email page print pageAll Topic Reviews
A New Understanding of Mental Disorders A Theory of Feelings Addictions Memory and the Self"Intimate" Violence against Women1001 Solution-Focused Questions101 Healing Stories101 Things I Wish I'd Known When I Started Using Hypnosis50 Great Myths of Popular Psychology50 Reasons People Give for Believing in a God8 Keys to Body Brain BalanceA Brief History of Modern PsychologyA Conceptual History of PsychologyA Conceptual History of Psychology: Exploring the Tangled Web A Cooperative SpeciesA Guide to Teaching Introductory PsychologyA History of Modern Experimental PsychologyA History of Psychology in AutobiographyA History of Social PsychologyA History of the BrainA History of the MindA Hole in the HeadA Matter of SecurityA Mind of Its OwnA Natural History of Human ThinkingA Place for ConsciousnessA Short Introduction to Promoting Resilience in ChildrenA Social History of PsychologyA Stroll With William JamesA System Architecture Approach to the BrainA Theory of FreedomA Very Bad WizardAbductedAbout FacesAccounts of InnocenceAction, Emotion and WillAdapting MindsAddiction and Self-ControlADHD & MeADHD in AdultsAdieu to GodAdolescence and Body ImageAdult Bipolar DisordersAdvances in Culture and PsychologyAdvances in Identity Theory and ResearchAffect Regulation, Mentalization, and the Development of SelfAffective MappingAgainst EmpathyAgainst HappinessAges and StagesAll Joy and No FunAll Out!All We Have to FearAlterations of ConsciousnessAmerican Psychiatric Publishing Textbook of Neuropsychiatry and Clinical NeurosciencesAn Argument for MindAncient Bodies, Modern LivesAnd BreatheAnimal MadnessAnimal Tool BehaviorAnimals in TranslationAnomalous CognitionAping MankindArtificial ConsciousnessAspects of PsychologismAsperger Syndrome and Your ChildAsperger Syndrome, Adolescence, and IdentityAssessment and Treatment of Childhood Problems, Second EditionAssisted Suicide and the Right to DieAttachedAttention is Cognitive UnisonAutism and the Myth of the Person AloneAutopsy of a Suicidal MindBecoming an Effective PsychotherapistBehavingBehavioral Genetics in the Postgenomic EraBeing No OneBelievingBetween Two WorldsBeyond AppearanceBeyond BlueBeyond BullyingBeyond MadnessBeyond MelancholyBeyond the BrainBeyond the DSM StoryBig DreamsBiofeedback for the BrainBipolar ChildrenBipolar DisorderBipolar KidsBlackwell Handbook of Childhood Cognitive DevelopmentBlind SpotsBlindsight & The Nature of ConsciousnessBlubberlandBlushBodiesBody ConsciousnessBody Image, Eating Disorders, and Obesity in YouthBody SenseBody WorkBorderline Personality DisorderBorderline Personality Disorder and the Conversational ModelBorn DigitalBorn to Be GoodBorn Together - Reared ApartBounceBoundaries in Human RelationshipsBounded RationalityBozo SapiensBrain and CultureBrain and the GazeBrain Arousal and Information TheoryBrain BugsBrain Change TherapyBrain Circuitry and Signaling in PsychiatryBrain FictionBrain, Mind, and Human Behavior in Contemporary Cognitive ScienceBrain-Based Therapy with AdultsBrain-WiseBrainstormBrainstormingBraintrustBrainwashingBrandedBreaking Murphy's LawBright-SidedBuddha's BrainBullying and TeasingBuyologyCan't You Hear Them?CaptureCare of the PsycheCartesian LinguisticsCartographies of the MindCerebrum 2007Cerebrum 2010Cerebrum 2015Cerebrum Anthology 2013Changing the SubjectCharacter Strengths and VirtuesCheating LessonsChild and Adolescent Psychological DisordersChildren’s Dreaming and the Development of Consciousness Chomsky NotebookClinical Psychiatry in Imperial GermanyClinical Psychology in Practice ClosureCognition and PerceptionCognition and the BrainCognitive BiologyCognitive DissonanceCognitive FictionsCognitive Mechanisms of Belief ChangeCognitive PragmaticsCognitive ScienceCognitive ScienceCognitive Systems and the Extended MindCognitive Therapy of Anxiety DisordersCognitive Unconscious and Human RationalityCold-Blooded KindnessComing of Age in Second LifeCommunication Issues In Autism And Asperger SyndromeCompassion and Healing in Medicine and SocietyComplementary and Alternative Therapies ResearchComprehending ColumbineConfessions of a SociopathConquering Shame and CodependencyConsciousnessConsciousnessConsciousnessConsciousnessConsciousnessConsciousness ConsciousnessConsciousness and Its Place in NatureConsciousness and LanguageConsciousness and Mental LifeConsciousness and MindConsciousness and the NovelConsciousness and the Social BrainConsciousness EmergingConsciousness RecoveredConsciousness RevisitedConsciousness, Self-Consciousness, and the Science of Being HumanConstructing PainConsumer NeuroscienceContemporary Debates in Cognitive ScienceConversations on ConsciousnessConviction of the InnocentCooperation and Its EvolutionCreating a Life of Meaning and CompassionCredit and BlameCritical New Perspectives on Attention Deficit/Hyperactivity DisorderCritical PsychologyCritical Thinking About PsychologyCross-Cultural PsychologyCrowdsourcingCrueltyCultural Assessment in Clinical PsychiatryCuriousDamasio's Error and Descartes' TruthDangerous and Severe Personality DisorderDaniel DennettDaughters of