See. Sci. Med. Vol. 31, No. 7, pp. 829-830, 1990 Pergamon Press pk. Printed in Great Britain

BOOK REVIEWS

Clinical Psychology in Africa, by KARL F’ELTZER and P!ZER EBIGBO. Chuka Printing Company, Nigeria, 736 pp. ISBN 978-2528-17-4.

This textbook contributes a specialized modem source on clinical health psychology with special reference to sub- Saharan Africa, the Caribbean and Afro-Latin America, where such relevant texts are sorely needed and where this work is certain to become prescribed reading at universities, medical schools and other institutions offering courses in social science and medicine. Furthermore, as the first text- book of its kind, a work concerned with clinical psychology in Africa, particularly relevant to Africa and written mainly by African experts in the field, it is an extremely valuable collection of knowledge for all universities, researchers, teachers and students concerned with the universal and broader context of healing.

Karl Peltzer and Peter Ebigbo from the University of Nigeria are author or co-author of 22 of the 40 chapters in the book. While chapters are rather arbitrarily divided into seven parts, these appropriately focus on psychosocial aspects of clinical health psychology. This reflects the view that “mental illness is dependent on the social order of a society, which is reflected in different manifestations and therapies in different African, Caribbean and Afro-Latin American cultures” (p. 4). On a more philosophical note, one may add that modem Western perspectives on psychol- ogy have tended to neglect essential inter-subjective foun- dations of human existence, long emphasized in African communal ways of life.

This theme of something new, something old runs through the book. On the one hand, in the first chapter Peltzer and Ebigbo introduce the task of an appropriate

clinical health psychology in developing countries. The final chapter is concerned with training in clinical psychology at masters level with special reference to so called ‘third world psychology’. On the other hand, we are reminded of original healing energy and consciousness as conveyed by the n/urn and !kia of-the Kung spiritual and community healing transformations in an excellent article by Katz and Wexler Also Ebigbo is insightfully succinct in “For Africans, the body is the mind, the mind the body. Physical images are often used to describe feelings of the mind and dispositions of an external mind (as in witchcraft) are attributed to the body” (p. 94). Overall the reader is left with an impression of an original new-old blend of clinical psychology.

It is impossible to do justice to such an original and lengthy book, which brings together a great variety of issues relevant to the theory and practice of clinical psychology, in a short descriptive review. On the critical side, it should be mentioned that some papers are very general essay style writings and there are too many technical/typing/spelling errors. However, this detracts little from the value of this book, on which the editor/authors are to be congratulated. It is hoped that this book will bear many fruits for clinical psychology in Africa such as the establishment of an African Psychological Association. It is sure to work towards the prevention of illness and healing of many.

Department of Psychology University of Zululand Private Bag Xl001 KwaDlangerwa, 3886 South Africa

STEVE EDWARDS

Mind, Stress and Health, by RICHARD TOTMAN. Souvenir Press, London, 1990,224 pp. f 14.95 hardback, f7.95 paper- back, ISBN 0285650904.

On the back cover of this book, the author states “whereas dietary factors, by and large, play no key role in the health of the individual, the effect of psychological factors, such as stress, personality and the support of other people, is profound”. This basically summarizes the main thesis of the book, that the medical profession has been concentrating too long on dietary factors and their contribution to health and disease, when the evidence of their effect has not been substantiated. He goes on to say, that “research into the effects of diet and drugs on health enjoys a much higher profile and level of funding than that into the effects of psychological states. Food and drugs are hard, tangible things that are easy to give or withhold, while ‘psychological stress’, ‘support’, etc., are often regarded as qualities too imprecise to be the subject matter of proper science. I argue that while this may have been the case in the past, there is no longer justification for holding such a view, and this bias in medicine must now be rejected as outdated.”

This is a forthright statement, which is substantiated throughout this very interesting and readable book. I found myself nodding in agreement, as the author reviewed the research on the tenuous link between saturated fats, choles- terol and heart disease; or the supposed association between

diet and cancer; or the numerous claims of medics that ‘radically modifying’ one’s diet or taking this or that ‘magic bullet’ drug can lead to better health. The evidence provided by Dr Totman is highly illuminating, undermining some of the ‘holy cows’ of the medical fraternity. For example, on healthy diets, he suggests “despite inaccurate and sometimes irresponsible reporting, looked at closely, research to find the ideal diet seems like the search for the Holy Grail”.

The rest of the book concerns itself with the link between personality, stressful situations and illness; the association between stress and the immune system; and the importance of social support and coping strategies in moderating the stress-strain relationship. The author clearly details the research evidence on the way stress affects the immune system, which he contends and demonstrates can lead to numerous illnesses. He concludes his detailed analysis of the mind, stress and health relationship with the following comment to medical recalcitrants, “these examples are enough to show that the stress-illness hypothesis can no longer be dismissed on the grounds of ‘no physiological basis’ “. In the final chapter of the book, Dr Totman rejects the diet-drug ‘black box’ of miracle cures for stress related illnesses, and recommends specific social, psychological and life style changes-keeping in mind that everyone has their own idiosyncratic ‘stress profile’.

This volume is not another ‘self help’ book on how to ‘eliminate stress in your life’. It is a well organized, well

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