Aiding survivors of abuse | |
After abuse. Gita Mammen. Melbourne: ACER Press, 2006 (ix + 139 pp). ISBN 0 86431 405 1. |
I wish this book had been available when I went to work in a women’s health centre over 20 years ago. Then, I was taken aback to discover how often the experience of childhood sexual abuse underlay many patient presentations. Gita Mammen, a psychiatrist and psychotherapist with a wealth of experience, shares with us her calm, compassionate and elegant approach to working with adult survivors of abuse. Written mainly for primary care counsellors, it is also relevant for general practitioners and specialists. The book is clearly structured, providing an understanding of the social context of abuse and abuse-specific work. Mammen provides insight into the way survivors may present — very useful for the new practitioner and the practitioner who does not yet recognise those survivors among their patients. Her framework emphasises the need to develop a respectful partnership with the client or patient, and she gives careful advice on how to enable a therapeutic relationship. This includes the importance of understanding the dynamics of childhood trauma and how this shapes a person’s current life-coping skills. She outlines a holistic assessment process, best suited to those with long appointments, but still useful within a general practice context. Mammen provides enlightening vignettes to illustrate key points, demonstrating a skilful form of questioning both respectful and supportive of the patient. The book is well laid out and each chapter provides summary boxes of key points, which I found very handy. I would have liked a little more on dealing with patients with somatising disorders and the controversial borderline personality disorder, but I appreciate that this was beyond the parameters of the book. The discussion on memory was similarly tantalising and had me wishing for more. I liked the way Mammen included the focus on balance in regard to therapy and for workers. Her awareness of interpersonal dynamics and her sage advice on avoiding some resultant problems could have saved me from making some beginner’s mistakes 20 years ago. I will read this book again and again. Lesley R Shorne
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