MadnessDeafness In MindDeath and ConsciousnessDeath of a ParentDecomposing the WillDeep Brain StimulationDeep ChinaDefining DifferenceDefining Psychopathology in the 21st CenturyDelusion and Self-DeceptionDelusions of GenderDennett and Ricoeur on the Narrative SelfDeparting from DevianceDescartes' BabyDescartes's Changing MindDescribing Inner Experience?Desert Islands and Other Texts (1953-1974)Destructive EmotionsDevelopment of Geocentric Spatial Language and CognitionDevelopment of PsychopathologyDialogues on DifferenceDid My Neurons Make Me Do It?Digital HemlockDirty MindsDisgust and Its DisordersDisorders of VolitionDo Apes Read Minds?Do Fish Feel Pain?Does Consciousness Cause Behavior?Doing without ConceptsDrunk Tank PinkEducating People to Be Emotionally IntelligentEffective IntentionsEffective Writing in PsychologyEffortless AttentionEmbodied Minds in ActionEmbracing MindEmbracing UncertaintyEmotion and ConsciousnessEmotion ExperienceEmotion RegulationEmotion, Evolution, And RationalityEmotional IntelligenceEmotionally InvolvedEmotionsEmotionsEmotions and LifeEmotions in Humans and ArtifactsEmotions RevealedEmotions, Aggression, and Morality in ChildrenEmotions, Stress, and HealthEmpathyEnjoymentErotic MoralityEscape Your Own PrisonEssays in Social NeuroscienceEssential Sources in the Scientific Study of ConsciousnessEthical Issues in Forensic Mental Health ResearchEthically Challenged ProfessionsEveryday Mind ReadingEvidence for PsiEvidence-Based Mental Health PracticeEvil MenEvolution and Human BehaviorEvolution and LearningEvolution, Games, and GodEvolution, Gender, and RapeEvolutionary Psychology and ViolenceEvolutionary Psychology as Maladapted PsychologyExacting BeautyExperiences of DepressionExperimenterExplaining the BrainExplaining the BrainExplorations in Neuroscience, Psychology and ReligionExploring TranssexualismExpression and the InnerExtending Self-Esteem ResearchExtraordinary BeliefsFact and Value in EmotionFaking ItFatigue as a Window to the BrainFavorite Activities for the Teaching of PsychologyFeeling GoodFeeling Pain and Being in PainFeelings and EmotionsFinding Meaning, Facing FearsFitting In Is OverratedFive Constraints on Predicting BehaviorFlourishingFlow: The Psychology of Optimal ExperienceFolk Psychological NarrativesFooling HoudiniForever YoungFormulation in Psychology and PsychotherapyFoucault, Psychology and the Analytics of PowerFoundational Issues in Human Brain MappingFoundations of Psychological ThoughtFree Will as an Open Scientific ProblemFreedom And NeurobiologyFreedom EvolvesFrom Axons to IdentityFrom Madness to Mental HealthFrom Neurons to Self-ConsciousnessFrom Passions to EmotionsFrom Philosophy to PsychotherapyFrom Symptom to SynapseFrontiers of ConsciousnessGay, Straight, and the Reason WhyGenerosityGenes, Environment, and PsychopathologyGenetic Nature/CultureGeniusGetting Under the SkinGlued to GamesGoing SaneGot Parts?Group GeniusGrowing Up GirlGuilt, Shame, and AnxietyGut ReactionsHallucinationHandbook New Sexuality StudiesHandbook of Closeness and IntimacyHandbook of Critical PsychologyHandbook of Emotion RegulationHandbook of EmotionsHandbook of Personality DisordersHandbook of PsychopathyHandbook of Self and IdentityHandbook of Self and IdentityHandbook of Spatial CognitionHappinessHappinessHappinessHappinessHappiness at WorkHappiness Is.Happy at LastHard to GetHardwired BehaviorHatredHealing the SplitHidden ResourcesHope and DespairHot ThoughtHot ThoughtHouse and PsychologyHow Animals Affect UsHow Animals GrieveHow Can the Human Mind Occur in the Physical Universe?How Doctors ThinkHow Enlightenment Changes Your BrainHow Families Still MatterHow History Made the MindHow Infants Know MindsHow Many Friends Does One Person Need?How People ChangeHow Professors ThinkHow The Body Shapes The MindHow the Body Shapes the Way We ThinkHow the Mind Explains BehaviorHow the Mind Uses the BrainHow to Change Someone You LoveHow We ReasonHow We RememberHughes' Outline of Modern PsychiatryHumanHuman BondingHuman Reasoning and Cognitive ScienceHume’s Moral Philosophy and Contemporary PsychologyHypnotismHysteriaiBrainIdentifying Hyperactive ChildrenIdentifying the MindiDisorderImagination and the Meaningful BrainImitation and the Social MindImpulse Control DisordersImpulsivityIn an Unspoken VoiceIn Defense of SentimentalityIn DoubtIn Search of HappinessIn the Wake of 9/11Individual and Collective Memory ConsolidationInner Experience and NeuroscienceInner PresenceInside the American CoupleIntegrated Behavioral Health CareIntegrating Evolution and DevelopmentIntegrating Psychotherapy and PharmacotherapyIntegrity and the Fragile SelfIntellectual DisabilityIntelligenceIntelligence, Destiny, and EducationIntentions and IntentionalityInterdependent MindsInterpreting MindsInto the Minds of MadmenIntoxicating MindsIntrospection VindicatedIntuitionInventing PersonalityInvestigating the Psychological WorldIrrationalityIs There Anything Good About Men?Issues for Families, Schools and CommunitiesJane Sexes It UpJoint AttentionJoint AttentionJudgment and Decision MakingJust a DogJust BabiesJuvenile-Onset SchizophreniaKarl