Pain Medicine Books - Page 5

Palliative Care Perspectives

James L. Hallenbeck

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Customer Reviews:
Total reviews: 4 Average rating: 5.0 of 5

Excellent, compassionate and very pertinent 5 out of 5 stars.
14 of 15 people found this review helpful.

Reading this book is like having Dr. Hallenbeck at your side coaching the reader to think critically about the evolving discipline of palliative care. Dr. Hallenbeck's voice is compassionate, articulate and strong throughout the book. I have placed Palliative Care Perspectives alongside some of my other references as I struggle to learn to care for patients at the end of life. I highly recommend this book to careproviders (physicians, nurses, PAs, nurse practitioners, socialworkers, chaplains etc) who have patients who are near the end of their lives. I have met Dr Hallenbeck and been privileged to work with him; if you are unable to work with him or to hear him speak, this treatise is like having him at your elbow when you need help. It is an intimate and thoughtful book that should be required reading for professionals in training.

Editorial Review:

Drawing from his extensive clinical experience and many years of teaching, Dr. Hallenbeck has written a guide to palliative care for clinicians. Topics addressed range from an overview of death and dying to specific approaches to symptom management.

As an introduction to both the art and science of palliative care, this book reflects the perspectives of one physician who has dedicated his career to this rapidly evolving field. the book links real stories of illness with practical advice, thereby delineating clinical practice in a way that reflects the daily concerns of clinicians.

The Anti-Pain Plan: 467 No-Nonsense Ways to Avoid Arthritis, Heal a Headache, Beat a Backache, Trounce Carpal Tunnel, Relieve Sore Joints, and More! (Jerry Baker's Good Health series)

Rick Chillot

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Editorial Review:

Providing fast pain relief for everything from stiff knees and migraines to muscle spasms and hemorrhoids, the treatments in this health guide use natural and inexpensive products to alleviate common discomforts. Pain specialists and practioners of natural health offer suggestions for relieving angina with garlic and onions, tendinitis with ginger, and back pain with water. More than 100 kinds of pain are discussed with remedies and treatments that offer comfort quickly.

Dangerous Doses: A True Story of Cops, Counterfeiters, and the Contamination of America's Drug Supply

Katherine Eban

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Total reviews: 3 Average rating: 5.0 of 5

Editorial Review:

When counterfeit prescription medicine started turning up in the nation's supply and threatening some of the sickest and weakest patients, Katherine Eban went in search of the story. What she found was an unlikely and irresistible group of heroes-five aging South Florida investigators who dubbed themselves the Horsemen of the Apocalypse and held their meetings at Hooters. Working around the clock on cases no one else wanted to tackle, they followed the trail of stolen and contaminated medicine in a takedown eventually dubbed Operation Stone Cold. This riveting page-turner takes us along with the Horsemen as they wade into "more rank Florida unseemliness than a Carl Hiaasen novel" (Salon) to ultimately uncover $33 million in bad medicine and make more than sixty arrests.

Thanks in part to the attention Dangerous Doses received in hardcover, the media, politicians, and drug companies are starting to address the problems it uncovered. This new paperback edition includes a chapter with the latest update on these developments.

Essentials of Pain Medicine and Regional Anesthesia

Honorio T. Benzon, Srinivasa N. Raja, Robert E. Molloy, Spencer Liu, Scott M. Fishman

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Total reviews: 5 Average rating: 5.0 of 5

Editorial Review:

This second edition of Essentials of Pain Management and Regional Anesthesia, offers an accessible and concise, yet complete, overview of today's theory and practice of pain medicine and regional anesthesia. From a review of basic considerations through local anesthetics and nerve block techniques, this book provides the reader with an excellent tool for exam review or practice of Pain Management.

• Organized in a concise, practical quick-reference format.
  
• All chapters are brief and easy to read quickly.
  
• Offers specific strategies for the evaluation and management of a full range of pain syndromes, including cancer pain.
  
• Features over 230 diagrams, illustrations, summary charts and tables that clarify the information and make it easy to apply.
  
• Discusses the latest drugs and therapeutic approaches, such as acupuncture.
  
• Presents the management of pain for every setting where it is practiced, including the emergency room, the critical care unit, and the pain clinic.

• Includes new topics such as: imaging in pain medicine, radiation safety, issues associated with the use of narcotics, intraarticular and intraperitoneal use of opioids, pain management in the emergency room and in the intensive care unit, pain management issues during pregnancy, geriatric pain, and hospice care and end-of-life issues.
  
• New chapters on interventional procedures include discography, intradiscal electrothermal coagulation (IDET), vertebroplasty, and piriformis injections. Truncal blocks and neuraxial blocks and anticoagulants are added to the section on nerve blocks.

With 89 additional contributing experts.

