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Reading this book was a rather humbling experience in that I realized that there is so much more research on the impact of early life trauma than I knew, even though I was familiar with quite a number of seminal papers in the field. One of the remarkable aspects of the book is the range of research that it covers, from the epidemiology of childhood trauma and the history of professional attitudes to the problem, through diagnostic controversies, psychosocial issues, longitudinal studies on the immediate and long-term neurobiological, psychological and physical effects of early relational trauma, to the implications all these hold for clinical work with children and adults who have suffered early-life trauma. This huge body of research is discussed and summarized in three sections, each of which has short co-authored chapters, so that the expertise of key researchers and clinicians across the whole field of traumatology is represented. The editors of the book are three psychiatrists, Ruth Lanius and Claire Pain from Canada, and Eric Vermetten from the Netherlands, all neuroscience and trauma research specialists who also explore the implications of empirical research for clinical psychotherapy practice.
The focus of almost all these papers is on the hugely damaging impact that neglect or abuse by primary caregivers has on the psychological and emotional development of the human infant, creating life-long consequences in terms of brain development, attachment and affect dysregulation, altered stress responses and a range of psychological symptoms, from the flashbacks and hyper-arousal of PTSD to altered perception, epileptic-type phenomena and dissociative states of varying degrees of severity, including borderline personality and dissociative identity disorder. This evidence from neurobiology powerfully supports the argument that it is real-life experience rather than innate unconscious phantasy that determines most of the problems our patients bring to the consulting