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Introduction to Trauma and Stressor-Related DisordersSigns and Symptoms of Trauma and Stressor-Related DisordersDiagnostic Descriptions of Trauma and Stressor-Related DisordersWhat Causes the Symptoms of Trauma-Related Disorders? Treatment of Trauma, PTSD, Abuse and Other Stressor-Related Disorders Conclusion, Resources and ReferencesDealing with the Effects of Trauma - A Self-Help Guide
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Depression: Depression & Related Conditions
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by Peter A. Levine
North Atlantic Books, 2010
Review by Tony Giordano on Sep 20th 2011

In an Unspoken Voice

Drawing creatively upon a variety of disciplines including animal ethology, brain research and his own vast clinical experience, Peter Levine challenges conventional wisdom by contending that many of our most important communications and processes occur in the body's "unspoken voice." A major premise of the book is that trauma is a common injury caused by fear, helplessness and loss and that healing is possible through the natural healing powers that exist deep within everyone. But in order to tap those healing powers one must first examine and make sense of the body's many nonverbal cues. 

According to Levine's argument, people historically have overestimated the power and the role of conscious, rational areas of the brain while underestimating the unconscious and the "premotor."  He contends that people consciously decide to act "only after their brain unconsciously prepares them to do so" by "firing a burst of electrical activity" from the premotor area. So, while the conventional wisdom is that a person runs from a bear because he's scared, Levine argues that a person instinctively runs at the sight of a bear before the conscious brain is even able to react, and the act of running then creates the fear. The rational mind naturally struggles with this kind of argument. 

Levine likes to cite Freud's well-known comment that "the mind has forgotten, but the body has not--thankfully." The book explains that memories, including traumatic ones, are stored in the more primitive areas of the brain such as the stem. The implication is that change and healing cannot occur simply through changes in thoughts as you often hear today, but rather must deal with sensation and feeling as well--the "totality of experience." Therapists in particular need to appreciate this point and be sure to implement it. 

Interwoven through much of the book is the notion that we are not as different from other animals as is widely believed and the author is fond of saying that we can learn a lot from animals. Indeed, the book cites numerous examples from the animal kingdom. Levine recounts how the human nervous system has evolved into a hierarchical structure, how the hierarchies interact, and how the more advanced systems shut down in the face of overwhelming fear, yielding operations of brain and body to more primitive functions. It seems that our brain assumes it generally has a top-down type of control when in fact bottom-up control is often in effect.   

While I'm not an expert in any of the subjects Levine draws upon, I like to think of myself as reasonably well-read in these areas. But I must admit I had trouble with a number of sections in the book. Part of the problem is simply language. The writing is at times highly technical and academic and I often wondered if the author could have found a simpler way to make his point. The book seems to be targeted primarily to those trained in neuroscience and psychotherapy.

Nevertheless, I feel a layman can get a great deal out of the book as long as the reader exercises patience and a willingness to wade through the rough patches. On the plus side, the book is generous in its use of actual clinical cases and revealing examples to clarify crucial points. Included as well are awareness exercises to be used for transforming and healing traumatic injuries.

All in all I'd recommend the book to most readers, particularly someone who's interested in learning more about the dynamics of trauma that often underlies mental illnesses. Increasingly research is finding trauma--variations of post-traumatic stress disorder (PTSD)--at the root of a host of mental disorders. It's vital for a sufferer to know this in order to unload the burdens of guilt, shame and weakness. Based on personal experience, I've become a strong believer in the therapeutic power of reading to learn about the causes and treatments of mental disorders, and this book was among the more helpful ones I've read.


© 2011 Tony Giordano


Tony Giordano, adjunct college instructor, peer educator and author of the recently published book, "It's Not All in Your Head: Unearthing the Deep Roots of Depression"