Overcome Neck & Back Pain

Kit Laughlin

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Editorial Review:

Using the principle of Eastern and Western medicine, Kit Laughlin has designed a system that that provides a way to stop back and neck pain, and which will protect you against future injury. This four-part program will, in most cases, enable you to overcome your back pain permanently by practicing the careful stretching and strengthening exercises.

Do You Really Need Back Surgery?: A Surgeon's Guide to Neck and Back Pain and How to Choose Your Treatment

Aaron G. Filler

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Customer Reviews:
Total reviews: 12 Average rating: 5.0 of 5

Editorial Review:

Most people have back surgery to relieve pain, but all too often it doesn't help. For the half million people who undergo back surgery each year, and the additional million who are seriously contemplating it, Do You Really Need Back Surgery? is a godsend--an informed, reliable guide to when you should consider surgery and when you should not.
Written by an internationally recognized expert in nerve and spinal surgery, this highly readable guide covers everything back patients need to know to make informed decisions about their treatment. The book discusses the details of spinal anatomy; the difference between acute, chronic, and recurring pain; shows how to keep the spine healthy; and explains such terms as spurs, stenosis, and slippage. It also reveals what clues your physician uses to predict whether a given type of pain is likely to go away with rest and exercise, and which types may become emergencies. Dr. Filler discusses the risks of surgery, the decisions you may be faced with and what options you have, and your expectations for recovery. He provides detailed explanations of the wide array of spinal injections and surgeries, including discectomies and fusions, as well as innovative procedures such as electrothermic and laser techniques and artificial disks. He explains the various medical imaging and diagnostic tests available and even covers the complexities of health insurance.
From Pilates to pedicle screws, and from osteoporosis to spina bifida, Do You Really Need Back Surgery? covers all the questions your doctor usually doesn't have the time to answer. Featuring more than 80 illustrations, it is an essential manual for every neck or back pain sufferer.

A Time for Listening and Caring: Spirituality and the Care of the Chronically Ill and Dying

Christina M. Puchalski

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Total reviews: 3 Average rating: 5.0 of 5

Editorial Review:

This book is a thoughtful, informative, and practical guide for anyone involved in caring for the seriously and chronically ill or dying. The connection between spirituality and medicine has been receiving a lot of attention in both the scientific and lay presses recently, but research and anecdotal evidence all indicate that spirituality is central to the care of the chronically ill and dying. It is therefore critical that healthcare providers who interact with seriously ill patients know how to address their spiritual needs.
This book presents current thinking on how spiritual care can be integrated into traditional caregiving. Part one discusses aspects of spirituality, such as presence, ethics, and relationships. Part two delves into a number of specific religious and theological traditions. Part three offers practical applications and tools, including storytelling, psychotherapy, dance, music, and the arts. Part four focuses on patients' stories and reflections. The book concludes with appendices that have sample advance directives for Protestant, Catholic, Jewish, and Muslim patients.
Volume editor Christina Puchalski is the director of the George Washington Institute of Spirituality and Health. She is also an associate professor of medicine at the George Washington University Medical Center and an active practicing physician and medical educator. Dr. Puchalski is nationally and internationally recognized as a pioneer in the integration of spirituality and healthcare. Chapters are authored by an impressive group of medical and religious experts, and patients' stories also appear throughout, offering real-world examples. The book features a foreword by the Dalai Lama.

Yamamoto New Scalp Acupuncture: Principles and Practice

Richard Feely

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Customer Reviews:
Total reviews: 4 Average rating: 4.5 of 5

Editorial Review:

This book advances the theory and techniques developed by Dr. Toshikatsu Yamamoto to treat patients with musculoskeletal and neurological pain. It provides a concise overview of Dr. Yamamoto's principles of scalp acupuncture, with complete descriptions of Basic points, Ypsilon points, as well as new points developed by the author. Discussion of indications, contraindications, diagnosis, needling techniques and selection, and possible side effects provide the practitioner with the key information needed to determine the most effective treatment protocols for each patient.

Highlights of this text:

An accompanying DVD with instructional videos facilitates comprehension of the palpatory, diagnostic, and therapeutic techniques in the YNSA system

A laminated chart insert distinguishes YNSA points in color and serves as a convenient tool in the clinical setting

More than 70 figures and algorithms supplement textual descriptions of points and treatments

A chapter on the correlative theoretical principles of Traditional Chinese Medicine and YNSA treatments helps the practitioner gain a firm understanding of important concepts

An ideal text for beginners, Yamamoto New Scalp Acupuncture places special emphasis on the ease with which newcomers can integrate YNSA treatments into everyday practice. This book is an essential resource for pain specialists and practitioners seeking to enhance their patient care.

Pain

Dan Middleman

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Customer Reviews:
Total reviews: 9 Average rating: 4.0 of 5

The most forceful running book ever written 5 out of 5 stars.
13 of 13 people found this review helpful.

