Journal of Adolescence 1990, 13, 307-3 10

Book Reviews

Development and Psychopathology: Studies in Psychoanalytic Psychiatry. Clif- ford York, Stanley Wiseberg and Thomas Freeman. New Haven and London: Yale University.

The starting point for this book is the authors’ view that the potential usefulness of psychoanalytic thinking in general psychiatry, alongside other disciplines, has not been fully exploited. They feel both are poorer for this lack of integration. Similarly, the sub-specialization into working with either children or adults means both may lose an overall developmental perspective. Their exposition is designed to overcome some of these divisions : hence the book’s succinct and apt title.

The authors are psychiatrists and Contemporary Freudian Psychoanalysts who are all members of the Anna Freud Centre. Their approach is based on the concept of “Developmental Lines” as elucidated by Anna Freud. These describe different areas of development and the manner in which they proceed. Healthy development occurs when they unfold in an orderly and integrated way while pathological development occurs as a result of a failure of this process (for either intrinsic or extrinsic reasons). Using clinical examples of neurotic and psychotic states they describe the manifestations of earlier developmental failures as they present clinically at different stages, and of the consequences of these failures.

There are 12 chapters covering 219 pages: the result is a very condensed and concentrated read which at times left me wishing for more expansive explanation. The first three chapters are particularly useful in presenting a lucid introduction to their theoretical viewpoint. Of the clinical examples, those describing disturb- ances in adolescence linked with the theoretical formulations perhaps present the strongest argument in support of the authors’views. It should be noted, however, that the authors have explicitly excluded consideration of management and treatment issues hoping that these will follow logically from the increased understanding provided by their formulations.

The book is aimed at all mental health workers who wish to consider or further develop an understanding of the applications of psychoanalytic thinking (specifi- cally Freudian) to clinical practice. The argument is well presented but it should be noted that this is not an introductory text. At times the exposition can feel abrupt to the point of appearing dogmatic. I think this arises from the authors’ familiarity with their terminology and conceptual framework-I would recom- mend having Rycroft’s “A Critical Dictionary of Psychoanalysis” close to hand in order to gain most benefit from it. This is an extremely important contribution to

308 BOOK REVIEWS

the field: I hope the authors will provide us with further, expanded texts in the future.

Dr iidr&zn Szftton (Cons&ant Child and Family Psychiatrist, University ofManchester.)

The Characteristics of Ebung People in Ibuth Treatment Centres. Spencer Millham, Roger Bullock, Kenneth Ho&e, Michael Little. University of Bristol: Dartington Social Research Unit, 1988. 59 pp. The Experiences and Careers of Young People IRaving the Ibuth Treatment Centre. Spencer Millham, Roger Bullock, Kenneth Hosie, Michael Little. University of Bristol: Dartington Social Research Unit, 1989. 125 pp. Alternative Care Careers: The Experience of very D$kult Adolescents outside the Youth Treatment Centres. Spencer Millham, Roger Bullock, Kenneth Hosie, Michael Little. University of Bristol: Dartington Social Research Unit, 1989.

32 PP,

These three publications will be of interest to all professionals working with adolescents, particularly those who present with very disturbing behaviours or serious offending and who cannot be helped in any alternative existing forms of residential provision. The DHSS were responsible for the setting up of St Charles Youth Treatment Centre in 1971 and Glenthorne Youth Treatment Centre in 1978; they are now managed by the DoH. From the outset they were envisaged as offering long-term treatment, with gradations of security. It was hoped that there would be an arrest in the deterioration of the adolescents’ anti- social behaviour, a prevention of further personality damage and an increase in the general understanding of severe disturbance in adolescents. Many of the adolescents originally referred were viewed as being“inconvenient to the system”, only prone to aggression and running away. The demand for places has increased, particularly for those older adolescents (15 plus) found guilty of serious offences and convicted under 53 legislation (CYPA, 1933).

The present study has been undertaken by the Dartington Social Research Unit which, in the past, has undertaken and published a considerable amount of research into services for deprived and delinquent adolescents, with studies of boarding schools, approved schools and secure units in the child-care system. Their work is highly regarded, and has the advantage of being published in clear, comprehensible English. This study has been in progress since March 1986 and these publications report the results of a retrospective study of all 102 leavers from the two Centres between January 1982 and December 1985. This has been complemented by a study of difficult adolescents outside Youth Treatment Centre provision. The authors recognize the difficulties of such a retrospective study and are undertaking a prospective study, which is still in progress.

Al1 these young people have been discharged for periods in excess of one year,