«Praise for Life After Trauma, Second Edition “Step by guided step, this workbook offers a careful, caring assist out of the emotional tangle that ...»
Praise for Life After Trauma, Second Edition
“Step by guided step, this workbook offers a careful, caring assist out of
the emotional tangle that can result from trauma....Clear, comprehensive, well grounded, and well organized—real help for those in a vulnerable place.”
—Kirkus Reviews, on the first edition
“This practical workbook explains the impact of trauma and provides
resources for coping. Survivors will benefit from the empathic tone and
the personalized worksheets. Most important, this is a hopeful book that emphasizes that healing is possible, a much-needed message.” —Christine A. Courtois, PhD, author of Healing the Incest Wound;
private practice, Washington, DC “A thorough and compassionate workbook. The authors combine basic information, exercises, and examples in a highly readable and accessible format. This book will be particularly useful for readers taking their first steps on the journey of recovery from trauma.” —Maxine Harris, PhD, coauthor of Healing the Trauma of Abuse “Anyone who chances on this workbook or is referred to it is extremely fortunate. It offers hope and guidance, speaking to the reader in personal ways that open paths for growth. I am especially impressed by the number and diversity of practical, realistic exercises. The authors provide concrete direction as they share their collective wisdom and experience.” —Carroll Ann Ellis, MA, Director of Victim Services, Fairfax County (Virginia) Police Department “Life After Trauma is written by two attuned, experienced trauma professionals who connect with their readers’ pain, resources, and determination. The reader feels seen, held, guided, and respected all along the way.” —from the Foreword by Laurie Anne Pearlman, PhD Life After Trauma Life After Trauma Second ediTion A Workbook for Healing dena Rosenbloom, Phd Mary Beth Williams, Phd with Barbara e. Watkins Foreword by Laurie Anne Pearlman, PhD THe GUiLFoRd PReSS new York London © 2010 The Guilford Press A Division of Guilford Publications, Inc.
72 Spring Street, New York, NY 10012 www.guilford.com All rights reserved The information in this volume is not intended as a substitute for consultation with health care professionals. Each individual’s health concerns should be evaluated by a qualified professional.
Except as indicated, no part of this book may be reproduced, translated, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher.
Printed in the United States of America This book is printed on acid-free paper.
Last digit is print number: 9 8 7 6 5 4 3 2 1
LIMITED PHOTOCOPY LICENSEThe Publisher grants to individual purchasers of this book nonassignable permission to reproduce the exercises in this book. This license is limited to you, the individual purchaser, for personal use. This license does not grant the right to reproduce these materials for resale, redistribution, electronic display, or any other purposes (including but not limited to books, pamphlets, articles, video- or audiotapes, blogs, file-sharing sites, Internet or intranet sites, and handouts or slides for lectures, workshops, webinars, or therapy groups, whether or not a fee is charged). Permission to reproduce these materials for these and other purposes must be obtained in writing from the Permissions Department of Guilford Publications.
Library of Congress Cataloging-in-Publication Data
Life after trauma : a workbook for healing / Dena Rosenbloom, and Mary Beth Williams, with Barbara E. Watkins ; foreword by Laurie Anne Pearlman. — 2nd ed.
Includes bibliographical references and index.
ISBN 978-1-60623-608-6 (pbk. : alk. paper)
1. Psychic trauma. 2. Post-traumatic stress disorder. 3. Stress (Psychology) I. Williams, Mary Beth. II. Watkins, Barbara E. III. Title.
