Reviews, September 2013

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Barrier of ignorance
This year is the 150th anniversary of the opening of Broadmoor Criminal Lunatic Asylum in 1863. Harvey Gordon's book coincides with this landmark and describes the medico-legal wrangling that gave rise to its creation. It then goes on to trace its development and discuss its transition to the special hospital for mentally disordered offenders that we have today. Along the way Harvey Gordon, a former medical director of Broadmoor, scrutinises the death penalty; the contentious M'Naughten rules (even the spelling disputed); the apparent contradiction of therapy within a secure environment; the advances in knowledge and treatment that were nevertheless pioneered there and, ultimately, the rebuilt and rethought-out modern hospital we have today.
This is timely. Even after 150 years the objections to Broadmoor's very existence continue whilst ignorance and misunderstandings as to its patients, its functioning and even its whereabouts, continue. When these persist through successive generations, as has been my experience, one even comes to believe there is a deep need for society to maintain this ignorance: to have, as it were, a place out of sight and out of mind where the most bizarrely destructive of our fellow human beings can be shut away and forgotten.
Perhaps a landmark anniversary is the time, therefore, when we can take off the covers and confront the reality of a place that has provided this public relief; to see where it has travelled and what it does for us today. For, make no mistake, were it to be closed tomorrow, as many would like, even among my former colleagues on the Mental Health Act Commission, someone would have to reinvent it to accommodate all the people none of the rest of us want to bother about. And maybe now that it blends more seamlessly with the regional secure unit system of this country it will perhaps be seen as fulfilling less repugnantly the role we all seem to require of it.
Also in this anniversary year the Berkshire Records Office (yes, that's where it is!), where the recently renovated Broadmoor archives are kept, reopened at new premises in Reading in May; and a TV programme is scheduled for this month tracing Broadmoor's history.
Harvey Gordon's book, painstakingly tracing over 2000 historical references, joins the ranks of the surprisingly few devoted to a professional and inside view of the place and its workings. With these few others it complements and updates the story. The original history by Partridge (1953) gave the basic information on the place and its workings. My update (2003) built on this with the post-war developments. Cohen (1981) describes some of the more graphic details and controversies. Kaye & Franey (1998) survey how a lay administration managed Broadmoor after the demise of medical superintendents. Murray Cox (1992) tells of psychotherapy at Broadmoor and the effect of Mark Rylance bringing the Royal Shakespeare Company there to perform some of Shakespeare's tragedies; a revelation to patients and cast alike. Perhaps this small collection, supplemented by Harvey Gordon's much expanded historical perspective, will break through the barrier of ignorance.

References
Black, D.A. (2003). Broadmoor interacts. Chichester, Barry Rose Law Publishers.
Cohen, D. (1981). Broadmoor. London: Psychology News Press
Cox, M. (1992). Shakespeare comes to Broadmoor. London: Jessica Kingsley.
Kaye, C. & Franey, A. (Eds.) (1998). Managing high security psychiatric care. London: Jessica Kingsley.
Partridge, R. (1953). Broadmoor. London: Chatto & Windus. (Reprinted 1975 by the Greenwood Press, Connecticut)

I    Psychology News Press; 2012; Hb £25.00
Reviewed by D.A. (Tony) Black who is a retired Director of Psychological Services, Broadmoor Hospital

 

From the Cannes Film Festival
Jimmy P. – Psychotherapy of a Plains Indian
Arnaud Desplechin (Director)
Jimmy P. – Psychotherapy of a Plains Indian, released in May at the Cannes Film Festival, is the story of a Blackfoot war veteran who sustains injuries in the Second World War
in France. Upon his return to civilian life, Jimmy suffers from debilitating headaches, deafness, tremors and nightmares. He is taken to a famous hospital for veterans in Topeka, Kansas. Investigation reveals that there is no apparent physiological cause for the maladies that plague him.
In the spirit of the age, Jimmy is assigned a tentative diagnosis of schizophrenia, and a psychoanalyst/anthropologist is contracted to assess him. Jimmy's psychoanalyst is a whimsical, bright-eyed Romanian man named Devereau who has lived and worked among the Mojave people. He displays a keen interest in and understanding of Jimmy's cultural heritage. This stands in stark contrast to Jimmy's previous doctor's musings over whether 'Indians kill themselves' and unabashed lack of cross-cultural knowledge.
An enchanting journey into Jimmy's psyche follows, with Devereau gently and persistently leading the way, through a maze of dreams and memories. We follow his journey through his childhood, the oppression he faces as a Native American, a startlingly Oedipal moment of finding his mother in bed with a man, stories of early sexual encounters and his complicated relationships with women: lovers and daughter. As Jimmy and Devereau work through Jimmy's early life together, the blinding headaches and nervous symptoms vanish.
Jimmy P. skillfully avoids the trope of transference, instead presenting the viewer with a vivid and real therapeutic encounter, based on Jimmy's triumph over his 'psychic trauma' or 'soul pain' and his relationship with the analyst who walks with him into his psyche.

