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I thank the authors and the publisher for providing me an ARC copy of this non-fiction book that I freely chose to review.
As some of you might know, I’m a psychiatrist, and although I am not working as a psychiatrist at the moment and have mostly worked in Forensic Psychiatry, there is no specialty of psychiatry where we don’t come across Post-Traumatic Stress Disorder, unfortunately. As researchers and practitioners have discovered in recent years, trauma is more widespread than people think, and it can have a bearing even in some of the classic psychiatric diagnosis, like schizophrenia and bipolar disorder.
You have probably come across many books written by survivors of a variety of traumatic experiences, and this is a very useful trend, as one of the things that people who have experienced trauma share in common is the feeling that they are alone and nobody understands or shares the way they feel. Reading other people’s accounts and sharing in their hope can be a very useful first-step towards seeking specialised help and starting the journey towards recovery.
This book manages to combine two aspects contained in books on the topic that are difficult to get right. On the one hand, there is a solid and clear explanation of the main therapeutic technique he uses and some adjunctive therapies, and the background to the approaches that Dr Jaremko has used in his everyday clinical practice for many years. On the other, and to illustrate the theory, there is a fictionalised account of a series of sessions of group therapy that seven patients engage in throughout the book. These patients, males and females, from different backgrounds, ethnic and social origins, and who had suffered a variety of traumas, meet regularly for a whole year and learn together, through their interactions within the group, how to apply the lessons learned through the therapy, while supporting each other and modelling their behaviours upon those of the others in the group who might be further away in their journey. Some of the patients, like Ashley and Darren, had been attending the group for a long time, while others, like Patty and Felicia, are newcomers. Beth Fehlbaum, the co-author of the book, has her personal experience as a trauma survivor to bring to the book and her years as an author too, and the fictionalised part of the book works very well. The characters are individualised, fully-fledged, and we get to know them, not only through their group sessions, but through some fragments of chapters when we share in what they think and how they feel from their own perspective. There are highs and lows for all the characters, and not a single one of them is always right and well (life is not without its bumps), even those who have come the farthest through the process. Because it is a process and there are no magic bullets, but there is help out there, and that is what the book excels at: giving hope to those who experience PTSD but have never tried therapy, or have tried therapy but it has not worked for them.
As I read the book, I kept wondering about its format. At first, especially as somebody who has read a bit about the subject (although I have never worked exclusively as a therapist, run group therapy, or used Cognitive Processing Therapy, the approach recommended by the book and also by many experts working in PTSD), I found that there was a fair amount of repetition of some of the key elements and theoretical concepts, that would make sense if the book was read more slowly by people interested in becoming familiar with many of the basic therapeutic aspects, perhaps chapter by chapter. Although I felt readers would probably connect more easily with the fictionalized characters and their difficulties and experiences, than with the purely theoretical parts, I realised that the process is somewhat similar to that the characters go through. They have much to learn and to become familiar with at first (you cannot enjoy stories if you don’t know the alphabet and understand the mechanics of reading), but slowly they gain in confidence, start applying what they have learned and can offer insights to others that they might have missed. The book, towards the end, becomes more dynamic and we can follow more directly the group sessions and the events in the characters’ lives, with the therapeutic aspects more seamlessly incorporated.
Dr Matt, the fictionalised version of Dr Jaremko, also shines through the book, and we get to know him, not only as a professional, but also, although less, as a person with his own plans and interests outside of his practice. Although he is well-liked by the patients, there is no hero-worship at play, and the book clearly explains that finding a therapist with whom one can work is not easy, no matter how good a professional the therapist is or how highly recommended s/he comes. The book emphasises the importance of finding a therapist or a mentor expert in the condition and there is never any suggestion that the book itself can cure anybody, but it is meant as a way to explain and exemplify what the therapeutic process might look like, and to offer hope and encouragement to those who have been stuck suffering, unable to decide what to do, or firmly believing there is no solution.
The book also offers great resources, to both professionals and patients. There is a bibliography at the end that includes books, articles that can be downloaded, and websites to check for more information. The appendixes include relaxation techniques, worksheets, advice on how to choose a therapist (and although some aspects of this are very USA based, the general principles would apply anywhere), and one of my favourite aspects of the book was that each chapter contains a playlist including songs and movies relevant to the aspects of trauma and therapy discussed there, and there is much emphasis placed on the importance of reading and of books that inspire the journey to recovery. In the same way that no patient would be cured just by reading this book, but they might feel inspired to seek help, no psychologist or therapist would become an expert on how to treat PTSD just by reading this book, but they might discover new approaches that they might want to explore further and learn more about. Although the book talks about PTSD, as I read it I could not help but think that many of its lessons and the examples of behaviours and erroneous beliefs highlighted through the theory and especially the sessions (there are some individual sessions also illustrated in the book, although they always result from questions or aspects of a patient’s experience that has been discussed in one of the group sessions) would have practical application in many other conditions. Cognitive errors (or “stinking thinking”, as it is known in the sessions) are common in many psychiatric conditions, and we all get stuck with them at some point or other. Much of the advice about how to change behaviour (CPT has its roots in CBT, cognitive behavioural therapy) could be applied to aspects of our lives that we wish to change, and that is one of the beauties of this method and the book, that it feels common-sensical once we get used to analysing the way we think in those terms.
As a writer, I also thought this book would be a great resource to other writers who are interested in understanding their characters’ motivations better, in particular to those who write about characters with a diagnosis of PTSD or severe trauma.
This is not a book for everybody, but it is a book that I am sure will provide useful information to people interested in the subject, and you do not need to be an expert to follow the theoretical basis behind the therapy. It is also very well written, and you will get to care and feel for all the characters in the group, and that is something that as an avid reader I know is not always easy to find, even in fiction. As you can imagine, the book contains descriptions of the traumas that the characters have suffered, as that is necessary to understand the therapy and the way the patients react to it. Those go from sexual and physical abuse to war trauma, natural disasters, hate crimes, and road traffic accidents. So, plenty of trigger warnings. On the other hand, if the book can inspire readers suffering from the condition to seek a therapist and start in the way to recovery, it is well worth a read.
Note that both authors are happy to provide copies of the book to people who cannot afford it but feel might benefit from it.
A great resource for professionals and others interested in the topic, with characters that feel real and we get to understand and care about. Highly recommended.
