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Life After Trauma: A Workbook for Healing
By Dena Rosenbloom & Mary Beth Williams, New York: The Guilford Press, 1999, 352 pages, $18.95
Written by Dena Rosenbloom and Mary Beth Williams, Life After Trauma: A Workbook for Healing is a comprehensive guide for those working through the effects of a traumatic experience. Through a series of systematic discussions and exercises, readers are encouraged to explore their own thoughts and beliefs as they apply to a number of basic needs. In addition to the clarity with which their material is presented, the authors also effectively convey a sense of empathy throughout the text. These strengths, as well as others, make this a valuable tool when working with individuals directly affected by trauma as well as when working with the relatives and friends of such persons.
A key strength of this book lies in its authors’ experience in working with those who have experienced trauma. As one half of this book’s authorship, Dena Rosenbloom has gained experience through her clinical practice which has been focused on populations who have undergone traumatic life events. Similarly, Dr. Rosenbloom’s co-author, Mary Beth Williams, also likely benefits from her experiences serving as a social worker as well as the President of the Association of Traumatic Stress Specialists. Throughout their work, it is apparent that Rosenbloom and Williams’s clinical experience working with individuals affected by trauma has contributed greatly to their effectiveness as authors. Passages focusing on the reader’s well being, establishing this as the primary concern, create a textual atmosphere of empathy from which therapeutic growth may proceed. In addition to the authors’ experiential knowledge, much of the content of this book is based on the constructivist self-development theory (CSDT) model of Pearlman, Saakvitne, & McCann (McCann & Pearlman, 1990; Pearlman & Saakvitne, 1995). Founded upon an extensive investigation of resources that included trauma survivors, experts, and relevant literature, this model postulates that the effects of trauma typically are seen in 5 areas of basic human need.
In-line with the CSDT model, Rosenbloom and Williams focus their readers on the status and beliefs associated with each of these areas of need. This process is not hastily begun, however, as the authors sensitively provide an introduction into this work. During the opening chapters, information intended to put the reader at ease with him or herself and with the process which they are beginning is provided. Chapter one includes discussions explaining the nature of traumatic experiences and how these experiences often affect those who have been exposed to them. Efforts are made to reassure the reader that he or she is not ‘abnormal’ or ‘crazy’, and such work is continually touched upon throughout the remainder of the book. Chapter two continues the introduction as information focusing on the importance of coping skills and the way in they are often disrupted by trauma is provided. Following this, the reader is led through exercises aimed at identifying and correcting current coping styles. Chapter three concludes the introductory transition phase as the process of “Thinking Things Through” (REFS) is introduced and clarified through examples and case illustrations.
Having been acclimated to the work ahead, the reader is then guided through discussions focusing on safety, trust, control, value, and interpersonal connection. These sections are designed to allow the reader to evaluate the current fulfillment of each need while also assessing the thoughts and beliefs associated with it. A systematic method, reflecting the authors’ cognitive-behavioral approach, is employed throughout this book. Each chapter opens with work encouraging the reader to examine the meaning of his or her beliefs and closes with discussions and exercises focusing on “Weighing the Evidence” for the highlighted beliefs. These two tasks are each further subdivided into smaller objectives, thus providing several easily accomplished assignments.
Central to Rosenbloom and Williams’s therapeutic efforts are a number of exercises included in each chapter. These tasks provide the reader with an opportunity to examine various aspects of their current beliefs and explore ways in which these thought patterns may be made more adaptive. While these exercises are designed to bring about therapeutic growth, Rosenbloom and Williams caution that such work should not be taken on at too fast a pace. As a result, suggestions including taking ‘Time Out for Self-Care’ and consulting with a knowledgeable psychotherapist during this process, are integrated throughout their work. Utilizing features such as this, Rosenbloom and Williams effectively establish an accepting and empathetic climate, serving to reaffirm each reader’s sense of individuality and humanity. Case examples, trauma survivors’ statements, and general explanations all provide the reader with a sense that he or she may be understood by others. At the same time, statements reflecting the idea that no two experiences are alike validate the reader’s experiences as unique in an unconditionally supportive manner.
Another major strength of Life After Trauma: A Workbook for Healing is derived from the way in which it is presented. The systematic and predictable organization of each chapter allows the reader to become familiar with the techniques used and the progression of work. This structure sets up a framework through which thoughts and beliefs may be systematically assessed, thus providing the reader with a skill which may be generalized to other contexts of life. Within the organization of their work, Rosenbloom and Williams provide many ‘spaces’ in which the content and speed of work can be adapted to accommodate the unique experiences and readiness of each reader. In addition to these strengths, elements such as integrated exercise forms and clear wording make the task of working through this book more agreeable, and therefore, promote its completion.
