reviews: books photography

183 � 2000 Blanton-Peale Institute

Journal of Religion and Health, Vol. 39, No. 2, Summer 2000

Reviews

BooksRELATIONAL PSYCHOANALYSIS: THE EMERGENCE OF A TRADITION. Editedby Stephen A. Mitchell and Lewis Aron. 514 pp. Hillsdale, NJ: The Analytic Press,1999. $39.95.

D.H, LAWRENCE AND THE PARADOXES OF PSYCHIC LIFE. By Barbara AnnSchapiro. 155 pp. Albany: State University of New York Press, 1999. $17.95.

“Traditions,” writes Mitchell and Aron, “cannot be founded or self-consciouslycreated; they can only be retrospectively, self-reflectively discovered” (p. ix).Indeed, as psychoanalysis has developed, adding many rich methodologies toFreud’s original theories, it has also grown to contain many clinical and con-ceptual traditions. Over the past few decades a new tradition called “rela-tional psychoanalysis” has emerged from the shared worlds of psychoanalytictheory and therapy. As the editors note, the term relational bridges the tra-ditions of interpersonal relations, as developed within interpersonal psy-choanalysis and object relations, to later advances in self psychology, inter-subjectivity theory, social constuctivism and gender theory. RelationalPsychoanalysis is a rich and influential collection of essays that delineate thisemergence of the relational tradition within psychoanalysis.

Mitchell and Aron have compiled both a retrospective and prospective lookat relational theoretical and clinical innovations. Most of these papers herewill be immediately familiar to readers in the field—a gathering of contempo-rary classics by well-known practitioners. Each paper is introduced by theeditors, and set in a historical context that highlights its significance in theevolution of the emerging relational tradition. Each author has written abrief afterword to underscore subsequent developments in their own thinkingsince the paper appeared. For example, in his afterword to “The Area of Faithin Winnicott, Lacan, and Bion,” Michael Eigen remarks, “The very alivenessof life can be horribly threatening. We do what we can with what uplifts usand tears us apart. How much of ourselves and our aliveness can we use andmanage to bear?” (p. 37). Such a powerful question leads us to significantthemes of the book, in particular the manner in which relational views decon-struct “misleading dichotomies and exaggerated polarizations,” while placing“an emphasis on maintaining the tension between the extremes, on ambi-guity, dialogue, dialectic, and paradox” (p. xviii). Thus, for these theorists, the

184 Journal of Religion and Health

psyche is depicted as more a matter of internalized relational configurationsthan of the classical notion of inherent drives, and this view underscores amultiple dimension of selfhood. As Thomas Ogden concludes, the experienceof engaging in the analysis of intersubjective worlds is, quoting A.R. Am-mons, “not so much looking for the shape/ As being available/ To any shapethat may be/ Summoning itself/ Through me/ From the self not mine butours” (Ammons, “Poetics,” 1986).

In Barbara Shapiro’s study of D.H. Lawrence, the application of a rela-tional hermeneutic to fiction is deftly illustrated. Drawing on Lawrence’s abil-ity to show dramatic interpersonal dynamics held in a delicate balance ofopposites, Schapiro emphasizes how his fiction involves what Michael Eigencalls “the interlocking of rigidity and fluidity” (p. 3) which constitutes thevery nature of psychic life. Thus, the author maintains that intersubjectivetheory “broadens the focus and uncovers new territory for psychoanalytic in-vestigations of Lawrence’s work” (p. 18). Shapiro summarizes her guidingperspective:

An intersubjective approach will also expose some surprising psychologicalironies. Beneath the fantasy of the dominating, devastating mother is the experi-ence of a wounded, fragile mother whose impaired subjectivity is vital to under-standing Lawrence’s imaginative world. The overriding anxiety is that the frag-ile m/other cannot survive the destructiveness of a ruthless self-assertion. Thefull, unchecked release of bodily impulse and desires, the self unconsciouslyfears, will overwhelm and devastate the other on whom it depends. My textualanalyses hope to prove how this anxiety plays an important role in the formationof Lawrence’s sadomasochistic fantasies. (p. 18).

As we are guided by Schapiro’s hermeneutics through Lawrence’s most ac-complished writing—works such as Sons and Lovers, The Rainbow, andWomen in Love—the focus on interpersonal relations between characters re-veal not only destructive polarities of gender and of domination and submis-sion, but also reflects “psychic flexibility that can accommodate, indeed play,with dialectical tension, with deep ambivalence, and with paradox” (p. 19). Aswe have seen in Mitchell and Aron’s collection, the vital tension between selfand other conveys a middle space of paradox and polarity—“opposing identi-fications, positions, and desires operating within any single psyche” (p. 19).As Schapiro notes, “While the characters fall into certain recurring relationalpatterns and are often trapped in polarized narcissistic fantasies, the narra-tive perspective frequently resists and counters those fantasies by encom-passing them within a larger intersubjective awareness” (p. 19). This dy-namic is what Lawrence called “the trembling instability of the balance”(“Mortality and the Novel,” p. 528). Thus, her work focuses on specific modesof mother-child and self-other interactions in Lawrence’s fiction, especially inregard to interruptions of relational attunement and recognition. The result

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is an excellent interdisciplinary study that brings together literary criticismand psychoanalytic wisdoms.

Although a reading knowledge of Lawrence’s work would magnify thedepths of Schapiro’s rich psychoanalytic study, her use of intersubjective the-ory to explore character interaction and narrative plot—twinned with Law-rence’s own commentary—makes a previous reading of Lawrence’s work al-most unnecessary. This is due in many respects to Schapiro’s agile ability toset the narrative scene clear enough for a psychoanalytic commentary towork through the example itself. Although the reader may be unfamiliar withsome of Lawrence’s writing, Schapiro’s method teaches us as much about re-lational theory as it does about many unexamined regions of Lawrence’s fic-tion.

Claude Barbre

TECHNOLOGY AS MAGIC: THE TRIUMPH OF THE IRRATIONAL. By RichardStivers. 240 pp. New York: Continuum Press. 1999. $24.

