The Man With His Head in the Clouds; and more…

Looking down on a phobia from 3000 feet

Hilarious, enlightening and inspiring The Man with His Head in the Clouds is anything but ordinary. Smith has artfully created a category-defying juxtaposition of historical biography and autobiographical recovery story.

The author captures the ventures of the scarcely remembered, decidedly daring aeronaut, engineer and inventor James Sadler (1753– 1828), the first English person to fly. Sadler's determined indifference to the dangers of his chosen career is in striking contrast to Smith's own lifelong, all-consuming fear of heights – he is terrified even at the prospect of climbing a flight of stairs.

Using a confidently comic, self-deprecating style, Smith depicts his struggles with height phobia, or acrophobia. Smith has been crippled by severe height anxiety since early childhood when he fell down the stairs twice, and was terrorised by the 150-step spiral staircase of Tattershall Castle. After counselling, graded exposure, mantras, reassurance seeking and 12 cancellations of the flight due to imperfect weather conditions, Smith looks down on Oxford from a hot air balloon.

Paradoxically, a failed attempt at flying and returning a dog safely instilled Sadler with sufficient confidence to propel himself into the English skies in a balloon of his own design, fuelled by ingenuity, audacity and highly flammable hydrogen gas (and with oars fitted to help him 'paddle to a higher height'). Torrential rain and gale-force winds were no impediment. Seemingly insatiable, Sadler broke records and bones; he crashed but remained unabashed. On one occasion he was forced to jump from the balloon and reportedly described it as 'a tremendous experience'. He both inspired 'balloonomania' and terrified farmers (who mistook the balloon for an alien intent on stealing their cattle). Astonishingly, after 50 death-defying expeditions and repeatedly being deemed 'fortunate to survive', Sadler died in his bed aged 75.

Entertaining but controversial is a chapter on the terminology of phobias, together with the excessive use of diagnostic labels throughout the book. For those not in favour of diagnostic labels it is like walking on a lawn laden with thistles. The author refers to himself as acrophobic and bathmophobic, two labels that would never be used collectively in clinical practice – the former encapsulates the latter; we would likely instead call it 'fear of falling'. There is admittedly a difficult balance to be struck in between overpathologising, activating stigma and the use of multiple labels versus normalising and acknowledging the extent of someone's difficulties. As Oxford University clinical psychologist Dr Hannah Stratford explains, 'It's a double-edged sword. It's validating, it's helpful it's containing, it shows others people have this problem… and we know how to treat it… On the other hand… it may also come to mean "there is nothing I can do about it, this is how it is going to be".'

The reader accompanies Smith on the steep and rocky road to his recovery, learning about phobias with him along the way. With the help of Dr Hannah Stratford, phobias are placed firmly in an evolutionary context and linked to the fight and flight response, which lends a normalising and validating feel. Smith nicely depicts the merits of psychoeducation: 'Just learning about the psychology of anxieties and phobias has helped reduce their potency… Once you understand how the circuitry works, you can start tampering with it.'

In an unorthodox therapy set up with two trainee counsellors, the author explores and tackles his height phobia. He frequently refers to cognitive behavioural therapy (CBT) and provides some very neat and accessible descriptions and explanations of this approach. However, a slightly confusing inconsistency in the later part of the book is the lack of clarity that his counsellors are actually using CBT, aside from a little graded exposure.

Smith captures the slow, gradual process of exposure-based practices and fear-extinction learning: 'the frightened panic does not wholly subside, although the volume level of anxiety becomes progressively turned-down after repeated exposure'. He raises the issue of recovery and what this means: symptom absolution or management? Smith states: 'Although I still do not willingly embrace heights, I cannot tolerate them enough for acrophobia to stop being a barrier excluding me from life experiences… I never expected to be cured… Instead, I have crucially learnt to manage and thereby control, my anxieties and phobias."

The author's determination and hard work to overcome his difficulties, much of it done independent of therapist guidance, is exceptional and admirable Smith says: 'In a way, overcoming a phobia is standing up to a bully.' He doesn't just stand up to the bully, he looks down on it from 3000 feet, with his head in the clouds.

The Man with His Head in the Clouds is a fun and accessible read for anyone interested in anxiety and phobias.

Signal Books; 2014; Hb £14.99
Reviewed by Petrina Cox who is at the Oxford Centre for Anxiety Disorders and Trauma, University of Oxford
See also 'Letters', p.722 

Helping abused men cope
Living Well App
Living Well
The Living Well App is a free app designed to reach out to male survivors of child sexual abuse. The app is easy to navigate and contains information and practical resources to help male survivors understand more about the effects of abuse and learn ways of improving their lives and well-being. It is intended to complement, not replace, professional help.

