Jeanine Connor is a writer and editor and is regularly asked to review books by other authors on various aspects of psychotherapeutic work. These book reviews are published in BACP journals.



The rage for life, David Taransaud (2016)






currently reading and reviewing on 


behalf of BACP CYP


Horny and Hormonal: Young people, sex and the anxieties of sexuality, Nick Luxmoore (2016)

Review published in BACP Therapy Today




‘I’ve never worked with a thirteen-year-old for whom sex hasn’t been an issue affecting everything at some level’, so says Nick Luxmoore in the introduction to Horny and Hormonal. Me neither, but people are often aghast when I say so. Those people, and anyone who works with or is the parent of an adolescent, should read this book.

In chapter 2 Nick talks about the sexual undercurrent in school performances, the frissons between students and the sexual feelings teachers might experience towards their pupils. At a time when the media are all over relationships between young people and authority figures, this is honest and brave. Luxmoore argues that to deny sexuality is to send it underground which is potentially more dangerous. He references Suttie’s (1935) ‘taboo on tenderness’ and Nitsun’s opposing view that sexuality is part of any group experience. He is advocating honesty and practices what he preaches. This is evident throughout the book but most explicitly in the chapter about sexuality in the counselling room (chapter 8) in which he reiterates the importance of acknowledging our feelings towards our young clients and theirs towards us.  The author counsels that if we can enjoy the erotic transference we avoid idealization, demonization or acting out.

Luxmoore demonstrates his use of language when talking with young people about sex. He uses their language (dick, fanny, wank, blow-job, fuck) but he also his own to educate and inform. He includes a case example about a sexually active fifteen-year-old who’s taken an overdose. What struck me was Nick’s process of decision-making regarding confidentiality and when to share (or not) information with his client’s parents. This illustrates how such decisions are never cut and dried; they are grounded in experience, courage, and a certain professional mettle, which Luxmoore has in spades.  

Nick compares counselling with sex, stating that new experiences such as these are nerve-wracking but potentially transformational (p.30). He states also that how a person relates in therapy provides clues about how they behave sexually (p.163) and makes links between adolescent sexuality, infancy and parenting. These provide insight into how much relationship/how much aloneness a young person can tolerate with helpful theoretical references.
I noticed several gender assumptions such as girls portrayed as more likely to cry, be body conscious and it being their lot to withstand the advances of boys who are more likely to be sex-obsessed viewers of porn. This is how it is for most boys and most girls in most schools. The writing is honest, not stifled by political correctness.

Nick Luxmoore is my column-mate over in the CYP journal and I was delighted to be invited to review his latest book. We’ve never met, but I read everything he writes avidly, and often with a tinge of envy that such wise words are assigned to his name rather than mine. This book is no exception. Nick ‘gets’ young people and his writing is spot on. 

Rensal the Redbit, A psychoanalytic fairy tale, Eugene J. Mahon (2015)

Review published in BACP Children & Young People


I initially misread the cover title as Rensal the rabbit, but this was immediately rectified as the author explains that redbits are similar to rabbits except they are smaller, stay smaller for longer and are red. The story of Rensal has several features of a traditional fairy tale. It begins with the words ‘Many years ago in Mytherranea…’ which sets the scene for the tale of a mythical creature in a mythical land. It’s a short book (70 pages) divided into shorter chapters with a number of repeated refrains. It feels like a book that wants to be read aloud. It has pictures.

This jaunty tale describes the developing relationship between Rensal and The Tall One, a grown-up redbit who is somewhat of a sage. Rensal’s almost daily visits to The Tall One help him make sense of life’s mysteries. It is easy to draw similarities between the fairy tale relationship and that of client/therapist. After their first meeting, Rensal ponders on how ‘strangely different’ this Tall One is from other Tall Ones in the way he listens. Rensal muses that it’s as if ‘your words went into him…’ and ‘…what returns is a little of yourself, changed by contact with him, and a little of himself, changed by contact with you.’ What a wonderful description of the therapeutic process of listening, absorbing, digesting and giving back.

We are reminded of the Tall One’s acumen by the repeated refrain ‘he scratched his chin, waiting for a wise expression to appear on his face…’ which also illustrates his capacity to model thinking, as does ‘he chewed his pipe as if thinking with his mouth’. These descriptions made me consider the ways in which I demonstrate my thinking to children in sessions – I tap my fingers on my lips, I gaze skywards in quiet but obvious contemplation. Mahon reminded me that these cues demonstrate active thinking in otherwise ambiguous silences. 

The chapters are short, some only a couple of pages, with Rensal posing a particular mystery he’s been grappling with in each one. Topics include the metaphysical; dreams, secrets, curiosity, questions themselves and imagination, which the Tall One describes as ‘wishes and fears turned into good and bad pictures’. Big issues are also pondered over such as God, war, reproduction, beginnings and endings. Within these topics I noticed subtler themes of identification, projection and displacement and enjoyed the way the fairy tale relationship develops its own shape and form. The implicit power imbalance is also addressed, when Rensal confronts the Tall One with the assertion that ‘your wisdom clips my wings’ reminding us that sometimes the best thing we can do to foster curiosity is stay schtum.  

