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The group treatment of human problems: A social learning approach
99
BOOK REVIEW
Interpersonal
Approach to Psychoanalysis: Con-
View of Harry Stack Sullivan. B\ Gt~t/d Cl~zu~o~.di. Gardner Press, New temporary York.
1978
Dr. Chrzanowski has written an excellent book that considers in its first part Harry Stack Sullivan’s ideas about the theory and practice of psychiatry. Many of Sullivan’s ideas have been felt to be obscure and presented in a language that makes them less able to be understood. Dr. Chrzanowski has been extremely successful in presenting many of these ideas in a clear and concise manner. The same can be said of his presentation of Freudian theory. He compares and contrasts these two giants of psychiatry and amply demonstrates that many Sullivanian concepts have no counterparts in the Freudian systern. Often the same words are used but they have completely different meanings. One of the highlights of the book is the care taken in defining the various terms of the systems. A good example is the concept of anxiety. which from a Sullivanian point of view is seen as “an experience of tension acquired early in life and transmitted by one’s fellow human beings.” Anxiety is a disruptive force that interteres with the capacity of a person to recognize a need and do something about it. This is in contrast with the classical interpretation of anxiety as a signal that mobilizes defenses and promotes integration. It is to the author’s credit that he is honest in saying that some of Sullivan’s ideas have not stood the test of time, that some have not gone far enough. and that some aspects of the theory were overemphasized. He points out that Sullivan. in introducing the interpersonal approach. did not seek to do away with the intrapsychic. Also. for Sullivan the uniqueness of the individual was a phantom problem for psychoanalysis-that men are more alike than not. Many
of Sullivan’s
basic tenet\
are readily
accepted today but do not give him credit for them: these include the developmental scheme of cradle-to-grave life cycle and his criticism of the analyst’s neutral or “mirror” position. The second part of the book is fascinating. since the author takes up his ideas about prychoanalysis and its contributions and limitations in our present day society. Much of this revolves around the concept of the self and the therapeutic process. One issue is that .the individual is no longer the exclusive focus of psychoanalytic exploration but rather his entire network of past and present human integrations
under
the conditions
that
prevail.”
One in-
teresting corollary to this is the concept that childhood experiences cast a shadow on future events without necessarily determining the constellation of evolving human contacts. This is an appropriately optimistic stance for treatment. Dr. Chrzanowski points out how psychiatry and psychoanalysis have overextended themselves into fields where they have little expertise. This book should be read by Sullivanians and non-Sullivanians alike for two major reasons: one, because it is a well-articulated summary of Sullivan‘s theory and the application of this theory to current clinical practice; two. it grapples with some of the most crucial, complex and core issues facing modern American psychiatry.
The Group Treatment of Human Problems: A Social Learning Approach. G/oritr G. F/~/W;\ frtlj. New York. Grune KL Stratton. 1977 This book
is a compendium
of I8 articles
concerning various clinical applications of behaviorally oriented group therapy. Behavioral approaches to psychotherapeutic change have become increasingly popular during the last decades. This book differs in the fact that it does not reduce the therapist-client interaction to dyadic contingencies of reinforcement. Small group research has been utilized throughout the book and social learning theory is an integral part in the approach of most of the contributing authors. who view individuals as neither- only driven by inner forces nor exclusively manipulated by environmental forces. The person is understood as a continuous reciprocal interaction between behavior and its controlling conditions. Throughout the book, the clinical applications are presented with the available relevant research. Also, lack of research is honestly dealt with. The treatment of self-defeating behaviors (part I) include group treatments of anxiety. phobias. eating disorders. and smoking. These behaviors are known to respond to behaviorally oriented therapy. Description of appropriate and effective cognitive techniques in a group setting is the unique contribution of this book. Antisocial aggression, delinquent family members. and race or sex discrimination (part 2) similarly can be modified on a short-term basis. Group approaches to alcoholism and drug addiction (part 3) are no longer revolutionary.
100
BOOK
but certain
psychophysiologic
disorders
(part
4). such as sexual dysfunctions or dysmenorrhea. which traditionally have not been treated in groups. respond well to group treatment. Finally, in the acquisition of prosocial Aill5
(part 5). learning principles
are practiced
The author’s
excellent.
unexpectedly
REVIEW
poetic
style and considerable descriptive prowess vividly portray the hospital in extension and depth. With compassion, sensitivity. perception. and even humor. Dr. Denes reveal\ the special wol-Id inside the hospital. She explain5 the OI--
in group settings to achieve coping skills. social competency, assertive communication. and career decision skills. Man) of the authors are among the recognized expert> in their respective field\: like Meichenbaum (anxiety). Suinn (phobias). Nathan Ialcoholism). Only in part 4 (prosocial skills) injustice not done tu the topic. Theorists.
ganization and is graphically explicit with technical and surgical procedure\. The interview, with the staff. a, well as the patient\ and theil families. are in fact more often statement\ than dialogues. the interviewer.5 contributions remaining tantalizingly brief. The pel-\onnel. husy. harried. some likeable. \ome non. utensely human. are for the most part “dcdic;ltcd
\uch ;I\ Berenson and Carkhuff are ahsent and the book would have gained by their contrihulion\.
and full of douht. committed but unea\) .” The patient5 form ;i kaleidescope of women. \onie still children. some not young at all. tcrr-ilicd. remorseful. grieving. grateful. ci~llou\. ii-re\-
‘I‘hi\ houb i\ most useful to practicing mental health profesGonals who wish to increase their clinical
repertoires.
as well as to researchers Rho \eek to validate the effecti\ene\\ of pal-titular intcrvrntions. HC//,r/lt .Yri<~/r,P/r.I).