Dan Middleman, who has obviously read John L. Parker Jr.'s "Once a Runner," takes a different approach to the subject of the intensity of distance running that is anything but subdued, and thankfully so. This is a brutally honest and enthralling book that takes readers through the dark side of competitive distance running. Middleman's characters all face the toll of the double-sided card of competitive drive. Middleman focuses dually on the pressure they put on themselves to succeed and the pressure from the weight of the force of running to win in itself. The characters relieve themselves, even if only in a transitory way, by drinking beer like fish swimming through water, even if that itself turns into another problem, as several of the characters suffer from alcoholism. Parker's characters drank, but not like this. Middleman focuses on this aspect of college life more than Parker did, and as a college student myself, I have no doubts that these situations occur regularly just as described in "Pain."

Richard Dubin drinks heartily and runs even more heartily while trying to balance a serious relationship with a girl he is captured by. He suffers from extreme nervousness before races and becomes so jaded from it that his perspectives and personality change dramatically. Many college runners can identify with this, even though they may not take the tenebrous turns Richard does. This is a blunt, realistic, and entirely compelling book that is excellently written without being difficult to read or comprehend. There's not a false ring to it, especially in the narration and the dialogue; even the tragic ending, which will leave you reeling long after you've finished reading the book and carries an unexpected twist, is not farfetched. In fact, it's perfect considering the material that precedes it.

If you loved Parker's classic running novel, then you should check this one out to. Each captures the spirit of running in different ways. Both characters sacrifice themselves for the sport in unbridled, entirely believable ways, but end up with separate outcomes. Both of these novels should be examined for the effects on the competitive distance runner and the possible outcomes of such obsessions. They can be cathartic or ugly, but neither comes without a price before whatever the end result is. This book evinces the varying successes, failures, efforts, and thrashes that come with running, although the characters in the book suffer more than most.

As a college runner myself, I related to much of what happens in this brilliant book, particularly the varying mental states of a high caliber runner. While I am not as talented as Middleman's protagonist Richard Dubin and have not competed on as high a level as he does in this book, I was able to totally understand the struggles he goes through. Once I started this book late one night, I didn't want to put it down. Highly recommeneded.

Editorial Review:

Richard Dubin is a talented distance runner at a major southern university. Pain is the story of Richard's senior year as he proceeds with varying success through the year, from cross country through the Olympic Trials, all the while trying to manage a seesawing relationship with a beautiful and fascinatingly unpredictable woman, 10 years his senior. Richard's university is one of the great American party schools and we are treated to a series of uninhibited college blowouts, featuring copious liquid consumption, naked kegstands, nude relays. . . and, most daring of all, poetry reading! As the pressures mount, Richard's life begins to unravel. All the forces converge at the Olympic Trials in New Orleans and it is there that Richard comes to the edge of the abyss.

The Antipodes of the Mind: Charting the Phenomenology of the Ayahuasca Experience

Benny Shanon

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Total reviews: 12 Average rating: 5.0 of 5

Brave Journey into Awe (& brave, rational return) 5 out of 5 stars.
40 of 44 people found this review helpful.

INTRODUCTION
What happens when a worldly Israeli cognitive psychologist goes to the Amazon Basin where he ingests the famed psychotropic concoction Ayahuasca (the `vine of the dead') again and again and again? Our intrepid philosophical psychologist is no longer a sprightly youth, maddened for adventure. He is instead an accomplished theoretician with widely published articles (several in this journal) and a noted book (*The Representational and the Presentational*, 1993) that speak the from the perspective of cognitive (or phenomenological, for Shanon) psychology against the reductive tendency to view the mind's activities as created by the the brain's activities. Even before his Amazonian quest, he placed himself in the Gibsonian camp seeing the mind as dynamic intermediary between organism and environment and active participant in both. What did happen is this extraordinary book, a scientific analysis of his own visions and the education of both Shanon's views and, perhaps, his soul.

Benny Shanon's accomplishment in this unique and carefully written treatise is nonpareil. In his landmark attempt to chart and classify the experiences that follow ingesting the Amazonian brew, Ayahuasca (always capitalized by Shanon), he demonstrates a will to observe and explain as relentless as carbon steel, but his seeing and experiencing also require him to be as flexible as tungsten when he must shape his interpretations within experiences that have all but overthrown the pretense of objective observation. Indeed, as he becomes `educated' through his journeys with this brewed plant compound, apparently beginning his own shamanic initiation, his will, his very self must capitulate to experiences beyond words. Later, back at his desk, Shanon will use his notes and memory to go discover the order of things. This breakthrough study will achieve the respect and renown it deserves, but it is currently causing a stir in certain circles and amongst the openminded international intelligentsia.