The Well-being section emphasises the importance of taking care of oneself and contains many helpful suggestions; starting with the basics of improving physical well-being and gaining support from others. The app also includes ways to help manage the symptoms and difficulties arising from sexual abuse and provides a large number of relaxation and mindfulness audio files for men to listen to. A section of the app uses a timer to help users learn to breathe slowly and regain control of their anxiety and bodily sensations.

The app does not attempt to be a substitute therapist and so does not directly tackle the psychological impact of abuse. It does, however, contain many useful ideas and audio files to help men cope with their symptoms and day-to-day living; as well as encouraging them to seek further help.

Reviewed by Kay Toon who is author of the k2n apps for survivors of sexual abuse

Little psychological insight
Horizon: Should I Eat Meat? – The Big Health Dilemma
BBC Two

Epidemiological studies suggesting the effects of food on our health litter the media on a daily basis. Marking the first in its new series, Horizon and Dr Michael Mosley team up again to investigate a latest concern: the effect of meat on our health. With meat consumption worldwide doubling in the last 50 years, it seems meat has moved from being a centrepiece of occasion eating to a feature in most meals.

Various large-scale studies are presented: evidently providing a mixed picture. In line with his other documentaries, Mosley again turns medical guinea pig in an N = 1 case study. By beefing up his daily consumption of meat for 30 days, his cholesterol, body fat and blood pressure all rose greatly. However, there was no discussion of other potential health behaviours and lifestyle factors at play in these changes, such as stress, drinking and ability to exercise. As with most food documentaries of this nature, the resulting conclusion is an 'everything in moderation'-type affair.

Unfortunately this unclear body of evidence seems sure to have only further confused the viewer, rather than informing their purchasing and consumption choices. From a psychology perspective, what was missing was a greater appraisal of how individuals and society perceive meat and its origins. We do eat ever-increasing quantities of meat, but why? If there is a health effect, especially of processed meat, how can we introduce lasting adoption of replacement foods?

A second episode considered the impact of our meat consumption on the environment but again provided little psychological insight. Meat eating is evidently impactful on our environment, but how can we change food choices to reflect this? Although evidence presented across both episodes was thought-provoking, there was no consideration of how meat eating as a health and environmental behaviour can be managed. Given the vast amount of psychological research in these two areas – for example see the article by David Uzzell in the November 2010 issue, at tinyurl.com/uzzellmeat – it is disappointing that neither was evidently considered.

Reviewed by Emma Norris who is a PhD student at University College London and Associate Editor (Reviews) 

Essential resource
The Elderly Eyewitness in Court
Michael P. Toglia, David F. Ross, Joanna Pozzulo & Emily Pica (Eds.)

This is an important book for the legal profession, for the police, for forensic and forensic clinical psychologists, and, indeed for all interested and concerned with the administration of justice. Although it primarily focuses on the criminal justice system it is equally applicable to civil litigation where eyewitness testimony may be vital.

In the UK the number of people 65 and older is predicted to rise by 23 per cent between 2010 and 2018, thus older adults are increasingly likely to be both the witnesses of crime and its victims. Whilst taking a developmental perspective incorporating research on witnesses of all ages, the chapter authors use the findings to focus on issues unique to the older eyewitness.

The book 
is divided into three sections: 'Memory for People', which includes research into memory into line-ups and 'mugshots', with a chapter on improving the performance of the elderly on identification procedures; 'Memory for Events', covering topics such as false memory and ageing, accuracy of memory for events across the lifespan and issues around interviewing the elderly eyewitness; and finally four chapters on 'Special Topics' dealing largely with the issue of the credibility of the older witness including jurors' reactions to the older witness.

The book is entirely research-based, each chapter being written by acknowledged experts in their field. It thus provides a valuable overview of what is currently known and identifies what is not yet known. The chapters end with suggestions and recommendations for further research, which will be invaluable to prospective researchers entering the field.

I have no hesitation in recommending this book as an essential resource on eyewitness memory.

Psychology Press; 2014;
Pb £39.99

Reviewed by Clive Sims who is a Chartered Psychologist 

After the storm
Treating Traumatic Bereavement:
A Practitioner's Guide
Laurie Anne Pearlman, Camille B. Wortman, Catherine A. Feuer, Christine H. Farber, Therese A. Rando

Treating Traumatic Bereavement provides a much-needed rope of hope into the area of disturbing bereavement and psychological therapy. Combining therapeutic methods for post-traumatic stress disorder, including resource building, exposure techniques and cognitive behavioural principles, this book helps clinicians to treat those cases that are so rare that previously in their career, they may never have encountered or read about anything similar.

