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No More AnxietyReview - No More Anxiety
Be Your Own Anxiety Coach
by Gladeana McMahon
Karnac Books, 2005
Review by Kathy Tiell, Ph.D.
Dec 5th 2006 (Volume 10, Issue 49)

Although McMahon attempts to provide a brief, "hands-on" synopsis of the current cognitive and behavioral anxiety treatments in her book No More Anxiety: Be Your Own Anxiety Coach, it appears that she has some difficulty in reaching this goal. Firstly, her attempts to consolidate large amounts of material led to the removal of important information and a lack of text coherence. Secondly, her presented material was somewhat contradictory in nature. Thirdly, some of her material is inaccurate.

McMahon's review of cognitive-behavioral activities designed to reduce anxiety is poorly done. She provides an overly-simplified explanation for the tools, which does not allow the reader to fully understand the reasons behind them. She then makes a list of few activities that the reader could engage in. I found the lists to be paltry at best. Her consolidation of common thought distortions is so brief and under-elaborated that many of her "types of negative thinking" appear to overlap in definition. I also found the way that the book was written to be confusing. McMahon frequently provided a short explanation for topics that were covered in more detail later in the book. When I read the initial explanation and examples, I was surprised to read the material again in longer version later in the text. This "jumping around" made the book feel choppy and lacking of coherency.

In the first chapter, McMahon provides a wonderful description of the physical and cognitive sequelae of stress. In her synopsis, she indicates that high levels of stress leads to increased heart rate, respiration, and reduced immune system functioning. Later under the chapter "Frequently Asked Questions" she states that "anxiety is a really uncomfortable feelings with physical side effects, but that is all," suggesting that anxiety is innocuous. Which is it? Does anxiety tax the heart and leave the immune system open to attacks, or is it harmless?† In the next paragraph she states, "Anxiety does not cause mental illness". However, anxiety is internationally listed as a mental illness in and of itself.† Also in the chapter, "Frequently Asked Questions," McMahon asks the questions "Why do I feel so tired" and "Would resting be better for me," respectively. In answer to the first question, McMahon indicates "your body is working hard producing and coping with a range of stress hormones and their effects." In answer to the second question, she confounds the words "rest" and "avoidance" and leads the reader to believe that they should not rest. In all actuality, she needs to communicate much more clearly on this topic. Under the topic "Relaxation Exercises," McMahon states, "There are many forms of relaxation exercises, ranging from those that require physical exertion, to those that require nothing more than breathing or visualization techniques." In current nomenclature, relaxation techniques are designed to immediately reduce the rate at which the heart and lungs work, thus necessitating calming activities.

McMahon states on the first page, "Cognitive-Behavior Therapy is the only therapy that has sought to put itself forward for assessment and validation through research." This is blatantly inaccurate. All forms of therapy have used research as a means of assessment and validation of its paradigms and techniques.† While discussing OCD, she refers to obsessions as a "compulsive urge to take part in ritualized activities". Clinically, this is a confusing and misleading definition. The obsession is the thought and the compulsion is the behavior. In the above quote, she is referring to the obsession as a compulsion. The reason that this may be important is that it may impede later communication with a mental health specialist. In addition, McMahon discourages pharmacological treatments of anxiety, stating, "The problem with medication is that you end up having to take more and more and the effects wear off more quickly." This is untrue for the majority of the medications used to treat anxiety. Furthermore, research indicates that only 40% of individuals are successfully treated via therapy. Discouraging medication is therefore irresponsible, since the idiosyncratic response to treatment and medication suggests that some will react better to medication.

Overall, I felt that the author did a poor job in both her explanations and recommendations. Her explanations lacked some important detail, and were at times, misleading and incorrect. Her recommendations were in some cases, poorly exemplified and limited. It appeared that McMahon wanted to consolidate 50 years of stress research into a small, user-friendly book. Although this is an important goal, I believe she provided too "sketchy" of a summary to be of real lasting use for readers. In addition, she "borrowed" concepts from other researchers without giving them credit. For example, she provides an extract from a stress list, whereby events that are stress inducing are listed in order to stress induction. In the actual research, the authors gave the list of stress inducing events (e.g., the birth of a baby, marital problems) and assigned them a value. An individual could add up the values and determine their "stress" level and see into what category of stress they fell (e.g., 10-100 points= low stress; 101-300= moderate stress, and so on). McMahon did not include the full chart, nor did she give credit to these researchers. In her book No More Anxiety: Be Your Own Anxiety Coach, she merely provided a brief list of some anxiety provoking activities. I think that this section could be much more effective, if she had simply cited these authors and included the full chart. In that way, she would have provided a richer explanation for what constitutes stressful life events and the corresponding "Stress values," which in turn, would have enhanced the information given to the reader.

I feel that McMahon was on the right track, but missed her goal.

 

© 2006 Kathy Tiell

 

Kathy Tiell, Ph.D., Lawrence Technical University, Southfield, MI


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