Camille Claudel, 1915
Bruno Dumont (Director)
Camille Claudel, 1915 tells the true story of a talented sculptor and artist who has been confined to a remote asylum in the South of France by her family. Juliette Binoche superbly interprets the role of Claudel, the student and lover of Auguste Rodin. Claudel's family have unjustly confined her to the asylum, as they suspect that she is suffering from a mental disorder. They claim this is expressed as suspicion, paranoia, delusions of grandeur and persecution. We see little evidence of this in the film as we follow Claudel through a series of days in the asylum. Claudel's 'madness' appears to be a reflection of her rage and anguish at the cage she is trapped in, not of a mental illness.
The director, Dumont, skilfully portrays the bleakness of Claudel's life, surrounded by people with severe intellectual disabilities and mental illnesses. Controversially, Dumont chooses to use people with real disabilities and mental illnesses and their carers to portray the other inmates in the asylum. In contrast to her fellow patients, Claudel stands tall, stark and almost startlingly sane. She desperately tries to convince her brother, a devout Catholic poet, to have her released from the asylum. Despite her doctor's support for this, her family declines and she remains locked away until her death, 29 years later, unable to paint, sculpt or return to her beloved work and the world.
Whilst ostensibly the story of a woman struggling with mental illness, Camille Claudel, 1915 is also a striking indictment of religion, patriarchy, and the use of the rhetoric of 'mental illness' and institutionalisation to control women who subvert the social mores of the time.

I    Reviewed by Ahona Guha who is a psychology honours student at Deakin University, Melbourne, Australia

 

Recognising the problems
Face Recognition and Its Disorders
Sarah Bate
Around 2 per cent of the population suffer from developmental prosopagnosia (face blindness). This book adopts a novel interdisciplinary approach in order to highlight both the clinical and theoretical implications of such disorders. As a result, it represents a valuable addition to the literature, and is essential reading for a broad audience comprising cognitive and developmental psychologists, students, and clinical practitioners.
Eminently readable and accessible, the book is split into four main parts addressing theories of face processing, acquired and neuropsychiatric disorders, developmental disorders and treatment. The author's clear writing style and ability to succinctly explain complex theories, coupled with the book's summaries, guidance questions, and focus chapters, succeed in navigating the reader through a wealth of information and research.
Sarah Bate's empathy for people with face-recognition disorders shines through at various points; I found the chapter 'Living in a world without faces' particularly engaging. I share the author's hope that more effective treatments will be developed for face-recognition disorders, and would like to encourage readers to sign her e-petition, 'Campaign for formal recognition of prosopagnosia', in order to raise public awareness of these issues: http://epetitions.direct.gov.uk/petitions/46715

I    Palgrave Macmillan; 2013; Pb £29.99
Reviewed by Harriet Smith who is a psychology PhD student, Nottingham Trent University

 

To the internet, and beyond… 
The Internet: Understanding Qualitative Research
Christine Hine
The author states from the outset that, in comparison to more general texts on qualitative research writing, The Internet will focus specifically on writing for qualitative research using the internet. Sounds fairly niche?
Actually, the author offers an overview of the topic in such a way that it could easily be used as a step-by-step guide from project proposal to the end report; or equally as starting point for a social science researcher who is considering embarking on internet-based qualitative research, but doesn't have a clear idea of where to start. The book is written from a personal perspective, and the author uses her own experiences as examples, making it very accessible. There is a lot of justification for why qualitative research using the internet is worth the time and effort, and reassurance that the internet is not a place to be feared; but the opening sentence of the book seems sum this up perfectly using a quote from Castells that states 'the internet is the fabric of our lives', thus not a place for researchers to avoid.