JaspersKey Thinkers in PsychologyKidding OurselvesKids of CharacterKilling MonstersLack of CharacterLanguage OriginsLanguage, Consciousness, CultureLanguage, Vision, and MusicLaw, Mind and BrainLess Than HumanLet Kids Be KidsLet's Talk About DeathLiving NarrativeLiving with Mild Cognitive ImpairmentLonelinessLooking for SpinozaLossLOT 2Love at Goon ParkMachine ConsciousnessMacrocognitionMade for Each OtherMadnessMadness and Modernism: Insanity in the light of modern art, literature, and thought Making a Good Brain GreatMaking Habits, Breaking HabitsMaking Minds and MadnessMaking Up the MindMale SexualityMan and WomanMan's Search for MeaningMan, Beast, and ZombieManic MindsManlinessMapping the MindMarking the MindMarvelous Learning AnimalMasculinity Studies and Feminist TheoryMeaningMeaning, Mortality, and ChoiceMedical MusesMeditating SelflesslyMeetings with a Remarkable ManMemoryMemory and DreamsMemory and EmotionMemory And UnderstandingMental BiologyMental IllnessMental Time TravelMetacognitionMetacognition and Theory of MindMethods in MindMindMindMind and BrainMind and ConsciousnessMind Games:Mind in LifeMind TimeMind to MindMind, Brain and the Elusive SoulMindful AngerMindfulnessMindfulnessMindfulness and AcceptanceMindfulness-Based Treatment Approaches: Clinician's Guide to Evidence Base and ApplicationsMinding AnimalsMinding MindsMindreadersMindreading AnimalsMinds, Brains, and LawMindsightMindworldsMirrors in the BrainMistakes Were Made (But Not by Me)Models of MadnessMoodMoral Development and RealityMoral MindsMoral Psychology, Volume 1Moral Psychology, Volume 2Moral Psychology, Volume 3Mothers and OthersMotivation and Cognitive ControlMotivational Interviewing: Preparing People For ChangeMovies and the MindMulticulturalism and the Therapeutic ProcessMultiplicityMuses, Madmen, and ProphetsMy Family AlbumMyths about SuicideNarrative IdentitiesNarrative PsychiatryNarratives in PsychiatryNaturalizing Intention in ActionNature and NarrativeNature Via NurtureNeither Bad nor MadNerveNeurobiology and the Development of Human MoralityNeurochemistry of ConsciousnessNeurodiversityNeuroethicsNeuroLogicNeurological Foundations of Cognitive Neuroscience Neuroscience and PhilosophyNo Child Left DifferentNo Two AlikeNot By Genes AloneNot Much Just Chillin'Not So Abnormal PsychologyNurturing the Older Brain and MindOn AnxietyOn Being an Introvert or Highly Sensitive PersonOn Being HumanOn Being MovedOn Deep History and the BrainOn DesireOn KillingOn Nature and LanguageOn PaedophiliaOn PersonalityOn the Frontier of AdulthoodOn the Origins of Cognitive ScienceOn The Stigma Of Mental IllnessOnflowOpen MindsOpening Skinner's BoxOrigin of MindOrigins of PsychopathologyOther MindsOut of Our HeadsOut of the WoodsOvercoming Depersonalization DisorderPanpsychism and the Religious AttitudePanpsychism in the WestParenting and the Child's WorldPassionate EnginesPathologies of the WestPatient-Based Approaches to Cognitive NeurosciencePediatric PsychopharmacologyPeople Types and Tiger StripesPerception & CognitionPerception beyond InferencePerception, Hallucination, and IllusionPersonal Development and Clinical PsychologyPerspectives on ImitationPhantoms in the BrainPhenomenal Concepts and Phenomenal KnowledgePhenomenology and Philosophy of MindPhilosophical Foundations of NeurosciencePhilosophical MidwiferyPhilosophy and HappinessPhilosophy of PsychologyPhilosophy, Neuroscience and ConsciousnessPhrenologyPhysical RealizationPhysics in MindPieces of LightPlaying with FirePositive PsychologyPositive PsychologyPostcards from the Brain MuseumPostpsychiatryPosttraumatic Stress DisorderPoverty and Brain Development During ChildhoodPractical Ethics for PsychologistsPractical Management of Personality DisorderPractical Management of Personality DisorderPredicative MindsPredictably IrrationalPreference, Belief, and SimilarityPrenatal Testosterone in MindPrivileged AccessProcess-Based CBTProcrastinationProust Was a NeuroscientistPsychiatric SlaveryPsychiatry as Cognitive NeurosciencePsychiatry, Psychoanalysis, And The New Biology Of MindPsychological AgencyPsychological Concepts and Biological PsychiatryPsychological Dimensions of the SelfPsychologists Defying the CrowdPsychologyPsychologyPsychology and Consumer CulturePsychology and LawPsychology and the Question of AgencyPsychology for ScreenwritersPsychology of Women: A Handbook of Issues and TheoriesPsychology's GhostsPsychology's Interpretive TurnPsychology's TerritoriesPsychopathologyPsychopathyPsychosis and EmotionPsychotherapy, American Culture, and Social PolicyPutnam CampPutting a Name to ItQuantum Memory PowerQuietRadical DistortionRadical Embodied Cognitive ScienceRadical ExternalismRadical GraceRapeRe-Visioning PsychiatryReal MaterialismReality CheckReconstructing Reason and RepresentationReconstructing the Cognitive WorldRecovery in Mental IllnessRecreative MindsRedirectReducing Adolescent RiskRegulating EmotionsRelational BeingRelational Mental HealthRelational Suicide AssessmentReliability in Cognitive NeuroscienceRemembering HomeRemembering Our ChildhoodResearch Advances in Genetics and GenomicsResearching