email page print pageAll Topic Reviews
Health Care in America The Happiness of Burnout"Guns Don't Kill People, People Kill People""How Come Boys Get to Keep Their Noses?"17 Lies That Are Holding You Back20 Jazz Funk Greats50 Popular Beliefs That People Think Are TrueA Brief History of the SmileA Child of One's OwnA Citizen Legislature/A People's ParliamentA Clinician's Guide to Legal Issues in PsychotherapyA Colorful History of Popular DelusionsA Cultural History of Modern Science in ChinaA Cursing Brain?A History of Intelligence and "Intellectual Disability"A History of MarriageA History of PsychiatryA Little F'd UpA Loving Approach to Dementia CareA Man's Guide to Healthy AgingA Mind ApartA Mind So RareA Natural History of RapeA Natural History of VisionA Red Heart of MemoriesA Short History of MedicineA Student's Guide to the History And Philosophy of Yoga A Tear is an Intellectual ThingA Therapist's Guide to Understanding Common Medical ProblemsA Universe of ConsciousnessA User's Guide to the BrainA World Full of GodsABC of Eating DisordersABCs to Positive LivingAbnormal Psychology in ContextAbout FaceAccessible Yoga for Every Body DVDActs of ConscienceAdoption Beyond BordersAdvances in Culture and PsychologyAfter HarmAfter the Ecstasy, the LaundryAfter the Globe, Before the WorldAgainst the MachineAging Our WayAging ThoughtfullyAIDS & People with Severe Mental IllnessAkhenatenAl-JununAlgernon, Charlie and IAll About LoveAllergy ReliefAlone TogetherAlpha GirlsAltered EgosAltered StatesAlways On CallAm I Making Myself Clear?Am I Okay?AM/PM YogaAmerica in the FortiesAmerican Science Fiction Film and TelevisionAmong the Great ApesAn American ObsessionAn American SicknessAn Anthropologist on MarsAn Illustrated Book of Bad ArgumentsAn Odd Kind of FameAnatomy of an EpidemicAncient Greek and Roman SlaveryAnger, Madness, and the DaimonicAnimal ArchitectsAnimal MadnessAnimal MindsAnimals in TranslationAnother CountryAntimatterAre the Rich Necessary? Updated and Expanded EditionArt and PoliticsArtemis FowlAs Nature Made HimAsylumAsylum on the HillAsylum to ActionAt Liberty to DieAtonement and ForgivenessAttention Deficit DisorderAttitudeAuthentic HappinessBe Very AfraidBeautiful MindsBeauty's NothingBeckett and AnimalsBecoming a DoctorBeing VirtualBelle and Sebastian's If You're Feeling SinisterBest of the Brain from Scientific AmericanBetrayal TraumaBetter Sex Through YogaBeyond AIBeyond GreekBeyond HealthBeyond ReasonBeyond ToleranceBibliotherapyBipolar DisorderBlack Man in a White CoatBlack MassBlind SpotsBlinkBlood and GutsBodies out of BoundsBody Piercing Saved My LifeBorn Standing UpBOSH!Brain LongevityBrain-Based Teaching for All SubjectsBrainchildrenBrainwashingBread Upon the WatersBreaking Murphy's LawBreaking WomenBreathingBrian Eno's Another Green WorldBrief EncountersBritain on the CouchBrothelBuddhism and ScienceBuilding Healthy MindsBullspottingBullying PreventionBurn UnitBuzzC StreetCalling Our Spirits HomeCamp ZCampus Sexual AssaultCan't You Hear Them?Cancer on $5 a Day* *(chemo not included)Cato's TearsCaughtChained to the DeskChickenizing Farms and FoodChild Slaves in the Modern WorldChildren's Learning in a Digital WorldChina on the MindChoices and ConflictChoosing CivilityChronic Fatigue Syndrome (The Facts)Classical Pilates Technique DVDCleopatraClinical Psychopharmacology Made Ridiculously SimpleClosing the AsylumsCognition, Creativity, and BehaviorCognitive Neuroscience of EmotionCollege Inc.Coming of Age in AmericaComing of Age in Ancient GreeceConceptual BlockbustingConcrete ReveriesConducting Insanity EvaluationsConfronting Postmaternal ThinkingConnected, or What It Means to Live in the Network SocietyConsciousnessConsider the LobsterConsuming InnocenceContagiousControlConversations About Psychology and Sexual OrientationCool WomenCorpora in Language Acquisition ResearchCorrect EnglishCorrupted CultureCount Us InCovered in InkCreative AngerCreative Core AbsCreative ThinkeringCreative Writing In Health And Social CareCreatures of AccidentCrime and Punishment in AmericaCritical