98 BOOK REVIEWS

neurosis. sexual disorders. behaviour therapy and psychotherapy. If they do, they are likely to be rather less impressed for these topics are handled with somewhat less authority and originality. Despite this. there is plenty here to interest any practising psychiatrist or clinical psychologist and the book can be recommended both for libraries and for a personal bookshelf.

M,G.GELDER

H. S. KAPLAN: The New Srx Thrapy. Vol. II: Disorders oJ Sexual Desire and Other :Vrw Comxpts and Techniques it1 Sex Therapy. Brunner/Mazel. New York (IY79). xx + 237 pp. 8 17.50.

Not so many years ago a woman who manifested sexual inclinations much like those of the average man would be deemed pathological by psychiatrists and diagnosed as a ‘nymphomaniac’. Today, a woman who manifests sexual inclinations much like those of the average woman runs the distinct risk of being diagnosed by sex therapists as suffering from ‘inhibited sexual desire’ (ED). Society. it seems, is never entirely comfortable with the range of libidos displayed by women. In Victorian days they were all expected to behave like ladies: today they are all expected to behave like men. Of course, if there is a major discrepancy between partners in level of sexual desire then a problem undoubtedly exists, but the application of labels that smack of individual-centred medical diagnosis seems to me value-laden and potentially counterproductive.

The main theme of this new book by Helen Kaplan concerns the need to distinguish three phases of the sexual cycle for purposes of diagnosis and treatment of sexual disorders. These are: (I) desire, (2) excitement. and (3) orgasm. Since her previous book, The New Sex Therapy. dealt mainly with the latter two phases, the current volume focusses on the desire phase. which she argues is the most complex in etioiogy and the most difficult to treat. There is no doubt this is true for whereas sexual performance itself can be improved by correction of faulty habits, the equalization or increasing of desire usually involves either changing the basic nature of one or both individuals or dealing with a relationship that has begun to break down.

Kaplan is by no means unaware of the magnitude of this task, though I could not help feeling that she was working within a slightly unrealistic framework imposed by certain unwarrantable assumptions. One is the strange concept that men and women are virtually identical animals: another is the fairy-tale idea that they are constructed as ideal complementaries who, in the absence of psychological pathology on either side, may be expected to live together in eternal monogamous bliss. Unfortunately. neither position can be sustained in the light of the hard, cold facts of nature (see Symons’ book, The Enoluriort of Hurnari Sexuality). Males and females have evolved partly incompatible instincts as a result of historical conflicts and it is futile to ignore this fact. It is interesting that Kaplan (a woman) regards security and intimacy as vital to good sex (p. 183) while Stoller (a man) is equally certain that risk and anger are essential to sexual incitement.

Sometimes the writing is lucid: at other times it seems to have been produced if not by the apocryphal monkey randomly hitting typewriter keys. at least by a computer programmed to emit psychoanalytic jargon. For example. what is one to make of this sentence? (p. 89). “Desire and love problems at length and analytic formulations regarding the etiology of fails to internalize and integrate appropriate introjects.” The mysterious words ‘sig’ and ‘patint’ occur every so often; the former is apparently a neologism meaning treatment tasks. while the latter seems to be a patent spelling of patient. There is also a grandiose and omniscient air about the book that is bound to irritate academic psychologists. There is no empirical documentation of any kind. and closely related work such as that of Britain’s own Dr. Patricia Gillan is totally Ignored.

Despite these reservations. this is a book that practicing sex therapists will feel obliged to read. though it is to be hoped they will do so critically. The case studies and detailed descriptions of treatment programmes will be a useful source of therapeutic ideas. and the appendix outlining the effects of various drugs and illnesses on the three phases of sexual performance will certainly prove useful.

GLENX WILSON

M. A. KOZLOFF: ,-I ~r~ram~or Families of Children with Learning and 3eha~i~ur frobie~s. Wiley-rnters~ence. New York (1979). xiii + 445 pp. f14.00.

This is an impressive book. comprehensive. sensible and well written. It offers a wealth of ideas and suggestions for professionals working with families of children with learning and behaviour problems. It is not, as the title might suggest, aimed primarily at the families themselves and parents reading it on their own might become daunted by the apparent immensity of the task in hand. The author describes how to organise and run a programme from the earliest stages through to follow up and maintenance: from how to make initial contact with parents and decide if they are ready to engage in a programme through to how to cope with the many problems that might arise. Although intended for those working with groups of parents the book will also be useful for those working with individuai families. It is written as a companion volume to Kozloffs 1974 book Educuring C~~~~~r~~i w~r~z ~ear~~j/i~ attd ~e~ra~iua~ frob~e~~ which would be useful extra reading butnot absolu- tely essential for those experienced in the field of mental handicap and child development.

