Of making many books there is no end: the development of the developmental literature

“Of making many books there is no end; and much study is a weariness of the flesh” said The Preacher, some time in the 3rd Century B.C. [Ecclesiastes xii,12] – a complaint that has been re-echoed time and time again over the years. By 1918, Lytton Strachey confessed that “The history of the Victorian Age will never be written; we know too much about it,” so all that a conscientious historian can do is to “row out over that great ocean of material, and lower down into it, here and there, a little bucket, which will bring up to the light of day some characteristic specimen from those far depths, to be examined with a careful curiosity.” (Strachey, 1918)

I have recently had the opportunity to lower a bucket into the depths of the child psychology literature, having been asked to review the seventh edition of the Handbook of Child Psychology and Developmental Science (Lerner, 2015) for Reference Reviews (Guha, 2016a) and, more or less simultaneously, asked to review the sixth edition of Rutter’s Child and Adolescent Psychiatry (Thapar et al., 2015) for The Journal of Mental Health (Guha, 2016b).

My professional life seems to have been intertwined with that of the Handbook of Child Psychology in its various incarnations [The latest version calls itself the “seventh edition” but, by my count it is the ninth, there having been two earlier versions before the present publisher acquired it.] One of the side-effects of growing old is that of suddenly noticing that acquaintances from your youthful days are growing old as well, though still somehow remaining recognizable. That scrawny ginger-bearded lad whose sole ambition in life was to become a New Orleans style jazz clarinettist is now a bald clean-shaven emeritus professor of social administration at a university which did not even exist when we were students. That impossibly beautiful slender blonde is now a doting grandmother [with, I am sorry to say, no other topic of conversation]. Some of us, alas, have died off along the way, but the one characteristic that most of the survivors share is that they are very much stouter than they used to be. One or two of us have managed to avoid this: I still have my last pair of school trousers, and they still fit me, but, in general, you can’t get as many of us into a Mini or a telephone box as you could half-a-century ago. The same, very noticeably, goes for books. A few that I had thought were destined to become classics have deceased, a few have not kept themselves up-to-date for some years and are looking distinctly doddery, but the survivors have noticeably made up for any loss of youthful vigour by a growth in girth, and a growth at least in gravitas if not actually in wisdom. What used to be a couple of slender volumes lurking unobtrusively in a corner of the reference library now sprawls solemnly over half a shelf.

The first two editions of the Handbook of Child Psychology, edited by Carl Murchison were originally published by Clark University Press. The first edition, published in 1931, was in one compact volume of about 700 pages. This had a genuinely international range of contributors, including, most notably Piaget, Anna Freud, Margaret Mead and Kurt Lewin. The first Wiley edition, edited by Leonard Carmichael, came out in 1946 with a slight change of title to the Manual of Child Psychology [I am not entirely clear as to the difference between a manual and a handbook. Is a manual is intended to be a bit more hands-on?] Carmichael followed Murchison’s structure quite closely, but expanded the work to just over 1000 pages, and, most notably, dropped many of the non-American authors in favour of more experimentally-orientated Americans.

I first came across what was by then oddly entitled Carmichael’s Manual of Child Psychology edited by Paul Mussen in 1971 when I became social sciences site librarian of N.E. London Polytechnic. It was, by now, in two volumes, and was regarded as a core reference text not just by psychologists but by a range of other social science students as well. It was joined on my shelves in 1976 by the first edition of Child Psychiatry, edited by Michael Rutter & Lionel Hersov (1976). When I moved to become librarian of the Institute of Psychiatry in 1981 both were still in use: dishing out the reference copy of “Rutter’n’ersov” was a regular part of the day’s work. Both books were soon updated, the two volumes of the Manual of Child Psychology being replaced by a four-volume edition, still edited by Mussen but reverting to the original title, while Rutter’n’ersov expanded more modestly within the confines of a single volume.