Shanon has written a slow-rising classic that should stay aloft for the duration of our era, not just as cognitive psychology or even as another narrative of the psychedelic experience, but as the revelation of the boundless potentials within the human journey itself. Since its release, it appears to have received universal praise from other critics and readers. However, word has not filtered out into the hungry minds of the general public or surely *Antipodes*(1) would be on a bestseller list. Either its subject matter - pharmaceutically induced altered states of consciousness - is still considered too politically threatening or Benny Shanon needs to hit the talk show circuit. His book enters deep waters yet never loses its way. It may be a challenge for some to wade through his classifications but in doing so may find their thinking clarified. Shanon's writing is clear as a mountain brook. He wastes no words for grand effect but always goes straight and true for the point of the topic he had begun. This makes for a very satisfying read, which is helped immensely by the greater story lurking within it to do with one man's awakening from the sleep from self consciousness. *Antipodes* is neither obscure nor excessive, so it might make a good selection for a book-of-the-month for educated readers. Oprah, are you listening?

Nothing exactly like this has ever been written before(2), beautifully rendered and incisively analysed yet finally superseding its own analytic. The reader joins a dedicated scientist on a journey that most would consider well beyond the possibility of scientific data gathering, except in terms of chemistry or anthropology. This journey is a phenomenological analysis, Shanon's close observation his own experience. He wastes no pages speculating on what the neural correlates of his visionary experiences might be, not even taking much time to explain the active ingredients of the `brew' or how it changes the brain. Within this work (but not always within his own experience), the phenomenological-analytical approach seldom wavers. Such an approach still requires a certain distance, so when the object of study is his own earthshaking visions or emotional tsunamis rising up to lay bare every suppressed anxiety, guilt, or self delusion - not even to mention the digestive trauma often encountered(3), one finds oneself in mute admiration for this stalwart scholar who steadily perseveres, refusing to be swept away from his purpose. He admits to making wrong choices in his early Ayahuasca journeys, lingering at banquet or resisting the lure of jaguar metamorphosis when he should have continued his quest, but he learns and begins again. As new worlds open before him, sometimes terrifying, he never retreats in a desperate attempt to turn the experience off. But he also learns when to surrender. Song pours from him amongst strangers, but he knew he must allow the joy to have voice. Though only briefly alluded to, it seems his perseverance and purity of purpose allowed him to finally transcend the limits of knowledge altogether by surrendering his cognition and his very self in a metanoia beyond the realm of words, memory, or interpretation. Needless to say, this experience is not described.

It is in this sense that *Antipodes* may find itself attacked (or ignored) from two opposed positions at once. Most hard science does not consider phenomenology a respectable undertaking since one's subjective experiences can neither be observed by anyone else nor shown to produce repeatable effects. One attempting to draw up analytical structures for drug-induced visions is likely to be dismissed out of hand as delusional, taking hallucinations for reality(4). On the other hand, true believers - religious followers, mystic esotericists, New Agers - will be annoyed for though Shanon puts the stamp of `reality' upon his altered-state journeys, he continues to be skeptical about the existence of supernatural deities behind the metaphysical curtain. In his captivating Prologue he states: `For years I characterized myself as a "devout atheist". When I left South America I was no longer one' (p. 9), but he later explains that his `theism' is more related to a Spinozan pantheism grounded in creative dynamics than to anybody's pantheon or hierarchy of static divinities. He also rejects as unlikely the many reports of enhanced psi powers during the Ayahuasca intoxication (noting that increased perceptual sensitivity and interpersonal attunement can explain the `mind reading' he has experienced and heard reported). He remains open, however, expressing the wish that reports like that involving the remote viewing of an actual European city by an Amazonian native who had neither seen pictures nor heard stories of such a place should be objectively investigated.

Others will argue, and have done so, that immersion in the vision quest involves the suspension of the judgmental, cognitive faculty. Shanon seems to have learned the right steps to his dance between reception and cognition. When the moment presents itself, he allows the imagery or ambiance to take over; but when he returns he makes note of all that can circumscribed. Such imagistic encouragement is similar to Spinoza's intuitive mode of knowing, as Shanon notes (p. 205), but he also stands by the need for subsequent careful analysis in the same way elucidated by Whitehead (1978): `The true method of discovery is like the flight of an aeroplane. It starts from the ground of particular observation; it makes a flight in the thin air of imaginative generalization; and it again lands for renewed observation rendered acute by rational interpretation' (p. 5). Whether this `rational interpretation' infects that which is so interpreted, thus standing on the primary ontological ground beyond that of visionary experience remains an open question, to be asked again below.

In what follows, I will attempt the briefest of summaries though such is an injustice to this groundbreaking psychological cartography of what is terra incognita to most of us. I will then share my perplexities and a personal response, before concluding.

SUMMARY
As a reader, I was hooked immediately by the dramatic Prologue as well as the few selected illustrations, all details from the artwork Planos by Brazilian `shaman-turned-artist' Céu. Each detail is a picture unto itself - a `frame of reference' - yet `the big picture' reveals them all as aspects of a greater dynamic spiralling out from or in towards a core of light that no doubt `passeth all understanding'. The plates seemed to be metaphor for *The Antipodes of the Mind*, frame of reference within frames of reference, each part structured by the whole, while the whole is changed by the activity of the parts.

