The Body Remembers Volume 2: Revolutionizing Trauma Treatment
". . . might be the most informative, useful book on trauma treatment . . ."
The Body Remembers Volume 2: Revolutionizing Trauma Treatment might be the most informative, useful book on trauma treatment for psychotherapists.
Babette Rothschild, well known for her writing and training for psychotherapists on trauma treatment, has produced another exemplary work.
What’s most notable is the common-sense approach she applies to trauma treatment. Her first topic in the book is evidence-based treatment and how a narrow view is more harmful than helpful for patients. Her humble approach, which comes as much from failure as success in working with traumatized individuals, beseeches therapists to employ individualized trauma therapies that empower clients to make important decisions about their care. She also expresses two important therapy goals: for the psychotherapist to make themselves obsolete and to help improve the client’s quality of life.
Improving quality of life before working to resolve memories is a major theme in this book. Rothschild spends a great deal of time talking about the ways in which therapists must consider patient safety first and work toward stabilization.
It is completely appropriate, in her view, not ever to work on memory reconciliation, but instead to address the issues that are facing the individual in the present. Regular decompensation, dissociation, anxiety or panic attacks, flashbacks, confusion, and shame are debilitating and should be avoided.
Certainly, some level of decompensation is to be expected when addressing past trauma, but the therapist must be careful not only not to re-traumatize the individual, but also to do whatever is possible to help that person be able to function in their day-to-day life. The “talking cure” popularized by Freud is not always the best for those who are working on trauma. Special attention needs to be paid to client safety when addressing trauma.
One way in which to improve client stabilization, according to Rothschild, is to work on the individual’s perceptions of control. Developing post-traumatic stress disorder is about losing control. Creating a contract with the client, at the beginning of the therapeutic relationship and revising over time, as often as each session, can help the client to feel more in control of their treatment and their life. “What can I help you with?” is an important question to ask and continue to ask over time.
As part of the client-controlled focus of treatment, Rothschild also emphasizes resources. It is often the case that traumatized individuals do not recognize all the resources available to them, the genuine support they have now or have had in the past. Underscoring and using these resources improves treatment outcomes.
Many individuals come to trauma therapy with the expectation that they need to divulge all of their deepest secrets in the first session. This can be wildly destabilizing and not the best use of therapeutic time and resources.
Instead, Rothschild suggests helping the client to see that the most immediate stresses in their lives are those that need to be addressed first. The past is the most stable aspect of our lives. What has happened has happened and is over. Those things that stress us in the present may trigger old feelings, but they also need to be looked at and dealt with immediately so that work on older issues can commence, if the patient desires.
The goals that Rothschild sets out for therapists helping clients with trauma are clear: 1) improve quality of life; 2) help the individual manage symptoms; 3) show the individual that the trauma is over; 4) and foremost to stabilize the individual so that more harm is not done. This is not a quick process, but it worthwhile for both therapist and client.
One of the most controversial parts of the book will be Rothschild’s discussion of providing symptom relief vs. reconciling memories. She emphasizes strongly that the client makes the choice about whether or not to work on past memories and that the choice to let the past remain the past is entirely valid. This is an empowering and important perspective that therapists working with trauma survivors should consider.
If there is a limitation to this book, it is that the section on how to understand nervous system response and help individuals stabilize themselves is complicated and not easily applied.
Rothschild does an outstanding job of suggesting ways in which therapists can offer multiple tools and types of therapy to clients, teaches how to use nervous system stabilization techniques to calm clients, and reminds therapists that traditional forms of history taking are valuable. Finally, she prompts therapists that if they are not the right match for a potential client, refer them to a colleague. It is a kindness to both therapist and client.
Individuals who are not therapists but want to know more about trauma treatment—clergy, university professors, even employers—will benefit from reading this book. It is a compassionate look at quality trauma treatment and will help non-professionals understand the difficulties of treating trauma survivors.
Any therapist, whether new or experienced in practice, should read The Body Remembers Volume 2: Revolutionizing Trauma Treatment by Babette Rothschild. It very easily could become the most dog-eared book on your bookshelf.