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“Trauma is memory without words” (p. 121)
This book is a compendium of information on the cognitive and emotional sequelae of complex trauma and includes a section on treatment for patients. It integrates research and theory from cognitive behavioral therapy, attachment research, neuropsychiatric studies, and some psychoanalytic theory. The authors define complex trauma as “result(ing) from being under totalitarian control for a long period of time” (p. 6). This includes interment in concentration camps, cult members, or being in an oppressive and controlling family.
Arnold and Fisch draw on an enormous amount of research to make their points. The book is divided into two sections: a detailed description of the experience of trauma on the developing individual from affective and cognitive perspectives, and a second section on treatment issues. In the first section, the authors walk us through the experiences of a typically (or perhaps ideally) developing child, and then contrast that with the development of a child who has been subjected to repeated life-threatening physical and psychic injuries. Not surprisingly, the child suffers on many levels, including the development of appropriate reality testing, the difficulty of affect regulation and ongoing deep mistrust of others. The authors remind us that in healthy development, the individual becomes more differentiated and integrated in thoughts, feelings, self states and relationships. In contrast, the sufferer of complex trauma is vulnerable to a developmental pattern of fusion and fragmentation. Fusion occurs with both the abuser and the traumatic experience itself, as it is experienced somatically. Because of the overwhelming nature of trauma, the experiences stay unmediated by self-reflection or symbolization. This point is returned to many times in the book, and yet it bears repeating: the survivor of complex trauma, by definition is profoundly challenged to put the experiences of that trauma into identifiable fe