The Body Keeps the Score
by Bessel Van der Kolk, M.D.
The work of Dr. Van der Kolk, highlighted in this book, shaped how I view my practice. His work with trauma survivors focuses on creating new physical experiences to counteract the impact trauma has on the body and the brain.
In this book he covers how he got his start working with veterans, and how advances in neuroscience helped him understand how trauma memories are stored (literally in a different place in the brain than non-traumatic memories). He looks at case studies of past clients and how trauma manifested in their lives. One of the most impactful sections of the book discusses how trauma shows up in peoples' bodies, how that affects sensory perceptions, & our physiological reactions to stimuli after a traumatic experience.
His work isn't just with veterans, he also looks at studies involving children and how they perceive their surroundings after experiencing trauma (an amazing study which involves showing children everyday scenes and asking them to describe what is about to happen).
Lastly, he shows us different ways in which trauma survivors can heal from those experiences through somatic interventions. This is one of the most compelling books I've ever read and it has guided my own interventions with clients, helping them to create agency in their lives & reestablish the brain-body connection.
I have talked about his research with several clients to provide some psychoeducation around the brain/body disconnection relative to PTSD and discuss ways we can work together to help them reintegrate the two. It's provided a starting point for our work, helping them feel confident that what we are doing has some evidence behind it and it validates their feelings of dissociation from their bodies. In their reactions I've watched the lightbulb go on, as they begin to understand more about how their trauma continues to impact their lives, and the relief as they hear about things we can do to try to heal that impact.
This Chair Rocks: A Manifesto Against Ageism
by Ashton Applewhite
This book entered my life via a gerontology class called Disrupting Ageism & I couldn't put it down. I read it around the same time I did my generalist internship with older adults, most of whom were living in congregate living facilities, so it was a perfect companion text & it helped me see my clients in a new light.
We all carry biases of varying degrees. As a child who sang in school choirs, which would visit nursing homes near the holidays, I had an aversion to them (back then they weren't called 'skilled nursing facilities'). I never enjoyed going because it made me uncomfortable to see people in various stages of declining health. Maybe I was worried that would be my grandmother some day, maybe I was worried it would be me. Either way I disliked going.
Fast forward to my internship in these communities, providing animal therapy as well as advocacy for those with dementia &/or in hospice. My reacquaintance with older adults in these settings coincided with reading this book & it provided a fresh perspective on what it means to age in our culture. I no longer think that physical and mental decline should just be accepted as we age. One of the things I most remember about this book, other than is an anecdote Applewhite tells about someone she knows who goes to the doctor because their shoulder begins to hurt. The doctor says something like 'well, you are getting to be 70..." The person's reply was "my other shoulder is also 'getting to be 70 and it doesn't hurt.' Why do we just accept a certain amount of suffering as we age? Because we are taught our entire lives that this is what happens, when in fact there are plenty of examples of it not happening.
The book argues that, when old age was a less common occurrence, we revered our older generation. Now that modern medicine has extended our lives into our 80s, 90s & sometimes 100s, it has changed how we interact with & view older adults. It reminds us that "it doesn't make much sense to discriminate against a group that we aspire to join" & provides statistics about how older Americans contribute to the economy in a substantive way. It challenges us to look at our feelings about aging & how fear of our own mortality can contribute to our ageist views. This is a must read for anyone who works with older adults, who has older adults in their lives, or who aspires to be an older adult someday. It has completely altered how I feel about aging myself and working with older adults.
Maybe You Should Talk To Someone
by Lori Gottlieb
As a grad student honing my craft as a clinician, this book helped me realize that even therapists sometimes need a therapist of their own. In fact, at the beginning of my MSW program we were advised to find a therapist and the importance of having one was stressed time & time again as a form of the self-care so integral to our work (you can't help others effectively if you are not managing your own life & stressors well).
Lori is a psychotherapist in private practice living in Los Angeles who finds herself in the midst of a personal crisis. Thus starts this honest, funny memoir of her journey through her own psychotherapy, while she continues to help her clients (we meet four of them, pseudonyms were of course used & consent of clients obtained). We enter her life as a witness to her healing & to that of her clients. She struggles with similar issues in therapy as her clients: being vulnerable is especially difficult for her as a therapist herself. This especially stuck with me as I begin my own career as a social worker: remembering that we are also called upon to be vulnerable and reflect on what is happening with us, even as we treat others. This book reminded me that though we aspire to help others, we are human too (and that I needed to find a therapist).
The Gift of Therapy
by Irvin D. Yalom, M.D.
I first came across Irvin Yalom's work while doing research on group design & facilitation. I was developing a grief group for class and in the process of researching for my literature review I realized his work was some of the most prominent in the field of group psychotherapy, especially with those facing mortality issues.
I share an interest with Yalom: psychotherapy with those facing end of life. As an existential psychotherapist much of his work focuses on the search for meaning. This book is no different except that he has turned his attention to toward the therapist. The advice he imparts to new clinicians like myself is born out of decades of research and clinical work. Advice like be "fellow travelers" with your clients, and "create a new therapy for each patient."