It is evident throughout this little book that Mahon is both a child psychotherapist and a poet. The imagery conjured by his use of language is quite beautiful. Some of my favourites are – ‘the question dropped like a pebble into his mind, you could almost see the ripples’ and ‘in the morning, the dream made off in a hurry like darkness running from light’. I enjoyed this psychoanalytic fairy tale very much and hope there will be many more to wonder over and explore.


 

 

Making meaning Clay therapy with children & adolescents, Lynne Souter-Anderson (2015) Review published in BACP Children & Young People

I attended a workshop earlier this year called ‘The use of clay in therapy’ facilitated by Lynne Souter-Anderson, the author of this book. As an experienced counsellor/psychotherapist and an amateur potter I attended out of professional curiosity and had not anticipated the impact the day would have on me. Within a week I had added clay therapy to my therapeutic repertoire and continue to be moved and astounded by what happens when young people work with clay in the therapeutic setting. I read Lynne’s first book, ‘Touching Clay, Touching What?’ and eagerly awaited publication and the opportunity to review ‘Making Meaning’ with its specific emphasis on clay therapy with children and adolescents. 

Making Meaning is divided into four parts. Part 1: Clay therapy deals with the practical aspects of sourcing, storing and handling clay and the equipment required to get started, which is surprisingly little. There is also guidance on basic construction techniques and how to work with creations and processes therapeutically. This section of the book encompasses the practical aspects of the live workshop and is an accessible, user-friendly guide to clay therapy for the novice. Don’t be tempted to skip it.

Parts 2 and 3 present ten case studies of children and adolescents ranging in age from 5 to 16 years. These are arranged in chronological order presenting a range of developmentally realistic issues – what a sensible idea. The author includes her reasons for selecting each case and relevant background information as well as honest depictions of her therapeutic work with each young person.  I read them hungrily and learned something from every one. My only criticism relates to typos. A curious one appears on page 50 in the discussion of 5-year-old Evie’s toileting trouble. It reads ‘there was much being communicated that neither of us wishe           ’ and then it stops, mid-word, mid-sentence. I could make mischievous interpretations about ‘withholding’ but most of all I want to shout ‘why wasn’t this noticed prior to publication?’ Also, I struggled to connect with ‘Mattie’ because of a number of typos and some jarring use of language that made reading this case study a bit like listening to a scratched record. Elsewhere in the book there was the odd typo here and there which is irritating but didn’t detract me as much as the ones I’ve mentioned.

Part 4: Clay Therapy Initiatives outlines five recent research projects that have investigated the use and usefulness of clay in therapy. This section is reminiscent of Lynne’s first book, but it is brief and worthy of inclusion. One of the research projects asks the question ‘Is pottery on iPads therapeutic?’ I must admit I winced at this title. Clay is a wet, soft, malleable, earthy substance; it can’t be replicated electronically. Except, of course, it can. The research found that virtual clay offers opportunities for enjoyment, achievement and activating the imagination. I’ll be sticking to the real stuff and no doubt dipping in and out of this book to guide me along the way. 

 

Handbook of working with children, trauma and resilience, Aida Alayarian (2015)

Review published in BACP Therapy Today

 This title is part of the UKCP book series, which provides resources to practitioners within the psychotherapy profession. Aida Alayarian is a well-chosen author. She has almost thirty years clinical experience and is the founder, Clinical Director and CEO of the Refugee Therapy Centre (RTC) in London. Her book fulfils the series’ overarching aim of combining research, theory and practice.

The book focuses on the experiences of refugee and asylum seeker children, with the explicit aim of examining the impact of torture. The opening chapter reminds us that one quarter of asylum seekers are children and that the trauma they endure is threefold; encompassing stressors endured in their country of origin, their flight to safety and their new environment. The author acknowledges her feelings of pain and anger in response to the children’s narrative but acknowledges also that this will not help them and is not what they need. The book contains many clinical vignettes depicting the horror of refugee’s experiences. It is difficult not to be pained or angered by them, providing a stark example of the challenge of working with this client group.

I found Alayarian’s no-nonsense style of writing appealing. She draws on a wealth of psychodynamic literature including Freud, Erikson, Bowlby, Stern and Ainsworth. Readers without a psychoanalytic background may find this a challenging read, although Alayarian does a sterling job of making the underpinning theory accessible. She defines specific theories fully and explains with clarity how they relate to clinical work with refugee children. Alayarian’s caution against pathologising is refreshing. She identifies post-trauma anxiety and depression as normal responses to environmental stress rather than signs of mental illness. Similarly, the importance of recognising adaptation strategies as a sign of health is illustrated, for example, by identifying ‘healthy dissociation’, which shifts the focus away from trauma and provides a much needed psychic break.

The ‘resilience’ part of the RTC model encourages a shift away from the traditional ‘deficit, disorder, problem-behaviour’ paradigm and instead encourages a focus on competencies, capacities and resources; in other words, the emphasis is on the haves rather than the have-nots.   


