Psychological and Psychosomatic Problems.

This book, edited by two physical therapists from Oslo, Norway, is one in a series of several books on international perspectives in physical therapy. The overall goal of the series is to present the reader with an exchange of ideas and an exploration of different approaches to physical therapy practice in different parts of the world. Similarities and dissimilarities in practice, relative to psychological and psychosomatic problems as well as to traditional and nontraditional approaches, are highlighted in this particular book.

The all-pervasive theme of the book is the holistic approach to physical therapy evaluation and treatment interventions, with a strong emphasis on the psychosomatic (psyche plus sona) elements. Emphasis is placed on the qualitative elements of evaluation and treatment, but the quantitative elements are not overlooked. The role of communication, the laying on of hands, and the art of touch in the process of evaluating and treating patients are overly and covertly emphasized throughout this book.

This book includes a chapter on autogenic training, one of many relaxation techniques. This approach is thoroughly described, and many case examples are included. It is suggested that the traditional physical therapy model include a focus on the interpersonal relationship between the therapist and the patient-client, as a significant part of the therapeutic approach and outcome. Psychomotor therapy, with its whole-body approach and specific emphasis on breathing, also is described. A chapter on body awareness therapy emphasizes the importance of integrating the body into the person's total experience of identity. Short-term goals of this approach may be symptom reduction, and long-term goals may be both an increased level of function and overall satisfaction with life. A chapter covering the more traditional psychological factors in recovery from physical disability also is included. Topics discussed include effects of motivation, affiliation, levels of aspiration, knowledge of results, emotion, and compliance.

Epitomizing the book's holistic approach to rehabilitation are the chapters on the rehabilitation of torture victims, which cover the importance of the relationship among psyche, soma, and social conditions. A graphic discussion of the types of torture and the physical and psychological evaluation and treatment approaches for these victims is provided. The book concludes with a discussion of integrated respiration therapy that focuses on the patient's breathing and the therapist's ability to identify the point at which respiration is blocked in order to bring out hidden feelings, so that those feelings can be worked through. This book presents nontraditional information with which physical therapists in most Western nations are not familiar. The text presents areas of focus and practice that have not routinely been explored by therapists concentrating on quantitative measurements. It challenges us to be more open and to research and explore the holistic (psyche as well as soma) approach to physical therapy management. The book is not intended for entry-level practitioners and in fact is intended only as an introduction for experienced practitioners to the various theories and approaches described. An annotated bibliography is provided for those who wish to read further about the specific topics discussed in the book.