April 26, 2019
Ode to Kai – Life in the Old Dog Yet
A book review, by yours truly, as published in the CSTA journal, September 2017.
As a plethora of books on the treatment of trauma hits the shelves, this second volume of “The Body Remembers” has been quietly published, with no great fanfare or book tour. This practical book is based on clinical evidence gained over many decades at the forefront of trauma treatment.
It loosely covers the same material as volume 1, but goes further in the practical skills required to enable a client and therapist to self-regulate. The masterpiece of the whole volume is the in-depth chapter on Precision ANS Regulation; comprising of a review, theory and practical tips for monitoring the ANS. To this end, Babette Rothschild has included a colour-coded “What to Look For” pull-out chart. This is a genius tool, for those looking to gain confidence in monitoring themselves and the client, using observable parameters. It is divided into columns representing 6 hypothetical degrees of ANS arousal, coded yellow-green-blue-orange-red-purple, and entitled “Lethargic”, “Calm”, “Active/Alert”, “Fight/Flight”, “Hyperfreeze”, “Hypofreeze”. The rows cover physical attributes, emotions, and ability to integrate.
This chart aims to resolve the difficulties and fill in the gaps that are not addressed with the standard two-column ANS chart. It is also available as separate post-card that the author encourages readers to have on-hand in clinic.
As with Rothschild’s trainings, the book focusses on the practical skills of stage 1 treatment; stabilisation. With regard to trauma / PTSD, the author makes the case that dual awareness – the balance between perception of exteroceptors and interoceptors (external and internal reality) is largely missing, leading to an over-reliance on distressing interoceptive cues and an inability to recognise the present as different from the past. Through the use of case studies, Rothschild illustrates choices available to therapists to encourage stabilisation. This is surely a useful adjunct to the tools already in the CST’s toolbox.
The chapter on Trauma Treatment Planning has useful elements for goal setting, when applied to CST. Whilst the CST therapist cannot plan what is going to come up in a session, he/she can use the principles outlined here to fully understand what the client wishes to achieve from treatment. Taking the simple analogy of baking; if one has eggs, milk, butter, sugar and flour, depending on one’s method of baking, one can make pancakes, biscuits, sponge cake, bread or scones. Naturally, to achieve a successful outcome, one needs to know what the end product is supposed to be prior to beginning the process. By planning ahead, suggests the author, the therapist is able to be clear about what the client is aiming to accomplish and will confirm that one has enough time and the right tools to ensure success in therapy.
The second half of the book focusses on the application of the theory and principles. Details are given on how to help a client to find an anchor or resource and how to antidote traumatic numbing with positive somatic markers.
Briefly touched upon in volume one, Rothschild devotes a further section to the detailed use of “outlining”. Here she suggests that a client can be engaged in verbal exploration of a trauma through the careful use of chapter headings, breaking the event down into manageable chunks, so that the client is able to tolerate and regulate periods of dysregulation.
Finally, chapters are devoted to adapting mindfulness, MSBR and yoga for those with PTSD and avoiding common hazards met by many a therapist.
I have found this book, and the three-seminar training that accompanies it, to be extremely useful in helping me to gain confidence in my verbal skills, enabling clients to self-regulate and to monitor my own ANS regulation. The pull-out ANS card is most useful in educating clients about their own observable states and helps them and the therapist to modulate those states by applying the brakes and prevents vicarious trauma in the therapist. I can recommend this volume to new and experienced therapists alike.
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