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12 and HoldingA Guide to Asperger SyndromeA Lethal InheritanceA Mother's Courage: Talking Back to AutismA Parent's Guide to Asperger Syndrome and High-Functioning AutismA Special EducationA Toss Of The DiceA Tribe ApartA User Guide to the GF/CF Diet for Autism, Asperger Syndrome and AD/HDA Walk in the Rain With a BrainABC of Eating DisordersADD-Friendly Ways to Organize Your LifeADHD Grown UpADHD in the Schools: Assessment and Intervention StrategiesADHD NationAdolescence and Body ImageAdolescent DepressionAggression and Antisocial Behavior in Children and AdolescentsAll Alone in the UniverseAlpha GirlsAmericaAnother PlanetAntisocial Behavior in Children and AdolescentsAsperger Syndrome and Your ChildAsperger Syndrome, Adolescence, and IdentityAsperger's and GirlsAssessment of Childhood DisordersAttention Deficit DisorderAttention-Deficit Hyperactivity DisorderAttention-Deficit/Hyperactivity DisorderAutism - The Eighth Colour of the RainbowAutism and MeAutism's False ProphetsAutistic Spectrum DisordersBad GirlBeen There, Done That? DO THIS!Before I DieBetween Two WorldsBeyond AppearanceBig Mouth & Ugly GirlBipolar ChildrenBipolar Disorder in Childhood and Early AdolescenceBipolar DisordersBipolar KidsBlackwell Handbook of Childhood Cognitive DevelopmentBody Image, Eating Disorders, and ObesityBody Image, Eating Disorders, and Obesity in YouthBoy AloneBrain-Based Therapy with Children and AdolescentsBreaking PointBreathing UnderwaterBringing Up ParentsBullying and TeasingBullying PreventionBut I Love HimCan't Eat, Won't EatCaring for a Child with AutismCatalystChild and Adolescent PsychiatryChild and Adolescent Psychological DisordersChild and Adolescent PsychopathologyChild NeuropsychologyChild Well-BeingChildren and SexualityChildren Changed by TraumaChildren with Emerald EyesChildren with Sexual Behavior ProblemsChildren, Sexuality and SexualizationChildren’s Dreaming and the Development of Consciousness City of OneCommunication Issues In Autism And Asperger SyndromeConcepts of NormalityConcise Guide to Child and Adolescent PsychiatryConquering the Beast WithinConsuming KidsContesting ChildhoodCount Us InCrackedCrossesCutCyber-Safe Kids, Cyber-Savvy TeensDamageDemystifying the Autistic ExperienceDescartes' BabyDilemmas of DesireDirtyDisconnected KidsDoing SchoolDon't Bother Me Mom--I'm Learning!Don't Pick On MeDying to Be ThinEarly Intervention Programs and PoliciesEating an ArtichokeEducating Children With AutismEight Stories UpElijah's CupEmerald City BluesEmotional and Behavioral Problems of Young ChildrenEpilepticEthical Dilemmas in PediatricsEvery Girl Tells a StoryExiting NirvanaExploiting ChildhoodEye ContactFacing BipolarFamily HistoryFast GirlsForever YoungFreaks, Geeks and Asperger SyndromeFreewillFrictionGirl CultureGirl in the MirrorGirlfightingGirlhoodGirlWiseHandbook of Evidence-Based Therapies for Children and AdolescentsHandbook of Preschool Mental HealthHealing ADDHelping Children Cope With Disasters and TerrorismHelping Hyperactive KidsHelping Parents, Youth, and Teachers Understand Medications for Behavioral and Emotional ProblemsHelping Students Overcome Depression and AnxietyHelping Teens Who CutHollow KidsHope's BoyHow Infants Know MindsHow to Keep Your Teenager Out of Trouble and What to Do If You Can'tHurry Down SunshineI Am Not Joey PigzaIdentifying Hyperactive ChildrenIf Your Adolescent Has an Eating DisorderIn the Company of CraziesIncorporating Social Goals in the ClassroomIntegrated YogaIntrusive ParentingIssues for Families, Schools and CommunitiesJake RileyJoey Pigza Loses ControlJoey Pigza Swallowed the KeyJuvenile-Onset SchizophreniaKim: Empty InsideLearning and Behavior Problems in Asperger SyndromeLearning Disorders and Disorders of the Self in Children and AdolescentsLearning Outside the Lines Let Kids Be KidsLiberation's ChildrenLife As We Know ItLisa, Bright and DarkLook Me in the EyeLoserLove and SexLove That DogMad at SchoolMaking ADD WorkMaking American BoysManicMastering Anger and AggressionMaverick MindMedicating