The years have rolled by. I have retired and am no longer responsible for the day-to-day task of dishing out books to child psychologists and psychiatrists, but here are new editions of both books for my successors to offer to them, both subtly altered in title. The Handbook has added “and Developmental Science” to the original. So much more is known now about the developmental processes that humans go through that it is impossible to discuss child psychology without taking on the processes of biological and ecological change. The use of the word “processes” in the sub-titles of three of these four massive volumes indicates that the old static view of the psychology of the child has disappeared.

Child Psychiatry has similarly undergone a subtle change. “And Adolescent” has, very sensibly, been added and the “Modern Approaches” have dropped off. I don’t know whether this means that we have got beyond the “modern” era. I have not actually noticed a post-modernist guide to child psychiatry but I would not be surprised to find one lurking somewhere in the plethora of developmental literature.

Size

The most noticeable aspect of both these new editions is their size. The four individual volumes of the Handbook each weigh more than five pounds on my kitchen scales. Murchison’s first edition weighed not much over two pounds in its entirety: a nearly 10-fold increase. Has our knowledge of child psychology really increased 10-fold over the years? The new edition of Rutter is still in one volume, but what a volume. The first edition was a comfortable handful, a bit over three pounds in weight, just over nine inches high, with 960 pages of well spaced-out, wide-margined text. This new edition needs both hands, stands eleven-and-a-half inches high and is over twice the weight in spite of using thinner paper, with well over a thousand pages of text set out in two densely-packed columns. New-born babies survive weighing less than this. The first edition had two editors and 41 contributors. This one required an editorial team of six and had 125 contributors.

The majority of the contributors to Rutter’s first edition worked in the Bethlem & Maudsley Hospitals or the attached Institute of Psychiatry: there were only three Americans in the batch. The new edition has a genuinely international roster of authors, though still including one survivor of the 1976 crew besides the indefatigable Michael Rutter: Bill Yule wrote on “Behavioural Approaches” and on “Reading Difficulties” in the first edition, and was still helping out with “Post-Traumatic Stress Disorder” in 2015.

The first, 1931 edition of the Handbook was similarly one compact volume of about 700 pages, with a genuinely international range of contributors from a range of countries, including an anthropologist with a strong interest in child development in non-Western societies, and a distinguished psychoanalyst whose views differed widely from those of some of the other authors. The new edition has an editor-in-chief, five volume editors and approximately 150 contributors, virtually all of them American academics, [mostly at this stage, I would say, “reputable” rather than “distinguished” but perhaps I am being unfair] with only a scattering of authors from other countries, all of them with a very westernised slant. Even the chapter in volume four on “Children in Diverse Social Contexts” is concerned entirely with different social contexts within the United States.

Readability

There is a clear difference between the first editions of both of these books and the new editions, in that the first editions are readable as books, and the current editions are not.

By readable as books I mean that you can comfortably hold them in your hand, and that it is possible to start reading at page 1 with a reasonable chance of getting to the end. Being a fairly rapid reader I can get through either of them in half a day. I did, in fact, do so recently, spending a couple of very pleasant afternoons in the British library reading both books all through, at the end of which I felt that I had reasonably covered all that was known about child psychology in the 1930s, and all that was known about child psychiatry in the 1970s. I find it hard to believe that many people will read through the whole of the new edition of Rutter, and I am quite sure that no-one, not even its own editor, will ever read the whole of the Handbook. These have both become books for dipping into, not for reading.

This growth in size has coincided with what has been suggested to be a decrease in attention span. The Handbook itself, having grown 10-fold over the years, mentions that children are possibly becoming more likely to dip rather than to read (Calvert, 2015).

Complexity

Along with increased size has come increased complexity. “Mussen’s Carmichael” as the handbook was sometimes known in the days of my youth, was used as a standard reference text by undergraduate sociologists, anthropologists, trainee teachers, social work students, health visitors, district nurses, etc. It is hard to imagine anyone without a substantial grounding in modern psychology being able to make effective use of this new edition. On the other hand, of course, when Murchison first started this book off the study of child psychology was a relatively new field. There really was not much else in print. Nowadays there are thousands of books on child development, including the inevitable literary detritus of “very short introductions” (Goswami, 2014) and “for dummies” (Smith & Elliott, 2011), etc. [May I say, in passing, how much I hate that “for dummies” series title, especially when used for books about psychology or mental health?]. The major textbooks however, are not designed to be readable.

