382 BOOKREViEWS

Dwelling on the latter, in particular the chapter by de Silva, written from a behavioural perspective, gives insight into the resemblance of centuries-old Buddhist self-management strategies and cognitive-behavioural techniques, for instance in pain control. Indeed recent research has shown that mindfulness meditation is an effective self-regulation technique in the treatment of chronic pain. Techniques like stimulus control, exposure, modelling, behavioural rehearsal as well as self-monitoring and distancing, frequently used by Beck, seem to bk‘old wine in new bottles’.

In the chaoters bv Watlev and Saeal, parallels are drawn between Rational-Emotive Therapy (RET) and Buddhist . meditation. They stress the similarities in goals and methods of disputing irrational ideas of grasp&g (or “musturbation” to use an Ellisian term). The ‘self’ is contemplated by Claxton and also by Fontana. Indeed, it was Ellis (1976) himself who once stated that besides of RET only Zen works at the abolishing of the ego. How much commonality can again be observed in the idea that, as humans live in a constant flux, an abiding self is illusory.

Fortunately, it is also made clear in the book that there exist significant differences too. Whereas in Buddhist practice one aims to become a ‘nobody’, in psychotherapy the claim is far more modest to become a ‘somebody’ through solving emotional problems. However, a spiritual outlook can offer a helicopter view to help clients out of the mud of their depression, phobia, obsession and what have you.

To conclude, this book is of interest for theorists to help creating a holistic psychology, for researchers to generate interesting hypotheses, and for behavioural-practitioners to gain depth in their therapeutic endeavours.

M. G. T. KWEE

.I. CUTTING: The Right Cerebral Hemisphere and Psychiatric Disorders. Oxford University Press, Oxford (1990). viii + 479 pp, f45.00.

This book examines the extent to which major psychiatric disorders (schizophrenia, psychotic depression and mania) can be understood as complex neuropsychologi~l syndromes even though, as in the case of schizophrenia, “no consistently detectable brain damage has yet been found in all cases” (p. 252). Cutting, therefore, is moving well-away from the organic-functional distinction between different psychiatric disorders to a view that hemisphere dysfunction and imbalance can explain the symptomatology of major psychiatric disturbance. His emphasis on right hemisphere dysfunction in schizophrenia, he recognises, is controversial.

Firstly, Cutting provides an account of hemisphere differences underlying basic cognitive functions such as language, perception, memory, emotion and attention. He emphasises in particular Kosslyn’s model of hemisphere functioning (Psychofogical Review. 1987) and returns to this model throughout the book. Also stressed in this first section is the usual state of collaboration between the two hemispheres, and the importance of individual differences such as sex and handedness in nemopsychological functioning.

Having emphasised the role of the right hemisphere in a multitude of cognitive processes, Cutting moves on to examine the role of hemisphere dysfunction in recognised neuropsychiatric disorders. In all of these, phenomenoiogy is related to impairments seen in patients with lateralised brain damage, and wherever possible consistent hemisphere differences are drawn out.

The third, most important yet most speculative, section is Cutting’s attempt to apply a neuropsychological framework to the phenomena observed in schizophrenia, mania, psychotic depression and infantile autism, in the absence of consistently detectable brain-damage in these disorders. What is most difficult in this section is that Cutting moves from the earlier concepts of hemisphere dysfunction based on clearly structural brain-damage, to a concept of imbalance which encompasses overactivity as well as underactivity of non ‘lesioned’ tissue, without clearly addressing this new concept until his final chapter. Thus his views about the precise nature of hemisphere imbalance in these disorders and why it should arise are speculations far more than conclusions. Causal mechanisms underlying the change in balance are also only speculated at.

Clearly written, well-set out with good cross-referencing, the book is a valuable source of case material, as well as neuropsychologi~l studies. One weakness, however, is the review of neuropsycholo~cal assessment techniques; another, the tendencies for end-of-chapter summaries to play down d&confirmatory studies. It should, however, continue to challenge test-designing neuropsychologists and neuropsychiatrists alike, and render Cutting’s area of pursuit less lonely.

LAURA GOLDSTEIN

H.-J. GJESSING and B. KARLSEX: A Longirud~naZ Study of Dyskxia. Springer. Berlin (1989). viii + 349 pp. DM 168

This book is subtitled Bergen’s ~~u~t~~arjafe Study of Chi~dren’s Learning Disabjij~ies and is essentially a comprehensive report on the Bergen Project. This project was a complex, developmental study of a group of I90 dyslexic children in Bergen, Norway, over a IO-year period. Multivariate analysis of several hundred variables (educational, psychological, social, visual, paediatric and neurological) was carried out over this period by an interdisciplinary team of specialists.

