224 Book Reviews

of outcome studies of cognitive and behavioural rehabilitation programmes. The latter highlights the methodological problems which render many studies diflicult to interpret and should help strengthen the design of future studies. Above all, the book usefully indicates that the neurobehavioural consequences of TBI are of multidisciplinary concern, requiring a structured approach to intervention if adequate rehabilitation gains are to be made.

LAURA H. GOLDSTFXN

R. PORTER (Ed.): The Faber Book of Madness, Faber & Faber, London (1991). xix + 5’72 pp. E14.99.

This historical anthology is a wonderful pot-pourri of writings about madness in its widest definition, from frank psychosis to the myriad of worldly cares which bring neurotic disorder in their train. The author incfudes the views of generations of psychiatrists, nurses, relatives, theologians and philosophers who have struggled to fathom the hydra madness, but he sets out primarily to give a voice to the “mad’ themselves.

There are a surprising number of books and monographs written over the centuries by those who have suffered from mental disturbance. Many of these have been written by patients seeking to attack the systems within which they were treated. Dr Porter has been careful not to overload the book with such accounts, although old favourites like John Perceval, Clifford Beers and Virginia Woolf make their appearance. Rather, he has included many fascinating texts in which the mad have sought to explain their delusions, behaviour and experiences. Many of these are worth reading in their own right, and offer idiosyncratic perspectives into societies of the day. They are an eloquent reminder to us of the experience of being a patient.

Our own era is no different from any other in its tendency to romanticise madness, Plath and Hemmingway having achieved mythic status for would-be suicides. In the 18th century Cheyne, Mandeville and Blackmore completely transformed Burton’s 17th century seriously ill melancholic. In the Augustan period ‘hypochondriak’ depression became the hallmark of a superior sensibility. The ‘English malady’ was the sole province of the beau-monde, and blossomed in the post-Restoration era of Whig toleration. The French commentator Le Sage thought the English for all their liberty, property and three meats a day, ‘the most unhappy people on the face of the Earth’. A touch of madness has always been modish, but this book also explores the tragedy and desperation of psychotic disturbance, and the various unpleasant therapies used over time: the swing chair, surprise bath, strait-jacket, insulin shock therapy, ECT and psychosurgery.

Porter includes a number of interesting passages around the embryonic development of ‘psychological’ methods of treatment. From William Pargeter’s early description of using the ‘eye’ to control patients, through Pinel’s use of fear and rewards to change behaviour, to the elaborate frauds perpetrated on patients to induce them to change their behaviour.

This is a superb bedside read, and a mine of interesting quotations, NICK HARVEY

DOUGLAS MURDOCH and PHILIP BARKER: Basic Behuoiour Therapy, Blackwell Scientific Publications, Oxford (1991). x + 190 pp. $12.95.

This is an introducto~ volume on behaviour therapy. It assumes no prior knowledge of the area. The early chapters deal with the main features of behaviour therapy, learning principles, basic ways of changing behaviour and cognitions. There follow a useful if brief chapter on behavioural formulation, and one on the essential steps in all behaviour therapy. After these general chapters, the reader is taken through the application of behaviour therapy for anxiety and depression, addictions, disruptive disorders, interactional problems, non-psychiatric areas of medicine and chronic conditions. Next is a chapter on philosophical and ethical issues, and-tinally-one on the current status and future of behaviour therapy.

As an introduction, this book is clear, readable, and sensible. It is true to its title in that what is discussed is basic. It does not discuss the treatment of many of the disorders in any useful detail. Nor does it really tell the trainee or inexperienced therapist how to implement therapy, as for example found in Wolpe’s 1991 book. However, as a text to read and study early in one’s exposure to the field of behaviour therapy, with additional reading to follow and good supervision from an expert in the practice of therapy, the Murdoch and Barker volume is a valuable piece of work. I should like to see this in the libraries of all institutions where teaching in behaviour therapy takes place. Because of the relatively low price, it is also a good buy for individuals.

A. READ

I. L. MCCANN and L. A. PEARLMAN: Psycboiog~caI Trauma and the Adult Supervisor-Theory, Therapy, and Transfor~ar~on, BrunnerfMaxel, New York (1990). x f 360 pp. $39.95.

This is a volume in the Brunner/Mazel Psychosocial Stress Series, edited by Charles Figley. It represents yet another addition to the rapidly growing literature on the effects of traumatic experiences. The authors are from the Traumatic Stress Institute in South Windsor, Connecticut, which specialises in this area. They offer their own theoretical ideas and their own model, based on their extensive clinical work and on a review of the literature. Their specific model is termed Constructivist Self Development Theory. The main feature of this is the emphasis on the interaction between the person and the situation. People actively create, they argue, their representational models of the world. These are shaped or disrupted, in a dysfunctional way, by traumatic experiences. McCann and Pearlman base their assessment and therapy of trauma victims on this model. After the body of the book, consisting of chapters on assessment and intervention and on special issues, a tinal chapter describes four cases in detail.

Behaviourally oriented therapists may feel that this book does not do justice to the role of behavioural work with this client population. The authors’ therapeutic strategies come from a variety of sources, with cognitive and self approaches