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This is a remarkable book. It represents an unparalleled broad and comprehensive description of and reflection on traumatized individuals and their treatment. The detailed presentation of clinical and process material brings the reader close to the complex inner and outer reality of severely traumatized patients in a way that gives deep insight into and opens new ways of understanding the horrible after-effects of human-made harm against other human beings. Most importantly, Henningsen gives one of the best guides that is on the market today for clinicians working with patients traumatized in different ways and in different stages of life.
There are several more or less evidence-based treatments recommended today, most of which are short-term and cognitive or exposure oriented. The evidence base on these treatments modes is, however, weak in that there is high drop-out rate and high non-response (Schottenbauer, 2008). What Henningsen offers is detailed treatment recommendations for patients with post-traumatic conditions that take into account the necessity for stable and secure therapeutic settings with sufficient duration, the necessity for which there is increasing clinical and also research-based evidence.
It is of special importance that Henningsen demonstrates how the past traumas are actualized in the transference and treatment relationship. These actualizations are not readily understood and frequently lead to broken treatments, unnecessary referrals to hospitals or treatments of lesser intensity. Many therapy modes, such as cognitive therapies, do not imply the necessary understanding of transference and countertransference dynamics which can make it possible to handle and contain these actualizations within a stable therapeutic frame. The result is that many severely traumatized patients are often left in a worse condition in that discontinuation of the therapy may become a repetition of the original traumatic situation, which almost always implied being lef