Richard Stivers’s book, Technology As Magic, is an antidote to mainstreaminterpretations of the technological age. Stivers, a sociologist at the Univer-sity of Illinois, provides a strong answer for those who wonder what it meansto be a radical today. He builds from Jacques Ellul’s seminal writings aboutthe milieu of nature, society, and technology as a way to look at human devel-opment and the subtly changing meanings of magic. The book is interdisci-plinary with connections to art, science, economics, management, andanthropology. In his introduction, Stivers traces the way “magic arises in thehiatus between the wish and its fulfillment” in the cyber-utopian beliefs andlifestyles of technopagans, new agers, and consumerists.

Calling attention to the major challenges in the milieu of technology,Stivers writes about magic’s relationship to language, statistical information,and the mass media. He argues forcefully that without collective self-reflec-tion and a willingness to confront assumptions, rationality will be drained.Stivers warns that “every advance in technical rationality today is surpassedby a decline in common sense and a growing irrationality, the signs of whichare everywhere.” He uses McLuhan’s analysis of technology’s psychologicalimpact upon the self to call attention to the dangers of contemporary therapy.When I found myself (a professor) defensive about how education is complicitin all this, I began to wonder if many psychologists and healers who readStivers’s book may also feel disturbed by the implications he draws.

The recent demonstrations during the World Trade Organization meetingin Seattle brought the reality of a worldwide concern about technologicalglobalization to CNN audiences everywhere. This is the core of a radical re-sponse to an ideology in which the sole aim is to stimulate the instinct for


“the pursuit of happiness” efficiently while the pillaging of the earth and theplundering of the poor goes on. It’s easy to get lost in e-mail, browsing, livingour working lives while staring at a buzzing screen. Could it be that like thejoke about the dog walking the human, we have become the tools of our ma-chines? Has language become subverted and redefined by technological con-trols, so that freedom has lost its meaning through dilution? Stivers book is acritical foundation for those who are looking for more than easy answers andfalse security.

Shalom Gorewitz, MFAProfessor of Media Arts

School of Contemporary ArtsRamapo College, NJ

REFLECTIONS ON A RAVAGED CENTURY. By Robert Conquest. 317 pp. New York:W. W. Norton & Company, 2000, $27.95.

In Reflections on a Ravaged Century, Stalinist historian and author RobertConquest investigates the disastrous role that absolutist ideas and ideologieshave played in the shaping of the twentieth century. Through its primaryfocus on the rise and fall of the Soviet Union, Reflections on a Ravaged Cen-tury seeks to demonstrate how ideas that have claimed to transcend all prob-lems, but were defective or delusive, became the disastrous mental distor-tions that have led to the devastation of whole countries and sent millions ofpeople to their death. The central theme of the book, clearly enunciated in itsintroduction, is encountered over and again throughout its pages: “that anyidea given anything like absolute status becomes not a guide to action but anabstraction whose imposition on reality reveals an incompatibility, as engi-neers say of parts that do not fit, and that can only be made to fit by mainforce, and even then ineffectively or ruinously.”

Like his previous works, among them The Harvest of Sorrow and The GreatTerror, Conquest presents a brilliant work of history with penetrating politi-cal prescience. He is clearly concerned by the power of fanaticism and by thelingering vestiges of rogue ideologies, such as various offshoots of revolution-ary Marxism. Such ideologies are often encountered in novel and unorthodoxforms in modern political thought and are usually made fertile within thewalls of academia. His concern becomes manifest, quoting, for example, theastonishing statement by Marxist historian Eric Hobsbawm in 1994 thatthe construction of a Communist utopia can justify the murder of twentymillion people. Although Conquest states that it is not his intention to developa psychology behind which the phenomena of abandoning reason for ideologyoccurs, he clearly is of the opinion that politics is a matter of temperament andthat ideologies are verbalizations largely of an emotional content. Thus, hiscentral aim is to show how and why these particular fallacies arise and develop,

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and the means by which they gain acceptance and allegiance. His worry iswhen ideas—of which we cannot do without—are made into Ideas.

Conquest’s analysis is strongest in demonstrating the inconsistencies of theMarxian utopian vision and in chronicling the corruption and demise of theSoviet system. He blends impeccable scholarship with a carefully consideredhistory of the myth of communism as it was perpetuated by its admirers.Although generally cautious of making sweeping generalizations, at timesConquest seems prone to hyperbole. For example, he is too quick to categorizethe fanatical temperament with the religious one. “Times of stress,” hewrites, “have produced both revolutionaries and mystics, Zealots and Chris-tians. It would be hard to define precisely the psychological differences be-tween the types.” Statements like this one, overlooking many shades of nu-ance, appear in various guises throughout the book and as such open the doorto considerable criticism and debate.

But this is only a minor quibble. On the whole the book is mindful andconsiderably forward looking. Conquest maintains that the existence of a freesociety, defined as “a system of compromise between the individual and thecommunity, between the population and the state” can only be sustainedwhen ideas and ideologies are subject to knowledge and judgement. Thus,whether it is in grasping the coming storm of the European Union, which hefinds excessively centralized and heavily bureaucratized, or in the rise inlarge-scale capitalism and government, which he envisions as tending to-wards a new corporatism, Conquest finds the future freedom of humanitybeing maintained only through a conscious seeking of balance between libertyand equity, between the proper rights of the individual and the necessaryrights of the state. In this regard, his book is of considerable importance, notonly in its perceptive analysis of the past century, but in its prescient consid-eration of our days to come.

Brian Peterson, M.A.The Harlem Family Institute, New York City

THE MYSTERIES WITHIN A SURGEON REFLECTS ON MEDICAL MYTHS. BySherwin B. Nuland. 274 pp. New York: Simon & Schuster, 2000, $24.00.

This is the latest in a series of books Sherwin Nuland has written addressingthe relationship of medicine and science to larger social and historical con-cerns. A medical historian and man of letters as well as a practicing surgeon,Nuland sums up his objective with the statement “The purpose of this book isto explore the journey that superstition, religion, and medicine have taken inone another’s company.” He successfully focuses upon the ongoing conflict andconversation between the traditions of vitalism and supernatural causality onthe one hand, and the advances of science and empiricism on the other.


