Book reviews, April 2006

Here's a thought

Intrusive Thoughts in Clinical Disorders: Theory, Research and Treatment
David A. Clark (Ed)
New York: Guilford Press; 2005;
Hb £25.00 (ISBN 1 59385 083 2)
Reviewed by Nicola Ann Cogan

WHAT we think and how we construe the world around us profoundly influences our behaviour and emotions. This book explores how the flow of human thoughts is frequently punctuated by unwanted intrusive thoughts (UITs), images or impulses that are self-orientated and emotionally charged. Each of its nine chapters consists of a contribution from a leading expert reviewing the impact of UITs on specific disorders, including PTSD, depression, insomnia, worry, OCD and psychosis. Its contributors discuss the range of treatment approaches that might be used to ameliorate the distress caused by UITs. There is a fascinating chapter that explores how increasing both the intensity and the likely occurrence of UITs (e.g. about detection) experienced by sexual offenders participating in treatment might reinforce their desire to avoid future harm to others.

The author places importance on the role of clinicians in formulating an understanding of the causality of an individual patient's symptoms, rather than adhering to a purely medicalised approach drawing upon diagnostic criteria. This book is highly recommended for students, clinicians and academics interested in the nature and cause of UITs in clinical and non-clinical individuals, as well as the treatment options available for various psychological disorders.

- Dr Nicola Ann Cogan is a trainee clinical psychologist in the School of Health in the Social Sciences, University of Edinburgh.

Dark secrets

Shell Shock to PTSD: Military Psychiatry from 1900 to the Gulf War
Edgar Jones & Simon Wessely
Hove: Psychology Press; 2005; Hb £24.95 (ISBN 1 84169 580 7)
Hate and the 'Jewish Science':
Anti-Semitism, Nazism and Psychoanalysis
Stephen Frosh
Basingstoke: Palgrave Macmillan; 2005; Hb £25.00
(ISBN 1 4039 2170 9)
Reviewed by Diana Barker

'I am sure it would be sensible to restrict as much as possible the work of these gentlemen, who are capable of doing an immense amount of harm with what may very easily degenerate into charlatanry.' Thus wrote Winston Churchill with reference to military psychiatrists. Having now read Jones and Wessely's excellent account of their activities over the last century, I can agree wholeheartedly with our former wartime leader.

If you share my perverted form of black humour, I can only say that this book is an absolute must. For here you will discover a catalogue of disasters of the highest order as a group of complete… er… gentlemen, try first to identify what being in a war can do to the minds of perfectly sane people, and then, even more shockingly, put its treatments into action. Did you know, for instance, that before the term 'post-traumatic stress disorder' (PTSD) was invented, ailing soldiers were told they were suffering from 'nostalgia' or 'railway spine'? The father of the military screening process, Harry Stack Sullivan, thought he could weed out anyone vulnerable to battle breakdown in 15 minutes flat by having all new recruits strip naked in front of him. The Fort Ord Inventory (FOI) developed during the 1950s checked conscripts on four highly scientific scales: delinquency, neurosis, 'fake bad', and femininity!

After an exhaustive survey, Jones and Wessely can only conclude: 'None of the pre-deployment screening, forward psychiatry during combat, or debriefing after combat prevents PTSD.' The authors note that soldiers often do not trust medical personnel with their emotional problems and suggest giving NCOs sensitivity training. Wounded minds, evidently, need spiritual rather than medical healing.

The Nazis, of course, had this sewn up. According to Stephen Frosh, they did not want psychiatrists to treat the mental problems of their elite SS troops, as by doing so they might be diagnosed as having a 'permanent hereditary degeneracy'. They decided, therefore, to let the psychoanalysts have their day as these insisted that 'neurotic conflicts' were temporary phenomena. The trouble was that the major school of psychoanalysis at that time was Freudian and thus of Jewish origin; immediately the authorities turned to nice, spiritual Dr Jung, and so the German school of psychotherapy was born. Frosh charts the descent of the Jungian theories into the bowels of the Nazi propaganda machine. As he notes: 'Psychotherapy, not for the last time, becomes a form of ideological instruction.'