RC552.P67R67 2010 616.85′21—dc22 To my family, friends, and clients; your courage, kindness, and resilience continually rekindle my hope And, for so many reasons, to Eve —DR
index ABoUT THe AUTHoRS Foreword to the Second edition An adult survivor came into my office a few years back, seeking reassurance and help. She had never been in therapy. Hers was a history of terrible childhood sexual and emotional abuse and an adulthood spent struggling to find dignity, develop healthy relationships, and raise her children with care and good guidance. At the end of our first session, in response to her request for homework, I recommended Life After Trauma. One week later, she opened our second session saying, “I’m not crazy!” In 1999, when the first edition of Life After Trauma was published, there were few self-help resources for adult survivors of traumatic life experiences. Life After Trauma clearly filled a need. While there are more materials available to adult survivors today, the continuing popularity of Life After Trauma speaks to its accuracy
in targeting central struggles in the recovery process. These struggles often connect to five basic psychological needs that this book clearly identifies and explores:
safety, trust, control, esteem, and intimacy. My own, my clients’, and my colleagues’ clinical experiences show that understanding and changing one’s beliefs linked to these needs can be a very powerful part of healing from trauma.
Readers will find many of their difficulties illuminated in these pages and will be comforted to see that others share the painful and confusing feelings that they might otherwise endure alone. The authors guide and encourage survivors to notice their feelings, to take care of their needs, and to stay connected to the present.
This workbook takes a present rather than past focus, and so helps readers stay out of the terrain of memories, which may be too challenging to survey on their own.
At the same time, the book offers concrete guidance with specific activities and exercises for addressing the main challenges of posttrauma life. Life After Trauma is written by two attuned, experienced trauma professionals who connect with their readers’ pain, resources, and determination. The reader feels seen, held, guided, and respected all along the way.
As the central developer of constructivist self-development theory, which xv xvi Foreword to the Second Edition underlies Life After Trauma, I am delighted to see the theory translated into practical assistance for survivors. Other colleagues and I have written a guidebook for therapists and other trauma workers entitled Risking Connection: A Training Curriculum for Working with Survivors of Childhood Abuse (see Appendix D). Risking Connection suggests that the path to trauma recovery is forming relationships that provide Respect, Information, Connection, and Hope (RICH). Readers of the current volume will reap RICH rewards from this book, and through their work with it, with themselves.
The only way a book such as this can be written is by pooling the contributions of many people. First and foremost, I thank the many clients I have seen over the years, whose commitment to healing has taught me much of what I most treasure and use in my work. I only hope I add to the lives of my clients as much as they enrich mine. Some clients have made direct contributions to this workbook, and countless others have informed my thinking by sharing their struggles and healing process. Each client contributes to my thinking and my work. I can never thank them enough for what they have given me.
I also want to thank my coauthor, Mary Beth Williams, for initiating this project. I had thought for several years about embarking on a workbook such as this, but it was her initiative and vision that brought it to fruition.
Many friends and colleagues also supported my efforts. I want to thank Pamela Deiter, PhD; Sandra Hartdagen, PhD; and Sherri Nelson Fitts, PhD, for their generosity in reading the original manuscript, giving feedback, and supporting me through our personal and professional relationships. My close friend Robin Grant Hall, although not directly involved in this project, has also been an invaluable source of support to me in so many ways over the years. I also want to thank Karen Saakvitne, PhD, for providing a safe place during my years at the Traumatic Stress Institute to discuss my clinical work from week to week. I learned immensely from her clinical sensitivity, compassion, and acumen. Even though we no longer meet, much of the wisdom in her words and our conversations returns to me as I need it.
My other former colleagues and friends from the Traumatic Stress Institute; Mark Hall, PhD; Amy Ehrlich Charney, PsyD; Sarah Gamble, PhD; Dan Abrahamson, PhD; Anne Pratt, PhD; Richard Nicastro, PhD; Molly Beaudoin; and Susan Kupec offered a community unique in its provision of both intellectual and emotional riches. I also want to thank Laurie Pearlman, PhD. Not only did she originally cocreate (with Lisa McCann, PhD) the theory upon which this workbook is based (constructivist self-development theory), but she has also been a treasured colleague and kindred spirit since we first met. A special thanks also to Brenda Shaw, who spent countless hours providing detailed and carefully considered comments xvii xviii Acknowledgments as she personally went through and completed the workbook. Her level of involvement and commitment has been a testament to the healing and hope possible for people who go through extraordinarily difficult life experiences. My parents, Cordelia and Joseph Rosenbloom, also provided me with support throughout this process. They both read an early version of the manuscript and offered encouragement and helpful ideas. My father’s writing over the years and my mother’s own healing journey have also inspired me. And my parents’ love and devotion have given me a foundation that carries me through my day-to-day life. I am saddened only that my mother did not survive to celebrate the completion of this workbook with me.
