Book Review: The Simple Guide To Complex Trauma and Dissociation: What it is and How to Help, by Betsy de Thierry.

Professional or Personal Perspective? Professional.

Genre: Non-fiction. Psychology.

Yay or Nay: Not sure. A bit of both.

Completion Status: Completed (though almost DNF’d due to the mismatch between title and content).

Worth Owning? Not for me.

Cost: $22 Canadian; $16 US (paperback).

Publication Year: 2021.

Publisher: Jessica Kingsley Publishers.

(Library) Borrowed or Owned? Borrowed.

Pros:

• Does define complex trauma in simple, easy to understand words.
• Designed to be used as an introductory guide to dissociation for professionals and parents/caregivers dealing with traumatized children who exhibit difficult behaviours. (Explains that what looks like deliberately bad, defiant, or “naughty” behaviour may actually be the result of survival-based dissociation).
• Mainly designed to address the issue of Dissociative Identity Disorder in children, and how to help children who experience it. (And to a lesser degree, less severe forms of dissociation.)
• Uses a significant number of references that can be used for further reading.
• Some of the later chapters on “what to do about it” are ones I really enjoyed and found had useful information in them. (Especially Chapter 5 – on recovery and what adults can do; Chapter 6 “Creating Safety”; & Chapter 7 “Learning to Feel”).
  • Of particular note, Chapter 7
    • describes why feelings, and also physical sensations can be so hard for traumatized children to deal with.
    • Brings attention to some of the problems that a “one size fits all” approach to mental health can cause.
      • Eg., Mindfulness that isn’t trauma sensitive, and breathing exercises as grounding exercises can both be re-traumatizing rather than helpful for children experiencing trauma, or who are still in survival mode after the end of traumatic experiences.
• The book seems to be referring Steven Porge’s Polyvagal Theory as a basis for much of it’s information.

Cons:

• There is a significant mismatch between the title and the content of the book. The main focus of the book is severe dissociation (think Dissociative Identity Disorder) in children who have experienced relational (complex/developmental) trauma, rather than on complex trauma itself per se. As such, there is only a small amount of information about what complex trauma is etc.
  • A much more accurate title would’ve been A Simple Guide to Severe Dissociation in Complex Trauma.
• I found the book focused far too much on severe dissociation and not nearly enough on the overal concept of what complex trauma is.
• It would’ve been nice if the promotional blurbs would’ve made it more clear that this series is designed to be used by therapists and parents caring for traumatized children, and not as general introductory guides to the subjects mentioned in titles.
• Sometimes the book sacrifices accuracy of information for uniqueness of terminology. It’s as if the author was so determined to rephrase things in her own words, she chose words that were less accurate than the commonly agreed-upon language found in professional literature (including that intended for laypersons).
• Also has a tendency to use words that are too colloquial, (in an effort to simplify the subject matter) instead of using the commonly used medical terms. (e.g. uses “fit” instead of “seizure”). For a guide that is intended for professional use, this is surprising (and disheartening).
  • Uses a lot of British colloquialisms (granted she is British), such as “fit” and “off with the fairies” in place of medical terms. This makes it hard for non-British readers to understand the content being discussed, unless they are thoroughly familiar with these colloquialisms.
• Uses confusing terminology when trying to distinguish between complex trauma (or Type II and Type III) and singular trauma (or Type I, aka “simple” trauma). Often contrasts the term “complex trauma” with “trauma”, as if there are no commonalities between singular trauma and repeated trauma. A simple grammatical change (such as I used in the previous sentence) could’ve clarified this greatly.
• The grammar was often poor, making it difficult to understand what was intended to be conveyed. E.g., there were often too many examples in one sentence to keep track of what the intent of the sentence was. Other times there were several thoughts conveyed in the same sentence, which was often confusing. Separating the different thoughts into separate sentences would’ve clarified things greatly.
• The author seems to be confused as to whether the concepts of “developmental trauma” and “developmental trauma disorder” (as proposed by Bessel van der Kolk) are the same thing, or two different ones. She often uses the terms interchangeably. (For the record, they’re different. One describes a general concept, the other a diagnostic term for potential inclusion in the DSM – Diagnostic and Statistical Manual – put out by the American Psychological Association).
• Uses outdated and/or pathologizing language when describing other disabilities.
  • Compares Autism to Fetal Alcohol Syndrome and Epilepsy. Calls them all “medical challenges”, and “health and wellbeing issues”. Seems awfully close to calling autism a disease, to my mind!
  • Similarly calls ADHD a “mental health issue”, rather than recognizing it as a neurodevelopmental condition.
  • Refers to PTSD as an “anxiety disorder” (it was removed from the anxiety category, and changed to a trauma related disability in 2013 when the DSM 5 came out)
• Uses the term “dissociation” without defining it until many pages later. Uses the term repeatedly before she ever gets around to explaining what she means. (I was always taught that this was a fundamental error to avoid when engaging in academic or professional writing).
  • Also uses the term “complex dissociation” without ever defining it. Whether she’s trying to say “dissociation in complex trauma” or “severe dissociation” or “extensive dissociation”, or something else entirely is unknown. Some unexplained personal shorthand maybe?
• In her initial discussions of dissociation as an “abnormal” trauma response, she never mentions that a certain degree of dissociation is a perfectly normal part of every human being’s daily life (even those who haven’t been traumatized). She only finally mentions this much later.
• Sometimes it seems as if the author is using references to back up what are otherwise flimsy arguments (at least the way they are phrased in this book).
• The author seems to have difficulty being consistent when describing complex trauma – sometimes she refers to it as a single event, (eg., pg. 127) rather than an series of ongoing ones. Sometimes she uses the terms “developmental trauma” and “complex trauma” interchangeably, and other times as if they are somehow different entities. (In any of my extensive reading on the subject, the two terms are always used synonymously).
• I had a lot of trouble understanding her description of her “Daisy Theory” that she’s developed to explain dissociation in children. Her description of it was nowhere near the “simple, easy to understand” explanation she claimed. It wasn’t until the very end of the book, and several more uses of the theory in different chapters, that I finally understood what she was trying to say.
• Refers to interoception as an intentional “reflective process” , rather than as one of the senses (I’ve often seen it referred to as the “seventh sense” in any reading on sensory integration/sensory processing, or neurodiversity I’ve done).
  • Doesn’t mention sensory integration dysfunction (or sensory processing disorder) as a potential primary cause of difficulties with introspection. Only references trauma as a cause.