Nuland’s method derives from his life long experience as clinician andhealer shared here through a recitation of case studies of patients beset withmysterious problems requiring surgical interventions. The cases involve or-gans with which Nuland has direct clinical experience (heart, spleen, liver,and stomach). He also includes an exposition on medical myths involving theuterus. In each vignette we are exposed to a narrative voice Nuland’s readersknow well from his previous works How We Die and The Wisdom of the Body.This clinical writing is illuminated by helpful medical illustrations which addto a text already lucid and at points riveting. Following these case historiesthe reader is exposed to a rambling but also fascinating exploration of themetaphysics of medicine which has progressed through human history towhat is now called biomedicine. Nuland is always respectful of tradition andits exponents (Hippocrates, Galen, Paracelsus, Empedocles and others), al-though he is quick to identify and occasionally skewer some of its mostwoolly-headed speculations. Nuland is careful not to judge the past only bystandards of the present but to see the achievements of previous theoristsand practitioners as building blocks which have enabled the enlargement ofthe scientific method in medicine. Prominent is his description of the wayclassical thinking about the four basic elements (Fire, Air, Earth, and Water)became identified with certain organs (heart, liver, spleen, stomach, andbrain), and humors (blood, yellow bile, black bile, and phlegm). At each pointthe reader is challenged to see the interdependence of medical theory, clinicalpractice, and prevailing world views. Put another way, Nuland has ap-proached social and intellectual history by way of medicine and surgery.

Nuland also discusses at length issues in the relationship of medicine andreligion. Clearly a skeptic, he nonetheless identifies and respects the comfortand consolation his patients have derived from lives of faith. He is at thesame time wary of traditional or alternative medicine whose claims of successcannot be supported by reputable research. He suggests that we cannot affordrelying on intuitive knowledge and anecdote only as an explanation for thosethings not yet understood. For him, “the god of the gaps is not a god worthworshipping.” Even as he acknowledges feelings of awe in contemplating theorgans of the body and the human heart in particular not to mention the roleof what he calls “dumb luck” as a potentially critical part of clinical interven-tions—he would not see these experiences as examples of epiphany or divineintervention.

He does, however, embrace the idea of a conversation between medicineand science on the one hand and religion and the impact of faith on health onthe other. He views this dialogue as providing an occasion for the cleansing ofsuperstition from religion thus permitting science to encounter religion not asan enemy or mere artifact of culture but as a discipline and human expres-sion deserving of respect and fair minded attention. Near the close of the textNuland quotes F. Scott Fitzgerald’s well known statement “The test of thefirst rate intelligence is the ability to hold two opposed ideas in the mind at

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the same time, and still retain the ability to function.” From this perspectiveNuland and others may see religion and science less as presumed antagonistsand competitors, and more as complementary points of view regarding thehuman condition and the pursuit of truth. Sherwin Nuland has apparentlystruggled a long time and with considerable integrity to get to this vantagepoint. Anyone reading The Mysteries Within receives the benefit of his effort.

Curtis W. Hart, M. Div.Director of Pastoral Care and Education

New York-Presbyterian Hospital, Weill Cornell CenterLecturer in Medicine, Weill Medical College, Cornell University

DISEASE, PAIN, AND SUICIDAL BEHAVIOR. By Elisabeth Stenager and EgonStenager. 127 pp. New York: The Haworth Medical Press, 1998. $17.95.

The authors discuss various somatic and psychiatric disorders and the riskfor suicide for such “disorders.” They examine risk factors such as alcoholabuse, drug use, depression, suicide risk for specific disorders (such as cancerand epilepsy), as well as the relationship between suicidal behavior and bio-logical factors. The book offers general information of what is already knownin the field of mental health, behavioral medicine, and even palliative care,offering very little new information. Much of the book is devoted to the meth-odological problems inherent in studies assessing suicidal risk and somaticdisorders. Written by two medical doctors, it tends to read like a medicalstudent’s handbook, and in this light, may be extremely helpful to those juststarting their medical studies.

Janet Masotti, Psy.D.Assistant Director, Early Intervention Unit

Leake and Watts, Yonkers, NY

TRAUMA ASSESSMENTS: A CLINICIAN’S GUIDE. By E. B. Carlson. 307 pp. NewYork: The Guilford Press, 1997. $30.

Dr. Eve Carlson’s recent book, Trauma Assessments, offers clinicians and pro-fessionals a comprehensive theoretical formulation about human responses totraumatic experiences. Although her book is not guided by a new theory oftrauma, it does provide a concise reintegration of both old and new conceptsdrawn from clinical practice and research experiences. Throughout her study,Carlson explores the wide variety of experiences associated with human re-sponses to trauma, detailing how multiple situations often provoke traumaticresponses that may impact individuals beyond the traditional scope of earlychildhood abuse and neglect—incidents such as the shooting at ColumbineHigh School at Littleton, Colorado; the armed conflict in the Balkans, which


caused death and displacement of thousands of residents, and the destructionof villages and towns by natural disasters around the world. Indeed, trauma-tic experience beyond the domains of abuse and neglect pose a great chal-lenge to clinicians and other professionals in the field of trauma who weretrained in schools with traditional abuse and neglect models. Carlson breaksaway from tradition by selecting a concise and yet inclusive theoretical ap-proach for understanding different types of trauma and selecting appropriateassessment procedures with the goal of restoring emotional balance in a per-son’s life.

Trauma Assessment is divided into three main parts, with separate sectionson measure profiles at the end of the book. Carlson guides us through anunderstanding about and empathy for the enormous impact of traumatic ex-perience on people’s lives. Although Carlson underscores that trauma theoryis still in a developmental phase of reassessment and nuance, she suggeststhat an event is traumatic when the experience is sudden, extremely nega-tive, and uncontrollable. Of these features the lack of control heightens theimpact of trauma. Secondary responses to trauma include despair, depres-sion, aggression, difficulty with self-esteem and identity, problems in inter-personal relations, including guilt and shame. We learn the importance of thesymptomatic meaning as it relates to the process of restoration of a person’sinner balance.