Kozloffs descriptions of the complaints. doubts and pesstmisms made by parents about behavioural approaches are perceptive and even amusing. He provides useful suggestions on how to answer these parents and what to do when things are going wrong. His portrayal of the everyday problems faced by professionals

BOOK REVIEWS 99

working with families is convincing and he comes across as an experienced and humane man. His list of things to do before actually starting a programme is another helpful feature of the book covering such topics as organisation. equipment and record keeping. KozlotT is a sociologist and this might explain his broad perspec- tive. He includes. for example. sections on dealing with marital conflicts, depression, attitude change and the problems faced by siblings. This contrasts with the more limited approach taken by many authors writing on a similar topic,

BARBARA WILSON

B. B. LAHEY (Editor): Behavior Therapy with Hyperactive and Learning Disahkd Children. Oxford University Press. New York (1979). ix + 260 pp. f5.75.

This is a collection of 25 articles, most of which have appeared in American journals since 1976, together with a specially written overview and brief introductory sections. Lahey and his colleagues suggest that the problems subsumed under the headings ‘hyperaction’ and ‘learning disabled’ have undergone a series of reformulations since they emerged from the 1940s views of brain damaged children. Neuropsychological, perceptual and psycholinguistic explanations dominated the 1950s. but little advances in either understanding of the nature of the disorder or effective intervention was evident.

The early 1970s saw the development of behavioural approaches to treatment. Early attempts produced equivocal results by concentrating on inappropriate targets. Lahey argues that later studies which concentrated on academic learning and high rates of inappropriate behaviour have had more success.

The selection of papers illustrate this sequence of development in research approaches, and the resulting collection is undoubtedly of considerable value for teaching purposes. However, none of the authors adequateI> tackles the vexing issue of how to define either of these categories of problems. Most of the American literature on ‘learning disability’ fails to operationalise the concept, whilst the definition of ‘hyperactive’ is so wide in comparison with European definitions qf ‘hyperkenesis’ as to be over-inclusive.

It is clear that there has been an epidemic of hyperactivity and learning disability in America-an epidemic which has all too often been treated with liberal doses of Ritalin. The papers in this collection demonstrate that behavioural interventions are as effective if not more effective than medication. and for this they are welcome. Their impact would have been greater had the issues of classification of the disorders been tackled.

WILLIAM YULI

W. E. LAMBERT. J. F. HAMERS and N. FRASURE-SMITH: Child Rearing Values: A Cross Narional Study. Praeger. New York (1979). xxii + 430 pp.

In the authors’ words. this is a ‘globe-trotting’ exercise. The book documents a series of comparative studies on child-rearing values of parents from over ten national groups. The authors begin by exploring the similarities and differences between the English-speaking and French-speaking parents in Canada, and subsequently extend the comparison to other groups, including the natives and immigrants from America, England, Italy, Belgium, Portugal, Greece and Japan. The account is fascinating to read, as each chapter unfolds new data and the two-, three-nation comparison is finally put into perspective in a ten-nation comparison in the concluding chapter.

As an empirical study, the methodology is sound and clearly reported. The data are collected by means of asking parents to respond to a taped recording of a child who presents himself/herself in different situations, and the parent’s responses are coded into several scales by independent raters. The method comes close to a direct behavioural survey, and although the data are not obtained through observation of genuine situations, it permits the observation of behaviour in a wider sample of controlled conditions. The procedure is consistent throughout, which enables interested readers to go through the entire text or consult any particular chapter with equal ease. The results are presented both in statistical tables and graphical forms. Together with the detailed discussion of results, this has met the authors’ aim that readers who are and those who are not statIstIcally oriented have both been catered for.

The theoretical discuss&m by comparison is brief, but in relating the findings on child rearing values with McClelland’s studies on motivation. the authors have put forward some interesting and testable hypotheses (see. for example, p. 367). There is also an attempt to consider the practical application of their findings in the understanding of the conflicts in values between parents and teachers in Canada.

Readers who have known W. E. Lambert’s work will find this book living up to the high standard of his previous publications. The book will no doubt be of interest to research workers dealing with child-rearing practices and values. The particular merit is that it has also provided a new model for comparative studies across nations or cultures.

MONA M. Tsor

J. M. NEALE. G. C. DA~~~CIN and K. P. PRICE (Editors): Contemporary Reading in Psychopathology (2nd Edition). John Wiley. New York (1978). xi + 463 pp. f5.25.

The editors were sufficiently encouraged by the response of both students and teachers to their first offering (1974) to embark on a second one only 4 years later. The nu’mber of articles has risen from 28 to 36. and