Children's ExperienceResilience in ChildrenRestoring ResilienceRethinking ADHDRethinking Learning DisabilitiesRethinking Middle YearsRethinking the Western Understanding of the SelfRevolution in PsychologyRoadmap to ResilienceRomance and Sex in Adolescence and Emerging AdulthoodSchadenfreudeSchizophrenia RevealedSchizophrenia, Culture, and SubjectivityScience and Pseudoscience in Clinical PsychologyScience and Pseudoscience in Clinical PsychologySecond NatureSecond NatureSecond That EmotionSecond-order Change in PsychotherapySecrets of the MindSee What I'm SayingSee What I'm SayingSeeing and VisualizingSeeing RedSelf and SocietySelf Comes to MindSelf Control in Society, Mind, and BrainSelf-Awareness Deficits in Psychiatric PatientsSelf-CompassionSelf-Consciousness and 'Split' BrainsSelf-RegulationSelf-Representational Approaches to ConsciousnessSelfless InsightSelvesSerial KillersSex at DawnSex on the BrainSex, Time and PowerSexual Coercion in Primates and HumansSexual DisordersSexual FluiditySexual ReckoningsSexualized BrainsShame and GuiltShatteredSimulating MindsSisyphus's BoulderSleepyheadSNAPSocial NeuroscienceSocial NeuroscienceSocial NeuroscienceSocial Psychology and DiscourseSome We Love, Some We Hate, Some We EatSoul DustSparkSpiral of EntrapmentSplendors and Miseries of the BrainSports Hypnosis in PracticeStanding at Water's EdgeStich and His CriticsStillpowerStop OverreactingStructure and Agency in Everyday LifeStructures of AgencyStuffStumbling on HappinessSubjectivity and SelfhoodSubstance Abuse and EmotionSuicidalSupersizing the MindSweet DreamsSynaptic SelfTales from Both Sides of the BrainTalking Oneself SoberTalking to BabiesTaming the Troublesome ChildTargeting AutismTeaching Problems and the Problems of TeachingTeleological RealismTen Years of Viewing from WithinTestosterone RexThat's DisgustingThe 5 Elements of Effective ThinkingThe Accidental MindThe Age of EmpathyThe Altruism EquationThe Altruistic BrainThe American Psychiatric Publishing Textbook of Clinical PsychiatryThe Anatomy of BiasThe Anxious BrainThe Archaeology of MindThe Art and Science of MindfulnessThe Art InstinctThe Art of HypnosisThe Asymmetrical BrainThe Bifurcation of the SelfThe Big Book of ConceptsThe Big DisconnectThe Birth of IntersubjectivityThe Birth of the MindThe Blackwell Handbook of Organizational Learning and Knowledge ManagementThe Blank SlateThe Body Has a Mind of Its OwnThe Bounds of CognitionThe Boy Who Was Raised as a DogThe BrainThe BrainThe Brain and the Meaning of LifeThe Brain SupremacyThe Brain That Changes ItselfThe Brain's Way of HealingThe Brain: Big Bangs, Behaviors, and BeliefsThe Cambridge Handbook of Cognitive ScienceThe Cambridge Handbook of Situated CognitionThe Character of ConsciousnessThe Chemistry Between UsThe Choice EffectThe Clinical Science of Suicide PreventionThe Cognitive Approach to Conscious MachinesThe Cognitive Behavioral Workbook for Anxiety: A Step-By-Step ProgramThe Cognitive NeurosciencesThe Cognitive-Emotional BrainThe College Fear FactorThe Commercialization of Intimate LifeThe Compass of PleasureThe Compassionate ConnectionThe Concepts of ConsciousnessThe Conscious BrainThe Conscious SelfThe Consuming InstinctThe Creating BrainThe Creative BrainThe Crucible of ConsciousnessThe Crucible of ExperienceThe Cure WithinThe Dao of NeuroscienceThe Developing MindThe Developing MindThe Development of PsychopathologyThe Disappearance of the Social in American Social PsychologyThe Dissolution of MindThe Duty to ProtectThe Educated ParentThe Ego TunnelThe Elephant in the RoomThe Embodied Mind: Cognitive Science and Human ExperienceThe Emotional Foundations of PersonalityThe Emotional Journey of the Alzheimer's FamilyThe Encultured BrainThe Encyclopedia of StupidityThe Enduring Self in People with Alzheimer'sThe Epidemiology of SchizophreniaThe Essential DifferenceThe Ethical BrainThe Evolution of BeautyThe Evolution of ChildhoodThe Evolution of CooperationThe Evolution of LanguageThe Evolution of MindThe Evolving BrainThe Executive BrainThe Faces of TerrorismThe Feeling BrainThe Feeling of What HappensThe First IdeaThe Folly of FoolsThe Folly of FoolsThe Folly of FoolsThe Foundations of Cognitive ArchaeologyThe Fundamentalist MindsetThe GapThe Gender TrapThe Geography of BlissThe Gift of ShynessThe Good LifeThe Good LifeThe Happiness HypothesisThe Happiness of PursuitThe Health Psychology HandbookThe Healthy Aging BrainThe Heart of TraumaThe High Price of MaterialismThe History of PsychologyThe Human FaceThe Human SparkThe Hypomanic EdgeThe Imagery DebateThe Immeasurable MindThe Imprinted BrainThe Incredible Shrinking MindThe Innate MindThe Innate MindThe Integrated SelfThe Intentional BrainThe Language of ThoughtThe Languages of the BrainThe Lexicon of Adlerian PsychologyThe Lie DetectorsThe Lives of the BrainThe Lonely AmericanThe Lust for BloodThe Madness of WomenThe Male BrainThe Man Who Lost His LanguageThe Man Who Shocked the WorldThe Man Who Tasted ShapesThe Man Who Wasn't ThereThe Matter of the MindThe Mature MindThe Mean Girl MotiveThe Meaning of EvilThe Meaning of OthersThe Meaning of the BodyThe Measure of