The Mental Health Consequences of Torture. Edited by

To understand OCD, Penzel describes the entire spectrum of these tormenting disorders, from the classic form characterized by the intrusive, repetitive, and often unpleasant thoughts, to body dysmorphic disorder (“imagined ugliness”), trichotillomania (compulsive hair-pulling), compulsive skin-picking, and nail-biting. Penzel takes the reader through each step of the most effective behavioral therapies, detailing how progress is made and how to avoid relapse. He also offers a modern discussion of medicine with a consumer orientation: how medication is used as part of the overall treatment, how to choose the best medicine, and how to know if it is working. In particular, Penzel discusses the treatment of children with these disorders, offers helpful advice for the families of sufferers, and lists sources of help and information (including sites on the Internet). The book also includes a useful appendix that features symptom checklists for each of the obsessive-compulsive spectrum disorders, the DSM-IV diagnostic descriptions, a reading list, and a glossary. This book is written in lay language so that it brings the reader close to the core of disorders very effectively. For example, directing the reader to create a hierarchy of situations that cause the particular anxiety that results from the reader’s symptoms, the author states, “Be aware that in order to eventually call yourself recovered, you will have to do all the items on your hierarchy.” Penzel then provides a sample hierarchy for someone with a hoarding compulsion that ranges from “Throwing out an old greeting card” to “Throwing away an old non-working appliance that was being saved to be repaired some day.” Penzel focuses on behavioral therapy, especially two types: exposure and response prevention for classic OCD as well as body dysmorphic disorder, and habit reversal training for skin-picking and trichotillomania. The author takes the reader’s hands and walks stepwise through behavioral therapy in the general treatment of OCD as well as several spectrum illnesses. He cites Vidal Sassoon’s phrase, “The only place where success comes before work is the dictionary”; Penzel introduces this “dictionary” to help his patients understand the work involved in conquering OCD. For example, eight pages of relaxation scripts and strategies are provided to help ensure that the reader gets to learn the art of those techniques. Penzel does not forget the families of children suffering from OCD. In chapter 5, Penzel integrates self-described accounts from both the children and their families to help the reader recognize the world of children’s OCD from their own perspective. Writing as both a clinical psychologist and the parent of a special needs child, Penzel shows not only a professional but also a parental appreciation of coming to terms with children’s OCD. He describes different forms of obsessions and compulsions. Each is accompanied by a storytelling paragraph from either the suffering person or from the sufferer’s relatives. Readers will feel a sense of relief when they recognize that they are not alone, similar to the response