Book Reviews

HIDE AND SEEK. Charles H. Knickerbocker, M.D.New York: Doubleday & Co., Inc., 1967, 338pages.

"This book attempts to gather material from thesevarious sources (pure science, biology, creative arts,religion, philosophy, ethics, and theoretical psychi­atry) into a comprehensible pattern representingpresent knowledge of some facets of human person­ality, motivation and behavior."

This is a large order for anyone and must havebeen for Dr. Knickerbocker who presents his creden­tials by stating, "This book basically concerns psy­chiatry and psychology, but I am an expert inneither field." Because of the psychiatric problemsthat present themselves in his practice of internalmedicine, he adds, "It is therefore necessary for meto act like a psychiatrist from time to time, thoughI am not a psychiatrist and often do not know whatI am doing in this field."

"In psychology, I have no credentials at all. Ihave never even had an introductory course in thesubject ... and I am suspicious of formal psychologyas a science."

Dr. Knickerbocker is honest about his lack ofbackground and training for the task he undertakes.He admits to selecting some material, rejecting others,adding what he pleases and bolstering it all withhis own experience. He is certainly an ambitiousdabbler. He has no feeling of inferiority or inade­quacy. He believes Freud was a genius but that"many who follow the trails he blazed are as muddledand confused as the patients they are trying totreat." He does admit that even as some psychi­atrists forget the body, some non-psychiatric physi­cians forget the mind and the emotions.

Yet Dr. Knickerbocker proceeds through 32 chap­ters to tell you that he is always aware of body andmind. He is certainly unorthodox in his views ofpsychiatry and strikes out in all directions. He doesnot think Freud knew all the answers, but I suspectthat Dr. Knickerbocker thinks that he does. Muchof what he states is common sense. Some of whathe says is psychiatry. For the lay person, this will bean interesting book. Most people like to read aboutmedical cases. The author cites a good many. Hisdynamics are simple and often superficial. He un­doubtedly feels that the science of internal medicineis not enough to fully understand or adequately treathis patients. He is reaching for help from psychiatryand apparently getting it. He feels like a better doc­tor, must surely be one, and seems quite proud ofit; proud enough to write it all down with littlemodesty and in a very opinionated manner.

Despite these criticisms, the book is written influid, readable language at the lay level. Specialterms are well defined and described. The generalpractitioner, if he can find time to read this book,might profit from it.-JOSEPH JOEL FRIEDMAN, M.D.

July-August, 1968

THE DRIFTERS: CHILDREN OF DISORGAN­IZED LOWER-CLASS FAMILIES. E. Pacen­stedt, Ed., M.D., Boston: Little, Brown. (Interno­ticmal Psychiatry Clinics, Vol. 4, No.4.) 345 pages.1967.

North Point in Boston is a slum, skid row andcachement area for the losers of a great city. It isdrab;dirty and dilapidated. The families living withinthis ghetto are called "multiproblem" by their socialworkers. In all too many instances family organizationis non-existent, and the products are children in chaos.

The book is a description of a demonstration proj­ect with pre-school children from 1955-1959. Thechildren, families and the setting are described. Theefforts to tame and teach these disorganized, mis­trustful and frightened children require ingenuity andimprovisation. The mothers seem hopeless, the fathersare non-existent. Psychopathology is inevitable andcovers an infant like a blight.

That children such as these cannot learn until theyacquire a measure of security is evident. That thetechniques and materials suitable for middle class chil­dren are unsuitable for these impulsive, inattentiveyoungsters is also obvious. The description of howthey can be reached is interesting. Regression to acowering, punishment-avoiding, emotionally impover­ished child is still reversible. Many improve underthe skilled care of the teachers and social workers.Even this handful is not to be spared from delin­quency. So little is changed in their surroundingsthat when they leave the Project to enter puhlicschool, most of them revert back to their previousmalfunctioning.

"The Drifters" is an excellent survey of the begin­nings of delinquency. It is recommended for thosewho are involved in attempting to correct a majorerror of our times-the misbringing up of childrC'n.

SIDNEY COHEN, :-'I.D.

IDENTITY: YOUTH AND CRISIS. Erik II. Erikson.New York: W. W. Norton & Company, Inc. 336pages. 1968. $6.95.

A series of the author's contributions, most of themalready well-known, have been brought up to date,partly re-edited and structured into a book, whosetheme is the sense of identity of the human being.