ConditionCritical Perspectives in Public HealthCritical Psychology: An IntroductionCross-Cultural Topics in PsychologyCrossingCrossing the Unknown SeaCruddyCultural Healing and Belief SystemsCulture and Subjective Well-BeingCustomers and Patrons of the Mad-TradeCyber BullyingCyber-Safe Kids, Cyber-Savvy TeensDance the Chakras Yoga WorkoutDancing After HoursDangerous EmotionsDarwin's Dangerous IdeaDarwin's LegacyDeaf Identities in the MakingDeath in the AirDebunked!DeceptionDecoding DarknessDeep GossipDefenders of the TruthDefining Moments in ScienceDefying DementiaDeinstitutionalization And People With Intellectual DisabilitiesDematerializingDementiaDementia Caregivers Share Their StoriesDemocracy StrugglesDemons of the Body and MindDemons of the Modern WorldDepression In Later LifeDirty DetailsDiscourse of Twitter and Social MediaDistractedDivine MadnessDMT and the Soul of ProphecyDo-It-Yourself Eye Movement Techniques for Emotional HealingDoes Science Need a Global Language?Doing GoodDon't Believe Everything You ThinkDon't Get Too ComfortableDr. Andrew Weil's Guide to Optimum HealthDr. Andrew Weil's Mindbody ToolkitDreaming and Other Involuntary MentationDSM-IV SourcebookDSM-IV-TR Case StudiesDuplicityDutiful DaughtersDying for TimeEarthly Bodies, Magical SelvesEastern Body, Western MindEating AnimalsEccentricsEcological MedicineEducating People to Be Emotionally IntelligentEinstein and OppenheimerElectroshockElliott Smith and the Big NothingEmergence and EmbodimentEmergencies in Mental Health PracticeEmotionEmotional Intelligence at WorkEmotions RevealedEncyclopedia of Asylum Therapeutics, 1750-1950sEntwined LivesErotic PassionsEssentials of Cas AssessmentEssentials of Wais-III AssessmentEthics for the New MillenniumEvamarie Pilipuf's Yoga Express DVDEvery Day Yoga for Every Body DVDEveryday GreensEveryday IrrationalityEveryday SimplicityEverything Is MiscellaneousEvolutionEvolution and Human BehaviorEvolution in MindEvolution's RainbowExploring the Edge Realms of ConsciousnessExuberanceEyes of SophiaFalling for ScienceFalse-Memory Creation in Children and AdultsFamilyFamily Desk Reference to Psychology Fashion and Its Social AgendasFashion, Desire And AnxietyFast, Fresh & GreenFat and FuriousFear and Other Uninvited GuestsFearless ConfessionsFeminist Philosophy And Science FictionFinal ExamFine LinesFixing My GazeFlesh of My FleshFlesh WoundsFlirting With DangerFlow and YinFlying ColorsFocusFood for Thought:Food, Medicine, and the Quest for Good HealthFool Me TwiceFreedom, Fame, Lying, and BetrayalFridaFrom Certainty to UncertaintyFrom Joy Division to New OrderFull Frontal Feminism: A Young Woman's Guide to Why Feminism MattersFull Steam Ahead!Galileo Goes to Jail and Other Myths about Science and ReligionGang of Four's EntertainmentGender and Its Effects on PsychopathologyGender and Mental HealthGeneration DigitalGenetics of Mental DisordersGeniusGenomeGetting a Good Night's SleepGetting Inside Your HeadGetting WastedGilded CityGirl in the CurlGirlfightingGirls Gone MildGirls on the VergeGod and the MultiverseGoing Into TownGood FortuneGood KarmaGood MedicineGood WorkGracefully InsaneGrassroots SpiritualityGreat Psychologists and Their TimeGulpHabeas CorpusHalf a Brain Is EnoughHandbook of AttachmentHappinessHappinessHappiness Is.Hate Crimes in CyberspaceHealingHealing SpacesHealth And the MediaHealth OnlineHearing the Person With DementiaHeavier than HeavenHello from Heaven!HelmholtzHelvetica: A documentary filmHemalayaa's Yoga for Young Bodies DVDHemingway's Second WarHerbs for the MindHere Is New YorkHeroes, Rogues, and LoversHeterophobiaHidden MindsHistory of ShitHistory of SuicideHoly Sh*tHoly WarHooked!Hot Body Cool Mind - Level 1Hot Body Cool Mind: Waking Energy Hot Chocolate for the Mystical LoverHot SpotsHotHouseHouse and PsychologyHow Children Learn the Meanings of WordsHow Doctors ThinkHow Emotions WorkHow Not to Get ShotHow Our Lives Become StoriesHow Proust Can Change Your LifeHow Science WorksHow to Build a Robot ArmyHow to Cook Everything VegetarianHow to Grow OldHow to Handle a Hard-To-Handle