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by S. Rachman
Psychology Press, 2004
Review by Leo Uzych, J.D., M.P.H. on Feb 16th 2006

Anxiety

Anxiety is an accomplished member of the family of books, called, collectively: "Clinical Psychology: A Modular Course". The books comprising the family are intended, broadly, to form, in integrated fashion, a comprehensive resource in clinical psychology. S. Rachman, the author of Anxiety, is a researcher in the area of anxiety disorders, who is anchored, academically, to the University of British Columbia, Canada. Rachman's cardinal purpose in penning Anxiety is to inform readers regarding surging advances, pertinent to understanding and treating anxiety disorders.

Rachman's primary focus is on anxiety as a psychological phenomenon. The book at heart is a very well crafted, psychologically rooted examination of anxiety. Although Rachman's sharp focus is on a psychological analysis, heavily biologically-tinged threads may also contribute vitally to the weaving of the tapestry, of anxiety. Indeed, an important lesson to be learned from the book is that theories purporting to explicate particular anxiety disorders may oftentimes be enmeshed by prominent cognitive as well as biological strands, which may become entangled in knotty, scientific uncertainty.

Medical scientific knowledge of many aspects of anxiety remains, lamentably, threadbare. Rachman's book may, hopefully, galvanize renewed scientific enthusiasm for further research concerning anxiety, and perhaps provide some structure for fruitful investigative forays, into this somewhat amorphous realm. Certainly, the need to collect far more evidence, regarding this fascinating, and still rather fallow, field of research endeavor, is compelling. And, it may be added, appropriately, that this need importantly extends to the developing of effectual treatments, for particular anxiety disorders.

Rachman writes with a finely honed academic pen, which has been wielded superbly to create a valuable contribution to the academic literature enveloping clinical psychology. A clearly discernible, didactic type current flows prominently through the text's pages, which may delectably provide abundant food for intellectual digestion, by mental health researchers and academics; there are, as well, numerous morsels, which may stimulate, if not sate, the professional appetites of clinicians bound, in some capacity, to the region of mental health. The book, however, in style and substance, is tilted steeply, away from lay readers.

Structurally, the body of the book is composed of ten, analytically hewed chapters. Adjoining the textual body are listings, of selected books ("Suggested reading"), and multitudinous academic references, fused to anxiety, which may gladden those seeking further immersion in the academically choppy and turbid waters of anxiety. The respective chapters are structured to include a succinct "Summary". Further contributing to the excellence of the text are well-designed "tables" and "figures", and, also, a goodly number of anecdotal snippets, grafted interestingly into the textual corpus.

At least in a generalized way, the psychological focused analysis, of anxiety, undertaken very capably by Rachman, may contribute helpfully to spirited discussion concerning anxiety. The academically thorny field of anxiety research contains a thicket of theories; and experimental and clinical data, of a germane nature, continue to accumulate. A full elucidation of many of the profundities of anxiety, and the possible bridging, or at least narrowing, of the formidable chasm, separating biological and psychological explanations of anxiety disorders, remain unfinished academic tasks. Plainly, much remains unexplained, regarding anxiety disorders; and much remains to be learned.

To his considerable credit, Rachman succeeds commendably in analytically traversing, in highly competent fashion, the expansive length and breadth of extant research data, tied to anxiety. Overall, Rachman does a very good job of identifying important strengths and weaknesses, of some of the multitude of fractious theories entwined with research efforts glued to anxiety.

In chapter one, Rachman artfully etches the lineaments giving form to the nature of "anxiety", and further delineates, adroitly, the contours bounding the core nature of "fear". A laconic explanation, of multifarious factors impinging, potentially, on anxiety, comprises the essence of the substantive content, of chapter two. The author, in chapter three, familiarizes the reader, albeit in a rudimentary way, with sundry schools of theoretical thought interjoined with anxiety, encompassing, notably: possible interlinkages, joining anxiety and cognitive concepts; the arguable impacting of psychoanalytic theory, on anxiety; and, not least, biological theories which may, possibly, be explanatory with respect to anxiety. The cynosure of the next (fourth) chapter is a highly adept dissection and examination of the conditioning theory of fear. Brief discussion of specific phobias is also enfolded into the chapter's contents.

An unraveling of the enigmatic nature of panic is the crux of chapter five, with a dichotomous focus on a cognitive theory of panic, in contradistinction to a biological explanation ascribed to panic disorder. Agoraphobia, in chapter six, tersely garners Rachman's rapt attention, while careful scrutiny of puzzling aspects of compulsive behavior and obsessions is at the heart of chapter seven. The variant of anxiety known as "social anxiety" is given centerstage attention, in chapter eight, with discussion being rooted deeply in a cognitive theoretical analysis of social anxiety. The text's penultimate (ninth) chapter expounds, instructively, on the contentious concept of generalized anxiety disorder. In the concluding (tenth) chapter, Rachman, in his characteristic workaday way, digs into the terrain of post-traumatic stress disorder, striving ardently, and gingerly, to unearth some of its psychological perplexities. The toilsome spadework, of Rachman, does, in fact, unearth deposits, of psychological import, reaching to: emotional processing, of traumatic events; a cognitive entrenched theory; and a dual representation model, of post-traumatic stress disorder.

Rachman's illumining book shows provides a revealing snapshot, of current anxiety related research. Experimental reports on anxiety are released continually. With this principal caveat, persons involved professionally with mental health work, especially those with some research nexus to this enthralling field, should be absorbingly edified, by the book's instructive contents.

 

2006 Leo Uzych

 

Leo Uzych (based in Wallingford, PA) earned a law degree, from Temple University; and a master of public health degree, from Columbia University. His area of special professional interest is healthcare.