Most of the common challenges faced by clinicians are identified in Chapter6, which also highlights the importance of gathering from the clients accuratereports of the traumatic event. We are reminded that “client’s perceptions ofevents are more influential in development of symptoms than the actualevents themselves” (p. 98). Among adults the most frequent challenges in theassessment of trauma is caused by the presence of intrusive thoughts, over—or under—reports, and secondary motivations. When working with children,clinicians are faced with their underdevelopment of cognitive and languageskills, and misreporting. Due to these many challenges, Carlson suggests thatclinicians need to decide which domains and symptoms should be assessedand which specific measure is recommended for such a task. The selection ofspecific measure depends on the characteristics of the clients in addition tothe content, format, reliability and validity of the measure selected. Beforechoosing a treatment modality, she suggests, clinicians should find out aboutits effectiveness. For example, behavioral methods such as systematic desen-sitization and flooding are effective in reducing symptoms of intrusion, Cogni-tive methods are effective in reducing a range of Post Traumatic Stress Disor-der (PTSD) symptoms. Other considerations include safety of the client, theclient’s capacity to tolerate the stress elicited by trauma memories, and theneed to address concurrent problems with adjunctive treatment such as de-toxification and pharmacotherapy. Carlson’s preferences are clearly behav-ioral and cognitive-behavioral approaches, which are often time-limited inter-ventions with a high success rate.

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Carlson’s book is certainly an asset to the field of trauma and PTSD. Al-though more clinical information would have been desirable to balance theemphasis on structured measures and instruments for the assessment oftrauma, her assessments are strongly recommended. Additional discussionabout traumatic responses across cultures makes a brief but significant ap-pearance in the book. In the end, Carlson presents valuable information onknown and some less known measures of trauma, which assists the reader inthe difficult task of selection and implementation of the most appropriateinstruments for either clinical intervention or research.

Frank R. Solano, Ph.D.Clinical Psychologist, Puerto Rican Family Institute,

New York City

ON INFANCY AND TODDLERHOOD: AN ELEMENTARY TEXTBOOK. By David A.Freedman, M.D. 247 pp. Madison: International Universities Press, Inc., 1999. $27.95.

In this compact and neatly written volume, Dr. Freedman has put togetherthe basic tenets of infant and toddler development in a way that readersunfamiliar with the material will find accessible. His initial goal in gatheringthis material was to provide an infant/toddler development curriculum forstudents of psychoanalytic psychotherapy, many of whom come from variedprofessional backgrounds and may not have focused on child development intheir training.

The major theories of stages of early development most relevant to psycho-analysts are described and connected to the analogous neurological and bio-logical developmental processes in a very clear and meaningful way. Freed-man lays out beautifully the overlapping edges of nature and nurture, and iscareful not to “adultomorphize” children along the way. Freud’s theories, ofcourse, are present throughout the book, along with Spitz and the develop-ment of the social smile; Bowlby’s theories of attachment; Margaret Mahler’sseparation/individuation paradigm; Erik Erikson’s stages of psychosexual de-velopment; Piaget’s theories of cognitive development; and Winnicott’s no-tions of true and false self. Although theories are covered briefly, they arepresented in a helpful way, always keeping in mind the relevance of thematerial for the therapist. Indeed, by following the perceived needs of psy-chotherapists, Freedman’s structures the book with chapters on early objectrelations, deprivation syndromes, psychic structuralization and mental repre-sentation, gender identity formation, and early and later preoedipal develop-ment. Studies that are familiar to students of child development are presentthroughout the book, such as Harlow’s monkeys, Selma Fraiberg’s work withblind infants, Helen Keller’s experience, and the Wild Boy of Aveyron. Forsuch a large task, covering so many areas, Freedman succeeds remarkablywell, creating a basic text that will be very useful not only to students of


psychoanalytic psychotherapy, but to any who seek to begin to understandthe complexities of human development.

Jill Kirby Barbre, MSEd., CSWLeake and Watts Services, Inc.

Psychotherapist in private practice, New York City

TUESDAYS WITH MORRIE. By Mitch Albom. 192 pp. New York: Doubleday, 1997.$21.

Tuesdays with Morrie is a blueprint for dying well—if we are given thechance. Not many of us could cherish the time provided by a long, slow pro-gressively degenerative illness the way Morrie did. In this impassioned taleof a student-teacher relationship that parallels the Zen master-disciple bond,Mitch Albom captures the essence of Morrie Schwartz and his remarkablewisdom about life and death. Opportunities for teaching arise in the mun-dane, and here, too, the ordinary experience of one man’s death is not onlywrought with pain and tenderness, but inevitably becomes an enlightenedteaching as well. Morrie Schwartz found possibility in turning his own de-mise into a subject for study, and requested that his former college student,Mitch Albom, record it as his “final thesis.”

As Morrie begins to take leave of his body, he is capable of engendering adeeper compassion and passion for life in both himself and his associates. Ashis faculties wane, he searches for the profound delight in his remainingsenses and abilities. He is truly a person who views the glass as half full.Although very few passages in the book deal directly with Eastern thought,and Morrie considers himself primarily a humanist, he at one point advisesMitch to “do what the Buddhists do”: envision a bird on your shoulder thatasks you if “today is the day,” that is, your last day to do all you can toliberate all sentient beings. While this book is neither an Eastern nor West-ern discourse on religion, it miraculously manages to capture the heart ofboth.

A chapter is devoted to exploring Morrie’s childhood, which clearly influ-enced the man he became. After losing his mother at the age of nine andenduring his father’s arctic personality, he was blessed with a caring step-mother who showed him both physical affection and academic discipline.Having been deprived of these things at a young age, Morrie treasured themand incorporated their influence into his own personality.

Morrie’s honor in the face of tragedy sustained him. Addressing the lastclass he taught at Brandeis, he informed them that he might die before theend of the term and said, “If you feel this is a problem, I understand if youwish to drop the course.” His belief about his own death also embodied objec-tivity and humor: “I’m on the last great journey here—and people want me totell them what to pack.” And Morrie does take us on that journey, well pre-

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pared to face the end—perhaps not as bravely as he does, but mindful alwaysthat love is heavy luggage at the entrance to the airport.

Carolyn Kraemer Cooper, Ph.D.Professor, The French-American School

Larchmont, NY

THE SORROWS OF THE QUAKER JESUS; JAMES NAYLER AND THE PURITANCRACKDOWN ON THE FREE SPIRIT. By Leo Damrosch. 322 pp. Cambridge, MA:Harvard University Press, 1996, $39.95.

What could be more alien to our consumer Zeitgeist than the symbolic act or“sign” for which James Nayler, an early leader of the Religious Society ofFriends (Quakers), is commonly remembered? In October 1656, a small bandof followers entered Bristol in pouring rain and knee deep mud, singing Ho-sannas and spreading garments before Nayler’s horse in a deliberate reenact-ment of Jesus’ triumphal entry into Jerusalem. Such a scene today would atbest evoke curiosity. But in the days of the Second Protectorate Parliamentreligious acts often carried political consequences. Nayler was convicted ofblasphemy. His tongue was bored through, his forehead branded with theletter B. He was whipped and pilloried, then placed in prison until Parlia-ment saw fit to release him.