KidHow We AgeHow We Are Changed by WarHumankindHungerHysteria Complicated by EcstasyI Contain MultitudesI Know Who You Are and I Saw What You Did: Social Networks and the Death of PrivacyI of the VortexI Only Say This Because I Love YouI, Little AsylumIdiot AmericaIf Men Could TalkIgnoranceIllness and ImageImagining NumbersImprove Your Writing With NLPIn Bed with MadnessIn Defense of FoodIn Praise of ScienceIn Pursuit of HappinessIn Search of FatimaIn the Line of DutyIn the Shadows of the NetIn Therapy We TrustIndivisible by TwoInsight Yoga with Sarah PowersIntegrative MedicineIntensive CareInto the Gray ZoneIntroduction to Ashtanga Yoga DVDIntroduction to Qi YogaIntroduction to Yoga DVDInvented KnowledgeInvestigating Digital CrimeIrrationalityIs Shame Necessary?It's Up to YouJanis Saffell Beverly Hills YogaJudo with WordsKanye West's My Beautiful Dark Twisted FantasyKids OnlineKilling MonstersKinds of MindsKissing DoorknobsKnowing the Nature of FearKnowledge MonopoliesKundalini Yoga for Beginners & BeyondLandscapes in My MindLaw, Mind and BrainLearning About School ViolenceLearning, Teaching and Education Research in the 21st CenturyLessons Learned on My Way HomeLicentious GothamLies! Lies! Lies!Life CoachingLife MakeoversLimboListening in the Silence, Seeing in the DarkListening to PainListening to the WorldLittle PeopleLittle Red Riding Hood UncloakedLiving DeeplyLiving Well with Pain and IllnessLiving with ArthritisLiving with SchizophreniaLiving, Thinking, LookingLocking Up Our OwnLoneliness as a Way of LifeLong Shadow of Small GhostsLosing My MindLove and Sex with RobotsLove Your Body, Love Your LifeLove, Sex & TragedyLust in TranslationMad Mary LambMade in AmericaMadhur Jaffrey's World VegetarianMadnessMadness in CivilizationMaidentripMake It CountMake It Fast, Cook It SlowMaking Babies the Hard WayMaking Dying IllegalMaking SpaceMaking the Big LeapMaking Your Mind MatterMale Female EmailMalefemaleMan As The PrayerManaged Care ContractingMandated Reporting of Suspected Child AbuseManic Depression and CreativityManlinessManning UpMapping the MindMarriage ConfidentialMary Pope Osborne's Tales from the OdysseyMaster PassionsMasters of the MindMathematical DoodlingsMatters of SubstanceMean GenesMedia ArgumentationMedia in the Digital AgeMediating MadnessMedical AnthropologyMedicine and Health Care in Early ChristianityMedicine and Philosophy in Classical AntiquityMedieval Writings on Female SpiritualityMemoires 1995Memory, Brain, and BeliefMental Health and Social SpaceMental Health MattersMental Illness in Popular MediaMerchants of DoubtMild Cognitive Impairment and Early Alzheimer's DiseaseMiles to Go for FreedomMillennium GirlsMind in Everyday Life and Cognitive ScienceMind WarsMind, Matter and Quantum MechanicsMindstormsMisconceptionsMistakes Were Made (But Not by Me)Mollie Katzen's RecipesMom's OK, She Just ForgetsMonsters, Demons and PsychopathsMoody BitchesMoral PanicsMorals Not KnowledgeMore Than MedicineMortificationMothers Who Kill Their ChildrenMusicophiliaMy Bloody Valentine's LovelessMy Life Among the Serial KillersMy Misspent YouthMy Stroke of InsightNakedNaked CityNarratives in PsychiatryNations Have the Right to KillNatureNear Death ExperienceNeurons and NetworksNeuroscience in Science Fiction FilmsNever Out of SeasonNew Versions of VictimsNew YorkNew York September 11Not a Crime to Be PoorNot by DesignNot Your Mother's LifeNothing to HideNurembergNymphomaniaOath BetrayedObesityObjects of Our DesireObliquityOdd CouplesOf Spirits & MadnessOf Two MindsOld AgeOn BlindnessOn Fact and FraudOn the BrinkOn the Origin of StoriesOn TrailsOne Nation Under TherapyOpening to Love 365 Days a YearOptimizing Teaching and LearningOtherhoodOut of the DustOutliersOutsider ArtOver My HeadOxford Guide to the MindPainParanoia of Everyday LifeParents Do Make a DifferenceParty GirlPassingPassionate VegetarianPathways through PainPeople Like OurselvesPerceptual NeurosciencePersons and ThingsPestos, Tapenades, and SpreadsPhilosophy of MindPhotography and LiteraturePilates for MenPink ThinkPlanning for