MadnessThe Measure of MindThe Medicalization of Everyday LifeThe Mind and the BrainThe Mind in ContextThe Mind of the ChildThe Mind of the HorseThe Mind's EyeThe Mind, the Body and the WorldThe Mind-Gut ConnectionThe Mindful BrainThe Misleading MindThe Moral MindThe Most Dangerous AnimalThe Most Human HumanThe Mother FactorThe Myth of ChoiceThe Myth of Depression as DiseaseThe Myth of Mirror NeuronsThe Myth of Self HelpThe Myth of Self-EsteemThe Myth of the Spoiled ChildThe Nature of the SelfThe Necessity Of MadnessThe Neuro RevolutionThe Neuron and the MindThe Neuropsychology of the UnconsciousThe Neuroscience of Human RelationshipsThe Neuroscience of PsychotherapyThe Neuroscience of Psychotherapy: Healing the Social BrainThe New BrainThe New Science of DreamingThe New Science of the MindThe New UnconsciousThe Normal PersonalityThe Origins of FairnessThe Overflowing BrainThe Oxford Companion to the MindThe Oxford Handbook of Philosophy of MindThe Paradoxical PrimateThe Perfectionist's HandbookThe Peripheral MindThe Phenomenology ReaderThe Philosopher's Secret FireThe Philosophical BabyThe Political MindThe Politics of HappinessThe Positive Side of Negative EmotionsThe Postnational SelfThe Postpartum EffectThe Power of PlayThe Praeger Handbook of TranssexualityThe Present Moment in Psychotherapy and Everyday LifeThe Primate MindThe Prism of GrammarThe Psychobiology of Trauma and Resilience Across the LifespanThe Psychological Construction of EmotionThe Psychology of Good and EvilThe Psychology of Good and EvilThe Psychology of HappinessThe Psychology of LifestyleThe Psychology of Religious FundamentalismThe Psychology of Science and the Origins of the Scientific MindThe Psychology of Science and the Origins of the Scientific MindThe Psychology of SpiritualityThe Psychology of StereotypingThe Psychology of SuperheroesThe Psychophysiology of Self-AwarenessThe Pursuit of PerfectThe Quest for Mental HealthThe Rational ImaginationThe Ravenous BrainThe Reasons of LoveThe Righteous MindThe Routledge Companion to Philosophy of PsychologyThe Routledge Companion to Philosophy of PsychologyThe Routledge Handbook of ConsciousnessThe Science of EvilThe Science of Intimate RelationshipsThe Science of Shame and its Treatment The Second SelfThe Secret History of EmotionThe Secret Lives of BoysThe Self and Its EmotionsThe Self-Sabotage CycleThe Sense of SelfThe Sensitive SelfThe Shape of ThoughtThe Social AnimalThe Social Nature of Mental IllnessThe Social Neuroscience of EmpathyThe Social Psychology of Good and EvilThe Social Psychology of MoralityThe Social Psychology of MoralityThe Story of Intellectual DisabilityThe Structure of ThinkingThe Survivors ClubThe Talking ApeThe Teenage BrainThe Tell-Tale BrainThe Temperamental ThreadThe Tender CutThe Tending InstinctThe Time ParadoxThe Trauma MythThe Trauma of Psychological TortureThe Trauma of Psychological TortureThe Trouble with IllnessThe True PathThe Truth About GriefThe Turing TestThe Uncertain SciencesThe Undoing ProjectThe Unhappy ChildThe Upside of IrrationalityThe War for Children's MindsThe Well-Tuned BrainThe Wild Girl, Natural Man, and the MonsterThe Winner's BrainThe Wisdom in FeelingThe Woman RacketThe World in My Mind, My Mind in the WorldThe Wow ClimaxThe Yipping TigerThemes, Issues and Debates in PsychologyTheoretical Issues in Psychology: An IntroductionTheory of AddictionTheory of MindThings and PlacesThink CatThink Confident, Be ConfidentThinking about AddictionThinking and SeeingThis Emotional Life: In Search of Ourselves...and HappinessThought and LanguageThought in a Hostile WorldTo Have and To Hurt:Toward an Evolutionary Biology of LanguageToward Replacement Parts for the BrainTrauma and Human ExistenceTrauma, Tragedy, TherapyTreating Attachment DisordersTreating Self-InjuryTreating Self-Injury: A Practical GuideTrue to Our FeelingsTrusting the Subject?Understanding and Treating Borderline Personality DisorderUnderstanding ConsciousnessUnderstanding ParanoiaUnderstanding PeopleUnderstanding TerrorismUndoing Perpetual StressUnlock the Genius WithinUnsettled MindsUnstrange MindsUnthinkingUnthoughtUs and ThemViolent PartnersVirtue, Vice, and PersonalityVision and MindVisual AgnosiaWarrior's DishonourWe Who Are DarkWednesday Is Indigo BlueWelcome to Your BrainWhat Do Women Want?What Dying People WantWhat Have We DoneWhat Intelligence Tests MissWhat Is an Emotion: Classic and Contemporary ReadingsWhat Is Emotion?What is Intelligence?What Is Mental Illness?What Is Thought?What Makes Your Brain Happy and Why You Should Do the Opposite What the Best College Students DoWhat the Dog SawWhat We Know about Emotional IntelligenceWhat We Say MattersWhat's Wrong With Morality?When Boys Become BoysWhen Perfect Isn't Good EnoughWhen the Impossible HappensWhen Walls Become DoorwaysWho's Been Sleeping in Your HeadWho's in Charge?Why Humans Like to CryWhy Love MattersWhy Lyrics LastWhy People CooperateWhy People Die by SuicideWhy Sex Matters: A Darwinian Look at Human BehaviorWhy Smart People Can Be So StupidWhy the Mind is Not a ComputerWhy Us?Why We LieWhy We LoveWhy We SleepWider than the SkyWilliam James at the BoundariesWilling, Wanting, WaitingWittgenstein And PsychologyWomen and Child Sexual AbuseWorking MindsYoga and PsychologyYou Are What You RememberYoung Minds in Social WorldsYour Brain on CubsYour Brain on FoodYour Brain on Food: How Chemicals Control Your Thoughts and Feelings,Your Brain on YogaYour Child in the BalanceZombies and Consciousness
