Signpost Book Reviews
Vol 8.1 2003
This page shows books which Signpost has reviewed. If you would like to become a Signpost book reviewer, please contact Signpost.
For guidelines click here.
For a full list of published reviews click
here.
The Experience of Alzheimer's Disease
-
Life Through a tangled Veil
Author: Steven R. Sabat
Publisher: Blackwell Publishers Ltd.
ISBN: 0631216669
Price: £17.99
As Sacks points out in his back cover comments, Sabat's book presents
"each person as a unique subject, and emphasis is laid on what is
strong and preserved, the ways in which the self and a sense of worth and
meaning can be maintained".
This psychological perspective is befitting of a highly rated and
established associate Professor of Psychology. He also has experiences of
co-facilitating support groups for dementia sufferers, and that empathy is
evident throughout this paperback.
Some assessors of Sabat's work have highlighted this as an existential
perspective: consequently Wittgenstein and Laing rub eminent shoulders
with Feil and Kitwood in the reference section. On browsing at the other
names, one in particular caught my attention, 'Carter, Jimmy, US
President'.
And those references perfectly highlight a major strength of this book,
appearing in a specific context within Sabat's framework. As the pieces
develop their themes, one recognises the benefits of accurately
transcribed conversations and interviews with dementia sufferers.
To place all this in context, a discussion is recorded with a 68 year
old Ph.D. holder, sub-headed 'His sense of loss with regard to reading',
which exemplifies the three virtues that practitioners in dementia care
use most regularly: patience, perseverance and lateral thinking.
It was by employing those three complimentary attributes that Sabat was
able to piece together the information that identified Carter as the man
being discussed - admittedly intuitive quasi-detective work also played a
part, as did an awareness of recent history.
This is one example of many that could be chosen from a highly-readable
and informative
paperback, which helps the
reader to understand the psychological issues behind Alzheimer's Disease.
Having progressed through seven chapters of keenly monitored
observations and thought- provoking asides, Sabat concludes by considering
the opinion that 'The Tangled Veil is also a Mirror'.
This final chapter draws together strands while widening the debate, by
embracing many references to Laing's 'The Divided Self and elements of
existential phenomenology. This study of the subjectivity of experience,
aligned with the impact of a 'hypercognitive culture' appears to be of
seminal importance to the key issues, and will possibly lead some to
re-evaluate Laing's writings.
How often have those who have undergone Bradford Dementia Group
'Dementia Care Mapping' training been concerned about how to react to
suggestions that dementia is, in some profoundly simplistic way, a return
to childhood?
Sabat clarifies this pseudo-detraction magnificently: "There is a
tremendous difference between the child and the (dementia) sufferer, who
has lived decades of independent adult life which can be understood as
existing in his or her 'personal present"' (page 323).
It is important that those for whom dementia care is either a personal
or professional issue read this book. And then the final sentences:
"Our treatment of people with Alzheimer's Disease speaks of who
and what we are, and so the tangled veil is truly a mirror. The challenge
to all of us is outlined in the reflection" (page 340) will make
perfect sense. Highly recommended.
Stephen Weeks BA (Hons.), RMN, Leeds
Burden of Sympathy
Author: David A. Karp
Publisher: Oxford University Press
ISBN: 01 19 512315 8
Price: £21.99 hb
‘Burden of Sympathy’ is the "second half of a story (which)
began in a previous book, ‘Speaking of sadness’ ". The first book
contained Karp’s account of his own mental health problems. Following
the success of this book Karp received many requests for a book which
detailed the experience of mental illness from the perspective of a carer.
This book, ‘Burden of Sympathy’, is exactly that. It is constructed
around over sixty extensive interviews with carers and also observation of
a family and friends support group.
Karp has used these interviews to chart the major theme’s which run
through each person’s individual account of the illness. He has
described and discussed both accounts of how the carers and relatives
themselves make sense of their situation and also provided his own
overview of all the accounts. In particular he has covered the issues he
found to be most pertinent to carers and relatives of the mentally ill,
which he terms ‘the four C’s’ – cause, control, cure and care –
and ‘surviving the system’. These include both practical information
and personal accounts.
