Transactional Analysis Journal

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Book Review: Phobics and other Panic Victims: A Practical Guide for Those Who Help
Them
Barton W. Knapp
Transactional Analysis Journal 1991 21: 55
DOI: 10.1177/036215379102100109

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survival. The "new brain"-the cerebral
cortex-is "the part of you that is conscious,
alert, and in contact with your daily
surroundings. It's the part of you that makes
decisions, thinks, observes, plans, anticipates,
responds, organizes information, and creates
ideas"(p. 10). The old brain retains images and
information that are largely archaic, but to
which we continue to refer.
In the second part of the book, entitled "The
Conscious Marriage," Hendrix defines the
conscious marriage as "a marriage that fosters
maximum psychological and spiritual growth;
it's a marriage created by becoming conscious
and cooperating with the fundamental drives of
the unconscious mind: to be safe, to be healed,
and to be whole" (p. 90). He lists ten character-
istics of a conscious marriage, including the
realization that one's love relationship has a
hidden purpose-the healing of childhood
wounds; the creation of a more accurate im-
age of one's partner; taking responsibility for
communicating one's needs and desires;
becoming more intentional in one's interac-
tions; and accepting the difficulty of creating
a good marriage.
In the remaining chapters of this section,
Hendrix examines issues such as closing exits
from the relationship, establishing safety, in-
creasing knowledge of oneself and of one's
partner, and handling rage and anger. He il-
lustrates how each of these issues affects the
relationshipand how, as they improve, the rela-
tionship functions more effectively and
satisfactorily.
In the final section of the book, Hendrix
describes 16 exercises he uses in working with
couples. Directions for the exercises are de-
tailed enough that lay readers can use them in
their own relationships.
Also included in the book is a brief section
on the appropriateness and relevance of pro-
fessional help for improving a marriage and
suggestions for how to obtain such help-
referrals from friends, a church, or reference
to professional organizations that can provide
names of competent professionals. A
bibliography cites a wide range of relevant
reading, and some of the important concepts
from the text are further elaborated in a sec-
tion of notes. For example, there is an in-
teresting discussion of the concept of "Im-
ago"-a term used by Freud, Jung, and Berne.
Vol. 21, No.1, January 1991
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BOOK REVIEWS
In fact, Imago Relationship Therapy is the
name Hendrix has applied to his own
therapeutic approach.
There is no index to the book, but this is pro-
bably not a major problem. One point which
does merit attention is Hendrix's attribution of
the concept of escape hatches to Frank Ernst.
To this writer's best knowledge, this concept
was first described by William Holloway in a
paper presented at the 1973 ITAA Summer
Conference. In addition, some of Hendrix's ex-
ercises bear a strong resemblance to material
presented in couples' workshops presented in
the mid-seventies by Josephine Lewis and Vann
Joines of the Southeast Institute.
Overall, however, this is an excellent, well-
written, substantivebook, useful to both layper-
sons and professionals. It is recommended
without reservation.
Phobics and Other Panic Victims: A
Practical Guide for Those Who Help Tbem
Janice N. McLean and Sheila A. Knights
Continuum, 1989
180 pp., $17.95 hardcover
Reviewed by Barton W. Knapp
In 1971 California psychiatrist Arthur Har-
dy founded the TERRAP Phobia Program-a
standardized program of treatment for people
subject to anxiety and phobia attacks. TERRAP
is an acronym for territorial apprehensiveness.
It is estimated that 15% of the population ex-
perience some kind of anxiety and panic symp-
toms. Many professionals find themselves
somewhat at a loss as to how to work most ef-
fectively with clients who have what DSM-ill-
R has termed Panic Disorder without
Agoraphobia. The TERRAP program is a com-
prehensive approach to the treatment of these
clients.
McLean and Knights-both experienced in
the TERRAP approach-attempt to provide
help for all those who are involved in dealing
with people who suffer from panic disorders-
the individual, family and friends, and
therapists and health professionals.
The book is relatively brief and begins with
an introduction-' 'Helping Those Who Panic:
The Victim's Problem, the Family's Problem,
the Solution" -that presents several scenarios
that any reader might face, situations in which
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BOOK REVIEWS
there is a clear and unavoidable danger. The
reader is encouraged to imagine himself or
herself in these situations and to experience as
fully as possible the terror they might feel.
While you, the reader, may be lucky
enough to have never experienced panic,
consider the physical reactions, thoughts,
and feelings you would expect to have in
the following situations:
1. You return home from work one even-
ing to find several ambulances and police
cars in your driveway-all with sirens
wailing and lights flashing.
2. While making a hairpin turn on a
winding mountain road, you feel your car
begin to skid, and you realize there is no
way to stop it from sliding over the cliff.
3. You answer your doorbell late one
night to find three men with masks and
guns shoving you back into the house
while shouting obscenities.
It's unpleasant even to even think about
such situations, isn't it? Now imagine ex-
periencing your reaction to these situa-
tions over and over again, but without
understanding why you were undergoing
such a dramatic transformation, without
the comfort of being able to say to
yourself, "Well, of course I'm
terrified-look what's going on!" This is
the life of the panic victim. (p.42)
Such vivid examples assure panic attack suf-
ferers that what they experience has been felt
by others-they are not alone, they are
understood, and they are not "crazy." These
scenarios also provide family members as well
as professionals with a deeper understanding
of what the individual feels. A somewhat dif-
ferent scenario is presented from the viewpoint
of a family member-one in which a spouse,
parent, or child experiences anxiety and panic.
In this scenario, readers are encouraged to
recognize how they might feel in the situation
described. This helps family members under-
stand how powerfully they may be impacted
upon by what another family member ex-
periences. It also gives the professional a
clearer understanding of the complexities of the
situation.
The next chapter details the treatment pro-
gram offered by TERRAP and similar
organizations. The authors contrast TERRAP
with other approaches that emphasize medica-
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tion or secrecy or those offered by a
"nonspecialist, " presumably a provider who
does not employ a multifaceted program com-
parable to TERRAP. They suggest that these
are "dead end" approaches.
The treatment that McLean and Knights
strongly support consists of:
1. Time limited treatment groups which
usually meet weekly.
2. Instruction in anxiety disorders and the
reduction of anxiety.
3. In vivo systematic desensitization
sessions.
4. Evaluation for medication.
5. Instruction in and discussion of related
issues of importance, e.g., assertiveness,
bereavement, self-esteem, etc.
6. An informational session conducted
for the family and close support people
of the panic victim.
7. Journal keeping.
8. Homework assignments, e.g.,
.readings directly and indirectly related to
the disorder and also practice sessions for
extending limits with a practice partner.
9. Individual psychotherapy and follow-
up support groups.
Many therapists will be familiar with the
elements included in the TERRAP program and
will likely have used some of them with their
own clients. However, a major strength of a
comprehensive, multifaceted approach such as
TERRAP is the integration of relevant and
useful approaches into a consistent format.
In the latter chapters, the authors discuss
ways family and friends, therapists, and physi-
cians or health care providers can help those
who suffer from panic attacks. For example,
the chapter for physicians describes the DSM-
Ill-R diagnostic criteria for the panic and
related anxiety disorders, including listings of
factors and conditions which may either con-
tribute to panic and anxiety symptoms or which
mimic them.
The final chapter, "Encouragement and Ad-
vice from Support People and Recovered Panic
Victims," opens with the following statement:
"There is a light at the end of the tunnel of this
difficult but challenging time" (p. 158). This
emphasizes that support people as well as the
"victim" benefit from the recovery process in
ways that they may not have anticipated. The
authors recommend a number of books, noting
Transactional Analysis Journal

