Caroline Garland speaking today at the International Psychotherapy Institute on aspects of trauma described how the traumatized person experiences the present trauma in the light of past trauma. Defenses against anxiety have broken down and led to extreme distress because the good objects have not been strong enough to protect against reality which now feels immensely unsafe. The person loses a sense of a personal future. When family love and supportive action is not enough, the traumatized person who comes to a therapist needs the containment of analytic psychotherapy — not hugs and action. We do not treat the trauma with compensation or solutions to block the pain. We offer a relationship in which we agree to listen and take in and bear the patient’s fear and pain and contain our reactions of helplessness and emotional distress. We need the support of analytic theory and discussion with our colleagues as we work to contain the trauma past and present and help the patient restore a sense of meaning and purpose in life.

—Jill Savege Scharff