3 2 8 B o o k R e v i e w s

and overwhelming growth in the commercial mar- kets of Europe, which in turn led to the temporary ascendancy of Europe. In each chapter, Blaut describes the various arguments which have been put forward to support the idea of European origi- nality and superiority, and rightly demolishes these as rationalisations to just ify European colonialism.

So why should this book appeal? There are a num- ber of reasons, not least of which is that the clarity and accessibility of Blaut's writing make the book a fascinating read for anyone interested in testing the origins of their own assumptions about the Eurocen- tric view of the world. Even if we would like to think that we no longer believe in such a view, all the arguments in its favour will be familiar to anyone brought up in a European or colonial tradition, but the arguments against the Eurocentric viewpoint are likely to be less familiar - - - anyone who has seen the portrayal of nonEuropean cultures in media stereotypes (e.g. Africa is only newsworthy during famines) will recognize the continuation of the Euro- centric view and the importance of this book in deconstructing that view.

It also behoves environmental psychologists to step back from their own research and consider where the majority of psychological studies are carried out and with what sort of participants. It may be an old complaint to say that psychologists know a lot about middle class American and European students, and not much about any other people, but it is a valid complaint nonetheless, and it takes little extrapola- tion to think from the arguments put forward by Blaut about a Eurocentric view of the world to thinking about the Eurocentric (and by extension, Anglo-American) bias of so much of psychological research. Blaut's book is a marvellous st imulus for considering not only the world wide geographical and environmental assumptions which he addresses, but also the similar and related assumptions that underlie much of social science research.

Environment and Mental Health. By Stephen M .

Williams. Chichester: Wiley, 1994. 184 pp. £39.95. ISBN 0 471 95002 5.

Mental Health at Work. Edited by Michael Floyd, Margery Povall & Graham Watson. London :Jessica Kingsley Publishers, 1994. 154 pp. £18.95. ISBN 1 85302 177 6.

Deafness and Mental Health. By John C. Den- mark. London: Jessica Kingsley Publishers, 1994. 160 pp. £12.95. ISBN 1 85302 212 8.

Reviewed by Hugh Freeman

Stephen M. Williams is a psychologist teaching at the North Essex Institute of Health Studies. John C. Denmark is Honorary Consultant Psychia- trist at the John Denmark Unit, Salford NHS Trust. Michael Floyd is Director of the Rehabilitation Re- source Centre. Hugh Freeman was Editor of the British Journal of Psychiatry and Honorary Professor at the University of Salford; he is Honorary Visiting Fellow at Green College, Oxford.

Having produced a book called Mental Health and the Environment in 1984, I did a double-take 10 years later on seeing a (rather smaller) one called Environment and Mental Health. Naturally, the first thing then is to look for one's name in the index. 'The leading authori ty on the research litera- ture', I discovered, 'Five hundred pages that you will have to read'. This encomium cast a warm glow on the newcomer, and at first, its hear t seemed to be clearly in the right place - - 'Not a conventional "en- vironmental psychology" text, but one which deals with clinical issues, and shows how environmental influences help with understanding mental illness'. More controversially, it will criticize the medical model 'by showing how achievements and insights of environmental psychology can offer sensible al- ternative explanations for disturbed psychology'.

Dr Williams says his main thesis is that 'Psychology has neglected environment as an explanation of be- haviour' and that 'this leads to pernicious outcomes' for mental health. He does not say wha t these out- comes are, but tells the reader tha t whether or not this book will work 'depends .. on how alike we are', which may reduce its satisfied customers rather drastically. Since, as he says, 'the social in general and the environmental in particular ' have been neglected by psychology, because they are so difficult to t reat scientifically, any new approach which helped to resolve that dilemma would be im- portant. But this cobbler jus t won't stick to his last.

