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This book is an impressive demonstration of creative clinical approaches and service development that are as responsive to complexity as it is possible to be in a health service culture, which often seems to struggle to appreciate the depths of emotional and relational difficulty we are attending to. The 16 chapters in this volume are a welcome contribution to the field of complex trauma, and illustrate impressive innovation, alongside the reliable pulse of clinical thought that’s deeply rooted within the Tavistock’s identity. As Young and Stubley note in their introduction, there has been a great deal of development since the group of analysts and therapists set off to support the people who had survived the Herald of Free Enterprise disaster in the late 80s. Garland (1998) recognised that the immediate aftermath of trauma was perhaps not the optimal therapeutic threshold she may have anticipated; however, the key motivation to move beyond the consulting room was an important starting point for the psychoanalytic approach of making sense of externally experienced trauma on the internal world. This constant interplay between internal and external experience and its therapeutic access points - rooted in Klein’s early developmental model - is perhaps even more significant in the work that has happened since Garland’s initial development of the Tavistock’s Trauma Unit and is the central link between all of the papers presented here.
There are many chapters in this book and while it is not possible to review every one, it’s fair to say it covers most areas of bio-psycho-social concern in the field of complex trauma with adolescents, young adults and adults. Additional areas of potential value could have been work addressing younger children, and parent-infant work, particularly given the early relationship and developmental focus of complex trauma. This is perhaps my one criticism of the book overall - particularly given the history of this work at the Tavistock. Graham