Reassurance and Relaxation
- Author:
Rippon,
M.R.C.S., L.R.C.P., and Peter Fletcher. Introduction by W. Russell Brain, M.D. Routledge & Sons, Ltd. Price 6s. net.
This small book dealing with a large subject contrives to be interesting and to give a clear presentation of the matter. It is chiefly directed towards the treatment of anxiety states which the authors regard as the basis of most, if not all, forms of neurosis. They adopt a broad humanitarian outlook and wisely stress the importance of the doctor’s attitude towards the patient. The need for compassion and for real understanding of the patient’s point of view they regard as essential. They also urge the importance of a physical examination of a kind “so thorough that the patient is left no excuse for convincing himself that his complaints of pain or organic distress have been ignored. He must be made to realize,” they say, ” that the doctor takes him seriously, and is as concerned as the patient himself to discover any organic condition that may be the cause or the part cause of the mental disturbance. The result of this examination should be explained to the patient in precise, simple language. Vagueness always frightens. It leaves the impression either that the doctor, out of mistaken kindness, is disguising his conviction that the patient is suffering from an incurable malady, or else that the physician is not troubling to give the sufferer the con- sideration he deserves. Equally unsatisfactory is it, when no organic lesion can be found, to tell the patient, ‘ It’s just your nerves That word, ‘ Nerves ‘, should be expurgated from medical parlance as a term to denote functional disorder. To the patient it always has a bodily reference and, as a rule, its only effect is to start him off on the road to hypochondria by way of intense interest in every patent medicine that promises a cure for his complaint.” This is a salutary reminder that psychotherapy should not be divorced from general medicine and that patients tend to have less confidence in the psycho- therapist who has not troubled to make himself acquainted with their physical condition. There are few psychopathological states in which some bodily symptoms do not arise from time to time, and to the patient it appears absurd that a doctor should state that these conditions have no organic significance without making any physical investigation.
This is a book which should be of value to the general practitioner who wishes to gain some understanding of the psychological difficulties of his patients and of the relation of these to many of the physical symptoms of which they complain.
D.M.O.
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