Time

Even at this size, these books are constrained by the limitations of the publishing format. Most professional information no longer comes in bound volumes however. It seems very unlikely that future editions of these books will appear in a printed form. Online services give the writer virtually unrestricted scope for expansion, opening up a “land of unlimited possibilities” (Schmidt & Wykes, 2012). It is noticeable that when this journal produced special issues on e-health – 21[4] 2012 and on self-help – 20[6] 2011, all of the writers welcomed this scope for expansion. No-one mentioned information overload or took on the second half of the Preacher’s message – “much study is a weariness of the flesh.”

Prolixity is also apparent in other information sources, such as medical records. In 1910, a patient’s medical record for a broken leg was one page. Even by 1925 a similar record consisted of eight written pages plus two forms and a graph (Howell, 1995), and that was at a time when everything had to be handwritten or manually typed. Now that records can be entered directly to a computer there is no real limit to their length, but there is an ever-increasing limit to the time the clinician can devote to reading them. The growth in size of information sources has coincided with a world-wide financial crisis. Austerity, and the resulting “inevitable pursuit of efficiency” (Patel, 2013) means that professionals of all kinds have less time to spend absorbing relevant information. Teachers, just for example, need to know about childhood mental health, but, even “when offered an excellent textbook, school staff are unlikely to have the time. Destructive pressure from OFSTED and the unwise emphasis on academia take up all of their time and energy” (Kane, 2014).

Given the possibility of an almost infinite expansion in the literature coupled with a decrease in professional reading time, there is a serious risk that professionals will restrict their reading to material which they agree with and know to be relevant. Forty years ago the Institute of Psychiatry library used to put each day’s printed journals out onto a table. Many academics made a daily point of coming up and scanning through them – one would see, for example, Hans Eysenck, the head of the psychology department, on one side of the table, and Bernard Donovan, professor of neuroendocrinology, on the other. Both of them would browse at least the contents pages of every single journal. Eysenck might pay slightly more attention to the Journal of Personality and Donovan slightly more to Psycho-Neuro-Endocrinology but both would be broadly aware of everything being published. No-one could possibly find the time to scan the titles of all the papers published each day now. Academics have to be selective, and will naturally be tempted to select what they know they will agree with.

The increased complexity of the literature has increased the distinction between the information available to professionals and the information given to service users. A reasonably well educated concerned parent could be expected to have got hold of and made sense of the first edition of the Handbook of Child Psychology but cannot be expected to get easy access to, or to make effective use of, the current edition. Milton & Mullan (2014) found that though the “quality of diagnostic information given to service users has increased over the past decade,” there is still “a gap in the system of communication between clinicians and service users” in spite of clear evidence that “the use of plain English… increases the implementation of clinical guidelines for psychological treatment.” “Guidance has been widely disseminated, however uptake has been slow” (Ince et al., 2015). More and more concerned clinicians are “exploring the needs of diverse consumers experiencing mental illness, and their families, through family psychoeducation” (Coker et al., 2016), i.e. giving them access to comprehensible information.

Conclusions

“All readers of this journal can surely agree… that community knowledge and understanding of mental health problems is not as good as it should be” (Mond, 2014), and surely most of us would agree that there is far more professional information available than any professional can assimilate, whatever form it comes in – “being technologically literate and being information literate are two different things” (Lipczynska, 2014). There is a need for:

• textbooks and other information sources that give mental health practitioners a broad overview of their subject;

• textbooks and other information sources that give people in professions tangential to mental health [ranging from schoolteachers to the police] brief up-to-date overviews of the subject;

• books and other information sources that carers and service users can be recommended to read. All professionals need to acquire “the art of guiding readers” to self-help sources (Guha & Seale, 2015);

• If, as the president of the Royal Society claims “Science marches on via debate, not dogma” (Ramakrishnan, 2016) ways must be found to ensure that professionals read publications other than those that they agree with.