Trauma and Recovery is a well written book surveying the recent history
of psychological trauma over the past century beginning with hysteria,
shell shock or combat neurosis and ending with sexual and domestic
violence.
A short but interesting history of the phenomena of hysteria, along
with facts concerning its leading figures, Janet, Charcot and Freud
is given. The author writes that Freud glimpsed the truth of sexual
trauma but recoiled from it in horror and it was not until the women's
movements in the 1970s that the real extent of the sexual victimization
of women and children was realized.
The author mentions that the first
in-depth attempt to study and treat shell shocked combat veterans
was begun after World War I. Emotional flooding techniques were used
to alleviate symptoms and return the soldier to combat. The author
has a strong feminist agenda as she makes an obvious effort to tie
in the three forms of trauma to political movements.
Dr. Herman (a Professor of Psychiatry at Harvard) describes some of
the effects trauma has on its victims including hyperarousal, feeling
that one has been intruded upon, surrender or constriction and the
feeling of disconnection. The psychological symptoms of being held
a captive for both a short term and long term are examined. The effects
of child sexual abuse are then examined. The author claims that childhood
abuse is one of the principle reasons why adults seek psychiatric
help for a bewildering array of nervous and depressive symptoms. And
so ends part one of Trauma and Recovery which I thought was interesting
and well presented.
The second half of the book is about recovery from traumas. Dr. Herman
discusses the development of healing relationships with therapists
and support groups. She reasons that since the effect of the trauma
is to disempower and disconnect the victims from others, recovery
from the effects of the trauma means that the victim becomes empowered
and able to form new attachments. In order to recover, the victim
must feel safe, writes the author. In the safe environment of psychotherapy,
the dissociated trauma enters into consciousness and the victim with
support becomes less isolated and becomes able to form more social
connections.
Some patients might feel that re-living the trauma in therapy will
solve their problems but the author feels that the therapist should
be cautious and not be like the perpetrator and inflict pain on the
survivor. The author feels that current cathartic treatments, which
have become popular, are simply just a quest for a quick magical cure.
She says that exploring repressed memories in depth sometimes causes
more symptoms to erupt. The watchword here is safety, but after having
emphasized that point, the author concedes that nonetheless the trauma
itself must be examined and integrated into the victim's life. In
therapy the victim tells the story of the trauma, but the emphasis
of Dr. Herman seems to be on caution and security, since she believes
that approaching the trauma too quickly leads to a damaging and fruitless
re-living. However, she acknowledges that showing the feelings which
accompanied the trauma is important.
In a chapter on Reconnection, the author emphasizes the importance
of self-integration. The author writes not about re-living the trauma
but rather about how important it is for the victim to reconnect to
the outside world and develop new relationships. The trauma, she believes, has made
the victim too self-centered and has interfered with her capacity
to relate to others so relating to others and connecting to the outside
world shows that recovery has taken place.
Unfortunately, the author
believes that this restored behavior points to the beginning of resolution
of the trauma. However, to me, it seems probable that the new behavior
may be merely a strengthening of the victim's defenses based on insight.
Dr. Herman concludes
Trauma and Recovery by writing that when the victim gets to the point
where she sees her own troubles as a "drop of rain in the sea'' then
she can rest from her work and the victim's recovery has been accomplished.
Are not defenses, and especially denial, wonderfully curative?
The only thing Trauma and Recovery has going for it are the excellent
descriptions and case studies of the psychological consequences of
trauma.
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