ChildrenMind FieldsMind to MindMommy I'm Still in HereMore Than a LabelMy Flesh and BloodMyths of ChildhoodNew Hope for Children and Teens with Bipolar DisorderNew Look at ADHD: Inhibition, Time, and Self-ControlNo Child Left DifferentNo Two AlikeNon-Drug Treatments for ADHDNot Much Just Chillin'NurtureShockOdd Girl OutOdd Girl Speaks OutOne Hot SecondOne in ThirteenOphelia SpeaksOphelia's MomOur Journey Through High Functioning Autism and Asperger SyndromeOut of the WoodsOvercoming ADHDOvercoming School AnxietyParenting a Child Who Has Intense EmotionsParenting Children With ADHDParenting Your Out-Of-Control TeenagerPediatric PsychopharmacologyPediatric PsychopharmacologyPediatric PsychopharmacologyPeople with HyperactivityPhobic and Anxiety Disorders in Children and AdolescentsPINSPlease Don't Label My ChildPraising Boys WellPraising Girls WellProblem Child or Quirky Kid?Problem GirlsPsychotherapy for Children and AdolescentsPsychotherapy with Children and AdolescentsPurgeRaising a Moody ChildRaising BlazeRaising Generation RxRaising Resilient ChildrenReady or Not, Here Life ComesReclaiming Our ChildrenRedressing the EmperorReducing Adolescent RiskRemembering Our ChildhoodResilience in ChildrenRethinking ADHDReweaving the Autistic TapestryRitalin is Not the Answer Action GuideRitalin NationRunning on RitalinRunning with ScissorsRutter's Child and Adolescent PsychiatrySeeing EzraSex and the American TeenagerSex, Therapy, and KidsSexting and Young PeopleSexual Teens, Sexual MediaShort Term 12Should I Medicate My Child?SmashedSnapshots of AutismSongs Without WordsSophie Spikey Has a Very Big ProblemSpeakStaying Connected to Your TeenagerStick FigureStraight Talk about Psychiatric Medications for KidsStraight Talk about Psychological Testing for KidsStraight Talk about Your Child's Mental HealthStrange SonStudent DepressionSuicidal Behavior in Children and AdolescentsSurvival Strategies for Parenting Children with Bipolar DisorderSurviving OpheliaTaking Charge of ADHD, Revised EditionTaming the Troublesome ChildTemple GrandinThe American Psychiatric Publishing Textbook Of Child And Adolescent PsychiatryThe Anti-Romantic ChildThe Bipolar ChildThe Boy Who Loved WindowsThe Boy Who Was Raised as a DogThe Buffalo TreeThe Bully Action GuideThe Bully, the Bullied, and the BystanderThe Burn JournalsThe Color of AbsenceThe Curious Incident of the Dog in the Night-TimeThe Depressed ChildThe Developing MindThe Dragons of AutismThe Einstein SyndromeThe EpidemicThe Evolution of ChildhoodThe Explosive ChildThe Eyes of van GoghThe Fasting GirlThe Field of the DogsThe Flight of a DoveThe Hidden Gifts of the Introverted ChildThe Horse BoyThe Identity TrapThe Inner World of a Suicidal YouthThe Inside Story on Teen GirlsThe Kindness of StrangersThe Last Normal ChildThe Little MonsterThe Medicated ChildThe Myth of LazinessThe New Gay TeenagerThe Nurture AssumptionThe OASIS Guide to Asperger SyndromeThe Other ParentThe Perversion of YouthThe Philosophy of AutismThe Psychoanalytic Study of the ChildThe Real Truth About Teens and SexThe Ride TogetherThe Rise and Fall of the American TeenagerThe Science of ADHDThe Sex Lives of TeenagersThe Survival Guide for Kids With LD*The Unhappy ChildThen Again, Maybe I Won'tTherapy with ChildrenThings I Have to Tell YouThings Tom LikesThrough the Glass WallThumbsuckerTotally WiredTouching Spirit BearTrauma in the Lives of ChildrenTreating ADHD and Comorbid DisordersTreatment of Childhood DisordersTwistedUnder the Wolf, Under the DogUnhappy TeenagersUnstrange MindsWastedWe've Got IssuesWeather Reports from the Autism FrontWhat about the KidsWhat in the World Are Your Kids Doing Online?What Works for Whom?What Would Joey Do?What's Happening to My Body? Book for BoysWhat's Happening to My Body? Book for GirlsWhat's Happening to Tom?When Nothing Matters AnymoreWhen Your Child Has an Eating DisorderWhose America?Why Don't Students Like SchoolWill's ChoiceWinnicott On the ChildWorried All the TimeYou Hear MeYoung Minds in Social WorldsYoung People and Mental HealthYour Child, Bully or Victim?