I    Oxford University Press; 2013; Pb £22.50
Reviewed by Lynsey Mahmood who is a PhD candidate, University of Kent

 

Solid content
Brainwashed
Sally Satel & Scott O. Lilienfeld
I wanted to dislike this book. You see, I was suspicious of the fact that one of the authors is a resident scholar with the conservative American Enterprise Institute (AEI), an organisation whose political values I oppose, and, insofar as it's an organisation with political values, has little business going near science.
When I found out that Brainwashed cites me (along with fellow neuroscience bloggers Mind Hacks and Neurocritic) in the Acknowledgements, and elsewhere, that actually made it worse.
A sense of intellectual possessiveness joined my ideological reasons for not liking the book. I was hoping that it would be dreadful, so that I could unleash the venom I had brewed up: 'Ayn Rand, Please Get Off My Bandwagon', I would 'The only good bits here are the bits they stole from me'. It would have been glorious. However, sadly, Brainwashed turned out to be good.
The book is subtitled 'The Seductive Allure of Mindless Neuroscience', and it covers a range of examples of the modern mania about 'the brain'. The overselling and misinterpretation of neuroscience is everywhere, because – for some reason – we've convinced ourselves that the human brain, which has been working away quite steadily for 50,000 years, has suddenly become more important.
Brainwashed begins with a brief introduction to functional magnetic resonance imaging (fMRI) scanning – because most, although not all, neurononsense involves this technique. Satel and Lilienfeld then take us through 'neuromarketing', lie detectors, addiction, and what neuroscience means for free will, the law, and moral responsibility.
These chapters outline several different ways in which, if we're not careful, misapplied neuroscience could cause real harm – in particular, in the justice system, as well as in medicine and business.
For example, in 2008 two Indian students, Aditi Sharma and Pravin Khandelwal, were convicted of murdering a classmate. The prosecution made use of evidence from a 'brain electrical oscillations signature' (BEOS) test conducted on Sharma – a lie-detector style method that supposedly revealed that she had 'neuro-experiential knowledge' of the crime, indicating guilt. Yet the neuroscience behind BEOS had never been subject to peer-reviewed evaluation.
Brainwashed is well-written and remarkably balanced; it doesn't make the mistake of throwing out the baby of neuroscience with the bathwater of hype. As for the AEI, there's no problem. This is one of the less political popular science books I can remember.
It's 150 pages of solid content; there's no waffle here. In fact, I wished this book were longer, and it's not often that happens.
This however brings me on to Brainwashed's main flaw. The reason I wished it longer is that the whole book felt like an introduction to something… but no, it just ends.
What I was hoping for was more of a bird's-eye view examination of what makes vulgarised neuroscience so attractive, and the fundamental reasons why it's wrong to use neuroscience in the ways that it is.
We don't really get that. There's a few bits, but by and large it's about particular cases. Brainwashed offers a pleasant and informative walk amongst the trees. But it doesn't show us the wood.
Should you buy it? Honestly, I would recommend it for anyone who doesn't heavily read neuroscience blogs like mine. Those that do will likely be familiar with the names and ideas in here. But for anyone else, or as a gift, it would be fantastic.

I    Basic Books; 2013; Hb £17.99
Reviewed by Neuroskeptic who blogs at http://blogs.discovermagazine.com/neuroskeptic/

 

Complex and sensitive
The pregnant brain
Radio 4 (Juniper Productions)

