Customer Reviews

A clear development of new theory and practice for trauma - By: , 12 Mar 2001
The Body Remembers by Babette Rothschild

This book gives a fascinating account of some of the ways trauma work has evolvedin recent years. It is framed around a particular episode of traumatisation which is developedin parallel with the theoretical model. Various other case histories are cited which give a real "hands-on" feel to the writing. The physiology & theory sides are clearly developed with references to other people workingin the field - there is a strong influence of Dr. Peter Levine. Some of the physiology is not yet fully verified by research eg the apparent link between lack of cortisol production (one of the glucocorticoids producedin the adrenal glands) & post-traumatic stress disorder (PTSD). This line of research has huge possibilities. Rothschild states clearlyin the introduction to her book that the theory is speculative & that controversy abounds amongst researchersin the field. She realistically refers to her book as minimalist & short-winded & it is all the better for that. People's ego-attachments to their beliefsin theory, as I know so well for myself, can only hinder their capacity to really listen. Rothschild quotes neurologist Antonio Damasio on the subject of scientific theory .... "I am sceptical of science's presumption of objectivity & definitiveness. I have a difficult time seeing scientific results, especiallyin neurobiology, as anything but provisional approximations, to be enjoyed for a while & discarded as soon as better accounts become available".

Although the theory is speculative, the practice is thoroughly groundedin years of successful clinical experience. About half way through the book Rothschild really gets on a roll - this is when she introduces the practical aspects of her work - much is related to tracking signs or autonomic nervous system (ANS) arousal & ways of using this as an indicator of when to start slowing the process down & helping to resource the client. I have been having a long internal debate about to what extent this work is directive & analytical. As a client I have always felt at least a vague sense of discomfort whenin the hands of a therapist coming from a directive & analytical viewpoint, due to a sense of being subtly (or not so subtly) manipulated by the therapist to do whatever they think is necessary, rather than respect for my own process & inner wisdom. Working with trauma is not the same as normal process work however, as Rothschild makes abundantly clear. My sense of this type of work, having been on the receiving end of it, is more that it creates a necessarily extensive framework of safety within which healing can occur. It is a method of work where the therapist takes a lot of initiativein terms of establishing clear boundaries, slowing the process down or finding resource. The concepts of attunement, misattunement & reattunement (not Rothschild's), despite being horribly ponderous terms, do lead to a very useful understanding of the development of therapeutic trust & progress. Briefly the phenomenon described is the shifting from an empathic state of well-being (attunement) to a polarised stand-off or conflict (misattunement) which then gives the possibility for finding the healthin the situation which allows a greater level of empathy to develop (reattunement). This is seen as not only an inevitable but also a useful part of the healing process. In some ways similar to the way the immune system develops its strength as a result of comingin contact with say measles & then dealing with it (my analogy).

Babette Rothschild counsels against the use of therapeutic touch with the most vulnerable & de-stabilised of PTSD clients (classed as type II B -where "clients have suffered such massive and/or multiple trauma that they lack the resources & resilience necessary for any direct confrontation of traumatic memories to be constructive. A betrayal of trust appears to figurein the overall picture of these clients." Whether it is possible for body therapists to have a clearly enough developed sense of safety & boundaries to be able to work with people experiencing this type of distress is open to debate. The author points out that it certainly is something where extreme caution is essential because of the likelihood of transference issues where the client will start to see the therapist as the perpetrator of the trauma.

Rothschild investigates the phenomenon of different levels of trauma & PTSDin a number of ways - all of them useful & interestingly presented. Her explanation of the history of development of understanding of the phenomenon of shock & traumatisation is groundedin years of successful practice & teaching. She has enormous clarity & a transparent appreciation of the dynamics of trauma, which enable the reader to make a deep exploration of her workin a way which is readily understandable. There are two chapters on the ways of developing the somatic resources of the body - presented as simple exercises. This book breaks new groundin the understanding of trauma-related work, particularly with respect to the development of resourcein relation to what happened after the traumatic incident. Every therapist who reads this book is likely to find their work benefits from it & all other readers will some hitherto unknown solace from it.

Reviewed by Mij Ferrett RCST (Editor The Fulcrum)