In this book, author Annie G. Rogers, Ph.D., seeks to explain her theories on a unique way of listening to clients (particularly, adolescent cisgenderIn this book, author Annie G. Rogers, Ph.D., seeks to explain her theories on a unique way of listening to clients (particularly, adolescent cisgender girls) who have a history of sexual trauma, based on her life's experience, clinical practice, and her reading of Lacan. She describes several "case studies" in detail, while tracing how the different elements of her theories came together.
Contrasting her psychoanalytic methods to standard approaches to diagnosing and treating PTSD (e.g., medication, cognitive behavioral therapy, or purely relational therapy), she writes, "...I worked against the grain of how many therapists think about trauma and how to treat it... In my practice I want to hear children in a way that invites them to say more, to find words for the unsayable-- and this necessarily means listening to the unconscious." (p. 200-201).
Truths about the girls' trauma are first communicated indirectly through their bodies, physical symptoms, actions, and especially through unintentional repetition of sounds, words, images and phrases in their speech and/or their dreams. Actually, repetition in any of these areas is especially meaningful. The truths that are communicated are not necessarily or solely the story of "what happened"- the narrative of assault or abuse- but are related issues that can't be known or spoken of directly. These include context, connections to intergenerational trauma, reasons why it happened or why it wasn't/couldn't be told, deep questions about why family/other protectors weren't there or didn't notice the impact of trauma, connections between trauma and the girls'perceptions of themselves, their families, relationships, and the world at large.
The most compelling parts are her discussions of long-term work with some of her former clients. Dr. Rogers walks us through (non-verbal and verbal) interactions during their appointments, then through the process closely reading over her transcripts and identifying repeated words, phrases, images etc that seem potentially meaningful. She then takes us to a next or future appointment, to her open-ended process of asking the girls about these repeated symbols, how they might be connected or what they might mean.
There is not always a definitive answer. But the process of becoming aware and attempting to decipher their personal web of symbols, meanings, and indirectly expressed truths, seems to move many of the girls to major breakthroughs. Symptoms suddenly disappear or lessen. Tears flow freely for the first time. They approach a loved one for a difficult conversation. They take responsibility for harm they've caused. They find a new activity or passion that brings them joy and purpose.
The book has its limitations, too. I disliked nearly all sections explaining Lacan (and Freud) for at least three reasons. First, it was too dense- it this is meant for a general audience (e.g. not mental health professionals) the language in those sections was pretty inaccessible and certainly over my head. Second, it was never made clear to me why someone with the serious responsibility of working with these girls through their healing, should be looking to the writing of Lacan and/or Freud as a guide. Why does a clinical psychologist study them? Third, well, I'm just not interested! (Mercifully, explaining and applying their theories comprised only a relatively small portion of the book).
As a non-binary trans person, the book definitely had limitations in its discussions and generalizations about gender (universalizes adolescent cis girl development, rendering all trans adolescent experience invisible or impossible). And all the Freud/Lacan stuff about early life, mothers, fathers, phalluses (???) - seems a very cishetero-centric jumping off place for guesswork about everyone's inner life. I also felt that not enough was done in this book to qualify that Dr. Rogers' insights into adolescent cis girl development may only be applicable/relevant to the culture where she practices, or to acknowledge issues of race and racial privilege. There is not actually one universal adolescent cis girl experience, nor one adolescent cis girl survivor experience.
But overall I'd recommend the book. What I like most about her approach is that it is centered on deeply listening, and working within a system of symbols and meanings that originates in the girl's unconscious - i.e. not imposed or pathologized. This contrasts to some common approaches to trauma "treatment" which can ignore meaning, devalue listening, and focus solely on managing symptoms / controlling behavior. I also like that Dr. Rogers seems to allow a lot of room for the girls to guide their own treatment, to speak when they're ready. She seems to genuinely care about earning their trust, rather than feeling entitled to it.
I also deeply appreciated the points at which she (though briefly and in passing) expressed her professional view that locking a girl up in a "more secure facility" following a violent incident, would not support that girl's healing. I would have liked to see a deeper social criticism of the various systems and institutions many of the girls she interviewed were cycling though- foster homes, group homes, hospitals, the "therapeutic school," etc. But it was encouraging to at least see her pushing against the disciplinary, retributive, and fundamentally carceral logic of how these facilities react to a traumatized youth's behavior....more