UncertaintyPoets on ProzacPostcards from the Brain MuseumPosthumanismPotatoes Not ProzacPower HerbsPower Yoga for HappinessPoxPractical ClassicsPractical Plans for Difficult Conversations in MedicinePracticing Feminist Ethics in PsychologyPrader-Willi SyndromePredictably IrrationalPretty in PunkPretty Is What ChangesPreventing Misbehavior in ChildrenPrime Ministers of CanadaPrint Literacy DevelopmentPrison MadnessPrivate Life in New Kingdom EgyptProblems in MindProtecting the GiftProust and the SquidPrudePsyche on the SkinPsychiatryPsychiatry in the New MilleniumPsychiatrylandPsychologyPsychology and the MediaPsychology for ScreenwritersPsychotherapy and ConfidentialityPublic Health LawPunishment in Popular CulturePure Yoga Pilates with Kerry BestwickQuantum ArchetypesQuantum LeapsR.I.P.Race in Contemporary MedicineRacial ParanoiaRaising a Self-StarterRaising AmericaReady for AnythingReady or NotReady or Not, Here Life ComesReal SexReckoning With HomelessnessReclaiming Our ChildrenReclaiming Soul in Health CareRed Lotus YogaReligion ExplainedRemaking a WorldRepublic.com 2.0Rethinking CommodificationRethinking Middle YearsReviving OpheliaReviving the LeftRewarding Specialties for Mental Health CliniciansRick SingsRights, Risk and Restraint-Free Care of Older PeopleSabbathSame DifferenceSamuel BeckettSatisfactionSavedScared SickScienceScience and NonbeliefScience in the MarketplaceScience TalkScience WarsScience, Consciousness and Ultimate RealitySecond OpinionsSeeds of HopeSelected Ambient Works Volume IISelf Hypnosis for Cosmic ConsciousnessSelf-Help NationSelf-Help, Inc.Selling the Fountain of YouthSells like Teen SpiritSerious ShoppingSeven Challenges To Change Your Life DVDSex, Mom, and GodSex, Time and PowerSexing the BodySexual Orientation and School PolicySexy FeminismShadow, Self, SpiritShop Class as SoulcraftShrink RapSick to Death and Not Going to Take It AnymoreSimulation and Its DiscontentsSinfully VeganSister CitizenSleeping With Extra-TerrestrialsSlut!Snake Oil ScienceSnoopSo Brilliantly CleverSocial RepresentationsSolar Flow Yoga DVDSold on LanguageSome Kind of GeniusSometimes Madness Is WisdomSorting Things OutSoul Made FleshSounds from the Bell JarSoupsSpace, Place and Mental HealthSpeaking Our MindsSpiritual CrisisSpontaneous HealingStates of MindStatus AnxietyStiffedStill HereStill LivesStrange BehaviorStrategies of Commitment and Other EssaysStrength, Grace, HealingStroke DiariesStumbling on HappinessSun SalutationsSuper Natural CookingSuperhumanSuperstitionSupersurvivorsSurgery JunkiesSwordfishtrombonesSylvia Plath ReadsTalk to HerTalking About RaceTalking Back to PsychiatryTalking Heads' Fear of MusicTalking ScienceTeach Yourself MeditationTeaching OnlineTeaching SexTech GenerationTeen LoveTeenageTextbook of Cultural PsychiatryThanks!The 101 Best Graphic NovelsThe Age of American UnreasonThe Alice Behind WonderlandThe American HotelThe American ParadoxThe American Psychiatric Publishing Textbook of Clinical PsychiatryThe Americanization of Social ScienceThe Anatomy of HopeThe Anatomy of MelancholyThe Angelica Home KitchenThe Antibiotic EraThe Ape and the Sushi MasterThe Architecture of MadnessThe Arctic IncidentThe Art of ChoosingThe Art of Exceptional LivingThe Audience EffectThe Bard on the BrainThe Barmaid's BrainThe Beginner's Guide to Healthy EatingThe Better to Eat You WithThe Biotech CenturyThe Birth of PleasureThe Birth of the PillThe Black DeathThe Blackwell Handbook of Organizational Learning and Knowledge ManagementThe Book of the PenisThe Brain That Changes ItselfThe Breathing FieldThe Bridge to HumanityThe Brooklyn Nobody KnowsThe Bully SocietyThe Cafe Brenda CookbookThe Call of the WeirdThe Cambridge Illustrated History of MedicineThe Case Against SugarThe Childless RevolutionThe Clitoral TruthThe Complete Guide to Herbal MedicinesThe Complete Vegetarian HandbookThe Consolations of PhilosophyThe Contemplative HeartThe Couch and the TreeThe Course of Gay and Lesbian LivesThe Creation of the Modern WorldThe Cult of PharmacologyThe Cultural Origins of Human CognitionThe