blanket over their head, who feel that the whole world cen-ters on them, and who see everything around them as a giantworld ready for exploration. If we had the ability to putourselves in their place for a moment, we could better un-derstand how difficult it is for preschool children to under-stand and comprehend the world around them. We couldfeel the pride that they experience when they learn to mastera task that their older sibling learned long ago or the joy ofmaking their parents proud by counting to 10 or saying thealphabet without help. We could experience the fear createdby seeing the two people whom they are most dependent onin an argument or the confusion when a parent leaves andnever returns. If we could only put ourselves in their places,we could experience these emotions and learn how a pre-school child tries to explain why a situation occurred. Hav-ing this insight would then enable us to treat these childrenmore effectively. We could focus on the feelings that aremost troubling to them and help them to make sense ofsituations without feeling that they are to blame for theactions of the adults around them. Unfortunately, we cannotput ourselves into their lives, their families, and their socialsituations from their perspective. Instead, we must utilize ourown knowledge of development and the knowledge of ourcolleagues to best understand preschool children. We areprovided with one outline of how to approach preschoolchildren in this text by Susan B. Campbell.

To best understand preschool children, we must first havethe ability to define and describe typical preschool develop-ment. Having knowledge of how preschoolers are expectedto behave can help to alleviate many fears and concerns thatparents will have about normal or expected behaviors. Thisknowledge will enable us to recognize when behaviors maybe consistent with developmental delays or when they falloutside the realm of expected behaviors. It will enable us toshare this knowledge with parents and colleagues who arecaring for preschool children. Campbell stresses the impor-tance of having a thorough understanding of preschool de-velopment and gives an explanation of the importance ofseveral developmental issues. She argues that “in order tounderstand the different developmental pathways that youngchildren follow, from early signs of difficulties or even goodadjustment to later functioning, it is necessary to begin witha detailed knowledge of normal development” (p. 1). Diffi-culties in the treatment of preschoolers often arise when thisknowledge of normal development has not been obtainedbefore treatment. Too often behaviors are described as ab-normal due to a lack of knowledge of normal trajectories orare missed when a treatment provider considers abnormalbehaviors as just a normal stage.

Campbell stresses the importance of seeing preschool dif-ficulties in terms of their broader environment. This includesfocusing on family relationships, sibling relationships, and

peer relationships. Understanding why a child has tantrums,why he or she cries constantly when separated from his or hermother, or why a child may hit siblings and peers can onlybe understood by taking into account the child’s relation-ships with others. Preschool children learn how to handlestress and how to deal with conflicts by observing how thisis accomplished within the family context. Campbell statesthat “the transactions over time between child characteristicsand parenting factors are the strongest predictors of chil-dren’s social and emotional functioning” (p. 144). Often theimpact of the family environment is overlooked in the pro-cess of finding out what is wrong with the child presentingto treatment. Campbell effectively stresses the role of thefamily in preschool development and the need to look intoall aspects of the family to determine how they affect theindividual preschooler.

Once problem behaviors are discovered, treatment of thechild and the family will begin. Campbell provides us withseveral psychotherapeutic methods for assisting the child andfamily and discusses methods for prevention of behaviorproblems in preschoolers. Less detail is provided with respectto treatment issues, especially psychopharmacological meth-ods no longer shied away from in this population.

In the treatment of preschool children, it is imperativethat we have an outline to follow. It must account for de-velopmental processes, relationship issues, and utilizing themost effective treatment available for each child. Campbellprovides us with an approach that is both thorough andinclusive. It stresses most effectively the importance ofknowledge of development and the role of the family andother relationships on the behavior of preschoolers.

John E. Bragg, Jr., M.D.Margaret A. Shugart, M.D.

Department of NeuropsychiatryUniversity of South Carolina School of Medicine

ColumbiaDOI: 10.1097/01.chi.0000129213.49393.61

Between Fathers and Sons: Critical Incident Narrativesin the Development of Men’s Lives. Edited by R.J.Pellegrini and T.R. Sarbin. New York: Haworth Press,2002, 252 pp., $49.95 (hardcover), $29.95 (softcover).

A 40-year-old patient described closing the gap he feltwith his father: “as approaching the speed of light—thecloser you get, the more impossible it becomes.” Men oftenuse images from nature, such as stones or mountains, todescribe their fathers. Freud compared fathers to the Sphinx:mysterious, unknowable, a container of secrets. Of course, whatfather does not at times feel equally flummoxed by his son?

