Therapy in L.A.


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October 2002
Reviewed by Carl H. Shubs, Ph.D.

by Dusty Miller
Basic Books, 1994

In this book, Miller presents a new diagnostic category that she calls Trauma Reenactment Syndrome (TRS), which refers to a constellation of behaviors and relationship patterns that she sees as being frequently occurring among women who grew up being physically or sexually abused, emotionally or psychologically violated, or neglected. Among the behavioral problem areas that she addresses and describes as self-destructive and that might be otherwise identified with these women are alcoholism, drug abuse, eating disorders, self-cutting, dissociation, or various conditions that might be seen as "biologically based." She contends that even with treatment of the addiction, the eating disorder, or the "mental condition" that may be identified as "biologically based," unless the trauma of childhood is addressed, the self-destructive behaviors will continue.

Her book is rich with personal stories and clinical vignettes that illustrate the psychological pain and suffering of the childhood of these women. She also presents her experiences with these women as adults and how they struggle together with those early experiences, the symptoms that have resulted from those traumas, and the ways those symptoms reflect that early life experience by presenting a kind of reenactment of it.

As she addresses the prospect for treatment, she states that "it is necessary to understand not only the history that initiated the self-abusive symptoms and the context that perpetuates them, but also the function they serve" (p. 181). She presents a three-stage therapeutic process of recovery and healing that includes psychotherapy, twelve-step and other group involvement, and psychosocial as well as psycho educational education about gender-based societal influences on childhood growth and development.

While the title addresses women and the book focuses on women, the issues addressed are just as relevant and appropriate to men. However, the reader is left to make those translations and adjustments in perspective themselves, particularly with reference to the gender-based issues she addresses.

By Caroline Kettlewell
St. Martin's Press, 1999

This book presents a memoir that follows a young girl from about twelve years old through her early twenties as she comes to discover how anorexia and self-cutting helps her to cope with her psychological and emotional pains of self-consciousness, inadequacy, and alienation in growing up. It is told in the first person and reads like a novel. Most of it focuses on the story of her life as expressed from her perspective rather than focusing particularly or exclusively on the cutting or eating.

It is about her view of herself, her relationships, and the world around her, told in a very literary style. If you are looking for an academic or clinically oriented book, this is definitely not it. However, if you are looking for something that feels very personal, is very introspective, and is both touching and enlightening, this book may be just the thing.

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