Culture of FearThe Culture of PunishmentThe Da Vinci DogThe Dark Night of the SoulThe Deadly TruthThe Decency WarsThe Digital MindThe Disobedience Of The Daughter Of The SunThe Dynamic NeuronThe Easy Yoga WorkbookThe Emotional BrainThe Emotional Journey of the Alzheimer's FamilyThe Employee Assistance Treatment PlannerThe End of MaterialismThe End of WarThe English and their HistoryThe Enigma of HealthThe Era of ChoiceThe Eternity CubeThe EvangelicalsThe Event of LiteratureThe Evolving WorldThe f WordThe Fabulous ImaginationThe Faces of TerrorismThe Farm Colonies: Caring for New York City's Mentally Ill In Long Island's State HospitalsThe Fat Studies ReaderThe Fate of Early MemoriesThe Female ThingThe Final LeapThe Firmament of TimeThe Five Things We Cannot Change ...The ForgettingThe Game of TruthThe Get Healthy, Go Vegan CookbookThe Gift of FearThe Gold Leaf Lady and Other Parapsychological InvestigationsThe Good Enough ChildThe Great BetrayalThe Greatest Experiment Ever Performed on WomenThe Guide for White Women Who Teach Black BoysThe HandThe Handbook of Disability StudiesThe Happiness HypothesisThe Healing Remedies SourcebookThe Health Psychology HandbookThe Healthy KitchenThe Heart of YogaThe Hedgehog's DilemmaThe Hero's JourneyThe History of Rhetoric and the Rhetoric of HistoryThe History of White PeopleThe Homework MythThe Hungry SoulThe Identity CodeThe Immortalization Commission:The Importance of Being LazyThe Indian VegetarianThe Insider's Guide to Mental Health Resources OnlineThe Insider's Guide to Mental Health Resources OnlineThe Insider's Guide to Mental Health Resources OnlineThe Insider's Guide to Mental Health Resources OnlineThe Intelligibility of NatureThe Interdisciplinary Science of ConsumptionThe Intuitive WriterThe Invisible PlagueThe Irreducible Needs of ChildrenThe Irritable Male SyndromeThe Jewel Tree of TibetThe Joy of MeditatingThe Language ImperativeThe Language Of YogaThe Language PoliceThe Language WarsThe Last PhysicianThe Last Self-Help Book You'll Ever NeedThe Law Is a White DogThe Lie DetectorsThe Little Book of Healthy TeasThe Little Book of HeartbreakThe Little Soy BookThe Little Yoga BookThe Lives and Loves of Daisy and Violet HiltonThe Lives of AnimalsThe Lolita EffectThe Lonely PatientThe Loss of Self: A Family Resource for the Care of Alzheimer's Disease and Related DisordersThe Lucifer EffectThe Lucifer PrincipleThe Madness of Adam and EveThe Madwoman in the AtticThe Magic of RealityThe Making of Dr. PhilThe Manual of EpictetusThe Marketplace of IdeasThe Mature MindThe Measure of Our DaysThe Meat Lover's Meatless CookbookThe Medical AdvisorThe Medicalization of SocietyThe Metaphysical ClubThe Mind's PastThe Misunderstood GeneThe MIT Encyclopedia of the Cognitive SciencesThe Monster WithinThe Mood CureThe Moral Intelligence of ChildrenThe Mystery of Mary RogersThe Myth of Freedom and the Way of MeditationThe Nature FixThe New BrainThe New Cancer SurvivorsThe NineThe Nordic Theory of EverythingThe Norm ChroniclesThe Normal OneThe Obesity EpidemicThe Omnivorous MindThe Orchid ThiefThe Origin and Evolution of CulturesThe Origin of AnxietiesThe Oxford Book of Modern Science WritingThe Pain AntidoteThe Paradox of ChoiceThe Paradox of SleepThe Paranoia SwitchThe Passion PlanThe Pastoral Counseling Treatment PlannerThe PatchThe Patient as Agent of Health and Health CareThe PDR Family Guide to Natural Medicines & Healing TherapiesThe Physics of ConsciousnessThe PlaceboThe Placebo Effect and HealthThe Playful BrainThe Pocket Life CoachThe Portfolio and the DiagramThe Power of FocusThe Power of Full EngagementThe Praeger Handbook of Learning and the BrainThe Private Life of the BrainThe Professor and the MadmanThe Psychoanalytic MysticThe Psychology of Religion and CopingThe Psychology Of The InternetThe Psychotherapy Documentation PrimerThe Quantum UniverseThe Quarter-Acre FarmThe Race for ConsciousnessThe Real Rules for GirlsThe Red DevilThe Republican BrainThe Richer SexThe Rise and Fall of Classical GreeceThe Rise of Mental Health NursingThe Roman Search for WisdomThe