In the Prologue, Shanon tells the story of his first encounters with the Ayahuasca brew and the questions that brought him to begin his mammoth research project. In his first experience of any consequence he had visions that included jaguars and snakes. He learned later that this was commonplace for Ayahuasca drinkers and his professional curiosity as a cognitive psychologist was roused: `Snakes and jaguars seem to be just too specific to define cognitive universals' (p. 7). But he also underwent horrible visions of human cruelty throughout history, including what must have been especially wrenching, the Jewish Holocaust. But rather than back away or fall into bitter cynicism, he countered it with contemplation of the beauty that humans had brought into the world: `However evil and petty human beings are, I thought, they are also the creators of some of the most beautiful things that exist in the universe. With culture and art, as well as with religion and spirituality, humankind can be redeemed' (p. 5). The anguish or fear evoked by unexpected and shocking presentations of evil must be the gate that has turned away many other first time drinkers from further pursuing this course. Through his faith in life and the human journey, Shanon himself emerged beyond the gates in a centre of serenity within which it seemed the world and himself was born anew: `It seemed this was the first day of creation' (p. 6).

After these first world-changing experiences with the Santo Daime Church (daime=Ayahuasca), he was thrown into a period of critical self-analysis. He knew he had to further study this vine and its power, but how? It seems he first had to accept who he already was, an accomplished cognitive psychologist; he confirmed this identity by ending his self-analysis and beginning his journey to other realities found through Ayahuasca and then a long critical, objective, and categorical analysis of the Ayahuasca experience. This book is the fruit of his labours. It is clear, however, that he had also personal motivations to discover a way to confront the human dilemma of good and evil, as well as facing (or `being faced by') the everpresent questions of a spiritual nature.

Shanon set the time aside, returned to the Amazon, underwent prescribed purifications, and became a dedicated student of the School of Ayahuasca, a mystes into its mysteries. He knew from the first he would never `graduate' as the result of a handful of Ayahuasca sessions, so he took his work seriously indeed. He travelled to gatherings among the three churches (two Christian inspired, one an offshoot of the Umbanda movement) in Brazil that use Ayahuasca as their sacrament and participated in their organized sessions. He sat with Amazonian tribespeople under the jungle canopy, often with the guidance of a ayahuasquero, the `specialist of the sacred', a shaman. Later, as he began to master his visions, he journeyed with few others among accomplished shaman-healers. He shared the brew with experienced users in urban settings, and, when he felt ready, flew solo. At the time of publication, he had gone on over 130 Ayahuasca journeys, though the `core corpus' of his phenomenological research work is his first 67 sessions. Each session was summarized at its conclusion. Beyond that, he read everything he could find on the brew, from early reports of missionaries or explorers to current extended scientific analyses. None combined scholarly analysis with extended personal experience. Finally, he set out in good cognitive psychological fashion and interviewed others who had just concluded their own sessions or anyone in general who also had extensive experience with the brew: `My estimate is that, all told, the data discussed here are based on about 2,500 Ayahuasca sessions' (p. 410).

Then Shanon got back to his desk to reveal the structure of the world (perhaps that should be `worlds'). The bulk of the book consists of prolonged exegeses, enumeration and elaboration of steps, systems and subsystems, categories of subcategories within supercategories, and lists of effects and affects. His point of departure is the phenomenology of his `core corpus'. I will not summarize here his structural program, central to his topic as he deems it to be. Strange to say, I rarely found this approach tedious. For one thing, as noted above, the objects of his classifications are confrontations and participation with other realities, so there is a veritable tale of wonders interwoven within the data. Running through the exposition like an unruly stream upon well-manicured fields is the underlying narrative of the paradigmatic hero's journey into meaning. Furthermore, Shanon's mind, as expressed in his writing, is so refreshingly clear and organized that one feels perfectly secure in boarding his `aeroplane' to survey mysteries of terror and delight well beyond most of our experience or comprehension. It may be, however, that Shanon needed this comprehensive organization as a grounding for his more ultimate revelations. Perhaps it was necessary for him `systematically to chart the various phenomena that Ayahuasca may induce and *to establish order in them*' (p. 48, my italics), so he could at least recall the pathway back toward the Source, the `still point of the turning world'.