Both authors are well known to anyone in the field. Given the manualized philosophy of CT and CBT, this has become the most researched trend in delivering psychotherapy in anxiety disorders.
Three sections of the book expose the last few decades of advancement in this field, given this burgeoning research.
The first elaborates on the original models that began to emerge in the mid 80's, the second, the strategies that emerge across the anxiety disorders as putative treatments, and the last, more specific approaches to the individual diagnoses within the anxiety nosology. This is all in keeping with Beck's commitment to empiricism in demonstrating what is now considered the evidence base for the interventions which come under the heading of CT.
Chapter one examines anxiety and fear, as if for the lay person who does not understand the conditions, or the difference between a fear, and fear of the unknown, but also to reiterate what exactly is the approach to these conditions as they are described. Once anxiety and fear are distinguished, and of course Barlow's definitions are invoked, then the idea of what might be considered functional and thus normal, and what might be abnormal and leads to dysfunction, are of course in keeping with the DSM's over the years, in that any condition which might otherwise be considered normal, eg not doing maths, becomes abnormal if it leads to dysfunction. Any fear or grief or anxiety is only really to be considered pathological if it leads to an inability to deal with events in life which should ordinarily be coped with. The other common issue with anxiety, is its comorbidity with other conditions, the most ubiquitous being depression, living alongside as a diagnosis in about 55% of cases, as high as 76% when taken as a lifetime statistic. Not only intra-category, there is comorbidity with other anxiety disorders as well. In fact, comorbidity is more common than individual conditions appearing without another category, confirming what Steve Hyman wrote about in Nature Reviews Neuroscience, when he noted the lack of distinct categorization in clinical diagnosis, which did not mirror the DSM manuals. Symptom frequency and intensity are thus variable and an integral part of the assessment.
The role of the two major branches of the autonomic nervous system is examined, with diminished autonomic flexibility exhibited in chronic sufferers, as Selye suggested it should. The role of the sympathetic branch is well understood, the role of the moderating response from the parasympathetic less so. The work of various researchers into heart rate variability has demonstrated more clearly the relationship between the two branches. Barlow of course noted that anxiety prone individuals typically exist in a state of constant hyperarousal despite an absence of a direct stimulus: anxiety is a forward looking state after all, so the role of anticipation has to be researched. As Montaigne said, he had lived through many disasters, both big and small, most of which never happened at the end of the day. One of my colleagues noted that for depressed people, the worst had happened, but for anxiety prone individuals, the worst is yet to come. For the chronic cases, heart rate variability studies demonstrate lower cardiac vagal control. The wider neurophysiology and neurotransmitter systems are examined in light of recent findings. Balancing this, behavioral theories are explored, including conditioning, fear module, and the case for cognition obviously given the tone of the book. As opposed to the unitary role of the amygdala which was part of earlier thinking, other areas of the brain, and other sensitivities of the amygdala are discussed. The case is clearly also to be made of the role of the higher levels of cortical functioning in containing or modifying the fear response.
Given the tone, the second chapter speaks to the cognitive model of anxiety, based in the primary and secondary appraisal, and the automatic and strategic processing of a preconscious attentional bias for threat. The central tenets of the model include the exaggerated threat appraisals, heightened helplessness, (related to the strategic evaluation of response capacity), suppression of information incongruent with perceived level of threat, an impairment of reflective capacity, so constructive modes of problem solving are less accessed. Clinician guidelines throughout the book deliver the take home message that each section delivers. A fuller description of the cognitive model follows, beyond those already mentioned, demonstrating the quarter century of advancement which resulted in some modification of the original model. The 12 hypothesis of the cognitive model of anxiety are put forward in their revised format.
