When we think of PTSD, what all too often comes to mind is hyper-vigilance, flashbacks, nightmares, intense fear, and debilitation, even among therapists like myself. We often fail to recognize that strength and resilience, too, can start with trauma and adversity. The path toward resilience can be confusing, uncertain, and downright scary, but in Post-Traumatic Success, Fredrike Bannink diligently leads the way.
In this quest, Bannink has company. What Doesn’t Kill Us, by Stephen Joseph, and Posttraumatic Growth in Clinical Practice, by Lawrence Calhoun and Richard Tedeschi, both explore growth after trauma. Whereas Joseph, a professor in Nottingham, weaves narrative examples to illustrate the concepts that he backs with research, Calhoun and Tedeschi, both researchers, rely heavily on their large studies to draw out the core concepts of post-traumatic growth.
But here is where Bannink parts ways. While both Joseph and Calhoun and Tedeschi offer a comprehensive description and multiple examples of post-traumatic growth, Bannink dons her solution-focused hat. Bannink, who is also the author of 1001 Solution-Focused Questions, shows us that in asking the right questions, and looking for the right exceptions to the problem, we can facilitate this kind of resilience and growth.
Bannink draws a firm line between typical PTSD treatment approaches and what she calls post-traumatic success. Many of the psychologists and psychiatrists who work with PTSD are “pathologizers,” she writes, who subscribe to what she considers myths: that everyone who experiences trauma will have PTSD, that there are only negative effects from trauma, and that in order to be cured, PTSD survivors must have psychotherapy. It is here that she surprises us: “Most people who experience a traumatizing event will not develop post traumatic stress disorder,” Bannink writes.
She backs her claim with evidence, writing that dropout rates for PTSD patients are forty-seven to fifty percent, and that there is a decided “lack of consumer confidence.” The issue, as Bannink sees it, is that we are looking at the problem of trauma, and in doing so, we are not seeing the exceptions: the strengths, resilience, and growth hidden within it.
Having laid out information about positive psychology, solution-focused approaches, and post-traumatic success, Bannink describes just how growth works. First, she reminds us, we must create the environment for change, one that builds a “positive therapeutic alliance” and allows for all types of clients, has the therapist “lead from a step behind,” and uses acknowledgement and validation to build hope and optimism.
We as clinicians, as well as our clients, she writes, must shift our focus from what isn’t working to what is. Only then can we truly build on what progress we do make by using “solutions talk” and positive imagery, changing perspective, enhancing self-control, and upping our positivity ratio.
Along the way, Bannink offers numerous case studies, exercises, and stories — all helpfully boxed — to use as tools for each clinical concept she describes. Later, she describes “skeleton keys,” interventions that “can initiate change even when therapists do not know in detail what the problem is.”
After laying the groundwork, Bannink explains how follow-up sessions help create a so-called growth mindset. She encourages us to use consolidating questions, build a culture of feedback, and even become “supertherapists,” which, as she explains it, relies on two things: client feedback and the therapist’s own faith in their efficacy.
Toward the end, Bannink discusses children — she says that they, too, often recover from trauma — and then turns toward the social realm. Positive relationships, group therapy, and interactions in the workplace, she writes, help create the relationships that are the “primary protective factor against the development of PTSD.”
The last section of Bannink’s book is a veritable therapist gold mine. With over twenty frequently asked questions — including “What if my client cannot visualize?” and “What if my client says, ‘Tell me what to do, you are the expert’” — Bannink offers solutions for common challenges. She also offers appendices that include protocols for the first session, finding exceptions, and information on externalizing problems.
As a therapist and practitioner myself, I found Bannink’s book to be a must-read for any therapist — regardless of the population they treat. There is, too, a large and powerful message that Bannink presents: that trauma is everywhere, but so are the solutions.
Post-Traumatic Success: Positive Psychology & Solution Focused Strategies to Help Clients Survive & Thrive
W. W. Norton & Company, October 2014
Paperback, 416 pages