What Is Madness?
Darian Leader is a Lacanian psychoanalyst, and this alone may dissuade many psychologists from reading this fascinating book. It would be their loss. This is a truly important book, no least because, first and foremost, Leader seeks to understand the psychology of people who are labelled mad. This contrasts with the medical model where ‘illnesses’ are presumed to be the causes of psychotic behaviour and drug treatments seen as the treatment of choice. In his book Madness Explained (2003) Richard Bentall showed how inadequate this system is. Leader takes a similar stance, pointing out that a diagnostic approach that merely lists symptoms without reference to cause or meaning fails to do justice to the psychology
of madness. It is the individual’s relationship to their symptoms that counts, and only by understanding that can we begin to understand what madness is. Leader has researched deeply into what he calls,
the ‘old psychiatry’ (19th and early 20th century). He shows how the phenomenological investigations of the time revealed far more of the individual’s psychology than the symptom check-lists of today.
But what of the fact that this a psychoanalytical approach? And not only that but from a Lacanian perspective, perhaps the most difficult
of psychoanalytical theorists? All I can say is: be open-minded. In fact, Leader writes well and Lacanian concepts come through without too much difficulty. Moreover, he illustrates his points with many examples from his and published case histories, which leavens the intellectual argument. Towards the end of the book there are three chapters, each devoted to a particular case, Aimee and the Wolf Man from psychoanalytic history, and, most intriguingly, the multiple murderer Harold Shipman. This is a book steeped in clinical experience in which Leader’s sensitivity, intelligence and compassion shine through. Moreover, as he points out, seeking a psychoanalytical understanding is not the same as saying that people need psychoanalysis. What psychotic people need most is not conventional therapy but something more personal and supportive. From the glimpses we get of the way Leader works, therapy is tricky and time-consuming. It demands a willingness to put oneself on the line and to do so often for many years.
The particular strength of the book lies in Leader’s rigorous intellectual analysis. Like other psychoanalysts, he begins with the mother–child relationship and the interruption that comes when a third party (the father or equivalent) steps in. The Lacanian term is symbolization – a combination of language and law – describing the capacity of the child to tolerate separation through forming appropriate symbols. For various reasons, which Leader goes into, this is what is lacking in psychotic people. Unable to symbolise properly, they are overwhelmed with the immediacy of the world: everything signifies. This is an intolerable state of affairs. When everyday things lose their meaning they become enigmatic and threatening. There is a disconnect between the ‘signifiers’ and their usual meaning (the ‘signified’). It is a more complicated process than this but the essential point that Leader makes is that madness is an attempt to make sense of a fractured, invasive and uncertain world. Rather than the psychotic symptoms being the problem, they are part of an attempted solution, and, for that reason, attempts to suppress them can be counter-productive; there is a real risk they may matters worse.
One of the most interesting ideas in the book is what Leader calls, ‘quiet madness’. Many people who experience psychotic symptoms never get into the psychiatric system; they lead essentially normal lives. Psychosis is not always a noisy, visible state of affairs. It is when the adjustment breaks down that madness may become strikingly visible.
This is an intriguing and thoughtful book, one that deserves the attention of psychologistsand others who seek to understand what madness is.
Hamish Hamilton; 2011; Hb £20.00
Reviewed by John Marzillier who is a clinical psychologist and psychotherapist based in Oxford
For an interview with Darian Leader from The Psychologist, see tinyurl.com/darianleader
Musical Cognition: A Science of Listening Henkjan Honing
Readers expecting a conventional musical cognition book packed with specialist terminology, and accompanied by intricate illustrations of the brain and ears will be disappointed; Musical Cognition has neither. What this concise book does offer is a well-written and accessible introductory text that avoids technical jargon whilst encapsulating the main cognitive processes of music.