Given Beck's original bent towards empiricism, the next chapter covers the empirical status, healthy as it is, of the cognitive model. The 12 hypotheses are examined one by one, to establish the evidence base for each. E.g., the idea of an attentional bias to threat is testing by instruments such as the Emotional Stroop, looking at the interference effect of anxiety provoking stimuli on the response to presented colored words. The diminished attentional processing of safety, hypothesis two, can be demonstrated, and exaggerated stress appraisals can likewise be demonstrated, by word stem completion for instance. Up to number 10 is examined.
Selye and others have spoke of a diathesis, or vulnerability to stress and anxiety, and this is the subject of the 4th chapter. This is both variable, and not as well researched as the treatments, which of course reflects the industry that has grown around treatment and the research funds available for subjects related to anxiety. Another issue is the silence of this vulnerability until a precipitating event. There may be many vulnerability domains which can overlap and compound, making the disorder variable in severity in different individuals. There is no doubt that negativity, or neuroticism, has an influence, as do trait anxiety, a related concept, as does the fear of anxiety, namely sensitivity which may involve avoidance. Diminished personal control, or a fear of loss of efficacy is also discussed here, with helplessness and hopelessness related to control, a feature in the comorbidity with depression, seen as an end state when control of future events is seen as compromised. The cognitive model of vulnerability is then evaluated, namely from the perspective of Beck originally that in essence it arises from an evaluation of what the threat might be, versus what the capacity to deal with the threat might be as perceived. Within this, genetic, biological, developmental learning, negative affect, trait anxiety etc all play a part. A more contentious issue for both the empiricism and the personal vulnerability conferred by Hypothesis 11, as examined here, remains uncertain, as does the role of self-esteem for instance in anxiety. Hypothesis 12, namely enduring threat related beliefs, and how they are triggered. Here, the evidence for the role of schemas is more compelling. Overall, given the subject matter, the evidence presented here has to show a bias towards proving cognitive issues as a source for vulnerability, and hence a target for change. Here, the evidence overall is slightly deficient, given research has progressed only in the last few years.
Part II of the book now turns to assessment and intervention strategies. The three aspects of assessment, namely diagnostic information, symptom frequency and severity, and personal data are discussed. There are many diagnostic tools in the toolbox, and the Beck Anxiety Inventory is of course the gold standard for the book, as well as following discussion on the Hamilton, the DASS, State-Trait Anxiety Inventory, Cognitions Checklist, Daily Mood Rating, Beck Depression Inventory II with no explanation why it stands alone here, except for the high comorbidity with anxiety. Fear Activation assessment is described, and the various other elements well known to this model are discussed, e.g., secondary reappraisal. It's not all negative, but includes an assessment of constructive responses including spontaneous exposure, realistic threat appraisal etc with some case formulations. A wonderful appendix includes some useful evaluation forms, as well as a quick reference guide, given the intricacy of a cognitive assessment.
The crux of the matter comes in chapter 6 which goes into the cognitive interventions, following the main objectives of cognitive interventions, such as shifting threat foci, focusing on appraisals and beliefs which direct the anxiety, the modification of such things, the normalizing of fear and anxiety, strengthening of personal efficacy, supporting a more adaptive approach to safety, etc. Cognitive intervention strategies include education, self monitoring and identification of anxious thoughts, cognitive restructuring are also revisited as are identifying thinking errors, generating alternative explanations and testing these, as well as gathering data on threat and vulnerability appraisals. Newer skills now include attentional training, namely how to interrupt repetitive self attentional processing that supports anxiety states. Metacognitive interventions incorporate thinking about thinking, a metaposition now reflected in Metacognitive psychotherapy being offered. So discussion around an anxious thought would include a discussion not of the consequences or likely outcome, but of what elements of such a thought constitute the threat.
Imaginal reprocessing is another newer innovation, involving reviewing imagery connected to the anxiety in its own right, and involving written descriptions in expressive narrative, to be used in later exposure techniques. Mindfulness based cognitive therapy and acceptance and commitment therapy have come into existence, with the cognition in ACT more a description of thought as a private behavior, rather than cogntion. In these ways, moderation of appraisals of threat, safety seeking and vulnerability are approached within anxiety, using both more now traditional approaches to CT, and at least addressing some of the more novel, offshoots of that core field. However, when attending some of the newer workshops on these approaches, one hears very old names invoked, dating back to the family therapy movement and Eriksonian hypnotherapy. Again, the appendix contains the names of helpful manuals and various therapy monitoring forms are available for copy.
Ch 7 then begins to explore the importance of behavioral intervention from a cognitive perspective, given the frequent existence of avoidance and escape behavior so common in aversive experiences of anxiety. Hence, behavioral assignments remain vital in disrupting the behavior: in a sense, the disorder's impact is more than a bad feeling, and more of the dysfunction that avoidant behavior might bring, especially in severe cases of PTSD or OCD. Changes in thinking patterns which have become dysfunctional are thus targeted by behavioral tasks which provide experience and challenge of cognitive misappraisals. As has always been the case, it is important, or perhaps vital that the real therapeutic impact comes in the post-task behavior when demonstrating how the 'neurotic' appraisals differed from the actual experience. Hence Milton Erikson's hypnotic techniques involved seeing how close clients could come to their perceived loss of control setpoint, and how that could be shifted. In any event, experience under controlled intervention where complete avoidance or escape is likely, learning takes place under the same or similar circumstances where the original anxiety was learned or created. Exposure interventions are of course the most assertive of such interventions, involving as usual, rationale discussions and training before exposure, not mindless exposure until the client stops screaming. Often then the behavior is initially under therapeutic control, then this is titrated back, and vanishes, meaning there is both in session and between session interventions, none of this new to the established CT, B or CBT practitioner. Despite commonly held beliefs, relaxation training in moderate to severe anxiety is not really useful, and can be used as an avoidance strategy, rather than immersion during exposure. So could giving the client the option of calling for phone support for instance. Paradoxical intention still hangs in there from strategic therapy days, with the instruction given to worsen the anxiety provoking stimulus, thus placing elements of the anxiety under client control: I am not helpless, I am actually inducing the uncomfortable behavior. So although most therapists regard any haven from anxiety as being counterproductive, judicious use might be useful.