I want to extend special gratitude to Barbara Watkins, our editor from The Guilford Press. Her tireless work, commitment, excitement, and belief in the project truly made it possible to create a finished and helpful resource for trauma survivors. She has again brought her skill and dedication to this second edition.
And in a category all their own, I want to thank Aaron and Lia, who bring joy, hope, challenge, perspective, growth, and comfort into my life every day. Thank you.
In 1988, as I began my dissertation, I discovered an article by Lisa McCann, Laurie Anne Pearlman, and others. From that article, I created a 31-item belief scale that 531 survivors of sexual abuse completed. As I worked with survivors, I learned more of the centrality of their beliefs. In fact, as a conclusion from my dissertation research, I learned that the most significant variable leading to long-term posttraumatic impact of child sexual abuse was the perception of the abuse as harmful and negative. From my research on the theory grew the dream to create a workbook that would directly help survivors. This is the final product. I want to thank Dena Rosenbloom for her dedication and patience and Barbara Watkins for her effort and endurance.
I do not have an organization to acknowledge, but I do want to thank those who supported me during the creative process—my children; Joyce Braak, MD;
Hedi Fried; John F. Sommer, Jr.; David Niles, MD; and Lasse Nurmi. For this second edition, I continue to extend my thanks to those friends and especially Jackie Garrick. The past year has taught me personally about endurance, traumatic stress, and resilience. A freak accident led to shattered left leg bones, two major surgeries, and constant pain but also to thankfulness and gratitude that positive lessons can be found in the deepest tunnel.
These events can be traumatic when they contradict your understanding of how things are “supposed” to be. They can disrupt your sense of yourself and others. They can shatter illusions about how safe the world really is and how much control you have in your life. When trauma is caused by another person, it can undermine a basic sense of trust in other people; it can make intimacy with others difficult; and it can disrupt your own sense of self-worth and self-esteem. If you have had any of these, or similar, experiences this book can help you.
We are psychologists with specialized training in helping people rebuild their lives after trauma, whether the experiences occurred long ago or more recently. We have found that for many people the following help a great deal: finding comfort, learning to take care of yourself, understanding the impact of what happened to you, getting support from others, and having information such as you will find in this book. This book is an effort to offer information that can most help following trauma whether immediately after or years later.
2 Prologue: Before You Begin This workbook is written so you can use it on your own at home. If you wish, it can also be used as part of the psychotherapy process, but not everyone needs psychotherapy following a traumatic event. If you are already in psychotherapy, consider giving your therapist a copy of Appendix D, “How Mental Health Professionals Can Use This Workbook.” It offers suggestions for how a psychotherapist might best work with you as you use this workbook. If you are not in therapy and need more help than this workbook can offer, we encourage you to seek a psychotherapist with specialized training in treating trauma. Appendix C offers a list of resources to help you find the right therapist.
HoW THiS WoRkBook cAn HeLP YoU
This workbook is based on ideas developed by Laurie Anne Pearlman, PhD, Karen Saakvitne, PhD, Lisa McCann, PhD, and their associates. They studied the research on trauma, gathered information from colleagues, and worked extensively with trauma survivors. From this work, they developed constructivist self-development theory (CSDT). (A number of publications discuss this theory in detail; Appendix D at the end of this book lists some of them.) They came to believe that trauma
affects us by undermining five basic human needs: