The trouble with illness: how illness and disability affect relationships

This is an accessible and thoughtful book by Julia Segal, who has not only published work on Melanie Klein, but has also worked both for the NHS and privately as a counsellor for people affected by neurological and other physical health conditions. The book is aimed primarily at those who work, or whose life brings them into contact, with those who are ill or newly disabled in one way or another. As she writes,

Counsellors, psychologists, psychotherapists, professional carers and nurses are the main professional audience but many other healthcare professionals find themselves having to deal with the emotional and relational impact of these conditions on themselves as well as on their clients. And of course, anyone who themselves has a health condition or belongs to a family in which someone else does, or as a child was concerned about a parent’s health recognise their own experience and I hope see it in a new light. (p. 23)

Segal writes that the book is ‘about the effects of living with illness and changing disability on the mind, on thoughts, on feelings, and on the way people live their lives. It is about caring and being cared for, and about not caring and resisting dependency’ (p. 12). Her style is discursive, accessible, and the book is packed with short vignettes, as well as many verbatim quotes from patients, family members or carers. She makes constant reference to her own work, and the book is somewhat biased towards those suffering from neurological conditions such as multiple sclerosis and Parkinson’s disease, presumably a reflection of her own professional experience. Throughout the book one is reminded of her many years of experience, her compassion and the importance of a benign thoughtful other in the lives of patients, their family members and indeed, the healthcare professionals looking after them.

There are some particularly important and moving chapters. Chapter 8 is entitled ‘Damage to Capacities to Think or Feel’, and here she describes the situati