The RTC treatment model focuses on the actual or perceived reality of each individual rather than following a generalised formula and appears to caution against the provision of medication.  Alayarian advocates a systemic approach that considers the multiple factors and needs of the children themselves, as well as their families and school. If only the services of the RTC were available nationally and for all refugee children. And if only Alayarian could inform and educate all who encounter them! An excellent and timely publication. 


That's So Gay, Jonathan Charlesworth (2015) 

Review published in BACP Children & Young People

This book is about homophobia written by the Executive Director of Educational Action Challenging Homophobia (EACH) UK. As such its target audience is schools. I was intrigued by the images on the cover of coloured t-shirts depicting derogatory slogans such as – so boring, so pathetic and so gay. Having read the book I remain intrigued. The author’s premise is that homophobic bullying, which includes throwaway comments such as ‘that’s so gay’, is fundamentally different to other types of bullying, so I wonder why the cover illustrates them in a way that suggests they are the same. This dilemma continues throughout the book with the author maintaining that homophobic bullying is different while often describing bullying in general.

In Chapter 4 ‘Why do young people bully homophobically?’ the author suggests that both bullies and targets of bullying show signs of internalised distress, which is worth remembering but is not specific to homophobia. This chapter also contains some interesting examples of the ways that homosexual men and women are portrayed in popular television programmes, suggesting they are often ridiculed while the positive portrayal of gay characters is more subtle. While this was interesting, I was unsure how it related to the focus of the chapter.


Lots of the chapters contain, what seemed to me to be, good common sense; for example, descriptions of homophobic bullying, who experiences it, and the impact on those being bullied, etc. My concern is that this must be less than ‘common’ sense to have warranted five chapters in which case, the author provides a well-written reminder. Chapter 6 ‘How to respond’ contains some obvious sanctions and the advice that prevention is better than cure, as well as some less obvious ideas about celebrating success in the absence of homophobia.


Chapter 7 ‘Working with those who bully’ will be particularly helpful for school staff no matter what form the bullying takes. The advice about working with whole school systems and families is sound and evidence based. However, I disagree with the warning against working to raise self-esteem in aggressive bullies, which seems contrary to the author’s perception of bullies as having ‘internalised distress’. Surely raising self-esteem in the distressed young person is a good thing? It is in my clinical experience. As a psychodynamic psychotherapist, I winced at the author’s bias towards CBT but acknowledge that this reflects a general trend in the public sector.    


Chapter 8 ‘Sensitive handling of disclosures’ uses language in a way that school staff may find confusing. For example in differentiating between disclosure and statement and the sometimes contradictory uses of confide and confidential. 

 

The end of the book contains a glossary of terms that might perhaps be a useful place to begin reading. I wondered about the omission of ‘transexual’.

In terms of target audience this is not really a book for counsellors. In terms of how helpful it would be to encourage schools to think about and address homophobic bullying is difficult to say. It might be a case that those who are concerned enough to read the book don’t need to, while those who have the most to gain will ignore it and remain uninformed. This is a well-written book with some valuable aspects. Perhaps as a psychotherapist reviewer I haven’t done it justice.

Seeds of hope bereavement and loss activity book, Caroline Jay. Illustrated by Unity-Joy Dale (2015)

Review published in BACP Children & Young People

 I have just one criticism about this book so I’ll get it out of the way. Its subtitle is ‘Helping children and young people cope with change through nature’. It looks, reads and feels like a glossy children’s book with coloured images predominating over text on every page. I think this will put ‘young people’ off. Having said that, the activities at the back of the book aimed at primary school and secondary school are stimulating and age-appropriate. But otherwise, this is fundamentally a book for the under-teens. The blurb says it’s for children age 5+ but it would be really valuable for younger children too. With under-8s in particular, this is definitely a book to be read together with a containing adult rather than alone.

One of the great strengths of this book is the way it’s been illustrated. The book is divided into colour coded sections, rather than formal chapters, with each one just a few pages long.  The entire book has less than 80 pages and it is evident that the author and illustrator have opted for quality over quantity.

 The opening section, titled Imagine, invites the reader on a journey through the seasons, encouraging an awareness of changes in nature and reminding us that life is part of death is part of life. Throughout the book, there are links to nature, the animal kingdom and ancient customs with an emphasis on the cyclical nature of life. Children are directed to draw, paint or write about their own experiences and to consider their associated thoughts and feelings.


The experiential activities use the symbolism of nature to illustrate memory and loss. Children are encouraged to recall happy memories about someone they love who they no longer see. This serves as a reminder that, just as life and death are interlinked, so too are happiness and sadness. The book is about bereavement and loss and the activities reference parental separation, moving away and falling out with a friend as well as the death of a person or an animal. The book does not impose a hierarchy; loss is loss, and children of all ages will find this message reassuring and affirming.


The theme of change is explored further in the section about Lifetimes which reminds us that change might be expected or unexpected. The varying life cycles of flowers, animals, insects and humans are illustrated with a message that ‘sometimes the most beautiful things live for the shortest time’ (pp25). The reader is invited to consider their own position on the life cycle as well as that of their parents and grandparents. There are no presumptions, so if a parent has died the reader can place them in a different section to a surviving grandparent and this can be thought about. The lifetimes are depicted as circles with no beginning or end.


