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“Dissociation is not just a thing; it is THE thing!” If this was the only message that a reader of Elizabeth Howell’s most recent book, Trauma and Dissociation-Informed Psychotherapy, was able to internalize, that would, indeed be a lot. However, the book is so rich and multi-faceted in its approach to working with trauma, that it is likely the reader will learn much more. It is a book that a clinician will want to read and “consult” many times, as I do, whether teaching or supervising students, or in my own work with patients. Each reading further provides a deeper appreciation of Howell’s cutting-edge perspective on the Relational Psychoanalytic approach to working with traumatized states and the omnipresence of dissociation.
The subtitle, “Relational Healing and the Therapeutic Connection,” reflects Dr. Howell’s view that, since relational/developmental trauma occurs within an interpersonal context, the relationship between the therapist and patient becomes the essential variable in the facilitating of healing.
She discusses the development of the psychological self, especially using Attachment Theory to elaborate on this healing process and how trauma and dissociation impact development. While not critical or disparaging of other approaches to trauma work, she makes a very coherent case that incorporating a psychoanalytic approach, particularly the
relational one, adds a dimension not explicitly present in the wide array of other traumatological approaches.
Dr. Howell argues that the therapist must use the therapeutic dyad, focusing on the “transference-countertransference matrix” as the microcosm within which the traumatic states must be reexperienced and reflected upon. This elaboration of the patient’s internalized world then allows their healing process to go beyond what is gained from the traumatological emphasis on catharsis and memory recovery.
Dr. Howell is likely no stranger to the clinician familiar with the Relational literature. She has pr