and that as It IS Irrelevant to the task. such information competes for processing space and time. Thrs novel iden. originally put forward some 10 years ago by Hamilton. is carried quite persuasively. but fails to take adequate account of the Yerkes--Dodson phenomenon. whfch is based on observations of a curvilinear relationship between anvlety and task performance. Broad!? speaking. very high or very low levels of anxiety can impede performance. but in other circumstances a moderate amount of anxiety can facilitate it. One or two other points that are well worth noting are Lazarus’s insistence that denial can be beneticiai as well as harmfui. Janis’s use of the concept of denial in his account of the effects of stress inocufatton. and Breznitz‘s account of the FE~~~~~~s~~~ between anticipatory stress and denial. These and some of the other chapters are welt worth consulting. but overall Emustconfess to some disappointment at the ltmtted scope of the book and the failure to place the concept on a tirm and ctear conceptual basrs. A firm. single-author account LS required.
of
R. L. WOOLFOLK
and P. LMRER
iEds):
Prirrciples
and Practice
rrfStress‘~u~~i~~~~~~t. Gulfford
Press. \Iew York
(fY83).477
pages. An unforeseen result of the growth of behavioural mechcme IS the strong revival of interest in relaxatton procedures. .Acrnss a range of conditions, relaxation is proving to be effective. acceptable and rffictrnt. Repeatedly, the method that IS introduced as a placebo control condition turns out to be as or more effective than the active method under study. Apain and again. relaxation exercises have yielded results equal or superior to the sophrsticated biofeedback and related methods that occupied our interests and raised our hopes in the 1970s. None of this will surprise rhe father of modern relaxation procedures. Edmund Jacobson, whose original claims for the wide value of relaxation were regarded with quiet skepticism by psychologists who recognized the importance of the method in reducmg fear. but believed Jacobson‘s other claims to be v3in. ‘ ‘l’hc growing evidence of the value of relaxation procedures m treatins headaches and other pain states. insomnia. hypertension and so on is extremely welcome. buf there are grounds for concern about the theorettcai basis of these changes. We are far from LinderstandIn~ the reasons for the power and range of these procedures. and the sheer breadth and nonspecifcity of their aetlon Inevitably raise the possrb~lrty that our ofd friend and ally. placebo. is back in force. The problem is well considered by Lehrer and Woolfolk in their concluding chapter. Many of the chapters in this book describe or refer to the role of relaxatian in the management of stress. but with some exceptions. the useful clinical accounts are not accompdnled by much curtosity about or understandlng of the mediating processes. Too many of the contributors write optimlstlcally about thetr own applicattons wIthout noticing or caring that comparable claims are being made by people using other methods or dealing wtth other types of problems. The broader view 1s lacking. Pate1 gives a colourful and enthusiastic account of the value of yogtc therapy and claims that it 1s effective in the treatment of cardiovascular dysfunctcuns. asthma. drug dependence. headaches. insomnia. anrlety and stress. In the following chapter. Carrington makes comparable claims for the value of meditation. Similar ciarms are made by other contributors on behalf of btofeedback, relaxation. hypnosis, autogenic training and cognitive therapy. Perhaps the cjaimants arc &I justifit*i, and perhaps they rare being misled by an umdentified, powerful common mechanism. Either way, we need to gain cfariticarton soon. Hero the balanced and measured evaluationsby the authors. and by Borkovec ton research into relaxation). plus a splendid ~mmary of pharmacological agents hy tader. are of great merit. Their chapters will ensure &at this book achtcvc> WI& and iastrng use as a reference on this rncreastngly important subject. Most of the remaining chapters consist of full descriptions of the range of proccdurcs already mentioned. and for that reason are worth having for reference on details. desprte their disappointing lack of depth At tunes. these chapters remind one of a display of merchandise. some worthwhlic and other5 shoddy. but all promoted with equal cnthuhmsm. The prize goes to this claim for the charms of yogic therapy: “It trains the mind to conccntmte on one subyxt at a time. and the person is able to find a solution to any problem hccausc the mind is Ilooded with all the relevant ~&a!, and facts”’ (p. 871. This rcv~cw ha> conccntratcd on the role of relaxation proccdurcs in stress management for the reason that most progress hab hccn ach~cvcd wtth that approach. The hook also conlillns borne useful material on other methods. including hchaviournl ~ounsclrng and cognltivc therapy. The main theme however. is the role 3f relaxation and related procedures in reducing htress. It 5, a worthy and llmely c~~ilection.
