I once travelled from New York to Buffalo for a skiing holiday in Canada on the slow-moving Amtrak train system, safe and reliable, but rather stodgy, like hominy grits. Reading this book, appropriately written by an Associate Professor at the State University of New York at Buffalo, reminded me of that journey. The information therein is sound, there are no major fallacies, the content is comprehensive but there is little to excite the mind or the imagination. The author has trawled the pain literature in the New World well but controversies that have arisen elsewhere are unreported such as the thorny debate about the status of somatoform disorders. ^{Reference Sharpe and Mayou1} In this regard there is not one reference from the British Journal of Psychiatry although at the last count there were 1593 papers mentioning pain in this publication from which to choose.

The stuff of the psychiatrist in this book is devoted to evaluation of the patient in pain, psychiatric diagnosis and psychotherapeutic procedures. This is sensible and non-controversial. The majority of the chapters are concerned with non-psychiatric matters including the pharmacological, anaesthetic and neurological strategies that are employed in the treatment of painful conditions. The author should have followed Virgil, who wrote ‘Experto credite’ (credit one who has proved). Practitioners in techniques such as transcutaneous electrical nerve stimulation, sympathetic nerve blocks and the treatment of neuropathic pain should have been employed, among others, in writing about these subjects; the author is unaccomplished in these strategies.

Nevertheless, there is some value in this book for the UK psychiatrist working in the foothills of pain, who is likely to be inexperienced. There are very few psychiatrists working with people with painful conditions in Britain – only four are members of the umbrella organisation that is responsible for support and education, the International Association for the Study of Pain. This book provides a basic introduction but there are better ones that explain the practicalities in a more cogent and entertaining fashion.