The chapter then moves on to the in-vivo exposure related to treating the disorder under real life, not created exposure to the anxiety provoking stimulus. Imaginal exposure is also part of this philosophy, but devalued, as nothing about simulators is as good as the real thing, although simulator training prepares the client for the real life behavioral experiment, under controlled and pre-prepared conditions. Exposure to the physical discomfort of anxiety is also pretty much a necessity, however it is done, e.g. forced hyperventilation, so that the imagined threat presented by the scary physical sensations such as breathlessness, heart pounding, can be inoculated against. As with all CT, BT, CBT, the response to such noxious stimuli have to be disrupted or prevented to stop escape or avoidance behaviors. The goal as in all interventions like this, is for them to result in independent, self-guided interventions to dominate, rather than the therapist interventions. Again, rationale and training preparation is and are vital. Directed interventions around behavior, especially using such tools as role modeling with role reversal, provides skills which can be learned and practiced.
Notwithstanding its dysfunctional role in escape or avoidance, outside of the anxious, or panicky episodes, relation training is essential as tool in creating resilience and affecting the heightened physical tone. So too is breathing retraining, but a notable omission here is the idea of Heart Rate Variability Training which is now part of the approach to recovery in athletes, and which researchers have found to use the vagal and baroreflexes attached to breathing at a rate that maximized beat to beat variability, and enhance parasympathetic tone. Gewurtz and others believe that 20mins of this a day can inoculate against stress and anxiety responses becoming evident.
Again, the chapter ends with helpful downloads in terms of forms that can be used to monitor and direct exposure and other training.
Section Three now turns to more specific interventions, and covers Panic Disorder, Social Phobia (more an American thing than British), Generalized Anxiety Disorder, OCD and PTSD. In each case, the elements of each disorder are discussed, and then the cognitive model introduced for the disorder. Various elements of the scientific literature around the disorder are discussed, e.g., does Panic Disorder predict suicide attempts, in the absence of comorbidity? As before, core elements of the cognitive approach to the disorder are put forward as hypotheses, and then evaluated in terms of the evidence. Therapeutic interventions are then described. Outcome studies are also discussed, given the empirical bent of the authors. 75 pages finish the book off, devoted to the scientific references mentioned in the work.
There are of course dozens of handbooks out there referring to the treatment of anxiety disorders, but still, the ones written by the master himself, Aaron Beck, and his collaborators over the years are the ones to buy before any others. Given so much has been written in these disorders over the last decades when CT, and CBT began to reign supreme in the scientific outcomes literature, with its manualized presentation allowing for easy standardization of treatment and thus a path to defining the efficacy of the treatment quantitatively, the warmth of the relationship requirement identified by the NIMH studies still is cogent, but what the therapist does within the warm confines of the arrangement still has to have some weight to it.
CT is a body contact sport, and involves a lot of activity on behalf of the therapist, and long gone, despite the rehashing of much that has gone before, faddishly, as best practice therapy, are the days of the passive therapist or the passive client: this is hard work, and documented work as well, measured and paced accordingly, and requiring some skill of the therapist beyond active listening. However, precisely because of the manualized and prescribed approach, some therapists I work with do unusual things with that. Recently, a colleague noted that after 24 sessions of CBT, using the best manuals, she discovered that her client had anger issues. Any client centred therapist worth her weight in reflecting empathically, namely reflective listening, would have picked that up within minutes, or certainly within the first sessions. Therapy had gone nowhere until then, and compliance with homework tasks etc had been limited, until the anger was dealt with by cognitive restructuring and challenge. Although CT is a powerful and well proven tool, there are other aspects to body contact sports such as psychotherapy, where being face to face with a client, rich in diversity of emotion, behavior and thought, requires more engagement than just is evident from the manual. However, within CT this is not demeaned, and must be included in the general establishment of the relationship in which the client has to encounter their own resolve to change. The seduction of such wonderful books should not detract from the need for wider skills, in which both authors were originally trained. The word empathy does not appear in the index, and yet the NIMH studies did identify the warmth of the relationship as a really powerful factor in therapy. Those who thus warm to the stellar techniques which Beck exemplifies and has elaborated over time, should not neglect the need to be an accomplished listener, and a human being, capable of a warm therapeutic alliance in which patients are willing to adopt these new behaviors, not just be compliant. One of my own patients described, his brain injury and experience of a skilled CT therapist, as follows: "this was good advice I just couldn't take". Worse, his addled working memory did not allow him to follow the chain of thoughts and events, so his treatment failed.
CT has become and will remain the gold standard against with other treatments, including drugs will be measured, owing to the great Beck and his followers, and rightly so. Skills in this are essential, especially in anxiety and depression. The well rounded therapist will however require more tools in the toolbox than just these, but what CT has done is allow problem based learning to educate psychologists and bring them to competence in the most common disorders they will ever see. When they are being trained, this is the book they will learn from, and use throughout their careers.
© 2011 Roy Sugarman
Roy Sugarman PhD, Director: Applied Neuroscience, Athletes Performance and Core Performance, USA