Root of All EvilThe Routledge Companion to Landscape StudiesThe Same Stuff as StarsThe Savage CityThe Science of Good and EvilThe Science of Optimism and HopeThe Scientist In The CribThe Seat of the SoulThe Second SelfThe Secret History of DreamingThe Secret Lives of GirlsThe Secret World of Doing NothingThe Seven Sins of MemoryThe ShakeressThe ShallowsThe Social Psychology of StigmaThe Sociology of PhilosophiesThe Sociopath Next DoorThe Soul Knows No BarsThe Spa DeckThe Spiritual Anatomy of EmotionThe Split MindThe Star ThrowerThe Story Is TrueThe Storytelling AnimalThe Strange Case of Hellish NellThe Symmetry of GodThe Talking CureThe Thing You Think You Cannot DoThe Thorn NecklaceThe Three CulturesThe Three Failures of CreationismThe Toxic ConsumerThe Triumph of NarrativeThe True PathThe Truth About Chronic PainThe UndertakingThe Volitional BrainThe Wages of SinThe War Against BoysThe Way of StretchingThe Weblog HandbookThe Weight of the NationThe Why CaféThe Wild Ass’s SkinThe Will to Live and Other MysteriesThe Wisdom of FrugalityThe Wisdom of PsychopathsThe Wisdom of Your DreamsThe Words We Live ByThe World of CaffeineThe Worldwide Practice of TortureThe Worst-Case Scenario Survival HandbookThe Wow ClimaxTheaters of MadnessTheatre and AnimalsTheories of Scientific MethodTherapeutic LandscapesTheraScribe 4.0Think CatThink SmartThinking for a ChangeThinking With AnimalsThrough Deaf EyesToo Big to FailTooning InTop ChefTortured SubjectsTotal AstangaTotal PilatesTotally WiredTowards a Science of Consciousness IIITrain Your Brain to Get RichTransforming MadnessTraumatic PastsTreating People WellTreatment and Rehabilitation of Severe Mental IllnessTreatment Kind and FairTribal ScienceTrick or TreatmentTrusting DoctorsTry to RememberTutoring as a Successful BusinessTwelve Examples of IllusionTwinsUnder the Medical GazeUnderstanding and Treating Violent Psychiatric PatientsUnderstanding Child MolestersUnderstanding FitnessUnforgettableUnholy MadnessUnscientific AmericaUnspeakable Acts, Ordinary PeopleUnto OthersUp From DragonsUrban Tourism and Urban ChangeUseful BodiesValues in ConflictVarieties of Anomalous ExperienceVegan ExpressVegan Recipes from the Middle EastVegetarian Turkish CookingVegetarianoVertigo VisionsVictorian Popularizers of ScienceViniyoga Therapy for the Low Back, Sacrum and HipsViolence Against WomenVoices Of Alzheimer'sVoices of CaregivingVoices of MadnessVoluntary SimplicityWaking Up to What You DoWalkingWalking a Literary LabyrinthWall: A World DividedWarWays of KnowingWays of KnowingWe Shall Be No MoreWe Shall Not Be MovedWe've Got BlogWellbeingWhat Emotions Really AreWhat I Learned in Medical SchoolWhat in the World Are Your Kids Doing Online?What Makes Us Think?What Nietzsche Really SaidWhat Our Children Teach UsWhat Science Offers the HumanitiesWhat Video Games Have to Teach Us About Learning and LiteracyWhat's Holding You Back? What's So Wrong with Being Absolutely RightWhen a Family Member Has DementiaWhen Experiments TravelWhen Good Thinking Goes BadWhen History Is a NightmareWhen Johnny and Jane Come Marching HomeWhen Mothers KillWhen Sex Goes to SchoolWhen Someone You Know Is Living in a Dementia Care CommunityWhen Things Fall ApartWhere Biology Meets PsychologyWhere Good Ideas Come FromWhere is the Mango Princess?Wherever You Go, There You AreWhile They SleptWhispers from the EastWhite RageWho Rules in ScienceWhy Are We Attracted to Sad Music?Why Does E=mc2?Why Don't Students Like SchoolWhy God Won't Go AwayWhy Have Kids?Will They Ever Trust Us Again?WisdomWise Mind, Open MindWitch Beliefs and Witch Trials in the Middle AgesWitchcrazeWith Their EyesWithin ReasonWomanWomen and Mental IllnessWorking With Emotional IntelligenceWriting in FlowYogaYoga & Pilates Workouts for DummiesYoga Beauty BodyYoga for EveryoneYoga for People Who Can't Be Bothered to Do ItYoga for Regular GuysYoga for Regular Guys DVDYoga In BedYoga on DemandYoga SanctuaryYoga SculptYoga ShaktiYoga To Go's Yoga Quick Fixes DVDYogalosophyYou Are Not Your IllnessYou'd Be So Pretty If . . .Your Miracle BrainZen Encounters with LonelinessZen-Brain Reflections
