Edited by Roy R. Baumeister, Ph.D., and Kathleen D. Vohs, Ph.D., New York, Guilford Press, 2004, 574 pages, $70
Dr. Tabor is affiliated with the department of psychiatry at Kings County Hospital Center in Brooklyn, New York.
Among the various models available for describing how the mind works, let us now add regulation. That is, a major task of development, and the practical definition of maturity, is the exercise of self-control. Our society looks down on those without self-control (the obese, the gambler, the addict, the thief) partly because of the disruption such behavior causes to society as a whole and partly because to be controlled in action and emotion is, in our culture and society, a sign of mental strength. To state this is obvious, but the editors of this book have gone below the surface and into the brain to examine the sources of various self-regulatory abilities and have then provided practical ramifications of being either strong or weak in the area of control.
The introductory chapters of this handbook ought to be read first, because they lay the foundation for what follows. They begin with chapters that discuss various aspects of basic regulation. They define many terms that we probably take for granted, and break down motivation into two main classes, nurturance related (for example, eating and drinking) and safety-related (for example, risk-taking behaviors). They go on to discuss the different mechanisms of striving toward these goals, which are quite opposite; nurturance-related behavior is engaged in until satisfied, whereas safety-related behavior tends to center around avoiding harm. Right away we see the pathologies that arise out of disturbances in the function of either behavior. The nurturance function and safety function can and often do operate independently but are based in the affect-laden anterior cingulate gyrus, with its connections to the limbic. Temperament can decide the loci of difficulty.
Self-regulation and self-control are related but not the same, and the distinction is interesting. Self-regulation refers to both conscious and unconscious processes that have an impact on self-control, but regulatory activities take place more or less constantly to allow us to participate in society, work, family life, and so on.
After a theoretical and experimental discussion of self-regulation, including discussions of psychological testing and fMRIs, the editors include articles concerning practical ramifications of deficits in self-regulation. Each article distinguishes between self-regulation (unconscious) and self-control (at least partially conscious) and relates deficits in self-regulation to disorders as diverse as attention-deficit hyperactivity disorders, eating disorders, substance abuse, gambling, and so on. It is clear that addictive disorders can be conceptualized as disorders of self-regulation as much as disorders of self-control and that the ability to resist temptation is a combination of conscious will and unconscious factors, such as temperament, development, "ego strength," and the strength of internalized selfobjects.
Clinical applications of the theory of self-regulation stem from the belief of most, if not all, of the authors that whatever differences and deficits exist in the ability to self-regulate, either innate or learned during development, can be modified by additional learning. Particularly and not surprisingly, they refer to cognitive-behavioral therapy as an especially useful treatment, one directed precisely at the problem, the lack of self-regulatory strength.
An especially interesting chapter looks at gender and self-regulation. Rumination is discussed as the tendency to think about the problem as a problem rather than to try to solve it. Rumination occurs for several reasons, including a tendency of women to feel more responsible for their emotional state than do men and to feel less control over their emotions and their lives than do men, leading to more thought and less action. Yet it also notes that because "women appear more likely than men to use rumination to regulate their negative moods," they are somewhat less likely to use alcohol and other substances. However, many women use eating in precisely the same way that men are reported to use alcohol: to numb, to distract, and to soothe.
This book is quite a comprehensive handbook. It does not lend itself to casual reading and uses psychological jargon that is not always clear, at least to this reader, a non-research-based psychiatrist. The terms seem to have precise meanings in the psychological field, but in the book they were not always so useful in understanding the material and at times seemed to obfuscate it. In addition, the chapters reflect the increasingly popular but annoying practice of listing each reference by its entire roster of collaborators rather than by a number, which makes for choppy reading. However, I believe that the concept of self-regulation provides yet another useful model and framework for understanding human development and the development of human psychopathology, particularly with reference to addictive and impulse-control disorders. This fascinating compendium is a worthwhile reference for everyone interested in various explications of human behavior.