~ Pergamon Behav. Res. Ther. Vol. 33, No. 3, pp. 357-362, 1995 Elsevier Science Ltd. Printed in Great Britain

BOOK REVIEWS

H. B. GIBSON (Ed.): Psychology, Pain and Anaesthesia. Chapman and Hall, London (1994). vii + 314 pp. £17.99.

It is refreshing to see attempts to integrate psychology, nursing and anaesthesiology in the treatment of pain. In doing so, this book promotes a common language for interdisciplinary teams at pain centers.

There is an emphasis on practical applications. This single volume may not be all it takes to gain proficiency in these applications, but at the very least it is one way of becoming conversant in the most important tools used by clinicians serving pain sufferers. The coverage is sufficiently varied, interesting, and punctuated with references, so that the reader can pursue areas of specialized interest.

The chapter by Gibson reviews some of the historical findings on placebos and unorthodox techniques of pain management. Amusing in several parts, it turns out to be far more than a look at medical curiosities, but illustrates some of the basic psychobiological mechanisms of analgesia.

A very succinct chapter by Kerry Booker focuses on cognitive-behavioural approaches to rehabilitation of the chronic pain patient. Among its particular merits is the consideration of two often neglected issues in this area: sleep disturbance and anger management. In reviewing behavioural reinforcement principles, the author also takes exceptional care in reminding practitioners of the need to discriminate between instances when pain behaviours are maladaptive vs those when they serve multiple functions.

The chapter by Hart and Alden on hypnotic techniques of pain control offers guidelines for preliminary assessment of the pain patient who may be a candidate for hypnosis. Attention is drawn to such issues as the emotional significance of pain to the patient and the patient's expectations about hypnosis. The authors then present some very concrete and compelling examples of how to apply a range of hypnotic techniques, drawing from the broad ideas of Milton Erickson to the specific hypnoanalgesic procedures of Joseph Barber.

Psychological factors are not only discussed as moderators of the pain experience (e.g. anxiety, suggestibility and personality variables). They are also examined as concomitants of anaesthesia (e.g. effects on memory, attention). Two chapters by Mewaldt, Ghoneim and Block make sense of the voluminous literature on interactions between types of anaesthesia and stages of information-processing.

In general, this is a book that is clear and concise in its description of the practical approaches to pain management. Although not heavily research-oriented, it offers a succinct appraisal of the current status of each approach on the basis of empirical findings. The reader is presented with key concepts and findings without being bogged down in terminology or a melange of data. The material in the text could have been sequenced differently so that the two chapters on back pain are not at opposing ends of the book and the two chapters on post-operative pain follow each other. But that minor point aside, this is an excellent primer for pain specialists, particularly psychologists, nurses and anaesthetists.

EPHREM FERNANDEZ

THEO B. SONDEREGGER (Ed.): Psychology and Aging. University of Nebraska Press, Lincoln (1992). xiii + 276 pp. $18.95.

This book represents no Jess than the thirty-ninth volume in the series "Current Theory and Research in Motivation." It is published as a selection of contributions to the 39th Nebraska Symposium on Motivation held at the University of Nebraska in 1991, the subject of which was Psychology and Aging. It contains some vigorously researched and well thought out theoretical papers but also some excellent material for the teaching of the psychology of older age and for clinical practice. Hulicka's contribution on the teaching of Aging on Psychology courses provides a number of useful ideas. It gives relevant data and demonstrates the effective presentation of this data. The data is limited to American samples but the guidelines on how to present it are universal and the text benefits from many practical examples of presentation. Storandt's contribution on memory skills in older people provides an application of the principles of memory rehabilitation to the everyday cognitive difficulties of older people. It is a useful summary of some of the empirical work in this area. The rest of the contributions are reviews of some important theoretical issues in aging such as the nature of wisdom in older people, the implications of the slowing of cognitive processes, and the development of personality across the lifespan.

The book suffers from the cardinal sin of all symposia--a lack of cohesion of ideas. Highly theoretical papers, those reporting on detailed, empirical research and those tackling clinical and teaching issues, do not usually rest easily next to each other. The technical quality of the contributions is generally excellent, however. Perhaps not the definitive reference on the psychological aspects of aging, but a useful addition to the literature on the subject at an accessible price.

STEPHEN DAVIES

K. O'HAGAN: Emotional and Psychological Abuse of Children. Open University Press, Buckingham (1993). vii + 167 pp. £12.99.

The author of this book, a social worker, bravely aims to tackle the diffuse and complicated nature of emotional and psychological abuse in children. It aims to enable practitioners to define, identify and intervene in this relatively unexplored yet widespread challenge to the psychological health of children.