When I requested this book to read and review, I admit I was hesitant: it is a rather long read (just under 400 pages), and I anticipated it to be "heavy." Indeed, the topic of health and health care is serious, and has the potential to be controversial - with possible religious and political overtones, as well as confusing information about patient care - diagnoses and treatments. Personally, I was less concerned about being overwhelmed by the patient care aspect of diagnosis and treatment, than becoming embroiled in politics and policies. Sullivan's book was a pleasant surprise. While I found some of the concepts repetitive, each time an idea was visited and revisited, he did view it at least partially, through a different lens.
The book provides an interesting viewpoint as to the relationship of diagnosis and treatment, and the focus of the medical model on this as the foundation for patient care. Patients and their actions, buy-in, and compliance are intertwined within this diagnosis and treatment plan, perhaps not in the most beneficial way. There is much discussion as to how diagnosis of disease naturally means a focus on the disease process and its related treatment, perhaps without much regard to what the patient is interested in. Also, how the patient's life may best accommodate the symptoms, and recommendations for coping and improving them.
"Patient-centered care" is definitely a popular phrase in health care currently. In nursing, sometimes I wonder if it is being used without much regard for what it means. Sullivan attempts to clarify what patient-centered care is. How does it look and how do medical professionals center care around patients? Does this truly include the patient? Or is it more designed around the patient, with the expectation that the patient somehow fit themselves into the care? This is a thoughtful concern, as I think about the models of health care I have been immersed in for almost 36 years, I too can toss the phrase "patient-centered care" around, and make a statement that I have tried to ensure my patient care was always patient-centered. However, as I read the many references to patient-centered care in Sullivan's book, and the different angles he approached it from, I realized this is not a phrase that is easy to define. With consideration for his description of medicine being diagnosis and treatment oriented, I found myself thinking sometimes it may not be patient-centered at all, to attempt to fit people into diagnosis and treatment related planning, even as nurses claim the nursing care plan approach includes a holistic approach.
One of the main themes I noted is the notion of acute vs. chronic pain, and how significant a diagnosis chronic pain is. From the book, "chronic pain costs the United States more than $600 billion annually in health care costs and lost productivity. About 100 million US adults suffer from common chronic pain conditions, which is more than the number affected by heart disease, diabetes, and cancer combined" (p. 136). A distinction I found interesting, and simple, was a brief discussion of the difference in treatment of acute and chronic pain: acute care - healing is usually achieved by rest; chronic care - healing (and/or prevention) tends to come from activity (p. 96). This led me to further reflection. In both cases, it is not always easy for the patient to follow the treatment plan for either acute or chronic pain. Often, in spite of acute pain, people may find it difficult to take the time to rest to the extent needed, based on concerns for lost wages, or other outside influences. With chronic pain, there is often a cycle involved, that may include pain, leading to inactivity - leading to weight gain -- leading to excess strain on joints - leading to more pain and an inability to be active ... Thus, the cycle continues, and inactivity prevails, allowing the chronicity of pain to continue. And this led me to consideration of quality of life and how chronic illness affects patients' lives.