To the practicing clinician dealing
with individuals labeled learning disabled or attention deficited, there often
seems only two roads one can take. If
the diagnosis is suspect, one works to understand other, possibly more neurotic
causalities. This route is less accepted, being seen more as "blaming the
victim." The second is blind acceptance of the diagnosis and the
biological constraints of the disorder. The individual is, as she or he is,
because of the neuropsychological dysfunction. This route leaves the clinician
with an over-simplistic picture of the individual, almost as if one were
dealing with an organism of the single celled variety and not the complexity of
the more human kind.
Joseph Palombo takes a less
traveled path in his text Learning Disorders and Disorders of the Self,
one that attempts a space between the aforementioned two. Palombo makes no
attempt to argue against the various diagnostic criteria of learning disorders
and instead focuses on the ways in which these varieties of neurological
dysfunction challenge and often derail personality development. Taking a solid
self psychological stance (a variant of contemporary psychoanalytic thought
based on the writings of Heinz Kohut and focused on the ways individuals
develop and maintain a sense of self esteem), Palombo uses theoretical
constructs to map this third trail and guide the clinician who navigates it.
The text begins with an explanation
of Palombo's decision to undertake the writing of this book through a history
of his training and a very brief history of psychoanalytic theory in its
relation to child development. Palombo makes a useful sketch of past psychoanalytic
work with the learning disordered and a discussion of the history of the
disorders in general. Palombo then moves to the first of the three major
sections of his work: the ways in which disorders of the self occur in the
development of the child with a learning disability. Focusing on the context of
development, particularly the ways in which parental and/or social factors
assist the child in developing a self narrative (this being the implicit way
the child organizes his fantasies and expectations of his or her place in the
world), Palombo outlines the necessity of a coherent self narrative, the
consequences of an incoherent self narrative and the loss of self cohesion
(usually resulting in anxiety or depression) that results from disruptions in
narrative. The relevance of these concepts to learning disabilities is
illustrated by a variety of clinical examples.
Palombo's second section deals with
the major varieties of learning disorders and developmental difficulties. Each
chapter is organized along characteristics of the disorder, expected
developmental history, varieties of possible self disorders and recommended
intervention. Beginning with Dyslexia, Palombo moves from least problematic to
most debilitating developmental disorders. Along the way, he summarizes
relevant data and ties this together, through his clinical experience, with
self psychological constructs and clinical illustration.
The final section deals exclusively
with the role of psychotherapy with children suffering from learning
disabilities. Beginning from a place of caution (therapy must be indicated and
often may be unnecessary or even harmful), Palombo outlines the role of the
therapist, expectations of change, course of treatment and expected pitfalls
(called moments of disjunction by Palombo). He spends considerable time
outlining the ways parents and family could be incorporated in the treatment.
Palombo's text has a plethora of
strengths. His years of experience shine through, especially in the excellent
clinical examples. He writes in a clear, concise manner that verges on the
lyrical. The book is well organized, to be practical and used by the clinician.
Palombo also does an admirable job bridging psychoanalytic theory with
neuropsychological assessment. He does not shy from offering criticism of
either camp and, time and again, his empathy for the children in his care drive
him to criticize anything that complicates their betterment.
The weaknesses are really only
quibbles, though one does bear mentioning. Palombo relies almost exclusively on
a self psychological construct (almost is correct, since he does mention
several other relevant constructs) and, as a result, succumbs to the weaknesses
inherent in the theory. Though an accommodating environment is certainly important
in developing and maintaining self narratives and self cohesion, it would have
been interesting for Palombo to bring his considerable expertise to bear more
on the negative consequences of conflictual adaptation, to have him address the
self sabotage and self loathing that can disrupt development.
In conclusion, this is a remarkable
book and highly recommended to the practicing clinician or any interested
party. I suspect it would enrich the understanding and practice of both the
seasoned and novice clinician. Furthermore, it is written from a place of
compassion and a desire to heal.
© 2003 Dan L. Rose
Dan L. Rose, Psy.D. is a Clinical
Psychologist involved in direct clinical work and training at Columbus State
University and in private practice. His interests include psychoanalysis,
neuroscience, religion and literature.