British Homoeopathic Journal April 1997, Vol. 86, pp. 106-120

Book reviews

Mind Matters. J. R. Millenson. Churchill Livingstone, Edinburgh 1996. ISBN 0 939 61621 1. s Dr Millenson has a PhD in psychology and has already written a textbook on behavioural p s y c h o l o g y . He is also an expe r i enced teacher and practitioner of herbalism. It is this unusual combinat ion of skills which makes him equally at home in the treatment of physical and psychological illness, hence Mind Matters, a book about psychological medicine in holistic practice.

When I first perused this book I did not like the look of it. The author appeared to be too much of a scientific rationalist for my rather expansive, relatively non-scientific mind. All those lists and graphs put me off, as did the attention to trivial detail (e.g. body language: 'a patient frowning may disapprove of what the therapist is saying, or not under- stand it'). On closer acquaintance however, I found that there was much to commend this comprehensive analysis of all that is known of the mind-body connection.

Mind Matters is really two books in one. Half of its 14 chapters would constitute a decent introduction to psychosomatic medicine for the lay person. These deal with such topics as the meaning of the word 'psychosomatic', the meaning of 'mind', the physiological basis of the mind-body connection, and some basic examples. Therapists who already know that asthma can be exacerbated by emotional stress, or that the adrenal medulla is activated by the fright-flight response, would benefit more from the other chapters, which look into the symbol- ic meaning of disease, the various methods of psychotherapy, and basic counselling skills.

Millenson advocates the use of a mind body journal, in which the reader records daily his reactions to different stressors and to 'small controlled changes in lifestyle'. He is thus rec- ommending that we ourselves become guinea pigs in our own psychosomatic experiment. This is psychosomatics at its most scientific and most immediate, and it will appeal to the more scientific reader who wants to test out his own mind-body connection. There is a danger here of encouraging rampant hypochondriacs

(Arsenicum and Kali carbonicum readers will love it!). But I dare say readers more patient than I might gain some valuable insights about themselves.

Moving onto the history of psychosomatic theory, I found Millenson more appealing. His appraisal of the scientific contribution to the field of such masters as Hippocrates and Edward Bach was interesting, and his statement in relation to Maslow's hierarchy of needs that 'the conceptual independence of systems in hierarchy is very different to reductionist classi- cal science' reveals the author's ability to go beyond mechanistic and behavioural models in his search for understanding. In general, Millenson reveals a surprisingly wide and sub- tle understanding of the effects of the mind on the body and shows himself flexible enough to incorporate many diverse systems of thought into his overview, from physiology to the symbolic meaning of disease.

Reading this book I often found myself alternating between boredom and keen interest. In his search for thoroughness, the author devotes a couple of chapters to the connection between personality and disease, listing every known hypothesis and numerous studies to test them. Unfortunately, virtually every hypothesis was found to be unsupported by the studies, which made for pretty dull reading. On the other hand, I was rewarded from time to time with fascinating details, such as the story of the little town of Roseto. Roseto is a community of Italian immigrants in North America who have retained their traditional communal ties and eschewed the rat-race culture of the rest of the country. As a result, their rates of heart disease and stroke are a fraction of those in the rest of America, despite the fact that their diet is rich in animal fats, and they take little exercise.

When it comes to therapeutic intervention, the author reveals his bias towards behavioural therapy. He r ecommends the use by the patient of a behaviour diary, with an emphasis on Goal Choosing and Situation Control the limiting of situations which tend to elicit the symptom to be overcome. Flow diagrams are included which illustrate the mechanics of

106

Volume 86, April 1997 107

behavioural counselling, but they were too mechanical to retain my interest.

What did impress me was the author ' s overview of the majority of psychotherapies. Millenson displays a sympathetic and deep unders tand ing of such wide ly d i f fe r ing schools as cognitive psychology, Jungian analysis and Freud. I learned quite a lot from this chapter, despite the fact that I knew quite a bit beforehand.

Another chapter which was helpful and interest ing to me was the one about the meaning of disease. The author steers a sensible course between simplistic New Age systems of symptom interpretation (e.g. knee problems relate to pride) and an over ly mechanistic approach. He reminds us that a patient may have a stomach pain one day because he has unresolved issues with his mother, and the next day because he needs to take prune juice. He also points out that whilst it may be useful for the therapist to encourage the patient to look into the meaning of his symptoms, he must on no account foist his own interpretation on the patient. Such warnings are all too necessary to the practi- tioner who dares to venture into the jungle of the symptom symbolism.

Having been somewhat put off by the emphasis on behavioural therapy, I was later won over by the author's sensitive and skilful portrayal of basic counselling skills, and the importance of the therapeutic relationship. The chapter on psychological counselling points out clearly the various traps into which inexperienced counsellors fa l l - -us ing too many directions, warnings, rationalizations, being judgmental or excessively sympathetic. I liked the author ' s emphasis on Person- Centred Therapy, with its unconditional regard for the client and its differentiation between useful empathy and unhelpful sympathy. I also liked the case histories, which illustrate how several different psychologica l approaches can be used in the same case, alongside holistic physical therapies. Above all Millenson is prag- matic if it works use it, and he advocates the use of a wide array of therapeutic tools, from biofeedback to active imagination.

Mind Matters is a very different kind of book from the New Age versions of psycho- somatic medicine of Louise Hay et al. It is also very different from the inspirational books by Deepak Chopra or Bernie Siegal.

Unlike the latter, the focus here is on practical application by the therapist, and this is the strength of the book.

Mind Matters is aimed at the holistic practitioner. Practitioners who like a lot of facts, or are able to scan the page to assess its content before further reading, will not be too put off by the more basic chapters and will certainly benefit from the author's sensitive and comprehensive approach to a difficult subject.

PHILIP BAILEY

Documenta Homoeopathica Band 15. Matth ias Dorcs i , Franz Swoboda eds. Vienna: Wilhelm Maudrich 1995. Pp. 7+306. Price not stated. A critical review of a book, which most of our readers will be unable to read because it is in German, seems unhelpful. I shall there- fore limit myself to brief outlines of the 21 papers in this volume. Anyone interested in a particular one may then have it translated for them or get a fuller summary.

As always, Documenta Homoeopathica offers a rich range of subjects, many showing the special ability to combine clear, objective thinking with an artistic approach that to my mind is characteristically Austrian.

A brief editorial note at the beginning tells us that this, the 15th annual volume published by the Ludwig Boltzmann Institute of Homoeo- pathy and the Austrian Homoeopathic Medical Association, is a collection of papers written by physicians who are deeply connected with their work. Whilst they are individual and personal, the simifia principle lives in each of them, simi- larity between medicine and patient, author and subject, the homoeopathic medicine under discussion and the style of presentation, etc.

R. G. Appell paints a picture of Goethe's encounters with the Arnica plant, showing how well the poet and scientist's descriptions match the drug picture. He also presents Goethe's final illness and the medical treatment he received.

H. Zi l ler has contr ibuted a ref lect ive, meditat ive boat trip on an Austrian lake. Theme: the heart. Attunement is followed by the first stop: anatomy, the architecture of the muscle fibres and the topographical anatomy of the heart. Then we come to physiology, William Harvey, the language for and of the heart, and embryology. The author concludes