Damrosch, a Harvard professor specializing in 18th century English litera-ture, does not intend to provide a comprehensive biography. Rather he ex-plores “the meaning of the Nayler affair as his contemporaries perceived itand as he himself seems to have understood it” (p. 2). His admittedly secularstance is sympathetic to Nayler without attacking or defending his oppo-nents. This impartiality allows him to recognize Nayler as a double scape-goat. Parliament used the incident to assert its power over the more moder-ate Lord Protector (Cromwell) by inciting popular distress about the “Quakermenace.” Quaker leaders for their part, most notably George Fox (generallyconsidered the founder of Quakerism), joined what Damrosch calls the “Puri-tan crackdown on the free spirit,” citing Nayler’s “fall” as evidence of the needfor a more formal structure of authority within the new movement.

Damrosch’s secular objectivity is both a strength and weakness of his work.Not being a Friend, he feels no need to excuse the actions of Fox or any ofNayler’s other contemporaries, though he does view Nayler’s 50 odd religiouspamphlets as superior to those of Fox in both form and content. At the sametime one may wonder how it is possible for a person unaffected by the reli-gious import of Nayler’s concerns to fully apprehend the significance of hislife and death. For example, Nayler is best known to Friends not for Bristol,but his dying words. Released after three years in prison and, following aconciliatory meeting with a grudging Fox, beginning his journey home, he


was reportedly robbed and left for dead. A passing Friend took him in andrecorded a last testament of faith that begins with these words:

There is a spirit which I feel that delights to do no evil, nor to revenge anywrong, but delights to endure all things, in hope to enjoy its own in the end. . . .Its crown is meekness, its life is everlasting love unfeigned. . . . In God alone itcan rejoice, though none else regard it or can own its life. . . . (Whitehead, 1716,cited by Damrosch, p. 267)

Damrosch, writing with scholarly objectivity, hopes to bridge the gap be-tween Nayler’s time and our own. Yet the enduring power of Nayler’s witnesslies not merely in word or deed, but in a freedom of spirit that delights in Godalone, beyond words and time.

Felicity Brock Kelcourse, Ph.D.Recorded Friends Minister

Assistant Professor of Pastoral Care and CounselingChristian Theological Seminary, Indianapolis, IN

THE PASTORAL CARE OF DEPRESSION: A GUIDEBOOK. By Binford W. Gilbert.127 pp. New York: The Haworth Pastoral Press, 1998. $19.95.

Gilbert’s text on depression is aptly subtitled “a guidebook,” for it presents abroad, general overview of pastoral care strategies that is instructive andinformative. Gilbert begins his primer with a practical chapter on the subjec-tive experience of depression, followed by a general summary of its etiologyand treatment options that, for the most part, concentrate on cognitive inter-ventions and behavioral therapy. The author then moves into theological ter-ritory, devoting chapters on the unique roles of pastoral caregiving, twinnedwith chapters on the minister’s own mental health needs and self-help styledways for both practitioners and clients to “take charge” of their lives.

The strength of this book rests with its value as a primer on depression,complete with helpful definitions of clinical terminology and a host of practi-cal suggestions. For the minister who is unfamiliar with diagnostic and sta-tistical terminology, Gilbert provides short, pithy definitions that are easilyaccessible to all. He is likewise helpful in his general observations concerningthe role of pastoral counselors. However, sections on pastoral theology couldhave benefited from a more thoroughgoing theoretical integration. Much ofwhat is said concerning clinical work and theological reflection is sound, butthe relation between the two remains vague. This might also explain a simi-lar disjunction between the early chapters on etiology (which hint at a psy-choanalytic conceptualization, and the cognitive and behavioral treatmentstrategies that follow). As a reader, I found myself wishing Gilbert had drawnmore from the fertile overlap between depth psychology and theology.

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In a brief section in which Gilbert cautions practitioner against naivelybelieving we can heal all ills, he underscores “that in the final analysis, it isGod who heals” (p. 71). “The healer,” he goes on to say, “simply assists inremoving the barriers to the healing process” (p. 71). While I would agreethat healing may indeed result from a numinous experience, from an analyti-cal perspective it is also true that the pastoral counselor does more than sim-ply remove obstacles. Through the transference phenomenon there is a genu-ine encounter in which both parishioner and pastoral counselor may bechanged. Since the mystery of healing grows out of relationality, it is there-fore not wholly separate from the pastoral counselor’s process of individua-tion. C.G. Jung’s comment reflects this potentiality when he notes, “It is notwhat you know that heals, but who you are.” God’s healing emerges in thespaces and bridges between us.

Tom Martinez, M.A., C.M.H.C.Union Theological Seminary, New York City

LEARNING DISABILITIES AND PSYCHIC CONFLICT: A PSYCHOANALYTICCASEBOOK. By Arden Aibel Rothstein, Ph.D., and Jules Glenn, M.D. 504 pp. Mad-ison: International Universities Press, Inc., 1999. $78.

Rothstein and Glenn have chosen a very interesting method to construct thislarge and thoughtful book on the dialectic between learning disabilities andpsychic conflict. They solicited case material through notices in psychoanaly-tic newsletters and referrals from colleagues, and then organized the book bypresenting case by case summaries, each followed by a discussion. Both childand adult cases are presented. In some chapters, psychological test informa-tion confirms that learning disabilities are present in the patient, while inothers, learning disabilities are suspected due to difficulties in cognitive,school, or vocational functioning. All patients are seen an average of fourtimes a week on a long term basis, yielding rich case material that illustratesthe clinical discussions.

While four times a week analytic cases are the exception in these days ofmanaged care, limited pocketbooks, and stingy special education systems, thematerial will be familiar to anyone working with learning disabled childrenor adults in psychodynamic psychotherapy. The difficulty with certain egofunctions, such as the ability to control impulses, reality testing, attentionaldifficulties, regression, and limitations in play, are explored in depth; andwhile discussions often focus on the interplay of neurological deficits and psy-chological conflicts, the authors make the point that in terms of the experi-ence of the patient, both dynamics can have the same impact. Also, the mean-ing of whether a problem is biologically or psychologically derived is not loston the patients, nor to their parents, whose reactions to and handling of their


children is often affected by how clearly they understand the roots of learningand behavioral difficulties.

