What do combat veterans, prisoners of conscience, and survivors of child abuse all have in common? They all have an increased risk of developing post-traumatic stress disorder. Though the disorder is now widely recognized, patients and therapists dealing with PTSD have had to fight for its acknowledgement within the psychiatric and general community, and they have faced periodic erasure throughout the twentieth century.
In her groundbreaking and still-vital work, Trauma and Recovery: The Aftermath of Violence — From Domestic Abuse to Political Terror, Judith Herman not only traces the history of PTSD back to the so-called hysterics who put Freud on his path to psychoanalytic theory. She also inextricably links PTSD with the social and political, as well as the psychological and personal. This newest edition, published by Basic Books, contains all of the original text, including the 1997 afterword, plus a brand new 2015 epilogue written by the author. It is a must-read for activists, crisis counselors, and laypeople alike.
The book would be worth reading simply for its place in history, as it is the first text of its kind to tackle trauma so comprehensively. Although its periodic focus on dissociation may strike some readers as somewhat dated, it is impossible to deny its continuing relevance and applicability. This is no artifact.
Whether we’re addressing the issue of soldiers returning from conflicts in the Middle East or college students overcoming sexual assault on campus, the principles behind Trauma and Recovery continue to apply to contemporary society. Indeed, anyone who’s worked at a crisis center or hotline will immediately recognize the principles Herman describes in the text, including the stages of recovery, the necessary establishment of boundaries and need for empowerment, and the frequently circuitous nature of recovery.
As indicated by the title, the book consists of two fundamental halves. The first part details the traumatic disorders caused by war, captivity, sexual assault, domestic violence, and child abuse, while the second explores the necessary conditions and effective approaches for their treatment. Herman begins the book first by thanking the activists of the women’s movement, who have made the public discussion of “the common atrocities of sexual and domestic life” possible. As readers, we know immediately that Herman positions the personal within the political, and the first chapter, “A Forgotten History,” bears this out as she traces the study of psychological trauma from early psychologists treating hysteria to “shell-shocked” veterans of both world wars to survivors of domestic violence.
This study, she notes, has an unusual history: “one of episodic amnesia.” During these lapses in social awareness, we forget what we have learned about traumatic disorders, so that when interest resurges, it is with a sense of having to begin again completely.
But with this important text, Herman effectively prevents the next bout of such extensive erasure. She preserves the history of both therapists and patients dealing with trauma; she quotes extensively from relevant texts, including novels and poetry, as well as case histories and patients’ statements. You can learn a lot from this first chapter alone, which in its thirty pages gives a remarkable introduction to the issues and background.
Herman then delves into the various causes and manifestations of traumatic disorders and tracks the commonalities and differences among PTSD patients, which vary with the type and duration of the trauma. She consequently makes a case for the introduction of a new classification — complex or complicated post-traumatic stress disorder — to account for the difference of experience for those who have survived prolonged, repeated trauma, such as political prisoners or survivors of repeated child abuse.
In the book’s second half, Herman relays the necessary conditions for recovery, delineating that process into three distinct stages of psychotherapy: the establishment of safety, remembrance and mourning, and, finally, reconnection with ordinary life. In chapter seven, “A Healing Relationship,” she also explores the intricate requirements of a successful patient-therapist relationship, which depends heavily on the mutual imposition of appropriate boundaries. Perhaps most interestingly in this chapter, she delves into the potential risks of such a relationship for the therapist, including emotional imbalance, the temptation to feel like a “savior,” and potential ostracization by one’s professional peers.
The common theme in Herman’s discussion of recovery is a feeling of control for the patient. Trauma being a state of utter helplessness and disempowerment — often at the hands of someone we trust — makes this quality paramount to successful treatment. And although the traumatic event may not be left behind or forgotten, its successful integration into the patient’s ordinary life places it within her control. Essentially, she regains control over her own memories and experience. Of course, Herman notes, emotional life events do pose some risk to PTSD patients, but if properly warned, they can overcome them.
As a former rape crisis volunteer who has applied many of this book’s principles when interacting with survivors, I was glad for the opportunity to finally sit down and read it. I can say confidently that its status as a game-changing text is well founded and deserved. Not only is it incredibly accessible, but Trauma and Recovery simply remains relevant. Moreover, its connection between the political and the personal provides some significant food for thought about the way we treat oppressed and traumatized groups as a society. If there’s any core message to glean from the book, it is how damaging further disempowerment and silencing can be for survivors of trauma.
Consequently, this is not just a book for industry professionals or for people dealing with trauma. It is a book for any type of reader who wants to explore its ultimately political message: that we cannot push aside people simply because we don’t want to hear what they have to say about what happened to them.
Readers familiar with Trauma and Recovery may rightly wonder if this new edition is worth purchasing for its 2015 epilogue. An additional twenty-eight pages, the new text connects Herman’s theories to contemporary events such as the wars in Iraq and Afghanistan, the child abuse perpetrated by clergy in the Catholic Church, systemic racial oppression in the United States, and the current institutional lapses regarding sexual assault on many college campuses. Herman also provides updates about the inheritors of her work and in the final pages of the book calls herself a grandmother of current projects, allowing herself a moment to kvell.
Although this section is not necessary for a reader to grasp the core meaning of the book, the new material does add a feeling of continuity. If your own copy of Trauma and Recovery is a bit dog-eared or worn, the 2015 edition might very well be worth picking up. And if you’re new to the book and interested in the subject, I highly recommend it.
Trauma and Recovery: The Aftermath of Violence — From Domestic Abuse to Political Terror
Basic Books, July 2015
Paperback, 336 pages