For instance, an environmental concern is seen here as necessarily involving an at tack on genetics - - a science which 'seems to boil down to politics'. If approached from such a standpoint, the answer is indeed likely to emerge in terms of conflict, but that will not lead to any real advance in knowledge or understanding. Similar simplistic comments a r e

tha t 'genes are not the whole story' (no geneticist ever said they were) and that 'Hereditarianism flourishes .. because it supports the s ta tus quo'. In fact, knowledge of genetics is both politically

B o o k R e v i e w s 329

neutral and an integral par t of the biological sciences: the Lysenko episode showed the absurd results of trying to devalue it on political grounds. In an echo of those academic one-party states of the 1970s, Dr Williams suggests that, 'If science serves capitalism and the war machine, it is unlikely to undermine these by showing how inequalities come from people's environments ' - - yet the most egre- gious example of science serving the war machine was the very noncapitalist Soviet Union.

Like those of all other sciences, the insights of genetics are incomplete and transitory, bu t this author is seriously out of his depth in trying to demolish the genetic contribution to knowledge of behaviour. He does not, for instance, refer to Geschwyn on handedness or Dawkins on altruism. In fact, nei ther topic has much to do with the subject of the book, but he cannot resist telling us his views on most aspects of human life.

Any examination of 'mental health' usually fo- cuses on ill-health, because that is more open to identification and measurement , but here, it is soon bogged down in conceptual muddle. Dr Williams re- jects the term 'mental illness' because it presup- poses 'organic explanation of the mental states that trouble people', preferring 'disorder, disturbance or distress'. It all depends, though, on what you mean by 'organic': at the molecular level, there can be lit- tle doubt tha t altered mental states (whatever label you choose to give them) are associated with some kind of physical changes, which are jus t beginning to be understood. This may be less t rue at the macro level, though neuro-imaging is in fact producing growing evidence of structural abnormalities in conditions such as schizophrenia, where they hadn' t been expected. But in any case, 'illness' does not have the connotation he suggests, and is an entirely different concept from 'distress' - - often used as a code-word by anti-psychiatrists.

In similar vein, the author is concerned that neu- roleptic drugs may be prescribed, 'even for someone whose disturbance is environmental in origin'. But the assumption that a disorder's t rea tment has to be of the same form as its presumed aetiology is un- tenable: a major depressive disorder may need physical t reatment , even though it has been pro- voked by adverse life events, while psychotherapy may be appropriate for an organic condition. At the same time, describing a psychiatric disorder as 'en- vironmental in origin' nearly always presupposes much more knowledge of its aetiology than we actu- ally possess. The most reasonable assumption in most cases is that the causation will be multi-factorial: being concerned about environmental influences - -

as we should be - - is no reason to devalue others. A final illustration of the unsatisfactory way that these issues are discussed is the citing of Arieti and Laing as showing that 'family maladaptat ion is always present' in schizophrenia; neither of these authors produced any evidence to support their views, though others (not mentioned) have looked more scientifically at the problems of families with a schizophrenic member.

Dr Williams rightly draws attention to the poorly understood aesthetic aspects of environmental psychology: the idea that these are related to condi- tions which favour biological survival and that we admire landscapes where we can see without being seen are both intriguing. Whether or not they are significant for mental health, though, is com- pletely unknown. Mexico City, Cairo, or J aka r t a may seem an environmental hell to most of us, but large sub-groups within their populations might see their surroundings quite differently. The same les- son could be drawn from the huge urban clearances and redevelopments in Britain up to the mid-1970s.

At the end, the 'sensible alternative explanations' we were promised have not emerged very clearly. They might have done so more if the argument had remained within conceptual boundaries and if a determined editor had highlighted phrases such as 'scepticism made a difference', which do not tell us what the difference was. As a start, this dormant person could have asked why the picture of a s t reaker at a football ground was captioned, 'Is he the victim of an imperfect society?' A 'perfect society' has unpleasant echoes. But of course, the author warned us at the beginning that success depended on 'how alike we are'.

In the absence of useful alternatives, we have to make do with the conventional wisdom, and two other books make it clear tha t this still contains a lot of mileage. The combination of mental illness or learning difficulties with deafness can be a particu- larly disabling one, and sufferers of this kind have been neglected throughout the world. In Britain, though, the doyen of specialized professionals is John Denmark, a psychiatrist fluent in sign lan- guage, who has summarized his immense experi- ence for the first t ime in Deafness & Mental Health. Multiple handicap can be immensely complex, and the unthinking insistence on 'normalization' for people of this kind may be as unfortunate as long-term in- stitutionalization. It is the need for highly specialized multi-professionalism which emerges most clearly here, and this modest handbook will be essential for anyone involved with the combined problems of severe deafness and mental abnormality.

