Book Review
General Psychiatry
Affect Regulation and the Development of Psychopathology. Susan J Bradley. New York: The Guilford Press; 2000. 324 p. US$40.00.
Reviewer
rating*: Excellent
Review by: Mary V Seeman, MD, DSc
Toronto, Ontario
Susan Bradley is a child psychiatrist; thus it is no surprise that she carefully delineates the quality of affect in infants and children, its modulation, and the consequences to children of learning to regulate affect through reciprocal gambits with attachment figures.
What is surprising is Dr Bradley’s erudition. She knows and explains the trajectories of unregulated affect through development and all forms of psychopathology. In her scope, she embraces current knowledge of neuroanatomy and neurochemistry, as well as theories of mind. She presents well-integrated speculations on the role of affects and their dysregulation throughout life and the important role of experiential, cognitive-behavioural, and psychodynamic healing. These ideas are new, though they draw on current knowledge. Her arguments are mounted gradually from the first chapter to the last, so that the reader is slowly introduced to an ever more complicated system of integrative thought.
Placing affect regulation at the centre of the complicated system leads to the conclusion that individuals differ in their likelihood of developing psychopathology. Some of the difference is inborn, while some arises from exposure to prenatal and postnatal events that increase reactivity to stress. Stress reactive individuals, when faced with developmental hurdles, have difficulty regulating their affect, especially their negative affect. Attempts to cope and compromise with unregulated affect lead to all varieties of symptoms, which are accompanied by uncomfortable levels of arousal. How states of arousal are dealt with by the individual, by parents, by caregivers, and by treatment attempts all influence the specificity of the various forms of psychopathology. This book tries to understand all psychopathology and, by doing so, leads to a better understanding of specific pathologies and specific benefits of parent–child relationships, therapist–patient interactions, and medication effects. This book is masterly in its scope, and at the same time, the prose is lucid and easy to read. It is a must-read for students of psychology and psychiatry who want to integrate what they have learned by experience in the clinic.
*Reviewer
Rating Scale/ Échelle d’évaluation du réviseur
Excellent / Excellent
Very Good / Très bon
Good / Bon
Fair / Passable
Not recommended / Pas recommandé
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