Stuart C. Yudofsky

People can become stuck in many ways and for a wide variety of reasons, explains the author of Fatal Pauses, that rare book that both clinicians and general readers can benefit from and enjoy. Novelistic in its depictions of composite patients but clear-eyed in its analysis, the book offers a "3-D method" of addressing "stuck"-ness, which is defined as "not stopping something that is bad for us" or "not starting and staying with something that is good for us." The process of discovering why one is stuck, deciding to become unstuck, and then asserting the discipline required to do so is brought to vivid life by one of the most respected psychiatrists of our day. The book's structure is logical and engaging: The Am I Stuck? Scale can be self-administered by general readers or administered by clinicians to their patients. This first chapter sets the stage for what follows. The 3-D method of getting unstuck is presented in a systematic, easy-to-comprehend manner that begins with a brief overview and proceeds to more detailed instructions and insights. Riveting case examples make up the heart of the book. They are not mere summaries but consist of thorough and detailed clinical descriptions that provide context, in addition to extensive dialogue and analysis. Several of these cases are divided into multiple chapters, providing a comprehensive clinical picture to help both mental health professionals and lay readers increase their understanding of being "stuck." A range of categories or "stuck"-ness is addressed, including being trapped by career choices, limited by obesity, paralyzed by an unsatisfying marriage, incapacitated by addiction, and imprisoned by the need to please. Of special note is the case example of a young man whose interpersonal relationships have gradually, but progressively, become reduced to computer-based encounters. The author's examination of this individual's fixation on video games and virtual realities and his escape from this cyberprison through treatment is both timely and compelling. Finally, the author provides an evolutionary and neurobiological overview of how we become "stuck," which helps the reader grasp the underpinnings of this behavior and learn how to become "unstuck." Written in a warm and disarming style, Fatal Pauses will find a home in clinicians' libraries,waiting rooms, and on family room bookshelves.

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