The book is structured with a fair amount of theory in the first part and some practical suggestions in the latter part. In general, the author does not treat the ...
W I N T E R 1 9 9 8 — V O L U M E 21 N U M B E R 3
gently and gracefully shifts the reader’s
see it as a problem—in fact, the major
paradigm. For instance, reflecting on
problem—for many individuals?” These
T r ea t i n g A l c o h o l i s m
Luc Ciompi’s work, Mr. Watkins writes that “neuroleptic drugs may have their primary impact on the emotional level, for example, by exerting a dampening action on certain parts of the limbic system.” As this review is too brief to illustrate
controversies are explored and dis
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cussed throughout the text and, in
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doing so, differentiate this body of work
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from many of the others on the subject,
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which do not touch on controversies
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This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
trol of his material, uses it in his daily
REVIEWED BY MARTHA RYAN, PROGRAM D IR EC TO R V1NFEN CORPORATION, WI NC H EST ER , MA.
life, and creates space just by talking
amount of theory in the first part and some practical suggestions in the latter part. In general, the author does not treat the psychopharmaceutical aspects of schizophrenia. Instead, he concerns
mental model of treatment and recovery based on a foundation of ac ceptance of loss of control. Specifically, this approach treats alcoholism as a dis
about mental health and mental illness. The book is structured with a fair
this book does take a side on the sub ject in its presentation of a develop
properly, I will content myself with commenting that Mr. Watkins is in con
that characterize the field. However,
T h e addictions field has long been punctuated with controversy. When it comes to alcoholism, what constitutes the problem and what constitutes the treatment has long given rise to many different opinions on the subject.
himself with concepts of recovery, of
“Various political regimes, social
symptom management, and especially
mores, scientific and theological devel
with the family and social contexts in
opments, and even geography have de
which people with mental illness live.
termined a given culture’s drinking
Family and the life course are his sub
behavior, making it difficult to general
jects. His text is laced with well-cited
ize about the use of alcohol. When peo
quotations from scientists and from
ple drink (wine with meals is
consumers. This makes an interesting
sanctioned in Italian society; drunken
mix, and makes his book rewarding
ness is not), how much they drink (in
reading for professionals and for lay
toxication is valued in Irish society as an
ease, recovery of which consists of sev eral stages: the active drinking stage, transition, early recovery, and ongoing recovery. Throughout the text these stages are defined, detailing what hap pens, what the alcoholic can expect, and what the therapist’s steps for treat ment are. Part I discusses theory and controversy surrounding alcoholism and identifies the role of the therapist. The introduc tion presents an excellent historical framework for the text, which helps the reader to understand not only the alco holic’s denial, but the cultural factors and values that support the denial as well. Chapter 1 outlines a developmen
men. Mr. Watkins himself has many
expression of group cohesiveness and
years of experience as a psychiatric
as a gauge of masculinity), and what
nurse in Australia, and he is in a good
they drink (political and economic fac
position to explain that “I wanted to
tors in German society have determined
show that much of the apparently unex
beer to be the preferred beverage) tend
plainable or even frankly ‘bizarre’ be
to differentiate, rather than unify,
havior of people who receive a
human behavior with regard to alco
diagnosis of schizophrenia actually has
hol.” So starts the discussion of
ous stages of the developmental model,
torical framework of the social roots of
transition, early recovery and ongoing
a meaning and a purpose if only we can see it.” This book is a should- read.
Treating Alcoholism in presenting a his
clinical issues relating to alcoholism. In the context of this discussion the au thor identifies three controversies: “1) Is alcoholism characterized by a funda mental loss of control of drinking, or not? 2) Is alcoholism a symptom of an other problem, or is it the cause? 3) Are we to look at drinking as a privilege that people should preserve, or can we REVI EWS 299
tal model of treatment and fleshes out the corresponding stages. Recognition of loss of self control is discussed here as a fundamental step in the movement into recovery. Parts II and III further explore the vari addressing the assessment, drinking, recovery stages. Here the behavioral patterns and changes necessary for the alcoholics as well as specific interven tions and expectations for the therapist are detailed. The use of specific exam ples of relevant clinical experience and case studies that effectively illustrate and support the theory contribute to the reader’s understanding.
