What trauma means today

The classic dictum underlying cognitive behaviour therapy (CBT) is that 'men are disturbed not by things, but by the views which they take of things'. This is attributed to the Stoic Philosopher Epictetus (The Enchiridion Epictetus, translated by Higginson, 2020), who discussed it in the context of death. Epictetus was born into slavery and endured a permanent physical disability. In essence the Stoic philosophers were 'centralists' in taking the person's view of matters as playing a pivotal role in distress. Unlike the trauma-focused CBT theorists, the ancient Stoic philosophers did not see the distress as originating in the particulars of the adversity at the time – what has, in the modern era, been termed arrested information processing. In my new book Personalising Trauma Treatment, I suggest that the key focus should be on what the trauma victim takes the trauma to mean about today, rather than having the client re-live the trauma.

Moving on from Stoic philosophers, Samuel Pepys wrote in his diary on 2 September 1666 (republished in 2003) of the start of the Great Fire of London. Five months later, on 28 February 1667, he wrote 'it is strange to think how to this very day I cannot sleep a night without great terrors of fire; and this very night I could not sleep until almost two in the morning through thoughts of fire'. From the Restorative CBT (RCBT) perspective evinced in the book, the sights, sounds, smells of what Pepys had seen would be acknowledged and the question of what they mean for today would be asked. In essence, how relevant are these memories? Do they mean that he can't walk the streets of London? The therapeutic focus would be on helping him realise he was safe. A prime RCBT target is helping the person regain their sense of self by gradually doing what they did before; for Pepys, writing about his daily encounters and the restoration/rebuild of London.

Moving further forward in my time capsule, the Auschwitz survivor, Edith Eger – who later became a Clinical Psychologist – was, in 2017's The Choice, askance at the idea of deliberate re-living of the trauma. 'Work through it? I lived it, what other work is there to do? … I've broken the conspiracy of silence. And talking hasn't made the fear or flashbacks go away. In fact talking seems to have made my symptoms worse… we can choose to be our own jailors or we can choose to be free'. She did revisit Auschwitz but her sister, also a survivor, declined.

What is fascinating is Eger coped with dancing in front of the Nazi doctor, Josef Mengele, by transporting herself back to the stage on which she performed ballet. A key feature of my own book is how we do that mental time travel. The RCBT is easy to disseminate and hopefully will be useful for helping the mass of psychological casualties generated by the war in Ukraine.