With the exception of The language of flowers, which seems to be for information only, this is an activity book full of inspiring suggestions about how to explore loss and bereavement. The author has managed to share a host of beliefs and resources influenced by nature and varied cultures in a very gentle and entirely non-judgmental way. Even in Poems and Stuff this is evident; where words from Wordsworth and Longfellow sit alongside quotes from Ecclesiastes and The Koran and are followed by children’s own words and drawings about, among others, loss of a parent and of a remote control car. This book is just lovely and I know I will use time and again it to explore loss with my younger clients.  

   





Mindful therapeutic care for children, Joanna North (2014) 


Review published in BACP Children & Young People

When I read the title, I wondered what this book might have to say to me that I didn’t already know. Or if it had nothing new to say, would it inspire mindfulness and reflectivity in a more useful way? The first three introductory chapters did nothing to rouse my interest as they describe in wordy detail the concepts of reflective, reflexive and mindful practice. As I progressed through the next few chapters, I read case studies that illustrated the power of reflective practice, and these could be reassuring for trainee or inexperienced childcare professionals or parents. But those with even limited experience have little to gain. North asks the question: ‘How bad can it get when people refuse to use their minds and reflect on experience?’ Her answer: ‘It can get really bad.’ I almost gave up at this point. To illustrate, North uses the case of Vanessa George, the nursery school worker convicted of paedophilia, although for some reason she isn’t named. I found this choice of vignette bizarre, with its implication that George’s colleagues could have prevented the abuse she inflicted had they reflected on their own practice. Can that really be what the author means?

North supports her own ideas with psychological theory, but unfortunately this is outlined at such an elementary level that it seems ambiguous. For example, she states that Theory of Mind was proposed just 15 years ago by an American researcher, John Flavell. She then goes on to describe (what is essentially) Piaget’s concept of egocentricism. But Piaget, who died in 1980, gets no credit. And nor does Descartes, who I’m pretty sure was writing about Theory of Mind in the 17th century! While there is no reason for North to refer to the earliest origins of Theory of Mind, to reference it as ‘Flavell, 1998’ misleads the reader. Similarly misleading is the ‘Bowlby, 1988’ reference repeatedly assigned to attachment. We all know, North included, that attachment theory predates Bowlby’s 1988 publication by a good twenty years. As well as finding the content rather disappointing, I found the style of writing rudimentary and repetitive. The sentences are long. The text is littered with inappropriately used hyphens. The author says nothing new and even the typos felt predictable.

Chapter 6, ‘The Reflective Practice Pentagon’, is the longest and most beneficial chapter of the book. Although a pentagon, suggesting five aspects, the model details six components of therapeutic childcare – the child, the individual, the team, the system, expert help and theories, and working together – in detail, and as such, provides a constructive model for reflective practice. The pentagon model could form the basis of a valuable standalone manual for residential childcare workers (RCWs), social workers, foster carers and parents.

However, The Reflective Practice Pentagon, like the whole book, would be of little benefit to psychotherapists, except those in the very early stages of pre-clinical training and it bothers me that the list of ‘who this book is for’ lumps everyone who works with children together. In North’s defense, she is not the only author who presumes such wide appeal, but, nevertheless, this is a mistake. Foster carers, social workers, teachers, RCWs, counsellors and child psychotherapists have infinitely different trainings and our job roles are immeasurably diverse. At the risk of sounding hierarchical, this book could enable a basic understanding of mindful therapeutic childcare for unqualified or newly qualified practitioners, but it has nothing to say to psychotherapists that we don’t already know about in much more detail. 
      





Waiting to be found, Papers on children in care, Edited by Andrew Briggs (2012)

Review written for BACP Therapy Today

After reading the series editor’s preface and the acknowledgements and ‘about the editor and contributors’ and another preface and the foreword and the introduction, I finally got to Chapter 1. While I accept the need for some sort of introduction and context setting, I do think that 57 pages of preamble is overkill.  Chapter 1 is an homage to Hamish Canham, to whom this book is dedicated and who has contributed [posthumously] the next six papers of the book. Chapter 1 is supposedly a bona fide paper rather than another introduction, but in fact it explains, yet again and not very well, what is to follow. Having made it this far into the book, I just wanted to start reading something interesting.

 

Already frustrated, reading chapter 1 made me very cross indeed. There was a typo on the second page and by the time I had endured the full 15 pages I had circled so many grammatical errors, double negatives, incomprehensible sentence structures, and superfluous superlatives that I almost threw the book down in despair. ‘Where is the editor?’ I cried, before remembering that Chapter 1 was, unbelievably, written by the editor of this book.

 

Chapter 2, the first of Canham’s papers to be published in this collection, I have read before, but it was refreshing to read again. There is much to be learned from this and Canham’s subsequent papers; about therapeutic style, psychoanalytic insight and how to apply this way of thinking to work with Looked After Children, whatever discipline you work in.