Shanon learns there are stages of advancement into these mysteries: The novitiate begins passively watching wonders unfold as on a screen, but with experience and courage, learns to enter the vision and explore its reality from within. Then there comes a stage where a certain degree of control over the unfolding reality is possible, though such `control' is always partial and participatory - Shanon often uses the metaphor of playing an instrument or being played as such: `Thus, I say that the Ayahuasca experience is like music played on an instrument which is the soul and that this music is a perfect mirroring of one's entire being' (p. 380). Indeed, the final stage seems to involve gaining the power to engage many worlds (or realities) simultaneously, but also the power to act in this world in ways never previously attained or attempted, such as the expressive arts or guidance and healing. The `grades' of the School of Ayahuasca are summarized thus:

`First there was an exposition. ...the second course was discipline. ... The third course of my schooling was primarily concerned with healing and disease. ... The grades that followed focused on the sacred and involved powerful spiritual experiences. Then I had a long period-coupled with my partaking of Ayahuasca with traditional Amazonian healers-that focused on shamanism. ... The subsequent course ... focused on a variety of more specific issues' (pp. 302-3).

To get this far, the novitiate or mystes has endured many trials and temptations, yet s/he must be bold enough to know when to surrender to the reality that presents itself and wise enough to know when to actively alter it. One must have overcome the narcissistic limitations of one's fears while not inflating vanity over one's piloting control or expanding knowledge. Such hubris, as myths have taught us, may lead to the pride that goes before a fall.

Shanon found the pure heart and `empty centre' to be accepted amongst the healers of the Amazon rain forest. He mentions that now he feels his role has become more performative than explorative as guide, hierophant, and something of an ayahuasquero himself. In terms of powers, Benny Shanon emerges as `Benny Shaman' (though I doubt he would admit this or appreciate the wordplay). In terms of wisdom, he states his conviction that the most expressive gesture of ontological truth is found simply in songs of praise for all creation, in the 'Hallelujah' of his ancestors. As to the ontological question of what exactly is being so praised, Shanon avers it is not anything at all but the joy of the eternal dynamic process - neither God as an entity (or any other form of the supernatural), nor is it humanity or nature, as such. Creation is what the name implies, an ongoing unfolding of the infinitely potent creative core of all things, including ourselves.

Obviously, such `knowledge' cannot be attained either through phenomenological or analytic reduction. It is everpresent beyond the edge of the `known world', that is, beyond the conscious mind `Wherefrom words turn back,/Together with the mind not having attained...' (*Tattirïya Upanishad* 2.9). It is at this point that Shanon the scientist must give up on science and even knowledge in any usual sense and admit that such direct communion exceeds communication: `Yet, there were occasions that it was clear to me that I had to make a choice-if I really wished to undergo the experience presenting itself to me, I would have to forgo my future recollection of it and give up any thought of ever talking about it' (p. 355). Furthermore, even the path to the edge of this unspeakable awakening is one not of ordered signposts and structured roads but of intuitive knowledge, well beyond categorical reasoning. After all his phenomenological analysis, Shanon at last confesses that

`very poignantly, I realized how limited the scientific approach is. It was evident to me that [in] pursuing this stance, there are realms of knowledge that can never be attained. I further comprehended that there are levels of knowledge that demand one to let go and relinquish all critical, distanced analysis. ... In this respect, despite all its limitations in terms of sociological power and cultural permanence, the indigenous stance has the upper hand' (p. 356).

PERPLEXITIES
I continue to be perplexed about several things hinted at in this tome but not fully explained and I outline them here. These mainly result from my own application of traditional reasoning to that which eludes it or from Shanon's expressed reticence to reveal more personal detail or delve into metaphysics. My perplexities are mainly to do with the world of light and truth revealed to the author and apparently to other experienced Ayahuasca drinkers. Either the dark side is less real or it plays a smaller role than I had imagined.

Unlike with LSD, there are said to be no `bad trips' with Ayahuasca. Shanon admits he interviewed no one who drank the turbid brew but once, which would surely be the result if anyone `freaked out' or was just turned off by the whole experience. The nausea, gastritis, and vomiting, emphasized in other first person accounts, may be enough to cause one to avoid the substance next time, but actual `mind-blowing' has not been reported, to my knowledge. Shanon makes it clear that when faced with a personal crisis under the intoxication one must soldier on, dealing with fear and related negative emotions in as grounded and unperturbed manner as possible. Still, crises occur: `Quite commonly,' he states matter-of-factly, `people feel that they are about to die' (p. 57). Elsewhere he notes that a mental breakdown is real possibility. Yet not in Antipodes or anything else I have read to do with Ayahuasca experiences is such a breakdown recorded. Is it bad-trip free?

Along these same lines, my all-too-human binary thinking gets skewed in Shanon's brief discussion of the ontological status of good and evil. On the same page he reports that `Ayahuasca leads people to the conclusion that the world contains both good and evil, that the two are intertwined, and that the ultimate reality is beyond good and evil', but that, `Finally, there are visions in which one feels one is encountering the Supreme Good' (p. 174). I realize I'm probably not getting the mystical paradox here, but elsewhere it's said that Ayahuasca has a cosmic sense of humor (not always benign), that it lies or hides as much as it reveals. Is the Supreme Light without shadow, or what?