In heressity and Sorrow. Life and Death in an Abortion Hospital. Mostltr Ik/rc\. Ph.fl. Penguin Hooks 1977. Dr. Denes. psychoanalyst. pl-ofes\ol-. and mother of two, had an krbortion at age 37 and MA\ sufficiently haunted by unanswered questiun\ to return to the hospital in an attempt to learn
“v.hut
lie\
behind
the abortion
myths.”
What manner of people form\ the staff: what ot women 10s fol-!unutr: what of those who are desperate, alone. uneducated. incapable: thaw \rho have a choice. or none at all--ilu they \uffel- more or le\\‘.’
ponsible. uncaring. Those not alone are acconpanied by relative\ or men in consequence. \ome demanding. othcl-\ \ome supportive. blankly uncomprehending. The title is indicative of a retlective. engro\\ing book. in which the human dimcnxion. the catastrophic pl-oportion\. and the moral dilemma are never forgotten. although the \hecr repetition of the act. the appalling number-\ of affected women. numh the ~1ouI and erode the ahilit! to retain :I focu\ on the indicidual. Hew “no one i\ untouched. No one i\ unto1.n Whichebel- we choose. we low. And th;it. IOO. i\ p‘tr-t of being human. That too I\ the dilcmnxl of abort Ions.” Kegardle\s of each re;~clcr‘\ pc~.wxtl
opinion on a high11 contwersial
it uould wme
he difficult
moditication
\h ithout.
or 4ight
at the vel-y lea\t.
ne\\ thar ‘abortions vidual
I’hc
struggle.
enem!
\ub,icct.
to tinish thi\ hooh uith~rut
re4e
pel-tonal
i\ embedded
\hit’t in prrspecriic. ;i more acute :IHXXin the rt’xlm r)t‘ incii-
defect. PI iv,ltc hell. in being hum;~n.L I). 0 \irrii1
BOOK REVIEW
Interpersonal
Approach to Psychoanalysis: Con-
View of Harry Stack Sullivan. B\ Gt~t/d Cl~zu~o~.di. Gardner Press, New temporary York.
1978
Dr. Chrzanowski has written an excellent book that considers in its first part Harry Stack Sullivan’s ideas about the theory and practice of psychiatry. Many of Sullivan’s ideas have been felt to be obscure and presented in a language that makes them less able to be understood. Dr. Chrzanowski has been extremely successful in presenting many of these ideas in a clear and concise manner. The same can be said of his presentation of Freudian theory. He compares and contrasts these two giants of psychiatry and amply demonstrates that many Sullivanian concepts have no counterparts in the Freudian systern. Often the same words are used but they have completely different meanings. One of the highlights of the book is the care taken in defining the various terms of the systems. A good example is the concept of anxiety. which from a Sullivanian point of view is seen as “an experience of tension acquired early in life and transmitted by one’s fellow human beings.” Anxiety is a disruptive force that interteres with the capacity of a person to recognize a need and do something about it. This is in contrast with the classical interpretation of anxiety as a signal that mobilizes defenses and promotes integration. It is to the author’s credit that he is honest in saying that some of Sullivan’s ideas have not stood the test of time, that some have not gone far enough. and that some aspects of the theory were overemphasized. He points out that Sullivan. in introducing the interpersonal approach. did not seek to do away with the intrapsychic. Also. for Sullivan the uniqueness of the individual was a phantom problem for psychoanalysis-that men are more alike than not. Many
of Sullivan’s
basic tenet\
are readily
accepted today but do not give him credit for them: these include the developmental scheme of cradle-to-grave life cycle and his criticism of the analyst’s neutral or “mirror” position. The second part of the book is fascinating. since the author takes up his ideas about prychoanalysis and its contributions and limitations in our present day society. Much of this revolves around the concept of the self and the therapeutic process. One issue is that .the individual is no longer the exclusive focus of psychoanalytic exploration but rather his entire network of past and present human integrations
under
the conditions
that
prevail.”
One in-
teresting corollary to this is the concept that childhood experiences cast a shadow on future events without necessarily determining the constellation of evolving human contacts. This is an appropriately optimistic stance for treatment. Dr. Chrzanowski points out how psychiatry and psychoanalysis have overextended themselves into fields where they have little expertise. This book should be read by Sullivanians and non-Sullivanians alike for two major reasons: one, because it is a well-articulated summary of Sullivan‘s theory and the application of this theory to current clinical practice; two. it grapples with some of the most crucial, complex and core issues facing modern American psychiatry.