One of the key messages that resonate throughout this book is how music is experienced within the mind. Although music is capable of manipulating our emotions, memories, and perceptions, we often fail to appreciate the active and subjective role that our minds play in listening to it. Musical Cognition also challenges conceptions regarding what it truly means to be ‘musical’, using recent evidence to persuasively demonstrate just how ‘musical’ we all really are. I particularly like how the author highlights the innate musical abilities we are born with, namely beat induction, as well as the numerous skills we acquire and develop later on, such as pitch perception, just by listening!
Overall I found this book refreshing, engaging, enlightening and, most importantly, intelligible by all.
Transaction Publishers; 2011; Hb £24.65
Reviewed by Karima Susi who is a PhD Student at Nottingham Trent University
Social Development: Relationships in Infancy, Childhood, and Adolescence
Marion K. Underwood and Lisa H.Rosen (Eds.)
This is an excellent overview and was a pleasure to read and review. The editors have wisely chosen to narrow the field of child development enough to be able to provide a meaningful guide to an important area.
The chapters are divided into a framework of five sections: setting the stage; self and relationships; social behaviours; contexts for social development; and risk and resilience. Topics include attachment, identity, romantic relationships, emotional regulation and many juicy others. Up-to-date research is presented in a clear style, if sometimes placing more emphasis on US research than on other sources.
The book is a useful resource for lecturing, and as a reading list recommendation it gives students an academically rigorous overview. For clinicians, it gives updates on literature and a reminder of why the assessment of childhood social relationships can be so valuable from the point of view of mental health and social adjustment.
It is possible to dip in and out of this book or read it as a cohesive whole. I would highly recommend it to clinical and academic colleagues alike.
Guilford; 2011; Hb £43.95
Reviewed by Lucy Maddox who is a Child and Adolescent Clinical Psychologist
Marriage and Family Therapy: A Practice-oriented Approach Linda Metcalf
This book, although over 500 pages long and covering 14 different models, is presented in a comprehensive way making it very approachable.
My favourite part was the ‘Master Therapist Interviews’ at the end of each chapter. These interviews ask eminent professionals that use the models 15 questions, such as what attracted them to the model, as well as questions relevant to the particular model. This I imagine is interesting for experienced family therapists more so than the descriptions of the theories which are relatively brief. The contributors are largely from the US, but the theoretical models are broader.
Another favoured part is the case studies at the end of each chapter. These provide a rich flavour of the work in practice. This I find to be helpful clinically, in particular in the way that it provokes thinking about how one can use the models.
Overall the book provides a succinct overview of the models and has plenty of references for further reading.
Springer; 2011; Hb £73.95
Reviewed by Helen Eracleous who is a clinical psychologist in Hertfordshire
International Handbook of Suicide Prevention: Research, Policy and Practice Rory C. O’Connor, Stephen Platt & Jacki Gordon
According to the World Health Organization (2010) suicide rates have increased by 60 per cent worldwide in the last five decades. Consequently, the global mortality rate due to suicide is now one every 40 seconds.
Against the background of this drastic increase in suicide rates, the authors of the International Handbook of Suicide Prevention have collated a wealth of contemporary research from no less than
80 experts in the field of suicidology across the globe.
The aim of this mammoth enterprise was to emphasise the importance of international and multidisciplinary collaboration in order to reduce the number of suicide-related deaths. This task was approached through critical discussions of research, policy and practice in suicide prevention.
As a Samaritan and a mental-health professional, I am on the front line in suicide prevention, and as such I was keen to review this handbook. Overall this book has furthered my knowledge about the determinants, risk factors and prevention of suicidal behaviour. Moreover, I would thoroughly recommend this handbook as an accessible, comprehensive guide to anyone who has a professional or personal interest in suicide prevention.
Reviewed by Marie Sara Louis
who is an Honorary Assistant Psychologist at Surrey and Borders Partnership NHS Foundation Trust
For a list of books available for review and information on reviewing for The Psychologist, see www.bps.org.uk/books
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