Trauma and Recovery: A Book Review

One of the landmark texts in the field of trauma and psychotherapy– Judith Herman’s Trauma and Recovery, opened up the discourse after decades of silence.  The book documents the history of trauma throughout the field of psychology, and charts it along political and social dimensions in parallel.  The book is broken into two parts, with the first documenting said history and discussing what trauma is and how it unfolds and impacts the individual.  The second part focuses on the treatment of trauma dn the phases for treatment of trauma– that are still in use today in just about every model of trauma therapy.  

In Part One, Herman focuses on how trauma and the study of it had been silenced over the years, wherever it emerged.  Beginning with Get and his interest in the phenomenon of hysteria– Herman traces the development of the Seduction Hypothesis by Freud, and its eventual rejection by Freud and others in favor of repression and fantasy.  Sociopolitical factors pressured Freud to abandon his work on dissociation, and discredit the decades of work from Genet.  Genet and Freud had seen through their own research and clinical experience, that trauma lives in the body, and is expressed through psychological illnesses.  But, there was pushback against these ideals due to the suggestion of the rampant nature of child abuse, sexual abuse, and neglect.  

This interest in the effect of trauma would remerge after the wake of both world wars and the Vietnam conflict in the form of PTSD.  There was more and more shell shock and other similar traumatic conditions coming out of the battlefield that prompted research and advocacy for treatment on behalf of psychotherapists and mental health practitioners.  Though, the evidence was not taken outside of this research, or applied to non-combatants for some time.  And itw ould be decades efore outcries of women survivors of domestic abuse and sexual vilence to finally be heard for the similarites to post traumatic stress.  Again, sociopolitical factors would attempt to silence and push back against women and children’s experiences of trauma and violence– that is until the mounting evidence and research could no longer be denied.  Though, the silencing continues even to today, and has long -lasting effects upon those who have suffered at the hands of violent others or oppressive forces.  

The rest of Part One finishes by discussing the three main markers of trauma, and devising the basis for a model of understanding complex trauma.   Herman develops three categories of symptoms or clusters of symptoms, that are hyper-arousal, intrusive, and constriction.  All three of these clusters, when put together in the greater context of an individual’s experience, can help to shine light on a diagnosis of PTSD and thus guide treatment.  All three dimensions result in the life-changing negative impact on the individual’s life–and how the individual’s world can shrink and become hostile and terrifying.  If you would like to read more about these symptoms, please read the text, or check out another blog post I have on the subject.  

Part Two lays out the course for treatment and phases of trauma therapy that are still used today.  All models of current and present-day trauma therapy are either based on, or similar in structure to Herman’s original model.  This is due to the simplicity in the structure, and the robustness of the model.  Based on her experience, she divides treatment into three phases, with the first consisting of establishing safety and trust.  The second phase, is the processing of traumatic events and memories.  And the third and final phase, is the reintegration into life, and building a new future.   If you would like to read more in-depth on these models, please check out her work or other current models, which are similar.  Or check out another blog post on the specific stages of trauma therapy.  

I could go on about how incredible this book is, and how foundational of a text this is to the field of trauma and relational therapy.  If you are a therapist, and have not dived into this work, I highly recommend you put that to the top of your list.  If you are not a therapist, and just interested in learning more about trauma and its effects on the person– I also highly recommend it.  It is both an academic and accessible text for anyone of any profession.  It can be difficult to read at times, due to the extreme stories of pain that are contained within.  Nevertheless, it is a must-read for all therapists who wish to work with trauma.  Happy reading!