The book is divided into five parts. Part One provides an introduction to the purposes and design of the study as well as a discussion on methodological issues in dyslexia research. The Bergen Project used a definition of dyslexia which did not require the child with literacy skills deficits to have average or higher intellectual ability-a venerable ‘hot potato’ amongst researchers in this field. Part Two covers school learning disabilities; one of the many aims of this Project was to collect and present empirical data on the relationship between learning disabilities and socio-emotional characteristics. These data are presented in this section of the book, although methodological weakness only allows the most tentative of conclusions to be drawn. Part Three looks at the theoretical and clinical foundations of the present study, covering a review of dvslexia models and theories as well as a functional analysis of literacy behaviour. The results of this study and a discussion of dyslexia types are provided in Part Four. Results from multivariate analyses of clinical and statistical groupings as well as clinical findings from eye and neurological examinations are presented. This section is not for the faint-hearted, but despite the complex statistics and vast array of tables, interpretations in the text are clear and intended for psychologists,

BOOK REVIEWS 383

medics, educators and counsellors. Part Five summarises the Bergen Project’s contribution to research and its applied educational and clinical value. In essence, a theory of several types of dyslexia is supported by this research, and therefore it is argued that teaching techniques must be differentiated.

Although not recommended for bedtime reading, this comprehensive report is both a useful and informative summary of past research and a thou~t-provoking account of this most meticulous of research projects. Any professional concerned with children’s literacy skills should find this a rewarding read.

MICHELLE NEW

M. Gosop (Ed.): Relapse and Addictive Behaviour. Routledge, London (1989). viii + 305 pp. f29.95.

Although the word ‘relapse’ is used in the title, many of the contributors point to its limitations and inappropriateness as a concept. The problem seems to be finding a single term which would do justice to a whole gamut of complex and wide-ranging issues. There is also consensus amongst the contributors that ‘relapse’ should not be perceived as an event but a process.

The first part of the book looks at some of the most important forms of addictive behaviour and covers alcohol problems, smoking cessation, heroin and opiate addiction, eating disorders, gambling, intravenous drug use and sexual offences. Each chapter provides a detailed and up-to-date review of existing research and outhnes the author’s views; for example, Sutton discusses four major approaches to understanding smoking relapse, comparing their various strengths and weaknesses, and points to the merits of a self-efficacy model and also stresses the value of studying relapse from a decision-making standpoint.

The second part deals with conceptual issues involved in studying relapse without concerning itself with specific addictions. Shiffman points to the importance of analysing the causes of individual lapses in order to prevent their happening and thus reducing the chances of their turning into a relapse. Heather and Stallard discuss the widely used Marlatt model of relapse prevention and come to the conciusion that it underestimates the importance of substance cues as precipitants. They also draw attention to what they see as its neglect of craving as a determinant of relapse, and go on to suggest how social learning and conditioning models might be reconciled and used in the service of treatment. Eiser states that clients should be encouraged to accept that a lapse in one situation need not generalize to relapse in all situations. Berridge looks at the ways in which notions of relapse developed as part of medical and psychological approaches to addiction and its treatment. Saunders and Allsop contend that the focus should not be on just why relapsers relapse, but on trying to investigate why people in non-addictive situations do not keep their resolutions. Being a relapser is really a common process, the understanding of which will be better served by investigating non-pathological conditions, in normal rather than clinical samples, using established psychological models.

It has only been possible to comment on some of the chapters very selectively. This review has concentrated more on the second part of the book because there is more food for thought in the chapters contained in it, but the intention is not to convey that the chapters in the first part are not interesting or are not competently written. Anyone working in any field of addictions will find this book enormously stimulating, and it should tind a place on all library shelves of psychiatric hospitals and other addiction treatment facilities.

ASAD ABBAS

E. GUT: Productive and Unproductive Depression. Routledge, London (1989). xviii + 275 pp. 612.95 Paperback; f30.00 Hardback.

This book represents a view of depression from a psychoanalytical standpoint. The tenet of the model is that whenever there is a perception, largely unconscious, that a signi~~nt physical or psychological effort is failing its purpose or coming to a halt, the basic depression response will set in to alarm us that something is going wrong. Depression lifts if it is possible to carry out a formerly inhibited step towards a significant goal. In a normally functioning individual, this depression response enhances thriving, maturation and survival. Hence the process of depression is regarded as a form of communication to facilitate a productive outcome. Reaching a resolution requires strength, flexibility and courage to face the unexpected or unpleasant insight. It also depends on the person’s cultural and developmental factors. Case examples are given to illustrate the theoretical model. The author also draws heavily on the work of Bowlby, Basch, Freud and Winnicott.

I find the model interesting theoretically. However, I would like to see more scientific evidence, rather than case histories drawn largely from other people’s publications. As it is, the book presents an interesting theoretical framework for thoughts, no more.

DOMINIC LAM

D. HOWARD and S. FRANKLIN: Missing the Meaning? A Cognitive ~europsycho~og~cai Study of Processing of Words by an Aphasic Patient. MIT Press, Cambridge, Mass. (1989). xx + 171 pp. E22.50.

Missing the mean&g? follows the nineteenth century German tradition of research into aphasia, which centered around the extentive investigation of single cases and their contribution to models of lexical processing. In their book, Howard and Franklin exemplify the ‘cognitive neuropsychologi~l method’ by giving a detailed account of the deficits of a patient with evidence of five different symptom complexes: Wernicke’s aphasia, word deafness, surface dyslexia, semantic errors in repetition, and deep dysgraphia. In the first chapters, the authors review the literature on these symptom complexes and