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[Rain]

I was just reading the reviews for Van der Kolk's the Body Keeps the Score, and the very top review was quite helpful in itself.   Plus, below is an insightful reply in the Comments to Cloyd's review that I thought the OOTS forum may find interesting

"Tom Cloyd says:

Art, thanks for the appreciation of the review.

However, I think your pessimistic assessment of the usual outcome of trauma-informed psychotherapy is not quite accurate. It is important to realize that such therapy doesn't make a whole new person. It doesn't create healing of the sort that makes things as they would have been had the trauma(s) never occurred. It just works to stop the flashbacks and the various secondary symptoms they produce (avoidance, hypervigilence, etc.). This means you'll (typically) no longer qualify for a diagnosis, but you'll still have problems to address.

After trauma therapy there are two problems likely to crop up:

1. If you have lived with a trauma disorder for years, and especially if it's been since childhood, then while everyone else was learning to be a richer and more capable person, you were mostly just surviving. You missed out on a lot of learning. While you can definitely do a lot of catchup (and most people do), it is not always easy. And if you have an overly busy life, or some unresolved addictions, it will be even harder. But there's no denying that you have catching up to do in the area of human skills, both personal and interpersonal. Therapy cannot fill in those holes, but they were there all along anyway. Therapy does NOT create this problem or make it worse. It just makes it finally possible for the problem to be addressed. This is rather similar to the situation one is in if, after 30 years of alcoholism, one gets sober. You will have 30 years of catching up to with, relative to other people.

2. Chronic trauma in childhood very often produces damage in the parasympathetic nervous system (PNS) - the part of our nervous symptom which calms us down. Generally, this damage is permanent, because it is developmental in origin. Van der Kolk does take up the question of possible remediation of the PNS (which is one half of the autonomic nervous system) on page 266ff of the book. I've been too busy to give this careful study, but it's clearly worth the investment.

A couple of other things: If memories are still overwhelming someone, they are NOT finished with therapy. Ditto for dissociation. Generally dissociation should either stop or be minimal and manageable after trauma issues are resolved. If not, more professional attention is required to address this problem. However, I've done a lot of trauma work with my clients, and I've not seen this problem come up much at all.

I'm truly sorry you had problems with your intimate. Anyone with a trauma disorder who's in a serious relationship will, if they heal, be in a different situation, because they are in some fundamental ways a different person. A reassessment will have to be made. That does NOT mean a break up is likely. Things will just be different."

[Kizzie]

Tks for the link BH and for the comments Rain, he makes the process of recovery and the end point much clearer to me.  I find it hopeful that when the work is done EFs and dissociation etc are not likely to occur. Huzzah!

[globetrotter]

Thanks for that! Quite helpful...copying that for future reference, Rain.