This programme explored the latest research suggesting that mums-to-be are 'chemically reprogrammed in preparation for maternity'. The presenter, Zoe Williams, talked to psychologists and sociologists about the evidence for maternal programming, the effects of stress on the brain and fetus, and the notorious 'mushy brain' of the pregnant woman.
During pregnancy, a woman's hormone levels rise to more than 100 times those seen during any other naturally occurring life event. It is less recognised, said Dr Laura Glynn (Chapman University, California), that there are profound changes in the stress hormone system. This has given rise to the idea that such hormone changes throughout pregnancy play a role in shaping the maternal brain and behaviour to optimise motherhood: in effect, that mothers are made not born.
Unfortunately the evidence is complex, with much of it coming from animal models. 'We can at least say we've been to the very core of planet pregnant rat', Williams said. Craig Kinsley (University of Richmond) pointed to evidence of greater surface area on neurons, using the metaphor of 'a car at the lights spinning its wheels, revving up and revving up and then going when the time is right'.
Is this rewiring echoed in the human brain? Dr Rebecca Pearson (University of Bristol) presented research with 101 first-time pregnant women 11 weeks into their gestation, before hormone levels would have started to rise, repeated at 37 weeks. She demonstrated that attentional, physiological and perceptual systems prioritise different functions later in pregnancy (for example becoming more distracted by the aversive sound of a crying infant).
The second half of the programme tackled the societal implications of such research. In particular, asked Williams, does research on the impact of stress, antenatal depression and diet on the developing fetus represent an attempt 'to locate every possible outcome for the fetus in maternal behaviour'? Does it encourage expectant mothers to become worried about worrying?
Professor Carmine Pariante (Institute of Psychiatry) had an interesting conclusion for pregnant mothers: 'We want them in a way to get worried, because we want to help them. In a way we want to send two parallel messages – normalising as much as possible for most women, but advising women who are really suffering to seek help.' The scientific evidence, Pariante says, 'should remind us that a woman who is pregnant is the responsibility of the whole society'.
Williams did a good job of summarising the complexities and sensitivities of the area, when she concluded: 'We should be wary that such research isn't understood in a simplistic way, which plays into the hands of those who might argue that a domestic role for women is biologically predestined, or, by the same logic, that unorthodox families are biologically inferior. But it would also be a great shame
if our rather babyish cultural desire to see pregnancy as an unambivalently beautiful state were to get in the way of scientific inquiry which is revealing the complex interplay between the mother and the fetus.'
 
I    Reviewed by Jon Sutton who is Managing Editor of The Psychologist
(Read more about the maternal brain in the August 2010 issue of The Psychologist: see tinyurl.com/matbrain)

 

Honesty and authenticity
Pursuing the Good Life: 100 Reflections on Positive Psychology
Christopher Peterson
I was sad to read on the book sleeve that the author had died last year. His writing is so warm, witty and engaging that he brought positive psychology very much to life for me. He described positive psychology as an umbrella term for the scientific study of what makes life worth living and what we can do to work towards this, and that its value is to complement and extend problem-focused psychology.
It seems to sit well with ACT, mindfulness and solution-focused therapy approaches. He discusses its research findings and practical applications to illustrate how we can look at and make sense of how we live in the world.
He divides his reflections (originally blog entries) humorously into sections about emotions and experiences, traits and talents, positive relationships, work, school, sports and geographical places, putting
his personal spin about what's enabling and what's not. Mostly he says 'check out for your self what makes a meaningful life of work, love and play and go for it wholeheartedly'. His reflections, though personal and referencing life in the USA, are likely to seem resoundingly familiar to the reader.
This book is a very helpful and heart-warming addition to the positive psychology literature. It's attractively readable, enjoyable, informative and a worthy legacy from an author who seemed to advocate pursuing the good life with honesty and authenticity that doesn't necessitate being a Pollyanna or, in his words, appearing to others to be 'walking on sunshine'. What a relief, eh?

I    Oxford University Press; 2013; Hb £15.99
Reviewed by Marie Stewart who is an NHS Principal Clinical Psychologist in Lancashire

 

Lessons from over there that can be applied over here
Preventative Stress Management in Organizations (2nd edn)
James Campbell Quick, Thomas A. Wright, Joyce A. Adkins, Debra L. Nelson & Jonathan D. Quick

Preventative Stress Management in Organizations is an excellent text that provides theoretical and practical advice for organisational stress.
In this text, the authors argue that there is a strong relationship between individual stress and organisational stress, and that effects in one area can be significantly felt in the other.
A three-tier individual/organisational model has been constructed for conceptualising and managing stress (both distress and eustress) in the work environment. The first tier is directed towards primary prevention of stressors; the second tier focuses on secondary prevention or individual and organisational responses to stress; and the final tier covers symptom directed responses, for contexts where stress is perhaps unavoidable.
The book is sensibly arranged, as the first half of the text takes you through research findings on stress and presents the underpinning theoretical model. The second half of the book addresses practical strategies for assessing stress, management techniques and advice about the importance of protecting and developing social relationships. 
There are some nice case studies in the book. However, they are a little short and infrequently presented throughout the book. I would have liked some more case studies to help with seeing how the model has been applied in practice. Whilst the book aims at American business organisations, most of the ideas can be applied to the British context and public sector environments where staff stress and burnout are common concerns. With this in mind, the book can make a very informative practical text.