Several of the chapters will be quite familiar tomost readers: Erikson's work and nomenclature onhuman development has already become a classic.Even though one will suffer from a sense of de;d vuit is helpful to have those contributions in are-editedform, "under one roof' in this book. These chapterscan also be considered as the reliable core of the

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PSYCHOSOMATICS

book framed by more recent elaborations. It is thesethat will probably evoke a variety of responses notonly in a variety of readers, but in one and the samereader, judging at least by my own experience. Thesewill range from gratitude and recognition at the au­thor's attention to today's problems-social, political,economic-to the question whether Erikson, like somany great contributors, has not overextended theconcept and the dynamic implications of identity tothe point of making it too all-inclusive. That the de­velopment of the identity is an important process,possihly the eentral proeess, of the entire develop­ment of a person, many will agree; but whether iden­tity can be used as a rather universal approach toviewing man depends somewhat on what our fundionis at the time: philosopher, historian or psyehiatristdealing with a particular patient, a great deal ofwhom we unfortunately see in "cross-section" onlyand not longitudinally. When we arc in the role ofclinician, Erikson's original thinking of the specialimportanee of the dynamies of identity in the under­standing of the adolescent, fortunately still formingthe hasis of his philosophy, will be of the most im­mediatp and pragmatic help.

In his prpsent volume, as well as in his other works,Erikson's ideas and style arc apt to appeal to a widerangl' of rcaders, from the specialist to the layman.In spit<> of the fad that it is made up of "used"components, the hook is highly recommended.

IVAN FI\AS, \I.D.

MODERN PERSPECTIVES IN CHILD PSYCHIA­TRY. John G. HoweU~, Eel., M.D., D.P.M., Spring­field, IllilWis: Charles C Thomas. 595 pages. 1965.

\Iodern I'Nspedives in Child Psychiatry is a ratherlengthy book, eonsisting of 24 ehapters by 26 con­tributors. Each ehapter {'Overs a separate topic, withtopics ranging from research methodology to delin­quency, and from ethology to psychological testing.The solt· unifying theme is some relationship to childpsychiatry. The editor, Consulting Psychiatrist toIpswich and East Suffolk Hospital, and all of the con­tributors are working in England at the present timeso that the essential outlook of the book is English.

The book is divided into two major parts. Tenchapters in part one are concerned with the scientificbasis of child psychiatry, and fourteen ehapters inpart two are devoted to its c1inieal aspects. In dis­cussing its use, it seems wisest to begin by explain­ing what the book is not. It is not a textbook ofehild psyehiatry which systematically covers techni­ques of diagnosis, diagnostic entities, modes of treat­ment, and other information which eoupled withclinical experienee could enable one to develop prac-

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tical skill in child psychiatry nor is it a completeextensive presentation of any single topic.

The book is a series of more or less isolated chap­ters on a wide range of topics each of which can standalone, and each of which might merit an independentreview. In general, the chapters are thorough, well­written and, where pertinent, make clear the bias ofthe writer. Taken individually each chapter can beused as a moderately good, up-to-date (as of 1965)review of the subject at hand. Each with its bibliog­raphy can serve as an introductory reference to thesubject.

The chapter on the Psychosomatic Approach inChild Psychiatry by Dr. Philip Pinkerton perhapsbears explicit mention. In it Dr. Pinkerton discussesat length the rationale for a holistic approach to theevaluation and treatment of childhood psychosomaticdisorders; seeks to explicate the patterns of familyrelationships seen in families of youngsters with psy­chosomatic disorders; and outlines a comprehensiveapproach to treatment.

Taken as a whole, although best digested a bit ata time, the book would seem useful as a "mind-stretch­ing" orientation to the wide variety of areas of knowl­edge which are relevant to child psychiatry. For realmental exercise, one might try to interrelate the mate­rial contained in the separate chapters, a task whichthe absence of a summary chapter leaves to the pleas­ure of the reader.

A few flaws deserve mention. First, to the Ameri­can reader some of the material, such as the organi­zation of child psychiatry services in England, is notof particular use. Second, there are occasional omis­sions and possibly misleading assertions. For example,the chapter on psychological testing makes no mentionof the Rorschach, which is widely used in testing chil­dren in the United States.

Again, many child psychiatrists who have helpedchildren quickly with family therapy or with medica­tion would question Dr. Winnicott's assertion in thechapter on Child Therapy that the common correctprocedure to help children with emotional difficultyis for the psychiatrist to work with the child alonein psychotherapy, while a social worker works withthe parents.

Yet again, Dr. O'Corman remarks in the chapter onChild Psychosis that "tranquilizers have been extreme­ly disappointing when given to childhood schizo­phrenics." Many reports by American authoritieswould indicate more optimism.

Nevertheless, the book does live up to its title­to offer modern perspectives in child psychiatry. Over­all, I would recommend it for the purposes noted.

NORMAN SHER, M.D.

Volume IX