Having worked at the bedside in the acute care (specifically Intensive Care) setting for several years, the patient's environment was often a consideration and discussion point. What was their home like? As nursing care was planned, the background and environment the patient came from (and was most likely to return to) was a necessary consideration. Socioeconomic status, education status, literacy, community, family and social support - all those and more have to be included. These historical considerations may shed light on what the focus has been in the past, how that has been working for them (improvement in health and wellness or more frequent exacerbations of disease and increased necessity for treatment). Of the utmost importance is the patient's perception of their own status as healthy or ill.
Medicine and health care traditionally focuses on diagnosis and related treatment. Much of Sullivan's book is based on chronic illness, most especially chronic pain. There is an interesting introduction of pain theory, including centuries-old Cartesian theory of pain that resembles reflex pathways and the more recent Gate Control Theory (p. 136), which includes description of pain perception as going through an open gate, or if inhibited, not traveling through a closed gate. The gate can be opened and closed by neurological and chemical responses, including the release of natural pain-control (e.g. endorphins) or exogenous pain control (e.g. drugs).
Whether treating chronic pain, or other diagnoses, the focus is different for chronicity and acuity. Acute care, often by necessity of patient care, includes less direct action by the patient, as their actions were more likely an influence prior to the acute exacerbation. In the case, for example, of critical care, the patient is often not actively involved in their care, rather, care is placed upon them, and they are passive recipients. It is during times of less illness/more health or wellness (improved QOL) the patient is an active agent in their own care. Since ideally, this involves much more time than those acute episodes or exacerbations, it is during these times of wellness or positive coping with chronic illness, that the patient is active in their health behaviors. Whether following the recommended treatment plan, or displaying what is often termed "noncompliance," the patient is being the true agent of his or her own health care. These times are therefore of much more influence on the patient's health than times of acute illness.
Sullivan presents information relative to reimbursement, including some discussion of policy and politics. This includes a single-payer system, and some frank information as to what that means, and what the Affordable Care Act (ACA) is (or was), and what it was not. What seems to be definitive is that primary care is critical - for health and wellness, prevention of illness, and ultimately inclusion as a necessary consideration in acute and chronic ailments/diagnoses.
Autonomy and empowerment must be fostered, in order to provide the education and support necessary to create patients who have a capacity for self-direction and can truly become agents of their own health. In so doing, the potential is there for patients to also have more interest in, and ability to understand, their health care, and what that means to them. With Sullivan's premises, the likelihood of change within the patient-provider relationship increases - embracing more direction and input from the patient, and a more collaborative method of planning and delivering care.
As mentioned in the first paragraph of this review, I was initially hesitant to read this book, anticipating a dry textbook-type read. While the subject is not likely to appeal to everyone, it is actually something all should be interested in, and desire to know more about and perhaps be more involved in. For the benefit of one's own health, access to health care resources, and for those employed in health care, there is certainly much food for thought.
And I have to mention: the book was not dry at all! Sullivan has an interesting manner in his writing, whereby I found myself thinking it would be interesting to have a face-to-face discussion with him. His background as an anesthesiologist, pain-control expert, and obviously skilled clinician, made me think of stimulating discussion into topics I have been interested in as a bedside nurse as well as a nurse educator. I also found the patient case studies presented throughout the book to be a fabulous way to introduce actual people, with actual, and indeed common concerns, and very human behaviors. These people were excellent at personifying difficult concepts and patient care challenges. They illustrated some of the challenges of medical treatment, and of implementing patient-centered care, and what is indeed important to patients with various physical concerns. The book provides a truly holistic approach and a thorough provision of information on a variety of subjects that truly comprise the possibility of "the patient as agent of health and health care."
© 2018 Margaret Riley
BIO: Margaret Riley, PhD, RN. Margaret is a Registered Nurse, with experience in a high-acuity Intensive Care Unit. She is also an experienced nurse educator, having been faculty in clinical and classroom since 2006. Currently, she is the Program Chair of an LPN-BSN program. Her dissertation was a phenomenological study, titled, "The Lived Experience of Novice Nurses Who Have Based Decisions on Intuition."