Trauma and Recovery
by Judith Herman
Basic Books 1992/1997

This book is an even-tempered look at trauma, its nature, effects and treatment. Judith Herman is Associate Clinical Professor of Psychiatry at Harvard Medical School. She describes the effects of trauma caused by war, captivity, rape, domestic emotional/sexual abuse and battering, and child abuse. The book is mainly descriptive, and uses what could be called "common-sense language" about human psychology. There is little abstract theory here. A few theoretical terms are borrowed from psychoanalysis but without the structural support of any explicit psychoanalytic theory. They are, that is, used in a free-floating manner, as if their meaning required no deeper connections validating their use.

Herman divides her book into two parts. Part I, Traumatic Disorders, describes the traumatic effects of abuse; Part II, Stages of Recovery, describes the process of healing. There is a blurb from the New York Times on the front cover of the paperback edition saying this book is "one of the most important psychiatric works to be published since Freud." The author of that blurb has no concept of intellectual depth. Herman wants merely to establish the reality of abuse, and place traumatic responses to abuse within a diagnostic set of symptoms she has named Complex Post-Traumatic Stress Disorder, which has a slightly different set of symptoms from the more familiar PTSD. She is not interested, here at least, in understanding in any meaningful or profound sense why those symptoms occur as a response to abuse, but only in knowing and convincing us that they do occur. A consequence of her indifference to theory, however, is that Herman cannot distinguish false memories from real memories, and this makes her antagonistic to people who argue that not all memory is true memory, and not all claims of abuse are founded on actual abuse.

It came to mind while reading the chapter on child abuse that the radical feminist assertion that the nuclear, patriarchal family creates the fundamental psychology of the child falters on the evidence of trauma. As I've tried to point out elsewhere before, the mind must have a pre-disposition for any complex psychological pattern that we find in humans. Trauma is an example of this. In order to be traumatized there must be other traits of the mind that the experience violates. That is why we call it abuse. If a child from infancy onward suffered sexual and emotional abuse, then if the mind is nothing but a social construction under the power and whim of parental conditioning, it would follow that the abuse would not be experienced (then or within later memories) as abuse by the child because there would be no pre-existing traits to violate: the experience would be, in essence, programmed into the child as a natural condition of life. Clearly those traits do exist, however, because abuse is a trauma-inducing experience even for a child that grew up from infancy under abuse. Trauma, then, is a key to understanding human psychology. The traumatic response, no matter how young or old we are when the abuse that triggers it occurs, is evidence of traits that exist so indelibly structured within us that their desecration can occur even in infancy, where some social-political theorists place the beginning of social conditioning.

In discussing the therapeutic situation, Herman talks about transference and countertransference, terms and concepts originating with Freud. Herman, however, is not a Freudian, and early in her book she takes the typical (and politically motivated) anti-Freudian stance that Freud was wrong and cowardly when he renounced his seduction theory (i.e., childhood sexual abuse was the cause behind the neurosis which at that time was called hysteria) and developed in its place the significantly more complicated psychoanalytic theory involving theories of infantile sexuality, infantile neurosis, and the Oedipus Complex. Herman uses the terms 'tranference' and 'countertransference' in a casual manner. She seems to have no interest in their possible deeper meanings or implications for a theory of the mind. What she uses the terms for, regardless of their quite specific meanings within classical psychoanalysis, is to talk about the feelings, thoughts and behavior of the two participants of the therapeutic situation. The patient in essence confuses (unconsciously) the therapist with the abuser, and the therapist in turn confuses (unconsciously) himself (or herself) with, at minimum, both the abuser and the patient. Whether this is technically the same thing as transference and countertransference isn't important if what we're solely interested in is the details of how the patient and therapist respond within the therapeutic relationship; and most readers will not care a fig if Herman is using well-defined terms here. It is evident enough, for a practical understanding, what it is she is getting at.

The recovery (i.e. healing) process involves three components: the establishment of safety, remembrance and mourning, and finally a reconnection with ordinary life. (see p.155) Herman discusses these stages in chapters 8 through 10. Again, her discussion is not systematic or scientific. Everything is on the surface, and she gives no indication of having any explanatory framework that doesn't use language in popular and imprecise ways. This is not to say that readers who have experienced trauma or who know someone who has will not find the chapters (or book) useful or enlightening. The focus of the book is symptoms: symptoms of the victim in and out of the therapeutic situation, and also the symptoms of the therapist in relation to the victim and the period of consultation. But there is no real attempt to understand the deeper psychology of those symptoms.

Readers within the D/s community will be interested to read that, following trauma, "the dynamics of dominance and submission are reenacted in all subsequent relationships, including therapy." (p. 138) A related comment is the following:

The reenactment of the relationship with the perpetrator is most evident in the sexualized transference that sometimes [my emphasis, not hers] emerges in survivors of prolonged childhood sexual abuse. The patient may assume that the only value she can possibly have in the eyes of another, especially in the eyes of a powerful person, is as a sexual object. (p. 139)

Herman does not explore this topic or relate it to sexual roleplaying or the psychological complexities of human sexuality and desire. In fact, human sexuality is avoided altogether in the book except in its function as a perpetrator of trauma, or as symptom of the trauma, either for the victim or the therapist. For example, Herman remarks that "the therapist may experience voyeuristic excitement, fascination, and even sexual arousal. Sexualized countertransference is a common experience, particularly for male therapists working with female patients who have been subjected to sexual violence." (p. 145) After saying this she moves on, as if nothing more need be said. She's able to move on because she views the therapist's response as a symptom within the therapeutic situation. The question should be asked, however, why this might occur and why is it such a common experience in male therapists. Note that she calls it "sexualized countertransference" after first calling it "voyeuristic excitement". Well, which is it, or are they the same thing and if so how are they the same? Since she uses the terms 'transference' and 'countertransference' loosely, there's no way to determine what she really means. Nor does she explore in any detail the obvious topic of how other men (or women) besides the therapist might respond (or what might trigger the response) and why, except to vaguely wrap it all into the loose terminology of transference and countertransference. But if she explored this topic, she'd find herself asking when doesn't transference and countertransference occur, if they aren't specific to the consulting room, and is it necessary for trauma to be involved somehow or does it go on all the time in daily life? Then she'd begin to question why it happens, not just that it happens, and what the implications might be of its ineradicable presence in our ongoing experience of others.

The book is a fair first introduction that many readers will learn from, but it in no way goes deep enough to compete with the best of the classical psychoanalysts.