Traumatic bereavements may include accidents, homicide, suicide, natural disasters and war. The child who sees a sibling murdered in front of them; the eyewitness who must testify in court after witnessing a mob murder; a survivor of a paedophile ring who witnessed human sacrifice; these are all examples of cases that clinicians may be presented with on any given day.

Sensitively written and drawing both on personal experience of the authors and on vignettes of clinical cases, this book offers skills, tools and hope, both for the practitioner working in this difficult field and for clients who are plagued by traumatic flashbacks, sleep disturbances, and internal turmoil. This book presents a multifaceted therapy for these survivors, based on building resources, processing trauma, and facilitating mourning.

This treatment will help those who have suffered a traumatic bereavement develop the internal and external resources they need to process the traumatic dimensions of the death, and ultimately move forward in their lives. This excellently researched book covers in depth every aspect of bereavement including the shattering of the bereaved's assumptions, the relevance of individual spiritual beliefs and attachment style. It serves as a therapeutic mentor to the practitioners involved in these cases also, and is a good reminder that in the depths of the turmoil of these cases, that practitioners are not alone. Well-referenced, and well-written, a stimulating read that is difficult to put down. It is not, however, a bedtime read.

Guilford; 2014; Pb £25.99
Reviewed by Kirsten Nokling who is a trainee clinical psychologist for South Wales and Vale NHS Trust, Cardiff University

Extend your analysis possibilities
Bayesian Cognitive Modelling: A Practical Course
Michael D. Lee & Eric-Jan Wagenmakers

The Bayesians are coming. Their innovative approach to the analysis of quantitative data has already become a standard fixture in some disciplines, but has yet to be fully exploited in psychology and cognitive science. Those who do embrace Bayesian modelling in these fields are promised a flexible, yet easily applied, set of methods that will extend the possibilities for analysing data.

If this has whetted your appetite, then your first stop should be Lee and Wagenmakers' text, which is intended as a primer on Bayesian modelling for those from a psychological background. Its emphasis is on encouraging the reader to see for him-/herself how the methods work by having a go at using them. Right from the start, the explanations are interspersed with practical exercises and questions for
the reader to reflect on, which makes the book quite an interactive experience. At first the exercises cover basic techniques and study designs, but they become progressively more advanced, to the point where the reader is tackling some rather complex real-life case studies.

Lee and Wagenmakers are clearly knowledgeable and enthusiastic about the topic, but are also keen to make it accessible to those who are less familiar with the technical background. So while there are enough nods to the underlying algebraic concepts to excite the hardcore mathematicians amongst the readership, you need not understand any of this in order to get to grips with the core material; just the basics of probability from your undergraduate stats lectures and access to a computer with the required software (freely available from the internet). The authors have set up a booksite from which you can download the R or MATLAB code for the practical exercises, as well as answers to the questions posed in the book.

For all its potential to revolutionise psychological research, Bayesian modelling is something of a departure from the approach to statistics that is routinely taught to psychologists, and you may be wondering what it is, how it works and whether it is for you. A few hours working through this book will give you the knowledge you need to answer those questions.

Cambridge University Press; 2014; Pb £27.99
Reviewed by Denham Phipps who is a Research Fellow at the University of Manchester 

Accomplished and profound
We Are All Completely Beside Ourselves
Karen Joy Fowler

Start in the middle, Rosemary is urged by her psychologist father at the beginning of this novel; so she does. It's 1996, she's 22, and she's a student at the University of California. A frenzied scene in the student cafeteria throws Rosemary into the orbit of Harlow Fielding, wild-child and 'psycho bitch'. As they get to know each other, we realise that Rosemary is weighed down by a family secret. Is it to do with her missing brother Lowell, last seen when Rosemary was 11, and apparently pursued by the FBI? Or her sister Fern, also absent? We step back to 1979… maybe this is the start of Rosemary's story?

Attentive readers may work out the secret at the heart of this family from the hints Fowler drops along the way. Wise readers are also alert to the dangers of having a psychologist as a father in the 1970s. Try to avoid hearing the big reveal before you read this book, but even if there is no surprise this is a story so well told that enjoyment is inevitable. Fowler's writing is accomplished without showing off, funny without being crass and profound without being pretentious. At the heart of the book are questions about what it means to be a family, sibling love and rivalry, and how we live with loss. And if there's one moral for us as psychologists, it's that we must avoid repeating our discipline's sometimes inhuman history.

