Sport Psychiatry: Theory and Practice Edited By Daniel Begel & Robert W. Burton. London: W.W. Norton & Co., 2000. 276 pp. £28.00 (hb). ISBN 0-393-70295-2

The layout of this book follows predictable lines beginning with biopsychosocial factors in development, then passing to the psychobiology of athletic training. Much space is given to endorphins, which I always thought were hypothetical substances that gave you a ‘high’ after running a marathon, but which few people really believe existed. Race and gender issues are examined and the problems associated with being a ‘hero’.

Clinical issues are considered, mental illness, mood disorders, psychoses, anxiety, eating disorders, post-traumatic stress disorder and substance-related problems. Nothing remarkable.

Performance problems in ‘everyday athletic life’ are explored, including sudden performance failure and interpersonal problems. An account of youth in sports is highly relevant seeing the intensity with which youngsters are currently expected to practise and the level of performance expected from them. Substance misuse and performance-enhancing drugs rightly merit lengthy chapters. Therapeutic aspects include history-taking, seeing relatives and the family. Group and individual psychotherapy seem to be the main techniques used but there is also an account of psychotropic medication.

As a lifelong games player and exercise addict with withdrawal symptoms if it is raining too hard to get out at 6.30 am, I hoped to get both knowledge and insight from this book, a hope that was unfulfilled. Just so: as with the ‘psychiatry’ of any specialised area (cardiac, gastrointestinal, respiratory etc.) what one ends up with is a focused take on a defined area. Rather pedestrian really.

This is not to say that the two editors, who contribute something over half of the material, have not worked hard to present what is known about sport psychology — a better term I think — but when it is all added up there is so little rigorously established knowledge. If a high-jumper presented to my clinic because he always flunked at six-feet, I would send him to an experienced coach rather than ask him to free associate about his erections.