Fourteen behavior therapy patients were interviewed to determine if phenomena regularly observed in psychodynamic psychotherapies had occurred in their behavior therapies as well. Interview data were analyzed both statistically and clinically. Ratings by patients, their therapists, and the Es indicated that the prevalence of behavior modification techniques in the therapy was not significantly related to outcome, whereas a variety of the patients' personal feelings about their therapists were. Impressionistic analysis of the interviews also suggested that the important elements of these therapies were interpersonal ones, much as has been demonstrated in psychodynamic psychotherapy. The behavior modification techniques themselves seem to have added little to the therapies, and in some instances may even have facilitated continued defensive avoidance of problems.A careful reading of the proliferating behavior therapy literature reveals that the model of therapist and patient, rationally cooperating to the fullest in a straightforward, scientific enterprise, is met with only in theory and rarely, if ever, in actual practice. The observations of Klein, Dittmann, Parloff, and Gill (1969), for example, suggest that there is much more to the conduct of behavior therapy-at least as it is practiced by Wolpe and Lazarus--than is generally believed. If one pays close attention to patients' words and actions, as they are quoted or described in behavior therapy case reports, one is struck by the variety and intensity of feelings these treatments elicit, and the substantial portion of those feelings which is irrational, unreasonable, and even theoretically iconoclastic-precisely the same situation as exists in traditional, psychodynamic psychotherapy. Some of the authors who describe feelings which are similar to those arising in verbal psychotherapy include the following: Bond and Hutchison (1960), Carter (1968), Cooper, Gelder, and

Childhood depression as a component of the impact of childhood illness or developmental impairment on the latency age child is studied in relation to three diagnostic groups: children with asthma, cancer, and psychiatric diagnoses of behavioral disorders. The study revealed a range of coping styles to deal with the anxiety, loss and feelings induced by the specific _ crises. The special dimensions of stress and coping adaptations affected the child's developing self concept, the separation individuation process and the child-parent relationships. Depressive symptoms were variously present within and between the three groups of children.

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This is the third and final volume of John Bowlby's trilogy entitled Attachment and Loss in which he explores the development of a child's attachments to others and the ways in which a child responds to separation from, or permanent loss of his mother. In this volume he focuses on the process of mourning as a response to loss and the conditions under which mourning may be successfully resolved or predispose the individual to depressive disorders. The book as a whole is an important contribution to object relations theory and the clinical understanding of the significance of early attachment bonds and their development.Bowlby has departed from his original psychoanalytic frame of reference, and his theoretical constructs come largely from ethology and cognitive psychology. He is particularly critical of the psychoanalytic failure to understand that quite small children can genuinely mourn the loss of an important love object, and that if this mourning takes an unfavorable course, the person will be prone to experience later losses in a pathological way.The author restates the central dimensions of attachment theory that were fully explicated in the first volume--that it has its own dynamic, and that it is distinctive from feeding behavior and sexual behavior. It is different from object relations theory in that Bowlby doesn't hypothesize about the internal representations of the object, and is concerned primarily about emotions and behaviors that arise during the formation, maintenance, disruption, and renewal of attachment relationships between a child and his primary caretakers. He sums up this position at the end of the volume: "Intimate attachments to other human beings are the hub around which a person's life revolves, not only when he is an infant or a toddler or a schoolchild, but throughout his adolescence, and his years of maturity as well, and on into old age." (p. 442) Bowlby uses information processing theory to explain how individuals respond defensively to the pain of object loss, and how these defenses may be either pathological or adaptive. Actually pathological responses occur on a continuum from mild to severe, and at the more benign end of the continuum they are difficult to distinguish from healthy mourning. In reviewing empirical studies of adults who had suffered the loss of a spouse or a child, he was able to identify two forms of pathological mourning. The first is intense prolonged mourning, during which the person may experience anxiety, depression, and disorganization. The second is a prolonged absence of mourning or grieving, but the individual is likely to suffer a variety of symptoms or interpersonal difficulties which are cognitively and emotionally disconnected from the attachment bond. In both of these forms the sufferer is excluding painful information from awareness and unconsciously or consciously believes that the loss is reversible and the object can be found again. Healthy mourning depends on the individual's ability to recognize gradually that his loss is permanent and to re...