Serpent's Tail; 2013; Pb £7.99
Reviewed by Kate Johnstone who is a postgraduate student at UCL

Finding meaning in drawings
Inside Children's Minds
Valerie Yule

As the well-known quote (attributed to Albert Einstein) goes, 'Imagination is everything. It is the preview of life's coming attractions'; however, imagination is also much more than that. As Inside Children's Minds highlights, imagination is an important way of gaining a true insight into a child's current state of mind and experiences.

This book is certainly different from most others as it doesn't have paragraph after paragraph of theories and references. Instead, it includes dozens of examples of actual drawings and stories created by children that the author has come across in her work as a psychologist.

Each chapter covers one particular factor that is likely to have an impact on the drawings and stories that children create, such as families, wars and mental disorders. By looking at each of these in turn and focusing on the different ways in which children draw or speak of them, the author successfully demonstrates how a simple story or picture can represent what a child is experiencing in that moment of time. This is especially effective in chapter 4, which concentrates on the topic of houses; the author explains that houses represent security and safety, which is why a disturbed child may tell stories of houses being broken and destroyed.

This is an enlightening read that conveys how meaningful drawings can be and what they really represent about the artist. The book truly does what it promises and gives the reader an insight into children's minds, making it useful for both educators and psychologists.

Book Pal; 2014; Pb £12.80
Reviewed by Aleesha Begum who is a recent BSc (Hons) Psychology graduate from the University of Central Lancashire

Belief in hope
Fostering Resilience and Well-being in Children and Families in Poverty: Why Hope Still Matters
Valerie Maholmes

This new book is a timely reference that focuses on 'hope' and how this can be a way to manage and overcome adversity for children and families who are experiencing challenges due to economic difficulties. Throughout the book, interviews with families who have faced adversity, but have overcome challenging times through intervention, brings the theory into a real-world context that everyone can learn something from, both professionally and personally. The examples bring to life how parents and communities can help children overcome the difficulties they are facing and develop into adolescents and adults with a determination to succeed.

This book has a far wider audience than just those who work with children and families in poverty or academics. The discussions around building resilience and hope in children are relevant for all who believe in giving children the best start in life. The author's true belief that 'Hope still matters', and that hope is a primary construct to help understand how the effects of poverty can be overcome, shines through all aspects of this book and leaves the reader taking away some of her beliefs.

Oxford University Press; 2014; Hb £35.99
Reviewed by Anna Mary Cooper, University of Salford

A useful listen
Should Research Fraud Be a Criminal Offence?
BMJ podcast

The existence of research fraud is now common knowledge. High-profile cases ranging from infamous MMR claims to more recent stem cell and pharmaceutical examples are widely publicised in mass media and within academic circles. Research misconduct in biomedicine has real potential to cause bodily harm, with psychological misconduct potentially leading to the provision of ineffective services to at-risk groups. Currently, consequences are provided at institutional level, with fines or banning in extreme cases. However, are these methods enough? This thought-provoking podcast posits an interesting question: Should research fraud be criminalised?

In a 'head to head' format, two researchers convincingly present their views. Professor Zulfiqar Bhutta, from the Hospital for Sick Children in Toronto, argues for the criminalisation of research fraud. He presents research misconduct as a gradient, ranging from sloppy research and plagiarism to more severe research fraud: actively falsifying results to provide a preferred outcome. This may happen in researchers keen to satisfy research funders or promote their careers. Professor Bhutta believes research fraud is no different from economic fraud, as both involve misleading a funding source. He criticises the inadequacies of institutional sanctions not leading to criminal prosecution, even when economic fraud is detected. With often no lasting consequences for researchers, a soft touch, 'slap on the wrists' approach does not deter researchers from reoffending. He also argues that fraud is often committed not by juniors but by researchers at the top of their game, looking to have the highest impact results. Although Professor Bhutta does not seek to outline specific penalties to be imposed under criminalisation, he is keen that fraudulent researchers are made examples of with lasting repercussions.

Professor Julian Crane, from the University of Otago Wellington, New Zealand, argues against criminalisation. Instead of criminalising researchers and adding further burden onto the justice system, he argues that a change to the nature of research itself is required. By making research across all fields conducted and presented in the most open way, a culture of trust could thrive. Instead of criminalising a small proportion and tarnishing the wider research community, more sufficient policing by institutions is required. Professor Crane also argues that researchers of all levels need to ensure they are fully aware of all work accredited to their name. By having an environment of collective responsibility where questions can be asked rather than sanctions made, researchers could feel more accountable for their actions.

This 15-minute podcast brought to life a question that is relevant to researchers of any discipline. This question has huge implications for how all studies portrayed in mass media are perceived by the public. It is a useful listen for any researcher or student in any research field.

Available at tinyurl.com/m3nb96x
Reviewed by Emma Norris who is a PhD student at University College London and Associate Editor (Reviews)