 

Part II, from Chapter 8 onwards, also has lots to offer those of us working with children in care. I found something stimulating and/or recognisable in every case study and it was good to be reminded of the psychoanalytic literature that underpins our work with this particular patient group. This is a book I will dip in and out of again and again, but only from Chapter 2 onwards.   

      



Family-Centered Treatment with Struggling Young Adults: A clinician's guide to the transition from adolescence to autonomy, Brad Sachs (2013)


        Review published in BACP Children and Young People

I wasn’t looking forward to reading this book, deterred as I was by its cover and the undersized font within. But one should never judge a book by its cover (or its font size) and once I’d begun reading, I couldn’t put it down. This was everything I hope a book to be; engaging, intelligent, illustrative, interesting, educational and enjoyable.

I have every respect for those who practice what they preach and the author of this book does just that. In the preface and introduction, Sachs outlines his own professional and personal experiences so that the reader is invited into the author’s ‘system’ and can begin to see things from his perspective. Throughout the book he refers to his own families of origin and of making, and to his own personal experiences when it makes sense to do so. I like how Sachs uses excerpts from various genres of literature, film and music to illustrate the material throughout, rather than re-working quotes from more traditional psychological texts, as many authors do. I like this because it makes the book fresh and truly multi-systemic, and because it illustrates exactly what Sachs is advocating in his model of fluid family therapy (FFT). 

I’m not sure I like the term ‘launching stage’ which is what Sach’s calls the pre-adult phase of development, but I do like what he has to say about it. The first five chapters are, in essence, about starting family work at the launching stage, including assessment and family dynamics etc. In the latter five chapters, Sachs discusses the impact of life events, such as marital and money issues, at the launching stage as well as variations in his treatment model, including consultations with parents and with young adults.  There are three ‘interludes’, which are essentially mini chapters and it’s unclear why they are singled-out and called something different. These are integral to the book, and to the work, and focus on LGBTQ Issues, Digital Media and Countertransference (at the launching stage).   

Rather than use snapshots from case studies to exemplify theoretical concepts, which can feel forced, Sachs has a way of weaving extracts from his therapeutic work (and personal life) throughout the text seamlessly. It feels as if the reader is in conversation with the author each time he says ‘which reminds me of a patient of mine...’ or something similar, which he does on almost every page.

This is an excellent book, intelligently written, which will have wide appeal. For the first time in a long time I felt as if I was reading something new rather than a re-hashing of the same old stuff. Even the two typos (p41 and p182) can’t stop me from commending this book highly. And to respond directly to Sachs’ closing words: ‘You have not written in vain; far from it’.  


     





Reading Anna Freud, Nick Midgley (2013)


Review published in BACP Therapy Today

Like many UK-trained child psychotherapists, I am less familiar with the work of Anna Freud than I am with Melanie Klein. This book reads as a potted history of psychoanalytic theory with Anna Freud as the central character. It is well-researched and informative. Midgley’s writing is informal, reminiscent of Anna Freud’s herself, which makes the book accessible to a range of audiences. What it lacks in academic style it makes up for in content.

 

The book is arranged into 13 chapters, each focusing on a different theme including applications of psychoanalytic ideas to education, development, observation, illness, law, assessment and diagnosis. Chapter 1 presents a biography of Anna Freud’s life and work which provides a helpful context to the rest of the book.

 

It is difficult to consider Anna Freud’s contribution to child psychotherapy in isolation, and the author makes many comparisons throughout the book to the work of her contemporaries, Klein in particular. Midgley also discusses the many influences on Anna Freud’s work; including her father, Sigmund Freud, the Robertsons, Menzies-Lyth and Montessori, to name a few. This is helpful both in terms of historical context and theoretical understanding. It also provides a good model for thinking about the child in relation to and as a product of a wider system, which Anna Freud first proposed as imperative during the 1950s and 1960s.

 

The child as ‘product[s] of their family backgrounds’ (p35), is one of many taken-for-granted ideas about children which the author highlights as originating in Anna Freud’s work. He also describes the unease she experienced in making diagnoses based on symptomatology and the inappropriateness of treating children according to their symptoms (Chapter 8). These examples make the writing fresh and very much alive to the modern clinician bound by care pathways and NICE guidelines.

 

For me, the book can be summed up by quoting directly from Midgley who states that the purpose of psychoanalytic research is ‘not so much to assess the effectiveness of psychoanalytic therapy, but, rather, to develop a deeper understanding of the workings of the mind and of human behaviour’ (p83). ‘Reading Ann Freud’ is a good example of exactly this; I have a greater understanding of Anna Freud now than before I read the book and for that reason is seems churlish to focus on the efficacy of the writing.

    





The Thinking Heart: three levels of psychoanalytic therapy with disturbed children, Anne Alvarez (2012)


Review published in BACP Therapy Today

‘I love psychoanalysis, not least because it works.’ So reads the opening line of the introduction of this brilliant book. Here here! I first read Live Company¹ as a trainee, and remember being intimidated, baffled, and ultimately educated by Alvarez’ writing. This book challenged and enlightened me in much the same way. It is not for the faint hearted, and readers without a pretty solid psychodynamic base would struggle with its concepts.