This book felt intimate, like he was a mentor and we were sitting across from one another having coffee. It is a book that has informed how I interact with clients and how I view my role in their lives. What I've come to discover is that so many clients are seeking meaning. I can relate. It's why I came back to school. Meaning and purpose are a big part of self-actualization, the top of Maslow's Hierarchy of Needs. I need it just as much as my clients. We all do. This book is a nudge in that direction, a whisper saying "you can do this."
Trauma-Sensitive Mindfulness: Practices for Safe and Transformative Healing
by David A. Treleaven Ph.D
This book combines two big interests of mine: trauma work and mindfulness. It is the foundation for an independent study on Women, Trauma, and Mindfulness and how we can adapt mindfulness and meditation instruction and skills for female trauma survivors.
Part of what we ask of clients who are incorporating mindfulness skills into their treatment, is to be more present, to pay more attention to their body and thoughts. However, when someone has experienced trauma, asking them to do this is asking them to connect with painful memories, thoughts and sensations (survivors or sexual violence, for example).
Using the "four-R" approach of trauma care, Treleaven encourages clinicians to realize the extent of trauma in their practice, recognize signs and symptoms, respond using trauma-informed procedures, all to avoid re-traumatization. His approach provides a roadmap for therapists who use modalities which incorporate mindfulness, without the risk of re-traumatization.
I have begin shifting my language during mindfulness interventions. We may not also know about a trauma history, with new clients especially (they may not mentioned it straight away). Given what we know about the ACEs study and how 60% of people have had at least 1 adverse childhood experience, trauma history is very probable with most clients. Whether mindfulness is used as part of an ACT intervention, CBT or DBT intervention, approaching it through a trauma informed lens can only benefit the treatment. If we don't, and there is a trauma history, asking clients to be present and aware of sensations in their bodies, for example, may retraumatize them. Treleaven's approach is practical, compassionate and informed. I'm so glad I stumbled across this book.
An Experiential Approach To Group Work
by Rich Furman, Kimberly Bender,
& Diana Rowan
This practical guide is so straightforward. It looks at the history of group work as well as planning, organizing, facilitating, & evaluating therapeutic groups.
It also goes through the different types of group work; including support, psychoeducational, self-help, therapy, task-oriented, & macro practice groups as well as the phases a group goes through from first session to last. Part workbook, part handbook, it looks at how group work can be used with different demographics, & gives examples of exercises to use with different group structures & purposes.
When I was planning my grief group this book, along with many research articles on grief and loss, were the foundation of that group plan. I will refer to this source as a guide as I plan my future group work.
Counseling the Culturally Diverse
by Derald Wing Sue, David Sue, Helen A. Neville, & Laura Smith
Having read several other texts on the topic of addressing bias in practice, I wasn't sure what more an additional text on the subject would teach. I was pleasantly surprised and love this book! While it covers the topic of working with marginalized populations, its analysis of individual cases goes far beyond that of similar books. It tackles the systems of oppression and subsequent "minority stress" that is the result of a lifetime living within said systems.
Each chapter includes an "Implications for Practice" section, making it relevant to our work, taking it from the theoretical to the practical. There is also good discussion around biases that exist between people of color. One of the most important parts for me was around broaching the subject of racial identity in session, how oftentimes asking about how a person's identity factors in to what they are experiencing, instead of ignoring it can be helpful in building the therapeutic alliance. Ultimately I just love how this text is written, with no pretense.
Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACEs) Study
By V. Felitti, et al.
The ACEs Study was one of the first journal articles I read as an MSW student and it shocked me. The link between neglect, abuse, & household dysfunction to diseases decades later in adulthood, namely heart disease, cancer, stroke, diabetes, suicide, depression, obesity to name just a few was stunning. While I may have been able to predict depression and possibly suicide as linked to neglect and abuse, it was the increased risk for physiological diseases that really surprised me.
If we can address the root of adverse childhood experiences before they happen, we can save so many lives, not to mention the financial implications on our medical and insurance systems. Working with at risk children and their parents to reduce the risk of abuse, neglect, and household dysfunction (including substance abuse) has such a significant ripple effect on the lives of those children (and our society) for the rest of their lives. This research is probably the most important study to come out in my lifetime.
Beyond the Cliff
Laura van Dernoot Lipsky
Tedx Washington Corrections Center for Women
This video about secondary and vicarious trauma and how it can adversely affect our work as clinicians (and affect our personal life) really stuck with me. It solidified how important self-care is in this line of work.
Hearing van Dernoot Lipsky's story of how the impact of her work seeped into her home life with her family, and even her clients were asking her to take time off at first made me nervous. On a positive note I think the nervousness I felt contributed to the purposeful deepening of my meditation practice.
The trauma exposure response highlighted in this video is something that I will remember as I progress into this work.