I wonder also about the dark side of the initiatory process, especially shamanic initiation. In the pattern of the ritual death-rebirth cycle, there must be a dark night of the soul before the dawn of revelation. Shamanic lore especially emphasizes the almost universal experience of death and dismemberment(5) - apparently the death of the everyday self - before the shaman returns, being one with death yet remaining alive. Shanon modestly and perhaps wisely downplays the significance, but he acted as shamanic healer and guide for others and was accepted at least among one ayahuasquero guild. The fact of this exceptional book's existence is enough to convince me of Shanon's shamanic metamorphosis. No ordinary insight could have carried it through to the end. What I want to know is what sort of ritual or visionary death did our author have to endure? Or did he achieve his dawn without a dusk? Admittedly, he states such an autobiographical confessional was not his purpose here and may have to await a future literary venture.

And one wonders about the whole question of the existence or creation of orderly categories from the data resulting from his phenomenological and statistical analysis. What sort of lists, tables, categories, and structures are being brought forth here, and why? On the one hand he notes commonalities in his visions and those of many others as well as intriguing parallel reactions to these visions, especially amongst the Ayahuasca cognoscenti. As noted, it was in fact these inexplicable similarities that set him on his quest in the first place, professionally speaking at least. Does he then think his structural analyses is revealing the universal latticework of creation, or at least of the Ayahuasca experience? Or is he himself creating such a latticework to place over the chaos of creation? Neither, it seems, or both. Shanon is well aware of the ambiguities of his project and how boundaries in the realms of visionary experience seem to shift or even, with a wink and smile, disappear altogether. In a universe in which the only constant is creative dynamism itself, it is impossible to distinguish between that which one discovers and that which one projects. He states that `there is no clear-cut differentiation between interpretation and creation. ... In essence, all is interpretive, all is creative' (p. 351). If it is so that all phenomena are simultaneously the product of interpretation and creation then - aside from the author's need, personal or professional, `to establish order in them' (p. 48) - it feels like such cartographic detail is mapped onto shifting tides that will change with the phases of the moon.

This is a slippery metaphysics with which we are left. Shanon lays his detailed phenomenological analysis upon the creative essence with some ambiguity, it seems to me, like placing the picnic blanket on the lake. If our acts participate in the unfolding of reality then categories, maps, structures, laws of science, and what have you achieve their substance over millennia of cultural or even transcultural `use', which results in the reality of habitual consensus. They are as real as anything else that seems to just be there, in one place, here and now. Does this leave his categories and structures and patterns with a ground on which to stand? Probably - at least temporarily. In fact, his studies prove beyond much question that certain visionary and experiential patterns reoccur across cultures and in times far apart.

Several times Shanon asserts that his purpose is not to explore ontological questions, but he takes enough steps in that direction that the reader understands that when Shanon finally states that `the view put forth here is that the Ayahuasca experience is one of generation and creation' (p. 383), he is tantalizingly close to claiming this for our usual experience too.

He even briefly discusses the source of these patterns of creation, which brings me to my last perplexity, the uncertainty over the terms `creativity' and `imagination'. Early on, Shanon assures us that `Ayahuasca visions [exhibit] a beauty that is beyond imagination' (p. 17)', referring to our usual notion of the imagination as a post-language faculty activated by the self from other images already stored in memory. In speculating on the source of such beauty, he denies that such creative imagining comes either from a `world of forms', already `out there' in their own ultimate reality or from psychology, that is, the unconscious `in here'. So, in his interpretation, neither Platonic ideas nor Jungian archetypes will do.

To account for the reality of Ayahuasca experiences (and by implication, all experience), he posits a creational reality in which our own creativity participates but which ultimately exceeds our personhood or existence. So, `the notions of "human creativity" or "power of imagination" turn out to be much more fantastic then they are usually thought to be" (p. 396). Yes, indeed, but the originality of this position is where perplexity arises. In the first place, isn't this the core of the Romantics' apotheosis of the transpersonal imagination? Creativity as the core can also be found in some form in both Bergson and Whitehead.

In the second place, I think Shanon is too dismissive of Jung's concept of the collective unconscious by reducing it to residing `in here', but this may be mistaken assumption based on Jung's misuse of Freud's original term, the unconscious. In his later years, Jung wrote a good deal about the *objective psyche*, meaning that the collective or transpersonal unconscious is the very world with which we engage and which is our source. Shanon refers approvingly several times to the somewhat similar notion of the *anima mundi* (`world-soul') as source of the real, both subjective and objective. Then again, as a result of his experiences of communion he would likely disagree that the world or world-soul should be understood as `unconscious' (even if Jung meant `unconscious from the perspective of our self-contained conscious').

The Jung-inspired archetypal psychologist James Hillman (1975) brings us to the point where Jung meets Shanon when he proclaims that every perception, cognition, or memory is fantasy-laden and not possible without such imaginative elaboration. Fantasies, in this sense, are not individual: `The revelation of fantasies exposes the divine, which implies that our fantasies are alien because they are not ours' (p. 184). This may add some flesh to the ontological skeletal frame of Shanon's `generation and creation' pantheism, though he adds the last note that in the `dance' of creator and created it is impossible to tell who is leading.

