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Freud (1909) wrote, ‘a thing which has not been understood inevitably reappears: like an unlaid ghost, it cannot rest until the mystery has been solved and the spell broken’.
This book, another in the Tavistock Clinic Series, describes the meeting with and laying to rest of many such ghosts in the work of the Unit for the Study of Trauma and its Aftermath in the Adult Department of the Tavistock Clinic.
The book provides many detailed accounts of assessment, consultation, short- and long-term work of differing frequencies with traumatized patients. The writing is lively and clear and I found myself reading the clinical accounts with a sense of expectation.
All the chapters are written by clinicians who have been associated with the Unit's work. Throughout there is a thoughtful and thought-provoking integration of theory with practice. The writers convey the detail and the rich complexity of the therapeutic processes vividly. The diagram on page 24, which attempts to present a visual summary of the interplay of the contribution of the individual and the event, is helpful, especially as one reads on and gathers more of a sense of the different kinds of cases and experiences.
I sensed the difficult nature of this work, particularly the resistances against the symbolization and higher-level representation of traumatic experiences, and the restoration of the link with the representation of the benign object. A separate chapter on resistances would have been helpful.
There are five sections. The introduction, which comprises part one, contains a very clear exposition of the central psychoanalytic views which run through the book. As evident from the title, the book has a distinctive psychoanalytic approach to trauma and traumatic stress. The focus is placed on the treatment of traumatized states of mind. Caroline Garland traces the history of the concept of trauma through early Freud to more contemporary approaches. While acknowledging the Freudian notion of helplessness as a