The case discussions are very thoughtful and thought-provoking in theirformulations, teasing apart the issues, taking analysts to task on occasion.However, the emphasis on the classical psychoanalytic method that under-stands difficulties in functioning as products of “psychic conflict”—not tomention the author’s suggested treatment options that stress treating “con-flictual material and defenses”—leaves out other kinds of psychoanalytic un-derstanding and treatment approaches, such as object relations, attachmenttheory, and a clear integration of intersubjective treatment approaches. Inaddition, while work with parents is mentioned, more information on thispart of the treatment would have also been helpful in looking at the largerpicture. For the beginning clinician, however, the issues in this fine volumeare very well examined, and provides a helpful framework about the role oflearning disabilities in psychoanalytic treatment.

Jill Kirby Barbre, MSEd., CSWLeake and Watts Services, Inc.

Psychotherapist in private practice, New York City

HAUNTED CHILDREN: RETHINKING MEDICATION OF COMMON PSYCHO-LOGICAL DISORDERS. By Arthur F. Roemmelt, MD. 196 pp. New York: State Uni-versity of New York Press, 1998. $17.95.

Written in an informal and very reader friendly style, Roemmelt offers hisviews on the current state of treatment in our society, one that is often impa-tient for a cure and overly concerned with cost-effectiveness. Such medicationbased treatments seek to remove symptoms of distress only and create asense of well-being without ever untangling the memories and trauma thatbrought the person into treatment in the first place. Roemmelt offers casestudies of several children with whom he has worked. He views such trau-mata as “haunting” children, leaving them to act out with problematic behav-ior. Roemmelt believes that each child has a story to tell. While medicationcuts through the often “annoying and disturbing” emotions, it also cuts shortthe “story” a child has to tell. Once the child is off the medications, they are“haunted” again.

Roemmelt contends that it is utterly essential to understand that the hu-man relationship plays its part in both the etiology of pathology as well as inthe treatment of pathology. The relationship a child has to parents and signif-icant others is part of their “story.” Medications offer a quick fix, but often atthe sacrifice of relationship-based, psychodynamic psychotherapy, where feel-ings are acknowledged and hauntings may stop. Case studies are presentedof children who were difficult to reach, but for whom a relationship with theauthor was enough to keep them from being medicated and thereby, spared

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from further fragmentation when their psychological difficulties went unad-dressed.

Roemmelt does not deny that there is a biological basis to many disorders,but advises against the automatic use of medications as a first round treat-ment. Medications, according to the author, need to be considered as a latertreatment attempt, and not in place of relationship based treatment.

Janet Masotti, Psy.D.Assistant Director, Early Intervention Unit

Leake and Watts, Yonkers, NY

NAVIGATING THE DEEP RIVER: SPIRITUALITY IN AFRICAN-AMERICAN FAMI-LIES. By Archie Smith, Jr. 181 pp. Cleveland, Ohio: United Church Press, 1997.$15.95.

Psychotherapy is cultural enterprise that is predominately based on Euro-American origins. In his book, Navigating the Deep River, Archie Smith Jr.offers provocative reflections and practical tools for navigating therapeuticand spiritual resources on behalf of healing, transforming and empoweringfamily therapy and counseling. In particular, he explores the relationship be-tween African-Americans and psychotherapy. Guided by the assumption thatmany African-Americans think that psychotherapy is mostly for “white folks,”the author proposes a remedial approach that invites practitioners workingwith African-American families to imagine a larger frame and perspective inclinical settings.

Drawing from what Edgar H. Auerswald calls an “ecological approach,”Smith navigates American history, racism, and black experience in a multi-cultural context. Using the river metaphor, he stresses the therapeutic signif-icance of the spiritual resources of African-American families. His use of theriver metaphor is based on “the idea of water as a basic element of life andrenewal, and the river as an ecosystem that gives, nurtures, carries, andtakes life” (p. xxxi). This view leads Smith to stress that the African-Ameri-can family has great heuristic value for the study of systemic approach ofnavigating. Thus, in his river metaphor, families run at the interface betweenpersons (droplets of water) and the wider society (mainstream of the river).The key point for navigating, thinks Smith, is to “tap” an ever flowing stream(“deep river”) that feeds the many tributaries of African-American families.This “tapping in” to the deep river is what he calls “spirituality.” He employsthree interpretive tools to better understand families in their relationship totheir “deep river”—that is, their spiritual resources—in regard to the NorthAmerican mainstream: (1) dimension of depth, (2) reflexivity, and (3) sense ofagency.

The introductory chapters of Navigating the Deep River involve critical re-flection on social and historical analysis of the American mainstream. It is


the author’s contention that therapy should “focus on the interaction betweenthe workings of the larger society and the people who struggle from day today to make their lives meaningful” (p. 8). Drawing upon Vincent Harding’scontrast between “Negro History” and “Black History” Smith tackles the over-arching assumptions of Negro history that is often pessimistic about societalchange. He argues that therapy should be envisioned from a Black Historyperspective, and emphasizes “the interrelationship between historical forces,societal influences, and family structure” (p. 21).

Early on in the book, Smith deals seriously with the issue of “spiritualrefugees.” According to him, spiritual refugees are those who have been up-rooted from their faith community, yet never disconnected from their deepriver—a resource from which they draw an abiding spirituality. He goes on toclaim that the therapists should be ready to “listen to them and to utilizespiritual resources in the humanization of institutions . . . and in the trans-formation of society” (p. 53). Drawing upon Theophus H. Smith’s work in Con-juring Culture, Smith stresses the power of “conjuring” biblical narratives inAfrican-American spirituality. The author underscores that conjuring is “notonly a way to interpret what is going on, it is also a way to transform reality”(p. 44). In this sense, the Bible becomes “a conjure book, which African-Amer-icans use to interpret and reinterpret their experience of healing and curse,and to envision a transformed future” (45). Understanding a person, text, oreven a culture involves identifying underlying operative stories. In terms ofBible reading, conjuring involves not only identifying the underlying story inthe text according to a narrative context, it also means envisioning African-Americans as co-participants continuing the struggle for transformation ofthe American mainstream.