In essence, this is a book which guides the reader through levels of interpretation with disturbed states of mind. Alvarez, drawing on previous psychoanalytic theories and techniques, advocates subtle changes in grammar and syntax, depending on the state of mind of the patient. The ‘three levels’ of interpretation (and of the title) are: The explanatory level, which involves ‘why-because’ interpretations with neurotic, normal or mild borderline states of mind. The descriptive level; involving interpretations that attribute and elaborate meaning, for example with borderline or developmentally delayed states of mind. And the vitalizing level; involving interpretations which attract attention and assign meaning to, with patients who are unable to listen or feel and find it difficult to be interested in anything at all, such as those with autistic, psychotic or perverse states of mind.  


Alvarez revisits and elaborates previous psychoanalytic literature; her own and others’, in a way which engages the reader throughout. The 16 page bibliography might suggest that this is all she does, but actually, the flesh of the book is its rich case studies which hang on the theoretical bones and bring the whole thing alive. I like that Alvarez, with her 50+ years of experience, isn’t afraid to revisit her clinical work or previous hypotheses and realise what she could have done differently, better even.  I recognised aspects of my own patients in many of the cases presented, and felt encouraged to revisit, reconsider and ultimately reframe my thinking about these too. Alvarez is a great teacher; her knowledge is immeasurable, her writing is brave and her reflections are humble. She claims that her thoughts are ’only considerations, because the complexity of the human mind ... ensures that there can be no manual’ (p86). I believe that the work of Anne Alvarez is the closest we can get to such a manual.        

1.   Alvarez, A. (1992) Live Company: Psychoanalytic Psychotherapy with Autistic, Borderline, Deprived and Abused Children, London and New York, Routledge

        




A Parent’s guide to defeating eating disorders, by Ahmed Boachie and Karin Jasper (2011)


Review published in BACP Children and Young People  

What a brilliant book! As the title suggests, it is aimed at parents of children suffering from eating disorders and, unlike many books, it does exactly what it says on the tin.  It is theory-driven but not academic, intelligent but not intellectual, and condensed (163 pages) but never condescending. In fact, I think the authors have been fairly modest in that it delivers more than the advertising blurb claims.

The book is divided into nine easy-to-read chapters, including a conclusion. The authors begin by stating their rationale for the use of analogies and metaphors which are included throughout the book to explain the symptoms and presentations of young people suffering from eating disorders. Although these are often Americanisms, they can be easily translated and are really helpful at making sense of, a seemingly nonsensical, illness. I particularly liked the opening metaphor of the ‘911 call’ (p.17) where an eating disorder is likened to an intruder. In this illustration, the young person calls 911 to ask for help. When help arrives, the intruder/disorder has a gun to their back and they turn the help away, deciding it is better to live with the intruder/disorder than to relinquish it for an alternative coping strategy that may not work for them. This also brought to mind cases of deliberate self harm, to which eating disorders may be comparable, and demonstrates why both have such a hold over our young patients.    

There follows a ubiquitous history of eating disorders which includes a discussion of biological, neurological, psychological and cultural risk factors. While this is hardly news to mental health practitioners, it is laid out in an informative and educational way which absolutely absolves parents of any blame for their child’s illness. This message runs throughout the book and will be of enormous comfort. The authors remind us of the, now seemingly ridiculous, claim made in the 1940s that autism was the result of ‘refrigerator parents’. The absurdity of this will help parents to realise that holding themselves responsible for an eating disorder is equally misinformed.

What parents are responsible for, according to the authors, is facilitating the treatment and recovery of their child. We are urged to act quickly if we notice symptoms of a possible eating disorder, which are clearly spelled out. We are warned of the ways in which symptoms are masked, purposefully or not, and are encouraged to seek help early. We are cautioned that it takes 7 – 13 years for an adolescent to seek help for themselves and that recovery can take a further 5 – 7 years. If these statistics are intended to shock parents into action, I think they work.

Chapters 4 – 8 provide excellent vignettes which illustrate the various models of treatment for eating disorders. Each focuses on the importance of whole family intervention, and takes a ‘parent-as-expert’ approach. While this places responsibility with the parents, it does so in a way which empowers rather than disables. In one illustration the therapist states ‘you were able to feed [your child] when she was little and needed to grow... now she needs you to help her with this again’ (p75). In other words, reminding the parent that she knows how to provide the help her child needs because she has done it before. Like the tone running throughout the book, this statement is so gentle and yet so powerful.             

    



A Collaborative Approach to Eating Disorders, by June Alexander and Janet Treasure (eds.) (2011) 

Review published in BACP Children and Young People 

There is a strong temptation to call this book about eating disorders ‘weighty’ or ‘meaty’ but I would not describe it as ‘collaborative’. I came to the conclusion, about mid-way through, that the authors had not read each other’s chapters or engaged in a dialogue about how the book would pan out. The result is a poorly organised, repetitive tome, which is another unfortunate casualty of inadequate editing.

