Book Review by John D. Carter on Remembering, Repeating and Working Through Childhood Trauma
Lawrence E. Hedges
Remembering, Repeating and Working Through Childhood Trauma:
The Psychodynamics of Recovered Memories, Multiple Personality, Abuse, Incest, Molest, and Abduction Northvale, NJ: Jason Aronson, 1994, pp 336
The therapeutic community has become divided, the lines drawn, and opinions strongly held about the reality of recovered memories, especially with respect to the issue of abuse. Years of zealous search for the recovery of memories of abuse by some in the mental health community has led to a crisis in which parents have been accused, legal precedents have been set in cases of decade-old memories, some memories recanted, and therapists sued for planting memories, while experimental researchers have attempted to clarify matters. Recently, therapists are having to deal with the potential of false accusations directed at them. At last there is a perspective that takes the client’s phenomenal experience seriously without participating in the reification of the content of these memories.
In Remembering, Repeating and Working Through Childhood Trauma, nominated by the National Association for the Advancement of Psychoanalysis as Best Book of the Year, Hedges argues that verbally cognized abuse memories that emerge in therapy function metaphorically to express early non-verbally cognized traumas of infancy. Hedges says, “my thesis is that, while we are now aware of much more real abuse than has ever been acknowledged before, this widely reported class of memories surfacing in psychotherapy today is not new and cannot be taken literally. Memories recovered during the course of psychotherapy need to be taken seriously, considered psychodynamically, and dealt with in thoughtful and responsible ways by therapists, not simply believed in and acted upon (p. 4).”
Hedges develops this theme in four areas which become the basic structure of the book: One, Taking Recovered Memories Seriously; two, Multiple Personality Reconsidered; three, The Dual Relationship in Psychotherapy; and four, Psychotic Anxieties and the “Organizing Experience.” While each of these sections is rich enough and diverse enough in character to become a book in itself, taken together they form a thematic whole.
In the first section of the book the key insight Hedges puts forward regarding recovered memories emerging in therapy is that they are contextually dependent and need to be worked within the therapeutic setting. That is, (1) recovered memories occur in a supportive, empathic, and caring relationship—psychotherapy; (2) they occur in the context of transference and countertransference; and (3) the character and quality of these memories are dependent upon the current developmental functioning level of the client. Using these key insights Hedges analyzes the differential character of remembering at each of four functioning developmental levels, with particular emphasis on the earliest level, which he calls “organizing.” He describes how relatively minor strains produced by experiences early in life can have a cumulative effect that operates like a major intrusive trauma creating difficulties in relating and in remembering traumas later in life.
In the second section of the book Hedges reviews the literature and phenomena of multiple personalities. He maintains that the fragmentation and multiple states in these persons reflect early trauma and organizing level functioning, though often showing up in more developed individuals. Hedges argues for a “listening perspective” approach which focuses on the goal of listening to the current immediate style of relating or non-relating of the client rather than the value laden goal of mature functioning held by traditional psychoanalytic approaches.
In the third section of the book Hedges shows by concrete example and a case history how working through early traumas in therapy via transference and countertransference necessarily involves a “dual relationship” as the therapist struggles realistically to contain the re-emergence of early traumas in the therapeutic process while simultaneously maintaining an adult client-therapist interpretive relationship. He concludes this section with illustrations and suggestions on how therapists can avoid accusations of abuse by appropriate handling of client transference and awareness of their own countertransference.
In the final section, Hedges reviews clinical theory on primitive mental states and the character of psychotic transference in the organizing experience. He characterizes it in terms of rage, flight, and frozen effect as distinguished from borderline fusing and attacking. In the earliest organizing experience, Hedges suggests that attachment is desired but authentic connecting is avoided because it was once experienced as painful or frightening. Whereas in the developmentally later borderline or symbiotic level of relating the fear of abandonment is primary.
This book makes a contribution of great magnitude to the understanding of recovered memory phenomena. As Elizabeth Loftus, a leading memory researcher, says on the book’s dust jacket, “He (Hedges) shows how and why these memories—whether true or false, or metaphor—must be dealt with in a thoughtful and responsible way and not simply believed and used as tools for destruction.”
There is, however, a difficulty that does not reside in the book itself but may be created by some of Hedges* potential “Sorcerer’s Apprentices.” While Hedges’ thesis and descriptions are clinically clear and penetratingly insightful, there are enormous problems in translating this knowledge into therapeutic practice. The pitfalls of working with early affective experience are many. I fear that inexperienced clinicians may grasp the idea of the organizing experience but fall prey to the confusing convolutions of the process of therapy with these clients.
Hedges has shown therapists how to take clients’ memories of trauma seriously by examining the deeper developmental traumas, reflected in sudden memories of past abuses that arise to prevent present connection. He demonstrates and works with how to respect the therapeutic context in which they occur. Hedges stresses the importance of consultation and monitoring countertransference. Additionally, in his companion works, In Search of the Lost Mother of Infancy and Working The Organizing Experience, he has provided a more detailed explanation of his theories so that clinicians can grasp the idea of the organizing experience and how to work with clients who have profound relational difficulties manifest in recovered memories and multiple personalities.
Hedges’ work is likely to be of more interest to clinicians actually working with recovered memories than to the general public. It is rich, complex, and sophisticated. Remembering, Repeating, and Working Through Childhood Trauma represents a revolution in the approach to recovered memories that, should it be embraced by the therapeutic community, will return the work of therapy to the struggle to love and be loved rather than the more sensational struggle to seek satisfaction in retribution for unsatisfactory lives.