that they are "suggested for use in conjunction
with treatment or as a first step in seeking treat-
ment" (p. 169).
This book is well worth reading. It is recom-
Books Received for Review
Inclusion of a book in this list does not preclude
a subsequent review in the Journal. Should you
wish to review one of these books, please con-
tact the Book Review Editor: Barton Knapp,
Ph.D., 905 Newtown Rd., Devon, PA 19333,
U.S.A.
Brennan, R. J. (1990). Deadly blessings: Faith
healing on trial. Buffalo: Prometheus Books,
375 pp., $21.95.
Cardelle, F. (1990). Journey to brotherhood:
Awakening, healing and connecting men's
hearts. New York: Gardener Press, 324 pp.,
$15.95 (paper).
Fine, R. (1990). Love and work. New York:
Continuum, 336 pp., $24.95.
Fisher, R., & Brown, S. (1989). Getting
together. New York: Penguin Books, 216 pp.,
$8.95 (paper).
Gaylin, W. (1989). The rage within-Anger in
modem life. New York: Penguin Books, 224
pp., $7.95 (paper).
Vol. 21. No.1. January 1991
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BOOK REVIEWS
mended to support system members and pro-
fessionals and will be of particular value to
those who suffer from an anxiety or phobic
condition.
The Group for the Advancement of Psychiatry.
(1990). A casebook in psychiatric ethics. For-
mulated by the Committee on Medical Educa-
tion. New York: Brunner-Mazel, 128 pp.,
$21.95 (cloth), $14.95 (paper).
Prata. G. (1990). A systemic harpoon intofami-
ly games. New York: Brunner-Mazel, 192 pp.,
$25.00.
Sipe, A. W. R. (1990) A secret world: Sexuality
and the search for celibacy. New York:
Brunner-Mazel, 336 pp., $29.95.
Travers, J. A. (Ed.). (1990). Psychotherapy
and the remote patient. Binghamton, NY:
Haworth Press, 261 pp., $29.95.
Wolinsky, M. E. (1990). A heart of wisdom:
Marital counseling with older and elderly
couples. New York: Brunner-Mazel, 272 pp.,
$26.95.
Zahourek, R. P. (1990). Clinical hypnosis and
therapeutic suggestion in patient care. New
York: Brunner-Mazel, 272 pp., $25.00
(paper).
57