The Group Treatment of Human Problems: A Social Learning Approach. G/oritr G. F/~/W;\ frtlj. New York. Grune KL Stratton. 1977 This book
is a compendium
of I8 articles
concerning various clinical applications of behaviorally oriented group therapy. Behavioral approaches to psychotherapeutic change have become increasingly popular during the last decades. This book differs in the fact that it does not reduce the therapist-client interaction to dyadic contingencies of reinforcement. Small group research has been utilized throughout the book and social learning theory is an integral part in the approach of most of the contributing authors. who view individuals as neither- only driven by inner forces nor exclusively manipulated by environmental forces. The person is understood as a continuous reciprocal interaction between behavior and its controlling conditions. Throughout the book, the clinical applications are presented with the available relevant research. Also, lack of research is honestly dealt with. The treatment of self-defeating behaviors (part I) include group treatments of anxiety. phobias. eating disorders. and smoking. These behaviors are known to respond to behaviorally oriented therapy. Description of appropriate and effective cognitive techniques in a group setting is the unique contribution of this book. Antisocial aggression, delinquent family members. and race or sex discrimination (part 2) similarly can be modified on a short-term basis. Group approaches to alcoholism and drug addiction (part 3) are no longer revolutionary.
100
BOOK
but certain
psychophysiologic
disorders
(part
4). such as sexual dysfunctions or dysmenorrhea. which traditionally have not been treated in groups. respond well to group treatment. Finally, in the acquisition of prosocial Aill5
(part 5). learning principles
are practiced
The author’s
excellent.
unexpectedly
REVIEW
poetic
style and considerable descriptive prowess vividly portray the hospital in extension and depth. With compassion, sensitivity. perception. and even humor. Dr. Denes reveal\ the special wol-Id inside the hospital. She explain5 the OI--
in group settings to achieve coping skills. social competency, assertive communication. and career decision skills. Man) of the authors are among the recognized expert> in their respective field\: like Meichenbaum (anxiety). Suinn (phobias). Nathan Ialcoholism). Only in part 4 (prosocial skills) injustice not done tu the topic. Theorists.
ganization and is graphically explicit with technical and surgical procedure\. The interview, with the staff. a, well as the patient\ and theil families. are in fact more often statement\ than dialogues. the interviewer.5 contributions remaining tantalizingly brief. The pel-\onnel. husy. harried. some likeable. \ome non. utensely human. are for the most part “dcdic;ltcd
\uch ;I\ Berenson and Carkhuff are ahsent and the book would have gained by their contrihulion\.
and full of douht. committed but unea\) .” The patient5 form ;i kaleidescope of women. \onie still children. some not young at all. tcrr-ilicd. remorseful. grieving. grateful. ci~llou\. ii-re\-
‘I‘hi\ houb i\ most useful to practicing mental health profesGonals who wish to increase their clinical
repertoires.
as well as to researchers Rho \eek to validate the effecti\ene\\ of pal-titular intcrvrntions. HC//,r/lt .Yri<~/r,P/r.I).
In heressity and Sorrow. Life and Death in an Abortion Hospital. Mostltr Ik/rc\. Ph.fl. Penguin Hooks 1977. Dr. Denes. psychoanalyst. pl-ofes\ol-. and mother of two, had an krbortion at age 37 and MA\ sufficiently haunted by unanswered questiun\ to return to the hospital in an attempt to learn
“v.hut
lie\
behind
the abortion
myths.”
What manner of people form\ the staff: what ot women 10s fol-!unutr: what of those who are desperate, alone. uneducated. incapable: thaw \rho have a choice. or none at all--ilu they \uffel- more or le\\‘.’
ponsible. uncaring. Those not alone are acconpanied by relative\ or men in consequence. \ome demanding. othcl-\ \ome supportive. blankly uncomprehending. The title is indicative of a retlective. engro\\ing book. in which the human dimcnxion. the catastrophic pl-oportion\. and the moral dilemma are never forgotten. although the \hecr repetition of the act. the appalling number-\ of affected women. numh the ~1ouI and erode the ahilit! to retain :I focu\ on the indicidual. Hew “no one i\ untouched. No one i\ unto1.n Whichebel- we choose. we low. And th;it. IOO. i\ p‘tr-t of being human. That too I\ the dilcmnxl of abort Ions.” Kegardle\s of each re;~clcr‘\ pc~.wxtl
opinion on a high11 contwersial
it uould wme
he difficult
moditication
\h ithout.
or 4ight
at the vel-y lea\t.
ne\\ thar ‘abortions vidual
I’hc
struggle.
enem!
\ub,icct.
to tinish thi\ hooh uith~rut
re4e
pel-tonal
i\ embedded
\hit’t in prrspecriic. ;i more acute :IHXXin the rt’xlm r)t‘ incii-
defect. PI iv,ltc hell. in being hum;~n.L I). 0 \irrii1