In the remaining chapters, Smith explores how therapists can, through“conjuring,” offer hope and empowerment to make the societal transforma-tions that African-Americans desire. He elaborates on the three expressionsof African-American spirituality: outreach, inreach, and the communication ofintrinsic worth. In addition, the author introduces his own ministerialstory—a story which suggests ways to make connections between familytherapy and the wider social system. These connections lead us to Smith’soriginal theme by reintroducing the river metaphor for family therapy. Thera-pists are river-navigators, working in space and time—that is, they need tobe aware of the interplay between the synchronic (here and now) and di-achronic (historical awareness) dimensions of time. The river metaphor mustbe a tactful “root metaphor,” which directs us to more systemic orientations inthe family therapy and away from individually focused, psychodynamic orien-tations.

While I am enthusiastic about the insights of this book, there is one area Ifound somewhat unclear. It has to do with the depth and extent of empathybetween white therapist and African-American families in therapy. In otherwords, to what extent do non-African-American therapists hold close empa-

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thy with African-Americans through the river metaphor? Where are thera-pists situated in the river metaphor? I wondered if white therapists would bewilling to locate themselves in the mainstream and utilize it to change theirtherapeutic work. In a clinical sense, where are the therapists going after“tapping” the deep river? Hopefully, clinicians will not just tap the deep river,but jump into and float on it! Isn’t that what empathy is about? Even if theauthor expects the “global” use of the river metaphor, it would be helpful toknow more clearly what he means by “tapping” and how his appreciation ofBlack History perspectives has to do with the role of therapists. All thesequestions point to the necessity of making spirituality, like psychotherapy,not just a matter of ideas or techniques and interventions, but a matter ofintentionally pursuing a practice, a particular way of life. I hope that at somefuture time Smith will address these issues—especially in terms of the thera-pist’s own spirituality—as they effect our effort at navigating the deep river.

Soo-Young Kwon, M.Div., Th. M.Ph.D. Candidate, Graduate Theological Union,

Berkeley, CA

AL-JUNUN: MENTAL ILLNESS IN THE ISLAMIC WORLD. Edited by Ihsan Al-Issa. 382 pp. Madison: International Universities Press, 2000. $48.

While introducing this important book on mental illness in the Islamic world,Ihsan Al-Issa tells us that although there are 1 billion Muslims in the world,and 15 million living in the West, the study of mental illness in Islamic soci-eties “has rarely been taken seriously by Western scholars” (p. xiii). In thepast, the study of Muslim culture was often carried out by non-Muslimswhose work tended toward “intellectual curiosity for the exotic,” worn gener-alities, and romantic, hyperbolic characterizations. Al-Junun brings togethermental health researchers, mainly from the Muslim world, in order to explorethe dynamic history of Islamic psychiatry.

The first three chapters of the book prepare the groundwork for the re-maining parts of the volume by focusing on methodological and research di-rections by practitioners within a Judeo-Christian context—a context whichis then compared to Islamic psychiatry and culture. Especially fascinating isthe author’s own exploration of mental illness in medieval Islamic society. Forexample, we learn that “for most Muslims, al-junun (being possessed by thejinni or spirit) is madness and the term mental illness is related to Westernmedicine and more often used in a professional context rather than duringeveryday life” (p. xv). The broad use of the term as compared to the Westernconnotation, reflects a wide-ranging acceptance and tolerance of so calledmadness in the Islamic culture. In addition, the majun, or madman, is notonly the hospitalized patient but also anyone who deviates from culturalnorms. Thus, the meaning of madness in the Muslim world includes anthro-


pological, historical, and political influences, thus giving the study a broaderapproach to Islamic identity than Western psychopathological definitionshave previously afforded. This approach is clearly illustrated in the earlychapter on forensic psychiatry which focuses on how Islamic societies dealwith the insane.

The final sections of the book focus on psychiatric practices in diverse Is-lamic contexts—in particular, Algeria, Kuwait, Qutar, Iran, Malaysia, Paki-stan, and Saudi Arabia. An excellent overview of the mental health of Muslimimmigrants “in the diaspora” is quite informative as well for Western practi-tioners working with Muslim individuals and families. This kind of inter-disciplinary dialogue is found in Ihsan Al-Issa’s own method of discussingIslamic psychiatry within the framework of what he terms a “new trans-cultural psychiatry”—a view that gives vital consideration to tensions be-tween collectivist, communal contexts and Western individualistic perspec-tives. This is to say that psychiatric research in the Islamic culture is oftenguided by two kinds of psychiatry: a psychiatry practiced in the Islamicworld—that is, research guided by Western diagnostic systems—and Islamicpsychiatry itself which emphasizes Muslim religion and its impact on abnor-mal behavior. As Ihasn Al-Issa notes, “The aims of therapy in an Islamiccontext are not independence and self-actualization, but interdependence andadjustment to the demands of society” (p. 347). Both approaches are exploredthroughout the book—an excellent introduction to the study of mental illnesswithin the Islamic world.

Claude Barbre

Photography

Witnessing the Lack of Sanctuary

You may be aware of the recent museum exhibitions in New York City of oneof the most horrific legacies of America’s racist past: a series of photographsdepicting the lynching, between 1883 and 1960, of mostly African-Americanmen. First mounted with the title ‘Witness’ at the Roth-Horowitz Gallery inFebruary, the exhibit later moved to larger quarters in The New York Histor-ical Society on Central Park West at 78th Street. There it is called “WithoutSanctuary,” and will be on view into July.

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The pictures were post-card size because so many of the surviving photo-graphs were actual post cards that had been commercially prepared and pur-chased by those who wished to commemorate the event, sent as mementos tofamily members and as warnings to blacks. Many of the initial photographswere taken by unidentified photographers of unidentified victims, though insome instances the victims were known and identified, having been takenfrom jail cells or even seized during trials by mobs of 20 people or of thou-sands—men, women and children either overwhelming the forces of the lawor expecting their cooperation in relinquishing their prisoners. I was struck,nevertheless, by the few instances of resistance, in which the local police, themilitia, or even the National Guard had been mobilized to protect the pris-oners and even fired upon the crowd.