I    American Psychological Association; 2013; Hb US$69.95
Reviewed by Dr Mark Wylie who is a Clinical Psychologist with Cambian Healthcare

 

Insight and humour
The Locked Ward: Memoirs of a Psychiatric Orderly
Dennis O'Donnell
In this thought-provoking book O'Donnell recounts his experiences from seven years of working full-time in one of Britain's most severe inpatient wards. Insight from the minds of the inpatients are paramount, dabbling in common questions to the sane mind and the insane mind alike.  The inpatients debate the problems that religion causes in contemporary society, and its impact on the paranoid schizophrenic mind, whilst assessing exactly what counts as true sin? Is demonic possession possible? And what evil forces are there at work?  The patients debate the truth about Atlantis the Lost City, and conceptualise exactly what is the human soul?
O'Donnell's journey touches upon therapeutic models, new and old treatments, and topics of controversy such as the forcible use of electro-convulsive therapy prescribed to a patient detained under a Section 3. O'Donnell marvels at the true strength of the human spirit though the patients who, despite suffering incapacitating episodes of chronic mental illness, show remarkable determination to move towards an incremental improvement.  These individuals pick themselves up, and, despite hopes being dashed and constant readmissions, turn around and face it all over again.  What is not to admire? O'Donnell urges us to wonder.
This book is packed with witty insights and humorous moments, as O'Donnell guides us on his journey; to discover that there is no such thing as a textbook patient.  Packed with visual quotes, references to well-known film and media, and an easy-to-follow dialogue; this book makes for excellent bedtime reading.

I    Vintage Books; 2012; Pb £8.99
Reviewed by Kirsten Nokling who is a research assistant at the Spectrum Centre specialist research centre for bipolar disorder in Lancaster

 

Classic psychology on DVD
Mary Ainsworth: Attachment and the Growth of Love (2005)
Bandura's Social Cognitive Theory (2003)
Both DVDs appear as part of Giants Series from Davidson Films, who have been producing psychology documentaries since 1955. Both documentaries come in at 38 minutes, not long for what seems like a hefty price tag. These are certainly introductory films, aimed at those with little or no knowledge of their subject matter. They guide the viewer gently through the main ideas and influences of Ainsworth and Bandura, as well as the wider implications of their research findings.
Mary Ainsworth: Attachment and the Growth of Love follows the development of attachment theory through the life and work of Mary Ainsworth and includes both archive footage and more recent demonstrations and studies to illustrate the importance of Ainworth's role in the study early relationships.
The 'Influences' section looks at the impact of John Bowlby on Ainsworth and briefly discusses the origins of Bowlby's own ideas through his discovery of the ethology of Konrad Lorenz. The useful 'Data Collection' section includes the work of James Robertson, Ainsworth's own studies in Uganda and finally the highly influential Baltimore Study. There is a brief explanation of how the children were observed and notes taken, collated and analysed which would be of particular interest to pre-tertiary psychology students who may miss out on this more hands-on approach. A large section of the film is dedicated to the Strange Situation Procedure, seen in much more detail than many students will have experienced, concluding in a description of the main types of attachment. Finally the implications of Ainsworth's work are discussed in respect of the implications of attachment styles in later intimate relationships.
From Ainsworth and attachment we are presented with Albert Bandura and his social cognitive theory. The documentary is presented by Bandura himself, which gives a good personal feel, especially for students who see key psychologists as simply names in a textbook. The DVD would be of interest to students looking at both aggression and obedience as it investigates Bandura's classic studies into observational learning  (the 'bobo doll' experiments) and continues through to a discussion of moral disengagement. Other chapters include The Triadic Model, Fortuity and Efficacy.
Both DVDs represent good introductions to classic psychology and would be useful for pre-tertiary and undergraduate teaching. The use of archive footage (including interviews with Ainsworth and Bowlby and video footage from the bobo doll studies) is probably the greatest strength of both DVDs, as many students (particularly at pre-tertiary level) won't have had the opportunity to experience these giants of psychology beyond the pages of textbooks.