Page 20 RAIN July 1982 Access Health Social Causes of lUness, by Richard Tot- man, 1979, 263 pp., $10.00 hardcover from: Pantheon Books 201E. 50th St. New York, NY 10022 A few years ago a friend asked me if I knew the source of the most harmful toxins in my body. I figured I was about to hear snide or ironic news about the carrot I was eating, but instead, she reached out and tapped her finger against my temple. “Right in there. That little brain of yours. Stuff in there can make you vomit or wet your pants or make your heart jump out of your throat. You ever eat a hamburger that made you feel worse than your scariest dream?" Needless to say, that sticks with me still. Most of us accept it as common sense that illness is not just physiological. Richard Totman, in Social Causes ofIllness, picks up where my friend left off. He brings the rigors of clinical psychology to bear, reviews current research and theory, and introduces his own approach to the study of illness. The book reads like a sheaf of Scientific American offprints and has more footnotes than a hypochondriac has pUls. It's not casual, anecdotal reading. lAHiat Totman has done, however, is write a responsible scientific inquiry that ranges from faith healing and hypnosis to social upheaval and cognitive dissonance theory in a cohesive, understandable way. Totman is one of that not-so-rare breed, the structuralists. His approach melds psychological and sociological study by assuming that a structure underlies all human action and thoughts and so transfers directly to the social world. The structure Totman finds and upon which his model isibased is an unconscious organizing scheme made up of shared rules that we hold ourselves to. It is the dynamic of our kinship to these rules that makes or breaks us socially and will also determine, so it seems, our susceptibility to illness. The most promising side of Totman's theory regards a person's ties with society, especially when a breakdown is occurring. Hmong refugees in Des Moines, African villagers living amidst rapid urbanization, or laid-off mill workers in Oregon all grapple with extra-ordinary pressure to adjust their own outlook (or set of rules) to a social context that is changing, often at the expanse of their health. With a handle on how these causes link up with heart disease, hormonal screw-ups, schizophrenia, or cancers, we may be able to avoid a lot of suffering. The weak timbers in Totman's structure are those that fail to lodge emotions. How can a grasp on emotions that is limited to a purely objective view (i.e., mechanical or hormonal) hope to get at such phenomena as what we feel about what we think, or what we think about what we feel, or what we think about what we think We feel? These minutiae, after all, bridge our own experience and the "real" world of Totman's structure. Because of this, the structure is psychologically incomplete. This is a problem with any structural approach, however. If one can accept its shortcomings as fair trade for its workability and range, Totman's model offers great breadth. The book itself, except for a mercifully short and wrongheaded chapter on the social Darwinist evolution of illness, offers its own clarity and breadth and is well worth the time of anyone seriously interested in alternative notions of health. — James McQements Futures Building a Sustainable Society, by Lester R. Brown, 1981,433 pp., $14.95 from: W.W. Norton & Company 500 Fifth Ave. New York, NY IMIO Lester Brown's latest book is a good summary of the economically and ecologically nonsensical course this globe is upon, and of the ways this course can be altered in the direction of survival and sustainability. His answers will come as no surprise to appropriate technologists, ecologists and others who have paid attention to the direction of the system: population stabilization, restoration of farm and forest lands, resource conservation and recycling, a shift to renewable energy sources, simpler lifestyles among the affluent and greater local self-reliance. The first section of the book, "Converging Demands," is a well-argued case for the non-sustainabUity of the present economy. Using statistics which show that per capita production of most commonly used raw materials and foodstuffs began to decline in the 1970s, Brown makes the needed connection between depletion of natural resources, a world population growing at the rate of 70 million a year and the economic problems now facing most nations. The fantasies of Reaganomics notwithstanding. Brown makes clear there will be no economic solutions unless underlying questions of resources and population are answered. In fact, economic problems are likely to become more difficult because of the extent of the resources versus population crunch. The basic productivity of croplands, forests, grasslands and fisheries has already been seriously damaged. If the first section is somewhat depressing, the second part, "The Path to Sustainability," is quite hopeful. Brown meticulously documents each suggested solution with examples of successful applications taking place throughout the
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