Viewing the photos in a gallery—as if looking at mutely expressive worksof the most extreme kind of portraiture—one saw that each had its own sin-gular ability to shock, as if each had the burden of the need, by degrees, to bemore arresting than the preceding one, providing the next most extreme andshocking way in which a lynching had been conducted. Imperceptibly, how-ever, a numbing, depressing similarity set in. The idea occurred that therewas a limit to even the fiendish ingenuity of the lynchers.

Nevertheless, each photograph had the ineluctable beauty of the truth ofan artifact. The event had happened in none other than the way shown: thebody lacerated, mutilated or burned down to a heap of smoldering body parts,or swaying, singularly, starkly, forlornly; or accompanied by two, three orfour others, hanging from a tree or trees, broken necks always fixed at thesame unmistakably acute angle of death, heads thrown back in a violent sup-plication, as if forcibly wrenched from prayer.

Whether the victim was ‘discovered’ in some desolate place or was theprominently displayed fetishistic object for the delight of a gleeful crowd ofwhite faces, who afterwards may have fought for remains of the dismemberedcorpse, each swaying object seemed profoundly alone, abandoned, yet seemedto make vocal the soul’s solitude—or was it the separateness of death, or ofrace, or gender, or the privacy of the self—so wrenched from its sanctuaryand nakedly exposed?

After a while, the photos began to merge as one faceless image of some-thing both holy and defiled, abjectly human, yet humanly triumphant. Thecommon humanity, the link to ourselves, in the thing that was so differentand traduced, could never be snuffed out. It is the common bond that persists,in the image of emaciated bodies and transfixing eyes staring back at us frombehind the barbed wire of concentration camps who are still with us, no mat-ter how many corpses have been burned in the ovens, or the crucified figuressuspended from trees who speak for all time of the ways the divisions inourselves persist and are forever opposed.

One feature of the merging of the photographs into a common image is thatthe bodies began to look like dummies, unreal figures ludicrously dangling as


a demonstration of some nameless atrocity. The mind retreated from the rec-ognition that they could be actual human beings, like ourselves, igno-miniously paraded, violated, exempted from every agency of basic human re-spect, corpses denied burial for the purpose of defilement. The swaying objectis therefore an inhuman thing subjected to an inhuman rite, its remains leftto decompose, its ashes trampled upon. It is the apprehension of what theworst is that can happen to a human, the possible fate of one’s kind, alwayssomewhere possibly waiting, that can no longer, now, be imagined.

Who would want to view such scenes? Who would not want to see them,whether or not one actually has the will to do so? They represent the inherentinterest of the extreme. The most noble and beautiful things attract, just asdo the ugliest. We all know our petty resentments and the injuries we inflicton others, but I think it may be a good thing if we are increasingly able torecognize that our capacity to do harm joins us with all others who may rec-ognize no limits to the harm they can do. It is not just a matter of degree orkind. It is a matter of accepting, yet always seeking to overcome, the weak-nesses or destructive capacities of our humanity. Who does not recognize theease with which we will kill to protect our flawed and parochial notions of thegood; humiliate others to affirm our own self-importance; experience intol-erance toward the many things and people in the world different from thosewe approve of and are inclined to view as inferior or deficient—less thanourselves.

How far have we gone in the endless, righteous, self-justifying need to pre-serve our own self-regard at someone else’s expense is revealed by the imagesof these lynchings. Beyond what limits have we thus far transgressed? Thelynchings—and other such historical atrocities—tell us. And not only histori-cal ones. Consider the recent dragging and dismemberment of a man behinda pick-up truck in Texas.

Our notions of our finest ideals may be fed by the most ignoble motives.Another way to say this is that the irrational and instinctual dimension inhuman beings persists in its threatening potential as a force which overcomesreason or infiltrates and compromises it. This antithesis at the heart of men-tal functioning is precisely its unique and tragic nature. It is what the poetW.B. Yeats meant when he said that love has pitched his mansion in the placeof excrement. Its result is the picture, for example, of good men, who genu-inely hate violence, and want to protect us from it, but have become so cor-rupted and dehumanized by their own omnipresent involvement in it thatthey can fire 41 bullets at a defenseless, unarmed man, or can routinely andunapologetically brutalize innocent, law-abiding citizens, in the interest ofpromoting a sense of the greater public good for the rest of us.

So the views of these scenes—black and white—may not only represent agreater willingness to confront our past but a greater willingness to recognizeand confront our own complicity, sort of like an original guilt, in the acts ofthe past and present committed by our human brothers. I liked the fact of the

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presence of many whites at the exhibit, and it seemed to me that the look Idetected in their eyes (were people actually making an effort not to avoidlooking at each other?) appeared to be one, understandably, of shame, out-rage or hurt, but also of wonder, sort of like the realization that we cannotpretend that such things are not possible, and that if they are, we cannotafford to have the spurious comfort of thinking that they are committed onlyby other people. We all have the potential to do them—to do anything, it isjust that the majority of us know that we must not, restrained by the weightof the civilizing heritage thus far attained.

Lynching is a fact but it is also a metaphor of the starkest helplessness andmost profound injustice. Possibly one can think of a hanging without theovertones of a lynching, but it isn’t possible to think of a lynching without, bydefinition, being hanged. The first may be an expression of due process andconclusion reached by rule of law, while the other is the almost naked expres-sion of the lawless brutalizing of the helpless, but done under the guise of theagency of justice. Lynching dramatizes the dark fear of being seized in thenight and taken away, of the existence of no humane or civilizing authority towhom an appeal for protection can be made. It is the idea of being abused,abandoned and forlorn, that every child and every adult has known, with noone to whom one can turn, symbolized here by the lynched black body.

Abused, abandoned and forlorn, so that the only advocacy remaining is theassertion of the dignity of the lonely, imperiled self. This is what seeminglyhas struck so many people about one of the photographs, that of Frank Em-bree, standing on the back of a buggy, naked and chained, shortly before hisdeath in Fayette, Missouri, on July 22, 1899. He has been whipped, deeplacerations—gaping wounds—are visible on his body, but he stands erect andgazes unflinchingly, above the heads of his tormenters, directly into the cam-era. His is the gaze of the witness to the fact that there is no sanctuary, andyet what is ennobling is the thing in him that drives him not to flinch fromthe need to make this assertion.

Lee Jenkins, Ph.D.Professor, John Jay College, New York City

Faculty, The Harlem Family Institute, New York City

reviews: books photography

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