BOOK REVIEWS

J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY, 43:8, AUGUST 20041062

Profound currents of connection and disconnection, loveand hate, and competition and mutual support, shape thefather–son relationship. Fathers and sons share the same gen-der bond, which can lead to a blurring of boundaries andmutual distortions as well as to profound empathy. They arecompetitors for the mother’s attention even while they lookto each other for love and understanding. A son contains thefather’s hopes for immortality even as he defines his father’smortality. The father may remain a powerful judge in a son’smind, although the son strives for independence and au-tonomy.

Psychology, and our culture in general, has rediscoveredfathers over the past several decades, acknowledging moreopenly the importance of this figure often shrouded in si-lence and mystery. This edited volume by Pellegrini andSarbin approaches this relationship from a narrative perspec-tive. “We live in a story-shaped world,” Sarbin notes (p. 11),and the book brings together 17 stories—essays, really—ofvarying lengths by fathers and sons. Pellegrini states that “theworking assumption here is that the meaning of interper-sonal relationships, between fathers and sons or otherwise, isencoded in personal constructs of the individual, which areorganized in the form of stories” (p. 3).

Their intent is to capture specific “critical incidents” inthe lives of fathers and sons. The essays are grouped intothree sections focusing on (1) identity, (2) emotional life,and (3) self-understanding.

All the contributors (save one, who was in eighth grade atthe time of his contribution to an intergenerational story) arehuman development professionals—social scientists, educa-tors, and/or clinicians. Although this provides an articulatesample, it also presents problems and limitations.

The stories range over a variety of topic areas, from theway that fathers communicate values and life lessons in theirvery “doing” in the world (rather than verbally), to how sonscome to understand their fathers better as they age, to sortingout family secrets and miscommunications, to the impact ofcultural change and pressures to assimilate.

In these stories, we come to see that the relationship witha father is never over, that there is always the opportunity forchange and reconciliation, that a son struggles with his fathereven when he is physically absent, even in fact past his fa-ther’s death. We read about the profound importance ofsilence in the father–son relationship and the meanings ofsilence in men’s lives. We learn more about the often hiddenrole of shame in men’s experience and how profound thepain is when men feel that they are not living up to thecultural roles asked of them. Often fathers express much lovein their actions, sometimes unseen by their sons (and daugh-ters), even if that love is not spoken of directly.

The essays in the book are often very moving and showthe power of the narrative approach to human development.

It also exemplifies some of its limitations. The very expec-tation that the contributions be storied—with “a coherence,not only a beginning, a middle, and an ending, but also apoint” (p. 11)—carries with it a misleading picture. Most ofthese stories do not have the disorganized, uncertain, gropingquality that is perhaps the most experienced aspect of thefather–son relationship. Similarly, the choice of contributorswho are themselves so articulate and informed offers a nar-row perspective on the father–son relationship. Most of thesemen have reconciled with their fathers; many men do not.There is a danger in this enterprise for the “story” perspectiveto become imperialistic, coming to overwhelm the more in-choate, “unstoried” nature of most men’s experience of theirfathers. The story usually comes much later, if at all.

All approaches have their limitations. There is much tolearn in this touching, honest book written by fathers andsons who make profound efforts to understand each otherbetter in often risky, courageous ways.

The authors see this book as potentially a supplementarytext for college and graduate courses dealing with humandevelopment from a wide array of academic perspectives. Ithink that they are correct in this: The book would be veryuseful in psychology, anthropology, and sociology courses.So, too, male and female therapists would likely profit fromdelving into these life stories. The editors hoped to producea book of essays that talked to “both men and women aboutcore relationships in their lives.” In this, too, they have suc-ceeded. Men and women have much to gain from readingthe moving essays in this volume.

Sam Osherson, Ph.D.The Fielding Graduate Institute

Cambridge, MADOI: 10.1097/01.chi.0000129214.57017.03

Going on Being: Buddhism and the Way of Change. ByMark Epstein, M.D. New York: Broadway Books, 2001, 219pp., $13.95 (paperback).

I picked up Mark Epstein’s first book, Thoughts Without aThinker: Psychotherapy from a Buddhist Perspective, more than5 years ago and discovered much that was relevant to mytherapeutic work with children and adolescents as well aswith adults. I have found the same to be true of his mostrecent book, Going on Being: Buddhism and the Way ofChange. Mark Epstein, psychiatrist, writer, and Buddhist, isa key voice in describing parallel relationships between Bud-dhist thought and meditation and psychodynamic thoughtand psychotherapy.

BOOK REVIEWS

J. AM. ACAD. CHILD ADOLESC. PSYCHIATRY, 43:8, AUGUST 2004 1063