Even paranoids have enemies is the reply Golda Meir is said to have made to Henry Kissinger who, during the 1973 Sinai talks, accused her of being paranoid for hesitating to grant further concessions to the Palestinians. It is used as part of the title of this book to highlight the complex relationship between paranoia and persecution. The book is divided into three sections: section one addresses aspects of the complex psychological impact that experiences of external and internal persecution have on the individual; section two brings together expositions on paranoid and persecutory processes in groups, institutions and bureaucracies; and section three discusses the social, political and cultural factors which give rise to these processes. The theoretical viewpoints introduced and discussed come to life in the political, social and historical arenas where the politics of the Middle East, the pressures of Japanese society and the dynamics of the drug scene are used to illustrate and understand the issues involved in paranoid thinking and in persecution.

This compilation of articles, research studies and case material deals with the multi-faceted dimensions of hospital law. The volume brings together international experts' views on the interface between medicine, law and ethics as they relate to hospital policy and procedures. Topics explored include: ethics committees, informed consent, malpractice, medical experts and the courts, medical records, use of computers, DNR, death, organ transplants and bio-medical technology.

G. di Gennaro Abuse of drugs has reached such magnitude that it is regarded by most govern ments, scholars, and experts as one of the major problems of present-day society. The highest values of individuals and social groups are strongly attacked or are at risk as a result of the spread of drug abuse. As a consequence, society is deprived of the contribution of many of its members toward the establishment of better condi tions of life. On the other hand, considerable portions of the limited resources of so ciety are diverted to assist, cure, and rehabilitate drug addicts. The enormous gains derived from illicit traffic in drugs are contributing tremendously to the strengthen ing of criminal organizations and the rise of new aggressive criminal syndicates. The financial means of these groups are invested in illegal enterprises which extend the criminals' power to various sectors of the economy. One should recognize that the vast criminal network which is behind this crimi nal big business has achieved such strength that it acts as a counter-power. Corrup tion, racketeering, oppression, and illicit influences are among the dreadful ele ments which unavoidably accompany drug trafficking. The price paid for this by humanity is incommensurate."

The prostitution of the German psychiatric profession into a Nazi inquisitional tool was a major factor producing the total degradation of German medicine and moral ity. Its low point was its psychiatrists killing the patients they were sworn to care for, and its other physicians performing inhuman experiments on patients they were pledged to treat. In America also, psychiatry has been performing some of the functions of an In quisition: injuring innocents, both patients and dissenters, and exculpating crimi nals, terrorists especially. Innocents are being injured both in and out of psychiatric hospitals. The in creased fragmentation of care, the augmentation of its discontinuities, and assign ing the responsibility for organizing it to non-medical managers are some of the fac tors worsening the treatment results of our hospitals. Wrongful deaths, due largely to the specialty's intoxication with drugs while ignoring the importance of common human decency, have become a national scandal."

The papers in this section on the legal aspects of nursing can be divided into two parts: (a) the rights and responsibilities of nurses, patients, and the medical system and (b) treatment, with its legal ramifications. How does one decide whether patients' rights or the health professional's rights are to be considered more seriously? Is there an absolute "right" or "wrong"? Since legal rights are sanctioned by constantly changing social and political climates, this may, in effect, diminish the possibility of anything absolute. The question of the "equivalency" of legal and moral rights is also addressed. Due to the prevalent vagueness with regard to bioethical issues as they affect hu man and legal rights, often we become absorbed in philosophical polemics without being able to arrive at anyone answer. In order to move beyond the ethical/theoret ical fonnulations, there is daily confrontation in the nursing profession -the practi cal application of theoretics."

'This is the seventh volume in the therapeutic communities series and a highly informative and reassuring read for anyone interested in psychodynamic applications, or working with individuals with a mental illness.' - Therapeutic Communities Journal 'Having no first hand experience of working with mental illness from a psychodynamic perspective, I hoped that this book would provide me with an insight in to the therapeutics of mental illness within a community. The book certainly accomplished this and more. In keeping with the "community spirit" I also feel this book would be of interest to those already in the field, both nationally and internationally, as a means of sharing other therapy experiences.' - Therapeutic Communities Journal 'The book is basically an account of the Arbours Crisis Centre in London in the words of therapists who have lived and worked there. Part of the therapeutic community movement and the antipsychiatry tradition of RD Laing, the centre has long provided an alternative approach to mental health care. Of course the book goes beyond simply documenting the development of the centre to offer a an implicit critique of mainstream psychiatric treatment and an argument "for a humane, useful and cost-effective alternative to traditional, physical, psychiatric treatments".' - Mental Health Today A major question facing therapists today is how to treat psychosis effectively while maintaining patients' dignity, self-respect and, as far as possible, their psychological and social functioning. The authors of Beyond Madness have all been associated with the Arbours Crisis Centre in London, a unique facility established in 1973 where therapists and patients, or guests, live together in order to establish a space where extremes of distress can be tolerated, understood and ameliorated. This book provides important and engaging accounts of the special personal and interpersonal care offered by the Arbours Crisis Centre and kindred facilities. The authors demonstrate different ways of working with psychotic persons within individual, group and community settings. They describe the extraordinary experience of living and working at the Centre including the five stages of stay that guests invariably pass through. In addition, they discuss different strategies for intervening, especially with people who self-harm, and provide a theoretical framework for their interventions. They explore issues of power, authority and money, and show that the work of the Centre is cost-effective in comparison to other treatment modes. At a time when biological treatments predominate, Beyond Madness illustrates and argues for a humane, useful and cost-effective alternative to traditional, physical, psychiatric interventions.