STRESS MEDICINE, VOL. 7: 189-197 (1991)

BOOK REVIEWS

BOOK REVIEWS

Anxiety and Stress Management. TREVOR POWELL and SIMON ENRIGHT. Routledge, London, 1990: Price: g9.95.

This book is one of a series of guide books for mental health practitioners edited by Reinhard Kowalski. Writ- ten by two clinical psychologists, it is an uncluttered and practical manual for anyone working in the field, with no unnecessary discussion of the complex conceptual problems of the notion of ‘stress’. Two brief, acceptable introductory chapters provide a working model in terms understandable to the intelligent layman and a simple account of diagnostic issues.

An excellent chapter on assessment follows based on the approach developed by Lazarus. 1 particularly like the way typical therapist introductory questions preface each part of the assessment process. Illustrations included the most useful standard questionnaires. Educaiton is an essential part of anxiety management and the middle chapter emphasizes this and gives the trainee advice as to how to go about this process, which is often omitted or badly done. Self-help techniques are described with the traditional overemphasis on the technique of pro- gressive muscular relaxation, which many patients find

tedious and unhelpful. Fortunately the authors cover other techniques including: controlling hyperventilation; distraction; environmental focus; use of a ‘bridging object’; mental games; behaviourial activity; and a group of cognitive techniques. The section on practice is rounded off with a chapter on ‘Lifestyle Change’. Useful instruction is given on goal planning, time management. and assertive training. The book concludes with five varied illustrative case histories covering the treatment of simple phobia; stress and aggression; agoraphobia with panic attacks; post-traumatic stress disorder; and work stress. One important omission is the way depression may present with symptoms of anxiety, other- wise complex issues are well summarized.

Allowing for a bias towards psychological methods, this is the best introduction I have read to the practical management of anxiety-related conditions. Given some background in medical or mental health, having read this book you will be well equipped to take your first patient into therapy.

JOHN COBB The Priory Hospital, Roehamption

The Healing Bruin: A Scientific Reader, Edited by R. ORNSTEIN and C. SWENCIONIS. Guilford, New York, 1990. No. of pages: 262. Price: &21 .OO.

This is a thought-provoking and quite useful text, which sets out to give non-specialists an overview of recent research into links between a range of environmental and psychosocial processes and bodily health and dis- ease. A wide variety of scientists have contributed the chapters, which vary enormously in both length and style, ranging from the autobiographical through to the scholarly review. It looks as though authors have pur- posely been encouraged to be speculative, though in most cases the ideas are well referenced so that the serious reader can follow up the assertions. On the whole this works well: after all, speculation is a forerunner of science. About half of the papers have been published

elsewhere, while the remainder seem to have been written specially for the book.

The first main section of the book (after the Introduc- tion) looks at some of the psychosocial factors involved in bodily healing, from social support to the placebo effect. Section three focuses on environmental influences. There is a very brief exposition to the effects of negative ions on cortical thickness, serotonin levels, and ageing processes, and then two chapters on nutrient-dependent neurotransmitters and the behavioural effects of food constituents, respectively. Section four is concerned with psychoneuroimmunology, and includes chapters on the role of neuropeptides in mediating brain-body communi- cation, the interaction of nervous, endocrine and immune systems, the effects of human experience on immune function, and hypothesized links between the immune system and central nervous system. Section five is one

0 1991 by John Wiley & Sons, Ltd.