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358 Book Reviews

This volume contains nine chapters and a helpful bibliography. Following a brief introductory chapter containing a wry description about a fictional social worker, the second chapter addresses the difficulties in conceptualising emotional and psychological abuse and then moves on, in the third chapter, to definitions of this type of abuse. Chapter four explores emotional and psychological abuse within an historical, global and cultural context--many important issues, such as bullying, are dealt with summarily which is disappointing considering the increasing literature in this area. The fifth chapter contains a variety of case histories, highlighting the importance of the age and developmental level of children in determining the nature and extent of harm caused by particular abusive behaviour. Chapter six considers, rather briefly, those parents/carers who are perpetrators of emotional and psychological abuse. Chapter seven concentrates on the assessment of this type of abuse, although its clinical usefulness is difficult to discern due to the case-study approach presented. Again, some well established areas of research in child abuse have been disregarded in this potentially important source for child care professionals. Chapter eight contains a further, detailed case description and is followed by a final chapter on implications for management and training.

This volume is easily digested and contains clear headings and neatly summarized chapters. Although largely directed at practising social workers, other mental health and paediatric practitioners should find this book stimulating and interesting to read. Its usefulness for child care professionals lies in the emphasis on current child care legislation and detailed case histories.

Initially the book comes across as chatty, albeit easy to read. However, it is well worth persisting with the rather sandwich-like style of this book, for the filling is decidedly meaty and satisfying to those who wish to come to a fuller understanding of emotional abuse. The liberal use of case histories belies the anecdotal nature of research in this field, and the lack of empirical knowledge. Hopefully this book will go some way to give both practitioners and researchers the confidence to address emotional and psychological abuse and its significance in emotional disorders of childhood.

MICHELLE NEW

MARK BLOWS (Ed.): Towards the Whole Person; Integrating Eastern and Western Approaches to Body-Mind Skills. Linking Publications, Kenthurst, NSW (1993). vi + 98 pp.

This book reports the proceedings of a workshop, bearing the same title as the name of the publication, held in the summer of 1992 in Bruges. Representatives of different religions, and professionals in psychology and other related disciplines, participated. The workshop was convened by Professor Yutaka Haruki of the Waseda University of Japan.

The papers edited and presented here cover such topics as: meditation and personal identity; therapeutic aspects of meditation; meditation training; vipassana meditation; meditation and psychotherapy; varieties of emotional experience; meditation and compassion; breathing method; and Moslem spirituality. Taken together, themes of self-awareness and self-development, and the implications of these for therapy, are covered.

How would a book like this be of relevance to readers of this journal? Behavioural psychotherapists have, in recent years, been open to other approaches and to techniques from other sources, and this has been particularly reflected in the work of psychologists like William Mikulas and Deane Shapiro. The 'new' vistas that have aroused interest continue to offer ideas, techniques and theories and several practitioners and therapists have been pursuing these with enthusiasm. Some of the contributors to this volume are, indeed, from that group of people. The ultimate product of these endeavours, however, has to be the empirical examination of techniques leading to answers to questions of efficacy and utility. There are encouraging developments along these lines, for example Jon Kabat-Zinn's evaluation of the effects of vipassana meditation for pain control and for reducing anxiety. In this reviewer's view, what is needed is more work of that kind, so that psychology is enriched further by the inclusion of ideas and techniques from sources other than the traditional Western psychological laboratory, on the basis of empirical study. Workshops as the one reported in this volume ably edited by Mark Blows should provide the intellectual stimulation that is needed for this exercise. Events such as this can, potentially, also lead to a movement away from empirical evaluation, by generating such enthusiasm, for ideas and techniques from other sources, that may make some feel that the 'proof is already there'. Spiritually and subjectively, some may indeed be convinced of this. But this hardly contributes to psychology as a science. However non-trendy this might seem, one has to insist on rigorous, systematic study and evaluation of a technique before it is accepted as part of a therapist's repertoire. Without this, the claims of enthusiasts will remain as claims only, and that will be a pity. It is therefore pleasing that many of the leading contributors to this volume take a view that accepts scientific investigation, rather than reject or circumvent it. For example, Haruki says: "Although the Eastern thought differs greatly from that of the West, hence difficult to comprehend, it must be consistent with the rational understanding of the modern people of the world. Above all, it must not be a means of escape from Western thought, but must be a discovery of the wisdom to live in the reality of the 21st century". (p.8)

P. DE SILVA

C. G. LAST (Ed.): Anxiety Across the Lifespan: A Developmental Perspective. Springer Publishing Company, New York, (1991). xi + 220 pp., $37.95.

The role and value of diagnosis in psychology and psychiatry is controversial, to say the least. For some, the art of diagnosis is an essential first step in treatment and a guide for learning and research. For others, diagnosis is an arbitrary process obscuring the complexities of reality by filing heterogeneous experiences under a common label. As Cynthia Last demonstrates in this edited book, the controversies surrounding diagnosis are even more relevant in dealing with children, since the issues involved in the diagnosis of children's anxiety disorders are many and complex.

In her introduction, Last points out that the quest for a set of straightforward diagnostic categories embracing the multiple phenomena of childhood anxiety has been far from simple. This is in part because these categories were often seen as childhood analogues for adult disorders. For example, Overanxious Disorder was seen as a children's version of Generalized Anxiety Disorder and Separation Anxiety Disorder as analogous to agoraphobia. The various chapters deal with three different but related issues: the extent to which the phenomenology of anxiety disorders in children and adolescents are similar to or