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Valerie Sinason's book, Mental Handicap and the Human Condition, is resolutely centred on clinical material; her patients are children and adults who are mentally and often physically disabled, and are somewhat emotionally disturbed. She shows that they need and can benefit from analytic psychotherapy, even though the meagre resources allowed for treatment often drastically reduce its scope to what can be achieved in a few months of weekly sessions.
Her first long case, significantly, is not a patient whose mental handicap started at birth, or before: he is an educated man, an academic in his fifties, who suffers from Alzheimer's disease. His meetings with Dr Sinason enable him, and his family, to gather whatever resources are available to face the inevitable catastrophic decline. To my mind, the choice of this case to open the book represents a statement, which the author upholds unequivocally throughout, that handicapped people do not come from another world, they are not fundamentally different—they are people like me, writing this review, or the person reading it, but they are sometimes victims of truly horrific life conditions.
The author puts her topic into context with substantial discussions on the historical and social aspects of mental handicap: for instance, she discusses the terminology used over the course of the centuries to describe such conditions, suggesting that the attempts to solve the uneasiness felt in regard to disabilities by the use of forever-changing 'politically correct' definitions is destined to fail, unless it is backed by a fundamental shift in the way handicap and difference are perceived by individuals and codified by society. She points out that poverty and ignorance increase the risk of handicap, and that poor social provisions for handicapped people worsen their quality of life immeasurably. In the chapter about the not uncommon physical abuse of mentally-handicapped people, she shows how damaging it is that they are often n