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Understanding Trauma is a collection of high-quality chapters that apply analytic principles to the understanding of trauma, each written by an analyst or therapist from the Tavistock Clinic Adult Department's Unit for the Study of Trauma and its Aftermath. The authors' work with trauma ranges from individuals to community groups and covers the traumas of train crash, hotel fire, crushing by a soccer crowd, blinding and disablement from a burning car, sudden attack and beating by a violent patient, rape, sibling suicide, near-fatal medical error and random murder. Having collaborated to study trauma, the authors have developed a shared orientation, which gives the book a coherence that is lacking in many edited books. At the same time, each chapter stands alone, which means that many of them repeat basic concepts.
The book takes as its starting-point Freud's ideas on the stimulus barrier, mourning and melancholia, the compulsion to repeat and punishment from a sense of unconscious guilt. Also prominent is Freud's concept of binding of excitation, used in different ways at different places in the book. As part of her masterful review of classical theory at various stages of Freud's development, Garland introduces binding as a defensive process that is intensified by trauma. She holds that this leads both to fusion and to keeping open pockets of vulnerability. I thought that she might have linked this idea to the encapsulation of trauma that she later describes as a foreign body in the mind and the result of a failure of symbolic thinking. In a later chapter, David Bell invokes the concept of symbolisation as representation to link Freud's concept of binding anxiety with Klein's use of binding as a process of managing anxieties of annihilation and fragmentation so that they can be modified.
Despite the Freudian starting-point, the book's theory of analytic technique rests largely on Kleinian concepts: Bion's theory of containing