Jones and Wessely's book is highly interesting. Reading it is like watching a platoon of skeletons marching from the depths of a filthy ancestral cupboard. Frosh's account is even more disturbing, yet it should be required reading for all those involved in the teaching of psychology. The fourth and fifth chapters are quite simply masterpieces. I was previously unaware of these dark secrets in the history of psychology, and I question why the information contained in both books' pages is not more widely disseminated.

- Ex-psychology lecturer, Diana Barker, is currently not working as she is suffering from nostalgia and railway spine.

Seeing is adapting

Fitting the Mind to the World:
Adaptation and After-effects in High-level Vision
Colin W.G. Clifford & Gillian Rhodes (Eds)
Oxford: Oxford University Press; 2005; Hb £49.95
(ISBN 0 19 852969 4)
Reviewed by Andrew Dunn

THERE is a tendency to think of adaptation and after-effects as superficial maladaptations of the nervous system; parlour tricks for the undergraduate population. This, as Clifford and Rhodes demonstrate, is at best ill-informed and at worst a gross misrepresentation of what is proving to be a valuable research tool. Far from being a superficial parlour trick, adaptation is a continual multistage phenomenon of the nervous system; the system is constantly recalibrating itself for optimum performance, and it is only occasionally that we experience these changes in the form of after-effects. Adaptation is much more than low-level cell fatigue; it is more about trading absolute accuracy for increased differential sensitivity.

This book first presents the reader with a comprehensive account of the underlying physiology, the processes involved and the importance of adaptation as a research tool (themes that run throughout the book). Focus then turns towards understanding the neural consequences of adaptation and the impact this has for the whole visual system; the impact adaptation has on our phenomenological experience of the everyday world and normality – frankly, it is a wonder the visual world makes any sense at all. Towards the end, the book considers adaptation as a way of understanding attention and awareness, making you think about the wider application of adaptation research as a mind-probing tool. By doing so, the book feels nicely rounded and there is a sense of completion.

This book succeeds because for a narrow topic it is big in scope. It tries hard to ground the phenomenology in physical process and physiological reality. Moreover, it doesn't try to reduce everything down to a single cell activity or turn it into some kind of mysterious force. This book is not for the casual reader but it does provide a nice collection of articles that can be dipped into without having to worry too much about having to read everything else. This is serious stuff written by people who know (or know they don't know), and it is rightly unapologetic in making you think. The book is heavy-going in parts, but if you are interested in these issues, or think you might be, then this is an excellent place to start your reading.

- Andrew Dunn is a senior lecturer at Nottingham Trent University.

Meaning making

Narrative Identities: Psychologists Engaged in Self-construction
George Yancy & Susan Hadley (Eds)
London: Jessica Kingsley Publishers; 2005; Hb £49.95 (ISBN 1 84310 779 1)
Reviewed by Jo Kirk

I can imagine that convincing psychologists to put pen to paper to construct narratives of their own lives, revealing stories about significant influences in their personal and professional identities was no easy feat. Yancy and Hadley have done just this, and their edited book offers a fascinating way to gain greater insight into the theoretical ideas of key psychologists through their self-constructions. Contributors from a range of theoretical perspectives invite the reader to look through their personal and theoretical lens, and reflect on the process of their meaning making of self and identity.

As my interest in this area is in its infancy, I was unfamiliar with some of the contributors to the book. One notable exception is one of the main founders of narrative psychology, Ted Sarbin, who died recently. This loss highlights the precious personal element to the narratives within the book.

Some chapters ignited my interest more than others, reflecting personal preferences in writing styles and varied resonance with the theoretical ideas of contributors. However, this variety ensures that the book would appeal to a wide audience, with authors from feminist, social constructionist, and narrative perspectives.

My only criticism is that almost all the contributors originate from or work in North America. I'm left wondering what different stories might be written by psychologists from outside the USA. Nevertheless, I feel this book has lots to offer, facilitating reflections about self and identity and presenting many paths along which to continue the exploration into meaning making.

- Dr Jo Kirk is a clinical psychologist with South Birmingham PCT.