Robin Shapiro - The trauma treatment handbook: protocols across the spectrum

I didnt write this book alone. Thank you to all the people who helped me directly. The obvious ones are:

Kathy Steele, who, seemingly patiently, set me straight about many aspects of structural dissociation. For anything that is correct about SD, I give her credit. For anything that isnt, please blame me.

David Calof, my long-time consultant, who provided much of the structure and information for the clinical hypnosis chapter.

David Kearney, a physician who told me about his yoga and mindfulness training program at the Seattle VA.

Martha Jacobi, who let me crib from her prepublished descriptions of two kinds of somatic therapies.

Diana Fosha, who allowed me to steal liberally from a section of her book about psychodynamic therapies.

Sharon Stanley, who explained somatic transformation to me.

Marcia Herival, who vetted the exposure and CBT chapters and gave me more modalities to research.

Wayne McClesky, who reviewed the energy psychology chapter (years after teaching me most of what I know about it).

Jim Cole, who did the same for the reenactment protocol, the only intervention I know that ends with a giggle.

Trisha Pearce, who filled me in about working with military and veterans during a 40-minute phone call and had already trained me through her wonderful volunteer Soldiers Project NW.

Thank you to all the other teachers, trainers, authors, and consultants who taught me so much about trauma and its treatments. I hope I did you justice and that I got the references right.

Thank you, in advance, to each of you who are choosing to heal trauma as your lifes work.

Thanks to the people at Norton Professional Books who suggested I write this book and urged me to keep it user-friendly. Thank you to Andrea Costella, Kristen Holt-Browning, and Vani Kannan for guiding me, once again, through the publishing process. I tried to get it write, I mean, right, the first time.

Thank you, one more time, to my first reader and first editor, my mother, writer Elly Welt. I continue to improve my writing under your tutelage. Yes, I got the message about italics and quotation marks.

And to my long-suffering husband, Doug Plummer, who supported me in all ways through yet another book, including providing two more wonderful photos: I adore you.

AB/ISTDP: attachment-based intensive short-term dynamic psychotherapy

ACT: acceptance and commitment therapy; accept, choose, take action

AEDP: accelerated experiential-dynamic psychotherapy

AET: accelerated empathetic therapy

ANP: apparently normal part (in structural dissociation)

APA: American Psychological Association

ASD: acute stress disorder

BLS: bilateral stimulation (in EMDR)

BPD: borderline personality disorder

BSP: Brainspotting

CBT: cognitive behavior therapy

COS: combat operational stress

CPT: cognitive processing therapy

CT: cognitive therapy

CTSD: complex traumatic stress disorders

DBT: dialectical behavior therapy

DDIS: Dissociative Disorders Interview Scale

DDNOS: dissociative disorder not otherwise specified

DDP: dyadic developmental psychotherapy

DES: Dissociative Experiences Scale

DESNOS: disorders of extreme stress, not otherwise specified

DID: dissociative identity disorder (formerly multiple personality disorder, MPD)

DNMS: developmental needs-meeting strategy

DSM-IV: Diagnostic and Statistical Manual of Mental Disorders

DTD: developmental trauma disorder

EFT: emotional freedom technique

EMDR: eye movement desensitization and reprocessing

EP: emotional part (in structural dissociation)

EX: exposure therapy

HSP: highly sensitive person

IFS: internal family systems

ISSTD: International Society for the Study of Trauma and Dissociation

ISTDP: intensive short-term dynamic psychotherapy

LENS: low-energy neurofeedback system

MBSR: mindfulness-based stress reduction

NAS: nurturing adult self (in DNMS)

PAS: protective adult self (in DNMS)

PE: prolonged exposure

PTP: pretraumatized person (in the structural dissociation model)

PTSD: posttraumatic stress disorder

REBT: rational emotive behavior therapy

RP: reenactment protocol

SCS: Spiritual Core Self (in DNMS)

SD: structural dissociation

SDM: strategic developmental model

SDQ: Somatoform Disorder Questionnaire

SE: somatic experiencing

SIDS: sudden infant death syndrome

SIT: stress inoculation therapy

SP: sensorimotor psychotherapy

SSRI: selective serotonin reuptake inhibitor

STDP: short-term dynamic psychotherapy

TBI: traumatic brain injury

TFT: thought field therapy

WTF?: response to so many acronyms!

Trauma is an experience that overwhelms our ability to cope and leaves our relationships and our brains with the challenge of finding a way to remain integrated and functioning well. In many ways, a psychotherapist working with individuals who have been traumatized needs to use the trusting therapeutic relationship to cultivate healing by attuning to the internal world of the client and resonating with that experience. Robin Shapiro has written a practical guide to a wide range of treatment strategies for trauma that offer useful approaches to tracking and transforming traumatic symptoms and guiding the individual toward healing.

Healingbecoming wholecan be seen as a process of integration, linking the internal neural circuits that have become disconnected during the overwhelming events in a persons life. For therapists, staying present with trauma is not easy, and having a wide range of creative steps easily accessible in the clinicians tool kit makes the process more likely to be effective. The journey to learn a broad range of treatment approaches included in this book has enabled Shapiro to offer her clinical wisdom; she demonstrates in clear summaries and helpful clinical vignettes how to apply these specific techniques in particular clinical situations.

All psychotherapy needs to be individually tailored to the person presenting for treatment. In this way, we as therapists need to have a spectrum of interventions at our disposal in order to create the most effective and individually sculpted therapeutic experiences. When I first skimmed over this handbook, I thought that the lack of scientific studies supporting many of the various individual approaches would lead me to call the author and say that I could not write this foreword. But as I read each chapter and reflected on my own development as a therapist, I realized that this compilation was indeed a very helpful compendium of usefuleven if mostly not scientifically provenapproaches that would help any clinician working with traumatized individuals. These are the tools of the art of psychotherapy. So I read on and found myself soaking in the authors sensitivity, her directness, her compassionate reflections on the therapeutic process, and her skill at extracting the best from a range of clinical strategies to help the healing process evolve and be more likely to find a window of opportunity to make lasting change possible.