Allow me to reemphasize that my above `perplexities' are not in the way of criticism. These are questions I would love to sit and discuss with the author; no doubt the inadequacy of my understanding would soon be made plain. I should even apologize for critiquing the few hints of ultimate matters which he deigned to mention, for he himself admits they have not yet been fully thought through. However, feeling perplexed by Shanon's extraordinary encounters and the great work of his phenomenological analysis, I couldn't help but wonder, `What does it all mean?' Perhaps in his next book Shanon will explore an answer to that question.

PERSONAL REACTION
After reading Antipodes with great pleasure and new discovery each time over several careful readings, I retain two reactions that are probably mine alone. One is that I am now sure I will never seek an opportunity to drink the brew of the `vine of the dead'. Put simply, I doubt that I have the strength of character it took for Shanon to advance from audience member to conductor of the orchestra. In part, my reticence arises from my tendency to wander off and become thoroughly lost in the aforementioned psychedelic era, sidetrack to sidetracks. It is my understanding - faith, if you will - that cognition, rationality, and analysis are themselves particular cultural fantasies. When one give intuition primacy, one tends to wander as way leads on to way. Shanon could absorb his incredible experiences and then later at his desk, `establish order in them'. In fact, to the extent that it is possible, he has done just that. However, I fear I would become an Ayahuasca drifter, lost in other realities, but with no wish to return and nothing in order at all.

The second reaction was not one I had expected. *The Antipodes of the Mind* gave me, first dimly then with increasing illumination, *hope*, suffusing me generously with that unfamiliar but uplifting emotion. By reminding me, `There is more here than meets the eye and you know it!', a flood channel of forgotten memories opened and I was able to recall the moments I had found myself elsewhen or elsewhere (and not always as the result of substance ingestion). In the need to `get real' as I grew older, I had simply suppressed such experiences of wonder and awe because they were not `useful'. I had pushed aside visions or encounters that threw into doubt the solid finality of day-to-day reality so I could join the grim march through the lifespan toward dusty death. I'm no fatalist, but I felt as though this book fell into my hands at just the right time. It is not just poetic license but a fact of consciousness-limited awareness that we walk about in worlds unrealized. So I wish to end this book review with appreciation rather than criticism: Thanks, Benny. You've done wonders. Hallelujah to you and your important book.

NOTES
1. There is no singular form of `antipodes'. From my 1938 Funk 'n Wagnalls *New Standard Dictionary*: `antipodes, n. sing. & pl. 1. A place or region on the opposite side of the earth; also, any two places or regions so opposed; as, australia is the antipodes (or at the antipodes) of England. 2. Those who live on the diametrically opposite sides of the earth; as, our antipodes sleep while we wake; the two nations are antipodes.'

2. The only comparable work I know of may be John Horgan's (2003) recent study. Former senior writer at *Scientific American* and noted science writer, Horgan takes a similarly skeptical show-me approach, even to his own ayahuasca experience. In Horgan's Amazon.com review, he puts *Antipodes* on a par with classics on the further reaches of conscious experience by such as William James and Aldous Huxley. He errs, however, when he states that, after his journeys, Shanon remained an atheist, except in the most narrow definition of the term.

3. Shanon downplays the extreme digestive tract disturbances that have been widely reported, occasionally resulting in projectile vomiting. With experience, Shanon found he could avoid bringing forth such unpleasantness by bringing forth spontaneous song instead!

4. Benny cogently argues that such visions are more `other realities' than fictional hallucinations (also see Shanon, 2003).

5. `The shaman learns to know death in the course of his initiation, when he goes for the first time into the underworld and is tortured by spirits and demons,' declares Mircea Eliade (1990, undated entry 1952). Such universality (all universality for that matter!) remains highly controversial in academic circles.

6. It would be most intriguing for Shanon write a phenomenological cartography after experimentation on LSD trips. Knowing the differences and similarities would tell us much about the status of visions. Do they arise from specific drug, personal idiosyncrasy, or have they a transpersonal status?

Editorial Review:

This is a pioneering cognitive psychological study of Ayahuasca, a plant-based Amazonian psychotropic brew. Benny Shanon presents a comprehensive charting of the various facets of the special state of mind induced by Ayahuasca, and analyzes them from a cognitive psychological perspective. He also presents some philosophical reflections. Empirically, the research presented in this book is based on the systematic recording of the author's extensive experiences with the brew and on the interviewing of a large number of informants: indigenous people, shamans, members of different religious sects using Ayahuasca, and travellers. In addition to its being the most thorough study of the Ayahuasca experience to date, the book lays the theoretical foundations for the psychological study of non-ordinary states of consciousness in general.