Waking the Tiger: Healing Trauma [Kindle Edition]

As a psychiatrist and author of "Lost in the Mirror: an Inside Look at Borderline Personality Disorder," I have dealt with many kinds of trauma and am always interested in new approaches to this difficult area. I found "Waking the Tiger" an engrossing approach to the problem of how trauma creates damaging and often enduring symptoms. Dr. Levine's concept of the "freeze response" in the face of overwhelming threat provides a missing link to symptoms such as dissociation that our old ideas of "fight or flight" fail to explain.

Even more important to trauma survivors and their therapists is the redeeming message that immobilization in the face of threat is an automatic biological response that is not voluntarily chosen by the victim. The January 2003 issue of Clinical Psychiatry News reported that an overwhelming majority of victims of sexual assault describe a moderate or high level of paralysis occurring during the assault, consistent with Dr. Levine's observations.

Dr. Levine also provides an astute portrayal of the nature of memory by acknowledging that memories are not literal recordings of events but a complex of images that are influenced by arousal, emotional context, and prior experience. Like a painting, memories may even transform over time as new experiences add layers of meaning to the images. While remembering the past can be an important aspect of therapy, appreciating the subjective quality of memories is crucial to integrating them appropriately into the healing process.

As someone who was directly impacted by the September 11 tragedy this book was recommended by my counsellor on my return to the UK. I could readily identify with the third scenario of 'freeze' and how this affects the body in addition to the mind. The book is well written and it is easy to grasp the concepts and apply them to real life situations with good examples being used throughout. Peter Levine also extends the book into the impact and management of trauma in Children and this is particularly relevant, given that I am also a father of three small rugrats. The structure of the book is not convoluted and addresses each section and sub section briefly but to the point. I would recommend the book to those who feel trapped in their own cycle and cannot see a clear way out.

This book focuses on `shock trauma'; - the result of an isolated event or series of events with no consistent history of previous trauma. It also is written from the perspective that there is a community of family and friends - or caregivers - to support the traumatised through the healing process. Whilst it may help individuals who suffered long term childhood assault at the hands of their primary caregivers - that is not its focus or intent although the self help exercise in this book may help many traumatised people get into bodily sensations, feelings and thoughts. And that's really great and a positive aspect of the book. But whilst undoubtedly contributing to an understanding of PTSD and trauma (not the same thing), this book's fundamental flaw seems to be that it is written by someone who has a limited personal understanding of the impacts of long term sustained trauma without a normal and caringly supportive context.

Levine switches from an apparently factual style of writing to use of "I" and "we" throughout - so the reader never really knows the extent to which his own personal experience(s) of trauma influences what he puts forward as fact and influences his own interpretation of his client's stories. For example he claims one patient must have been "in denial" because she claimed not to have been frightened during a kidnapping a few years ago. What if that patient had been persistently assaulted at a very young age and lived a life of emotional numbness as a consequence? She truly may not have felt fear at the time of kidnapping in adulthood - having lived her whole life dissociated and devoid of feelings. Yet to say she is `in denial' of her fear is intensely disrespectful - she maybe had no fear resource available to her to deny. Unsurprisingly that patient did not return to him.

Phrases such as "I am endlessly fascinated by the subject of trauma" ... "we will continually be on edge" etc raise alarm bells as attempts to get the reader to over-identify with him and accept what he says. And in truth the freeze reaction certainly does exist in humans - but not always as the `feign death' response Levine postulates. Many adult PTSD sufferers will have experienced the conflicting mental urge to run at the same time as to turn and fight. This may lie behind some peoples' `freeze' reaction - but again appears outside Levine's experience. Eg he draws analogies with the response of prey animals to threats and to trauma - and applies them to humans. And this may be appropriate for children and adults who find themselves in a `helpless' state at the time of trauma. But what of the fact that humans are potentially vulnerable whilst young and then grow up to be the ultimate predator of all ? What happens to tiger cubs and lions who are turned on by their own parents ? It does happen - and some end up dissociated and unable to relate to other big cats as a consequence. And this book may not be of much help to those who have been through such an experience.