The authors of Chapter 1 introduce the concept of the ‘anorexic family’, which interests me and I settle into my chair. They reference lots of studies that support this idea followed by lots of studies that don’t and conclude that more evidence is needed. I scratch my head. I’m sure that the three eminent clinicians who wrote this chapter have something far more pertinent to say about their work than this...

The book is arranged into four parts, each divided into chapters. Part 1, on the whole, provided a sound introduction to risk and resilience for eating disorders. I learnt some new facts and figures but I wasn’t particularly interested. There are case studies in boxes at the start of each chapter but they remain in shaded isolation as the authors don’t really engage with them, which is disappointing.

Part 2 begins with a really positive introduction advocating the benefits of a multidisciplinary, collaborative, approach to treatment. But my high hopes were soon dashed as I was presented with more physical symptoms and more risk factors. Don’t they belong in Part 1, Editor, Part 2 is supposed to be about treatment?

In summary, this book contains some really useful stuff but reading it involves a lot of sorting ‘wheat’ from ‘chaff’. The book is inundated with references, 89 in the first chapter alone, and the complete bibliography takes up 61 of the 303 page total. I’m all for developing previous research and ideas but I also want to read something new to justify the cover price of a new book. 20% of this book is basically a reading list and the rest is padded out with quotes; the most ridiculous of all being ‘vegetarianism should be regarded with suspicion’. As an adolescent psychotherapist (and vegetarian) who can count many eating disordered patients in her case load, I didn’t know whether to laugh or cry.

       



You think I’m evil, by David Taransaud (2011)

Review published in BACP Children and Young People 

This book challenges the popular [perceived] assumption that adolescents are evil, an assumption based on media reports and research of the UK population. The author works with ‘challenging’ adolescents and argues that perceptions of this demographic as ‘feral’, ‘bad’ ‘monsters’ can be overturned if we take the time and trouble to explore the childhood experiences of the adolescents we have come to fear and hate, yet hope to help.

 

Taransaud introduces the concepts of Wounded Self and Omnipotent Self which he uses to describe the split-off and opposing parts of the adolescent who has been deprived of good-enough parenting. The Omnipotent Self is the persona the tough, aggressive adolescent presents to the world, and is therefore judged upon, which serves to defend his hidden Wounded Self. The case studies are honest, poignant illustrations of how to engage both parts of the adolescent in order to help him to heal and to change. They successfully portray a sense of hopefulness for all of us who work with difficult to engage young people as well as for the young people themselves. This is a realistic, and also a very optimistic, book.   

    

There is a healthy balance between scientific evidence and clinical illustration, as well as quotes from psychological theory and popular literature which are used well to support the author’s argument. There are some exceptions and, in my opinion, omissions; the descriptions of transference, countertransference and projection are sometimes confusing; projective identification is used in many case examples but not acknowledged; the author tackles the negative consequences of anecdotal labelling (ignorant, stupid, evil etc.) but fails to mention the effect of formal labels such as Attention Deficit Hyperactivity Disorder (ADHD) or Autistic Spectrum Disorder (ASD) which professionals will recognise from the text.       

      

The book is very readable; Taransaud’s style is conversational rather than academic, while his use of language is down-to-earth [and at times repetitive]. This could be seen as a positive or a negative depending on the reader’s experience and perspective. This book provides support, reassurance and practical advice which teachers, carers and social workers will find invaluable. Those with a more robust academic training experience should not be put off though. I was inspired, in particular, by Part three: practical strategies: new creative options which include suggestions for the use of stories, film and music within the therapeutic setting.   

 

On the whole, I enjoyed this book and was stimulated by it. I have reflected upon it in my clinical work and referenced it in my research into the effects of domestic violence and violent media on young people. David Taransaud should be applauded for the honesty, vulnerability and lack of pretention displayed in this timely publication. Unfortunately, his editor(s) have done him a great disservice. I found the dozens of typos, spelling mistakes and grammatical errors littered throughout the book hugely frustrating and I ended up feeling very sorry that the author’s work had not been shown the level of care it deserves. May I suggest professional peer review prior to the publication of book two? I would be happy to oblige!


   



Emotional disorders: A neuropsychological, psychopharmalogical and educational perspective. Edited by Steven G. Feifer, D.Ed. and Gurmal Rattan, Ph. D.

Review published in BACP Children and Young People  

This is a weighty book both in the sense of its volume and content. The size and structure is typically ‘text book’, which might cause a heart sink moment for some potential readers, it did me. Undeterred by its less than pleasing aesthetic and the tongue twister of a title I soldiered on. Chapter 1 begins with a vignette that engages the reader with the topics of social neuroscience and neuropsychology. The author uses this to illustrate the relationship between body, brain, thought, emotion and environment in a way which makes theoretical sense and is not nearly as scientifically intimidating as the title might imply. However, I found the rest of the book far less engaging.