PSYCHIATRIC REHABILITATION
JOURNAL
Also noteworthy is the author’s candor
by the alcoholic and how to provide ef
tention that the way we perceive our
in discussing treatment pitfalls and limi
fective treatment through a develop
physical body, either positively or nega
tations of the therapist’s role. For exam
mental model.
tively, affects our interpersonal relation
ple, the case of a therapist who gets trapped in a power play with a client in denial is discussed and illustrated. Additionally, in the very relevant and ever- present atmosphere of managed care, the limitations of treatment due to emphasis on focused, time- limited treat ment are discussed. In such an environ
This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
ment abstinence is seen as the “cure” or end of treatment, wherein this model it is only the beginning of recovery. To bridge this gap, the authors strongly ad vocate for the use of Alcoholics Anonymous as a means to provide on going support for the alcoholic. Throughout the book the authors em phasize the importance of therapists learning the language of AA, incorporat
This book is geared toward therapists and others providing direct counseling to the alcoholic. Consequently, it has
ships, and recreational and professional choices and impacts our general sense of satisfaction with life.
limited interest for others as it speaks
The Body Image Workshop provides a
so directly to the tasks and interven
structured framework for achieving an
tions of the therapist. However, it is a
accepting and positive body image.
good source book for anyone seeking
Based on work with hundreds of clients
to understand the treatment and recov
over 10 years, Dr. Cash has developed
ery of the alcoholic and alcoholic sys
an 8-step program that offers an alter
tems. As the author states, “We hope
native to changing the appearance of
you’ll have a feel for the painful experi
the body and advocates instead a long
ence of being alcoholic and of living
term solution for changing the attitude
with alcoholism, along with the joys
about one’s appearance.
and dilemmas facing you and your clients at every stage in this long- term process of change.” To this end, the au thors are very successful.
The workshop begins with examples and exercises geared to discovering the individual’s personal body image, differ entiating body image from appearance.
ing the AA philosophy into treatment
Driven by the assumption that people
and encouraging client’s participation
really do want to change their interior and are able to do so, the techniques
through meeting attendance and ob taining a sponsor. Chapter 5 is a discussion of dual diag
T h e B o d y Im a g e W o r k s h o p :
and readings highlight the individuality
A h 8 - S t ep P r o g m m f o r
of body image development: its histori
nosis, significant since, as the author
L ea r h i h g t o L i k e Y o u r L o o k s
states, “29% of people we see with a
Y
psychiatric diagnosis may also be found to have a substance use disorder.” Discussed in this chapter are the major types of dual diagnosis, the benefits of medications, and psychotherapeutic themes for effective treatment. Although limited in scope, this discus
F. C a s h , P h D a n d , CA: N e w H a r b i n P u b l i c a t i o n s , 1997, 2 2 1 P a g e s , $ 1 7 .9 5 .
interact to produce the individual’s selfportrait. The subtle and not- so- subtle
T h o ma s Oa kl
g e r
ALLEN PARK, Ml.
this population.
P erso n al appearance has become the
And, finally, Part IV discusses the alco
focus of attention for a vast number of
bers of the family. These chapters are structured similarly to previous ones, successfully accomplishing the book’s goal of establishing solid theory and specific steps for treatment. They enrich the text by recognizing the context of the alcoholic, discussing both those who influence and who are influenced
worth are presented. The reader is able her life. In addition, behaviors to relax, desensitize, and respond positively are presented. While body image is a totali
a therapist would have in working with
alcoholism as it relates to various mem
influences of family and cultural values of attractiveness and, consequently, to identify stressors specific to his or
REVIEWED BY MARY THERESE LEMANAK, RN,
sion briefly identifies the basic concerns
holic family, the alcoholic couple, and
cal contributing factors as well as identi fication of triggers in the present that
people today. Dressing for success or love, make- overs, time for a better you, and techniques for identifying and elim inating a myriad of physical flaws are topics that dominate the current popu lar press. For too many, the boundary between the body and the self has be come blurred and the self becomes de fined and evaluated in terms of an arbitrary standard of physical accept ability. Research supports the con RE VI EWS 300
ty, this book helps the user to break it down into individual personal compo nents to better understand and take control of it. Critical thinking is a skill that is not clearly taught nor is it encouraged in today’s society. In a culture of continual advertising, sound bites, and infomer cials, people are presented with a dis torted reality and tend to accept it as accurate. The critical thought compo nent teaches the reader to identify strengths, make independent decisions,
