Review of "Hanging By A Twig: Understanding and Counseling Adults With Learning Disabilities and A.D.D.," by Carol Wren and Jay Einhorn

Reviewed by Delores S. Doherty, MD, FRCPC, St. John's Newfoundland, in the Journal of the Canadian Academy of Child and Adolescent Psychiatry, 2006, 15, 95-6

This book could not have come into my experience at a better time.  My patients are growing up, and lo and behold, they are still disabled!

Hanging by a Twig is the way one disabled adult described her life, i.e., just hanging on and always precariously.  Mary's story is told in chapter 2, intermingled with information on the historical context of our current understanding of learning disabilities, learning styles, cognitive and strengths and weaknesses.  Each chapter in this book is built around the story of an adult with specific learning issues.  Carol Wren moves us through the stated purpose of the chapter while Jay Einhorn gives us a psychotherapeutic commentary on the issues described.  Together they take us through development of self, coherence of self, adult skill set, self-esteem, addiction, and other co-morbidities, looking at the issue and its impact on the individual.

The pervasive nature of these impairments of cognition on the overall functioning of the individual becomes very evident as we read these real life stories.  In addition, the challenges for doing therapy with these people, who are intrinsically at heightened risk for personality distortions, jumps from the pages.  The authors make clear the need to help these adults understand their own strengths and limitations.  Then they are better able to make informed choices in regard to further education and career, to seek appropriate supports for themselves, and to begin to consider the impact their disabilities might make on personal relationships.

As a group involved with children and adolescents, I believe that we also have an obligation to attempt to help our adult colleagues understand that these individuals suffer.

This book is a resource that we can recommend with enthusiasm.  It is well written and provides clear descriptions of a number of possible scenarios as well as suggestions for management.  I will be encouraging those I know who counsel adults with residual developmental concerns to read and learn from Hanging by a Twig.  I have already recommended it to our local chapter of the Learning Disabilities Association.  It is an excellent resource and an enjoyable reading experience.  

(published by Norton and Co., New York, 2000)