In ‘Burden of Sympathy’ Karp has focused on the changing nature of
the relationships between members of a family when one member becomes
mentally ill. Specifically, Karp highlight’s the need for members of the
family to draw boundaries between themselves and the ill person in order
to protect their own health and emotions. Without a certain amount of
distance it becomes impossible to continue caring he suggests, and
convincingly illustrates.
This is a fascinating book, made more so by the extensive use of case
studies and quotes. It provides a valuable insight into the lives of
people who love and care for someone with a mental illness, both for
people who have never had that experience, and also for people who have
had or are currently undergoing that experience. The easy to understand
format and language adds to the appeal and hugely increases the
accessibility of the book. It is ideal if you are interested in a book
written from an individualistic perspective.
However, this is not the right book for someone looking for a
scientific analysis, nor does it claim to provide any definite answers. It
is also written by an American, so whilst still providing valuable
information, some of it (especially the section on ‘surviving the system’)
is perhaps not as relevant outside of the USA. But don’t let that put
you off – this is an engaging and valuable piece of work that I would
highly recommend.
Emma Cooper, Placement Student, Cardiff
Health Anxiety : Clinical and Research
Perspectives on Hypochondriasis and Related Conditions
Author: Asmundsen, Taylor and Cox.
Publisher: John Wiley & Sons Ltd.
ISBN: 0471491047
Price: £27.50
This hefty textbook is a collection of essays by a wide range of
experts from around the World but with a focus on the Americas (and
consequently has an emphasis on the DSM categories of mental illness
rather than the ICD version.) There are however very useful contributions
from British experts.
There is little doubt that the book is relatively hard reading although
it is more profitable and satisfying to delve into specific chapters of
which the most useful are those which focus on specific liaison psychiatry
issues such as pain , chest discomfort and hypochondriasis. A chapter
looking at health anxiety in the elderly is particularly helpful too in
looking at the specific needs of this patient group.
One’s distinct impression of the book (and this is slightly
off-putting for the less academically inclined reader) is that of research
in this difficult area. Interestingly suggestions for the future direction
of research in these areas ranges from categorical concerns about the
classification of health anxiety (for reasons of "best fit"
treatment approaches) through to the science of genetics and its possible
impact on understanding anxiety.
Very practically the book is an excellent resource for those of us
encountering health anxiety of various kinds in the patients we serve. It
is recommended as a textbook for reference as and when needed coupled with
an excellent resource for those interested in research in this difficult
area.
Dr Clive Morgan, SHO in Psychiatry, Hull and East Riding
Community NHS Trust.
Keeping in touch With someone who has
Alzheimer’s
Author: Jane Crisp
Publisher: ASUMED Publications
ISBN: 0 9577988 2 2
Price: £12.95
This book is written from a personal and professional perspective. Dr
Crisp, recently retired as a lecturer in communication, media and women’s
studies at the Griffith University in Brisbane, Australia. When her
mother, who lived in New Zealand, developed Alzheimer’s disease she was
determined to use her insights into the academic world of communication to
bridge the potential gap that may develop. She had always had a very close
relationship with her mother and was determined to maintain this.
The book is written with gentle humour and a refreshing honesty that
makes it easily readable, leading you on a journey of discovery of trying
to understand the world of dementia as a sufferer and as an observer. It
never becomes sentimental but always offers an alternative
explanation as a means of creating a different framework.
Dr Crisp does not have a medical background and this helps to retain
the emphasis on the individual in their cultural and social setting. There
are eight chapters clearly identifying the areas they will cover; giving a
list of topics at the beginning and a summery at the end. Each chapter
keeps the focus on the person with dementia and often gives
"real"" examples of what is being discussed. Dr
Crisp uses her own personal experiences with her mother but also underpins
this with examples of current good practise from