I was interested in the way the author of chapter 2 links early emotional experiences with brain development and goes on to explain how, in turn, neurobiology influences the development of temperament and emotion. Chapters 3 – 6 tackle psychopathology from the perspective of a medical model. The authors cite a wealth of evidence, mostly American, to support their claims of a relationship between specific brain injury and particular psychological dysfunctions in children. Their argument appears to be one of cause and effect, i.e. that abnormality in the frontal lobe causes unipolar depression and right hemisphere damage causes visual hallucinations and psychotic ideation, although the authors are never so bold as to assert this overtly. In fact, they are never so bold as to assert anything very much and the book soon descends into a mass of statistics over substance. For example, we are told that comorbidity of SLD and mental illness affects approximately 15 – 80% of adults (p.202) – is that information supposed to be useful?  

The chapter (7) about psychopharmacology begins with a short aetiology of emotional disturbance which is said to be created by ‘bad signals or programming [which causes] good neurons to be inadvertently destroyed’. I was irritated by this remark and totally incensed by the later claim that teenagers have ‘lost their mind... since one-half of the synaptic connections from age 6 have been destroyed’ (p.149). The author goes on (and on) to explain neurotransmitter function and the effects of medication in a dull and monotonous way and I found myself thinking, not for the first time while reading this book, so what?

The authors of the later chapters suggest that ‘academic and behaviour problems tend to be viewed as single entities as opposed to a constellation of emotional, neuropsychological, cognitive, academic, motivational, familial and other factors’ (p228). They then stake a claim for multi-modal methods of assessment and intervention as if they are pioneering a brilliant new approach. Note to authors: practitioners have been doing this for at least the last 20 years. However, even then, the authors can’t quite resist resorting to form and claiming that ‘it is important first to determine the underlying or core condition within the child and then choose an appropriate intervention’ (p.239).  So the environmental dimension of the nature – v – nurture dichotomy remains firmly abandoned in chapter 2.

The book feels out-of-date in other ways too; for example in its proposition that ECT ‘may prove to be a valuable last resort’ (p.171) and that ‘medication is often used as a first line treatment for anxiety and depression’ (p.244). Actually, out-of-date may be too kind; these claims are false (or maybe we do things differently in the UK?) 

Overall, the explanations of emotional disorders, neuropsychology and psychopharmacology feel linear, reductionist and theoretical rather than interactional, holistic and therapeutic and I found the educational perspective to be obliterated by statistics. In my opinion, the authors have missed a valuable opportunity for joined-up thinking and this is a great shame.

    






Healthy Attachments and Neuro-Dramatic-Play,
by Sue Jennings (2011)


Review p
ublished in BACP Children and Young People 
The aesthetic of a book really influences my motivation to read it, so I was excited to receive this rather good-looking book for review. It has a pleasing size and shape; 271 pages and A5 respectively, and there are even illustrations, something many ‘serious’ authors shy away from. But Sue Jennings is a serious author with a serious message, as is apparent from the outset of this superb book. As a child psychotherapist, I discovered much within it to interest, engage and challenge me.

The first sentence of the foreword reiterates what I have learned to be true; that play is both powerful and necessary and that its presence or lack has a profound impact on children. This is a message which, in my opinion, cannot be shouted loud enough or often enough. The book tracks the development and application of Jenning’s concept of Neuro-Dramatic-Play (NDP); a process which develops alongside and supports that of attachment. The author begins with a review of existing theories of attachment and play from the usual suspects (Bowlby, Harlow, Winnicott etc.) and these are revisited throughout the book in an informative and reflective way. Jennings is not afraid to disagree with or develop a well established theory which makes her approach brave, refreshing and, dare I say it, playful!

A theme which runs through the book is the relationship between nature and nurture which, pleasingly, is becoming thought of less as a dichotomy and more as a mutually influencing aspect of development. As Jennings puts it; ‘Nature gives the brain its potential but it is the quality of the nurture (or neglect) that will determine the eventual growth of the brain and its capacities’ (p29). And for the author, a vital aspect of nurture is play. NDP, she argues convincingly, begins from the moment of conception throughout a critical period of six months after birth. It seems strange at first to think of playfulness and attachment as starting at conception but if we consider, as the author urges us to do, the contrasting situations of a pregnancy borne out of rape and one which is the result of a playfully intimate encounter, we begin to see where Jennings is coming from. This is striking in its contrast to earlier theories of attachment and play, but supports my personal view and that of many psychotherapists, that what happens in the womb and during the first months of life has a crucial impact on the capacity for relationships, empathy, emotion and behaviour. The taking of a detailed early history in child therapy referrals, including details of the conception, pregnancy, labour and early developmental milestones, is therefore imperative in understanding the troubled child we later meet in the consulting room.

While many established theories posit the notion that neglect, and in particular maternal neglect, is irreversible in terms of its negative effect on attachment, Jennings’ view is much more optimistic. She guides us through NDP techniques which can be used alongside conventional models of therapy for interventions with different aged children up to and including young adults, with a chapter devoted to ‘looked after’ children which I found particularly encouraging. Her emphasis on working with the family rather than the young person in isolation also made good therapeutic sense. All in all I found this an intelligent, thoughtful and hopeful book which I know will influence my clinical practice.