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Book Review: Trauma & the Struggle to Open Up

Our relationships can be our greatest source of pain, and yet without relationships, we cannot heal from pain. For some people, the pain is too overwhelming and avoidance seems the only option. Others may try to be open about their experiences and find themselves feeling too exposed, too vulnerable, and worse off than before.

In either case, healing from trauma requires that we find and allow ourselves to experience a healing relationship.

In his new book, Trauma and the Struggle to Open Up: From Avoidance to Recovery and Growth, Robert T. Muller, who is also the author of Trauma and the Avoidant Client, takes us inside the therapeutic relationship to show just how to reestablish trust when it has been lost, offer hope where it has been extinct, and, in some cases, help the client ultimately find growth and healing in the aftermath of trauma.

In trauma, Muller tells us, an important trust has been broken. “There are interpersonal losses or violations. Often, there’s betrayal. And the effects are felt for years,” he writes.

How the therapist receives the client, and the relationship that transpires — often affecting both parties — lays the groundwork for how the client’s trauma is handled.

Ideally, a client can tell their story, reveal the forbidden details and feelings within, and allow others to share the burden and ease the distress. Yet when clients reveal too quickly, it can often make them feel worse.

Muller writes, “Opening up too quickly, before feeling ready, can lead to a sense of being exposed, humiliated, vulnerable.”

Reaching a place where clients can tell their painful stories with openness and honesty can take time, and what matters, Muller tells us, is the client’s state of mind about their relational world.

What makes the difference is how the client feels about the therapist and the therapeutic process. Muller cites work done by himself and the Trauma and Attachment Lab at York University, where they examined the effect of encouraging children to create a trauma narrative with the therapist.

“During the period of assessment and treatment,” Muller says, “these high-risk children showed reductions in post-traumatic symptoms, which remained low even after months of treatment.”

Trauma changes how we see the world, the way we relate to those around us, and the meaning we give to the events in our lives. The painful feelings often incite a process of re-evaluation, a sort of reckoning with the illusions we may have operated under in order to feel safe and secure and the biases we hold about the way life should work.

“And it’s in that confrontation where the potential for growth lies. A growthful telling is effortful — an attempt to make sense of the trauma and the way it connects to one’s overall life narrative,” writes Muller.

However, trauma can instead lead us to deceive ourselves, create alternative narratives about our lives, and the residue of our traumatic past often leaks out like change falling out of our pockets.

Muller writes, “We’re able to stay guarded only so much, and for so long. But equally important, we want to stay guarded only so long.”

Asking clients about their history of depending on others often reveals their process of handling vulnerability. Muller describes the experience of his client Nicholas, who been beaten by his father repeatedly as a child and, in relating one particularly egregious episode, could not remember whether it was he or his brother who had to stay home from school for a week due to the obvious red marks on his legs.

Allowing ourselves to be vulnerable, to be truly seen, and to bear our most painful experiences, is indispensable to human connection and the capacity to heal.

The therapist must hold the space for the client to open up, acknowledging that the process is essentially a stripping of the protective armor of avoidance, and importantly, that the armor serves a very important purpose and must not be removed too quickly. “When therapists come at the trauma, guns blazing, without fostering safety first, without forging containment in the therapeutic relationship, what we have is an enactment of the rescue fantasy,” writes Muller.

In trauma we should not be in a rush to reveal, mourn, forgive, heal, pass over, move on or repair. Repair should be a slow, diligent process that sees relational safety as the foreground of healing.

Drawing on relevant research and richly illustrated case studies, Muller’s book beautifully demonstrates that in trauma, the healing is in the relationship. Trauma is all around us and Trauma And The Struggle To Open Up should be read be essential reading for therapists of all disciplines.

Trauma and the Struggle To Open Up: From Avoidance to Recovery and Growth

W.W. Norton & Company, June 2018

Hardcover, 224 pages

Book Review: Trauma & the Struggle to Open Up

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Claire Nana

Claire Nana is a regular contributor and book reviewer for Psych Central.

APA Reference
Nana, C. (2018). Book Review: Trauma & the Struggle to Open Up. Psych Central. Retrieved on November 26, 2020, from
Scientifically Reviewed
Last updated: 17 Sep 2018
Last reviewed: By a member of our scientific advisory board on 17 Sep 2018
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