233
REVIEWS
Important areas. He deals with the psychometric development of the scale, the clmlcal use of the scales, the use of the Wechsler In the assessment of Intellectual difficulties. In the assessment of cerebral pathology, m the assessment of schizophrenia. In the assessment of other psychiatric disorders. in scholastic assessment% and he also discusses the factors which influence the clinical use of subtest patterning. In most of these areas he finds that the Wechsler has not proved its value. and for cllnical psychologists these very detailed and well-referenced discussions are of ihe utmost value. There is one criticism one may make of the rather negative evaluation that Frank gives of the Wechsler subtests and arguments stemming from their interrelatlons. Looking at the factor-analytic studies whtch have been done on the Wechsler. he argues that the subtests do not measure highly unique factors. but, rather. that only two factors define what IS than eleven even relatively unique being assessed by the test. namely the verbal and the non-verbal factors. “Rather functions. the eleven subtests sample only two.” It is true of course that two major factors emerge from factor analysis, but there 1s still a large unique portion for each test, larger mostly than that accounted for by the communality. and thus adequate room for the Individual type of analysis which Frank seems to declare impossible. Of course the fact that there is a possibilltl does not mean that the actual groupings suggested by Wechsler. and particularly Rappaport, work in a meaningful way: I think Frank makes the case that they do not. Thus on the whole, this is a very salutory book which ought to be read by clinical psychologists using the Wechsler and interpreting it in a clinical context. H. .I. EYSMCK
R. R. HAZELWOOD. P. E. DIETZ and XIV + 208 pages. f22.00.
A. W. BURGESS: Autoerotic
Fatalities.
Lexington
Books,
Lexington,
Mass.
(1983).
It is relatively rare for psychology books to carry a health warning. In fact this is the only one I have come across, apart from several psychophysiological textbooks that advise readers not to electrocute their subjects unless equal numbers can be killed off In each group. As the final paragraph of the introduction we find this exhortation: “Do not attempt any of the autoerotic activities described or depicted in this monograph. These activities are inherently dangerous and carry a rusk of death. There is no reason to believe that these activities are pleasurable to the average person. and there is every reason to believe they may prove fatal.” The word ‘depIctIon‘ suggested photos. so having locked my office door (for no real reason other than feeling vaguely furtive). I flicked through the pages. Nothing-so I would have to read the book and use my imagination. On p. 1 I was stopped in my tracks. “Certain embellishments of masturbation sometimes result in death”. it said. I used my imagination: ‘Son. don’t believe them old wives’ tales about hairy palms and blindness, it kills you’. Page 86 told me what not to with a box of Band-Alds. a jar of petroleum jelly, an 11” vibrator and. for heaven’s sake a bottle of nasal spray. The book is a collection of single-case descriptions of how erotic risk-taking can sometimes lead t? accidental (occasionally deliberate) death-sex play incorporating ligatures around the neck. for instance. It is a thorough book, wellreferenced and quite well-written. but too limited in its sample size for real conclusions to be drawn. Anyone (professionally) interested in sexual deviation should read this unique volume. G. POWELL
S. BREZNITZ (Ed. ): 7%~ Dertiol01 Srress. International
Univ. Press. New York (1983). 3 16 pages.
825.00.
Denial 1s an intrtgumg concept. but one that lends itself to multiple meanings. The appearance of a book devoted to this subject is therefore to be welcomed. The present volume is a collection of contributions to an mtemational conference on the subject that was held in 1979. The lengthy delay in publishing these proceedings is regrettable but unexplained. As it turns out. however. comparative]) little of the material describes research findings. and from that point of view. the delay is not too serious. Ciiven the present state of uncertamty about the concept. readers can reasonably hope to obtain from a volume devoted specificall! to denial. some clarification of the concept and an ugto-date account of present knowledge. There is some doubt whether aims of this kind can ever be achieved at conferences in which the participants understandably tend to give accounts of their own thinking and research, rather than address the broader questions involved in a concept (such as denial) or give a comprehensive account of available knowledge. At the present stage. my own preference would be for a book of this kind. preferabl! written with a firm hand by a single author. Some of the contributions to the conference contain valuable information. but none of them satsifactorily cover the range of available knowledge. This flowertng of different opinions has its attractions of course, but the absence of sufficient common agreement on the nature of denial does detract from the contributions made by the participants. There are. of course. difficult philosophtcal problems to be dealt with by anyone usmg the concept of denial. and the problems of the reader can be illustrated by these extracts from the proceedings. On p. 168. Hamilton writes that denial is a statement that a thing 1s not true or existent and that there are different types of negating statements and different levels of negation He argues that all uses of the term ‘demal’ involve negatmg statements applied to objects. events. or persons (p. 1691. B! contrast. on p. 2X? In the editorial comment. it is stated that. “since denial is always without awareness. just as repressjon IS a necessar! facet of an! defence mechanism whatever its nature. so denial of denial is inherent in the concept Itself’ PlaInI>. these two contributors are using the term m totally different ways. The problem could be illustrated by numerous references to the \aryin_p ways m which the participants use the concept. but the point has been made. The reader IS Introduced to a varlet! of posslbilitles. but the arguments for or against any of the many meanings employed are not
argued to a conclusion. Thts produces a further probtem tn that it 1s difficult to integrate the arguments III the diffrrent chapters. deahng as the) do with very different meanin_es of dental. On the question of definitions. II is perhaps to be regretted thar the opportunity was not taken to tackle the difficult philosophical point of how It 1s possible to deny something of which one IS unaware. Scvcral of the parttcipants when faced wtth this difficulty skate around it and then retreat into old-fashIoned Freudian accounts. Hamilton makes an interesting attempt to integrate the concept of denial into hts general explanation for the impairment complex cognitive tasks by high anxiety-,-he argues that ‘anxletv IS itself information’ and that as It IS Irrelevant to the task. such information competes for processing space and time. Thrs novel iden. originally put forward some 10 years ago by Hamilton. is carried quite persuasively. but fails to take adequate account of the Yerkes--Dodson phenomenon. whfch is based on observations of a curvilinear relationship between anvlety and task performance. Broad!? speaking. very high or very low levels of anxiety can impede performance. but in other circumstances a moderate amount of anxiety can facilitate it. One or two other points that are well worth noting are Lazarus’s insistence that denial can be beneticiai as well as harmfui. Janis’s use of the concept of denial in his account of the effects of stress inocufatton. and Breznitz‘s account of the FE~~~~~~s~~~ between anticipatory stress and denial. These and some of the other chapters are welt worth consulting. but overall Emustconfess to some disappointment at the ltmtted scope of the book and the failure to place the concept on a tirm and ctear conceptual basrs. A firm. single-author account LS required.