330 Book Reviews

Mental Health at Work records the proceedings of a conference which explored 'rehabilitation issues, improvement in the workplace, training, occupa- tional health, and a range of initiatives recently un- dertaken'. The value of purposeful (and preferably paid) occupation for people with mental impair- ments of all kinds has been repeatedly proved. In the 1950s and 60s, occupational and industrial ther- apy developed more rapidly in Britain than in any other country, and many of those who passed through the units were resettled in open employ- ment. Today, that seems like a vanished golden age. In the older industrialized countries, paid employ- ment is likely to be an unat ta inable goal for anyone with an impairment, except through some sub- sidised or charitable scheme. Several innovative at tempts to provide for this need are recorded here, but it is obviously an uphill and often disheartening struggle. It is, though, only one small aspect of the immense and growing problems of unemployment in Europe and North America.

Archi tec ture a n d Soc ia l Reform in Late- Vic tor ian London. By Deborah E. B. Weiner. Manchester: Manchester University Press, 1994 256 pp. 91 b&w figures, £40.00. ISBN 0 7190 391 42.

Reviewed by T h o m a s A. Markus

Deborah Weiner received her doctorate from the School of Architecture at Princeton. The research for this book was completed over a seven year period while living and teaching in London. She is an Associate Professor in the History and Theory of Architecture at the University of British Columbia, Vancouver where she continues to teach and to write on the relationship between Architecture and the social and cultural context of its production.

Thomas A. Markus is Emeritus Professor of Build- ing Science at the University of Strathclyde. He is author of some 150papers and eight books, partly in the field of the social meaning of buildings. The latest is Buildings and Power - - Freedom and Control in the Origin of Modern Building Types (Routledge, 1993).

This book is about an archetypically British moment in history - - the last quar ter of the 19th century, when liberal charity, religion, radical academic thinking, social realist fiction, socialism, the Arts and Crafts movement, and educational innovation converged into a great legislative and

philanthropic project. Specifically it is about the manifestation of this project in London and what makes the s tudy specially i l luminating is its explo- ration of how it materialized in buildings. It seeks to uncover the meaning of the buildings which were central to the project,

The earliest phase, and the one described in such great detail tha t it occupies over half the book, was the establishment in 1870 of The School Board for London under Forster 's great Education Act en- acted earlier in that year. The fierce debates are briefly summarized: they focused on raising moral standards, stabilizing class relationships by instill- ing a proper sense of duty, and the danger to the so- cial order of an educated working class (a fear that prevented rate-aided grants becoming available to secondary schools till the turn of the century) coun- tered by, for instance, Disraeli who held that popu- lar education was 'the best guarantee for public order'. There seems, however, to be little realization of the longevity of these debates, which in fact are already articulated by Adam Smith over a century earlier, before the industrial revolution, and were elaborated throughout the early 19th century in Britain and post-Revolutionary Europe. This is an odd asymmetry - - for the author has a strong for- ward historical perspective, arguing that many of the dilemmas about the social meaning and produ c - tion of buildings faced in her late Victorian period mirror our current concerns, today, but a weaker backward one, here and elsewhere in the book.

Under its newly-appointed architect E. R. Robson, the Board set in motion an amazingly vigorous building programme, first of schools designed by architects entering competitions supervised by Robson but soon entirely executed by him. Following E. P. Thompson's metaphor of ' theatre' to describe the way 18th-century gentry presented itself, Weiner traces the way the production and use of these schools served as the site ( ' thea t re ' )o f class negotiation. They were intended to carry meanings embedded both in the newly defined social rSle of the State as well as in older perceptions of philan- thropy. Robson was himself quite clear about this - - the buildings had to teach a lesson, to be 'sermons in brick'. In 1874 his comprehensive School Archi- tecture elaborated not only this doctrine of symbolic expression, but every detail of construction, furni- ture, equipment and fittings (see Figure 1). The style chosen was Queen Anne Revival; not the elab- orate domestic version practised by Norman Shaw, as well as by J. J. Stevenson, with whom Robson had set up a private practice which he continued after being appointed architect to the Board, but a