While Life After Trauma: A Workbook for Healing may appear to be designed for unassisted, individual, self-help type initiatives, its greatest value may be seen when used as part of a formal therapeutic relationship. Both the informative discussion material and the exercises included in this book readily lend themselves to a collaborative process between client and therapist. Further contributing to therapeutic value of this work are the numerous ways in which it can be incorporated. Used in an introductory fashion where relevant chapters are assigned before discussing their subject matter during therapy, this book may prepare the client for future collaborations by providing him or her with a greater understanding of what will be discussed. By ‘priming’ the client in this fashion, therapeutic progress may benefit as the client may come prepared with a greater sense of what he or she feels necessary to discuss, thus contributing to both the accuracy and efficiency of therapeutic work. The use of Life After Trauma: A Workbook for Healing in this fashion must be undertaken cautiously, however. Such unassisted work may not be appropriate for those whose traumatic experiences are still fresh or for those who have not yet reestablished essentially coping abilities. As such, unassisted preparatory work should be reserved for those who, despite experiencing ongoing trauma-related difficulties, are capable of dealing with a limited degree of therapeutic work unassisted.
In addition to its usage as a pre-therapy assignment, Life After Trauma: A Workbook for Healing may be used to further solidify the gains begun during therapeutic work. Clients may be assigned to read those sections of text that relate to material discussed within therapy in order to provide them with a reminder of such work outside of the therapeutic context and between sessions. Additionally, the exercises integrated into this text further increase its value as homework tool as these may allow the client to further process the work of therapy in an independent and applied manner. Similar to the discretion warranted by preparatory usages of this work, post-therapy usages of Life After Trauma: A Workbook for Healing should be reserved for those who coping resources are adequate enough for independent work on issues related to their traumatic experiences.
In addition to the preparatory and supplementary usages of this text, Life After Trauma: A Workbook for Healing may also be used within the therapy setting. Taken on in a more directly collaborative fashion, therapists may find value in working through this book alongside their client during regularly scheduled sessions. In this context, the content of Life After Trauma: A Workbook for Healing may largely be used to direct the course of therapy. Though not all books are ideal for such work, the well laid out and therapeutically-relevant structure of this book makes it ideal for such usage. Used in this fashion, the client’s verbal and non-verbal reactions to both the discussion and exercise sections of text may provide the therapist with a better understanding of the nuances of his or her client’s difficulties while also enabling the him or her to become a source of encouragement during this work. As a result, the therapist can help to ensure that work is taken on at a safe pace and in a supportive context. As a result, when used in this manner, Life After Trauma: A Workbook for Healing may be used with those whose traumatic experiences are still fresh or those who may not yet be able to effectively process such material in an unassisted manner.
Though Life After Trauma: A Workbook for Healing may initially serve to direct the course of therapeutic efforts when used in this fashion, its true value may be derived from the way in which it may setup other topics of discussion. Stemming from the knowledge gained during collaborative work as well as the immediate discussions spurred by such work, the therapist and client may find themselves devoting much time to discussing topics tangential to the content of this work but crucial to the needs of the client. As such, Life After Trauma: A Workbook for Healing may serve as both a direct and indirect facilitator of therapeutic discussion.
Regardless of the fashion in which this text is used, it is likely to be of value when working with many individuals who have undergone traumatic experiences or know someone who has. With its concern for the individual and efforts to validate each reader’s experiences, Life After Trauma: A Workbook for Healing is an ideal source of encouragement that extends beyond the client-therapist relationship and is available at all times. In addition to its value when working with those directly affected by trauma, Life After Trauma: A Workbook for Healing, may also benefit the friends and family of such individuals. By providing information pertaining to the nature of traumatic experiences and the wide-ranging effects of such experiences, this book provides an invaluable look into the often misunderstood experiences of loved ones affected by trauma.
References
McCann, L., & Pearlman, L.A. (1990). Constructivist self-development theory as a framework for assessing and treating victims of family violence. In: Stith, S.M. (Ed.); Williams, M.B. (Ed.), Violence hits home: Comprehensive treatment approaches to domestic violence. (pp. 305-329). New York, NY, US: Springer Publishing Co.
Pearlman, L.A., & Saakvitne, K.W. (1995). Treating therapists with vicarious traumatization and secondary stress disorders. In: Figley, C.R. (Ed.). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. (pp. 150-177). Philadelphia, PA, US: Brunner/Mazel, Inc.