of
R. L. WOOLFOLK
and P. LMRER
iEds):
Prirrciples
and Practice
rrfStress‘~u~~i~~~~~~t. Gulfford
Press. \Iew York
(fY83).477
pages. An unforeseen result of the growth of behavioural mechcme IS the strong revival of interest in relaxatton procedures. .Acrnss a range of conditions, relaxation is proving to be effective. acceptable and rffictrnt. Repeatedly, the method that IS introduced as a placebo control condition turns out to be as or more effective than the active method under study. Apain and again. relaxation exercises have yielded results equal or superior to the sophrsticated biofeedback and related methods that occupied our interests and raised our hopes in the 1970s. None of this will surprise rhe father of modern relaxation procedures. Edmund Jacobson, whose original claims for the wide value of relaxation were regarded with quiet skepticism by psychologists who recognized the importance of the method in reducmg fear. but believed Jacobson‘s other claims to be v3in. ‘ ‘l’hc growing evidence of the value of relaxation procedures m treatins headaches and other pain states. insomnia. hypertension and so on is extremely welcome. buf there are grounds for concern about the theorettcai basis of these changes. We are far from LinderstandIn~ the reasons for the power and range of these procedures. and the sheer breadth and nonspecifcity of their aetlon Inevitably raise the possrb~lrty that our ofd friend and ally. placebo. is back in force. The problem is well considered by Lehrer and Woolfolk in their concluding chapter. Many of the chapters in this book describe or refer to the role of relaxatian in the management of stress. but with some exceptions. the useful clinical accounts are not accompdnled by much curtosity about or understandlng of the mediating processes. Too many of the contributors write optimlstlcally about thetr own applicattons wIthout noticing or caring that comparable claims are being made by people using other methods or dealing wtth other types of problems. The broader view 1s lacking. Pate1 gives a colourful and enthusiastic account of the value of yogtc therapy and claims that it 1s effective in the treatment of cardiovascular dysfunctcuns. asthma. drug dependence. headaches. insomnia. anrlety and stress. In the following chapter. Carrington makes comparable claims for the value of meditation. Similar ciarms are made by other contributors on behalf of btofeedback, relaxation. hypnosis, autogenic training and cognitive therapy. Perhaps the cjaimants arc &I justifit*i, and perhaps they rare being misled by an umdentified, powerful common mechanism. Either way, we need to gain cfariticarton soon. Hero the balanced and measured evaluationsby the authors. and by Borkovec ton research into relaxation). plus a splendid ~mmary of pharmacological agents hy tader. are of great merit. Their chapters will ensure &at this book achtcvc> WI& and iastrng use as a reference on this rncreastngly important subject. Most of the remaining chapters consist of full descriptions of the range of proccdurcs already mentioned. and for that reason are worth having for reference on details. desprte their disappointing lack of depth At tunes. these chapters remind one of a display of merchandise. some worthwhlic and other5 shoddy. but all promoted with equal cnthuhmsm. The prize goes to this claim for the charms of yogic therapy: “It trains the mind to conccntmte on one subyxt at a time. and the person is able to find a solution to any problem hccausc the mind is Ilooded with all the relevant ~&a!, and facts”’ (p. 871. This rcv~cw ha> conccntratcd on the role of relaxation proccdurcs in stress management for the reason that most progress hab hccn ach~cvcd wtth that approach. The hook also conlillns borne useful material on other methods. including hchaviournl ~ounsclrng and cognltivc therapy. The main theme however. is the role 3f relaxation and related procedures in reducing htress. It 5, a worthy and llmely c~~ilection.