The Body Bears the Burden: Trauma, Dissociation, and Disease » (2nd Edition)

Robert C. Scaer, MD, received his BA in Psychology, and his MD degree at the University of Rochester. He is Board Certified in Neurology, and has been in practice for 36 years, twenty of those as Medical Director of Rehabilitation Services at the Mapleton Center in Boulder, CO. His primary areas of interest and expertise have been in the fields of traumatic brain injury and chronic pain, and more recently in the study of traumatic stress and its role in physical and emotional symptoms, and in diseases. He has lectured extensively on these topics, and has published several articles on posttraumatic stress disorder, the whiplash syndrome, and other somatic syndromes of traumatic stress. His books include The Body Bears the Burden: Trauma, Dissociation, and Disease, which presented a new theory of dissociation and its role in many diseases, and The Trauma Spectrum: Hidden Wounds and Human Resiliency, which addressed the broad and relatively unappreciated spectrum of cultural and societal trauma that shapes every aspect of our lives. He is currently retired from clinical medical practice, and continues to pursue a career in writing and lecturing in the field of traumatology.

New edition provides updated concepts and ideas in simplified medical language

The Body Bears the Burden: Trauma, Dissociation, and Disease, Second Edition is the update of the classic book that explains the reasons behind some of the most common symptoms and conditions that previously defied a medical explanation. Respected author, Robert C. Scaer, MD, has diligently simplified the complex medical language that was used in the first edition to make it easier for lay readers and patients to understand—all without sacrificing accuracy. This valuable text presents a new theory of the neurophysiology of traumatic stress and dissociation and includes several updated chapters and new concepts that have been developed since the previous edition.

Human response is quite different than other animals’ response to trauma. This response is discussed in detail in The Body Bears the Burden: Trauma, Dissociation, and Disease, Second Edition, including the fight/flight/freeze cycle and how the human response causes abnormal regulation of many body systems which then may lead to many illnesses or conditions. The emotional and physical experiences of patients with Posttraumatic Stress Disorder and other syndromes such as whiplash are comprehensively examined. Patients and lay readers alike who have been told it is “all in your head” may well feel like this book was specifically written about them and the unexplained complex symptoms they experience.

Topics in The Body Bears the Burden: Trauma, Dissociation, and Disease, Second Edition include:

• the role of the fight/flight/freeze response in traumatic stress
• the neurophysiology of traumatic stress and dissociation
• the Whiplash Syndrome as a model for procedural memory in trauma
• analysis of traumatic repetition
• the theoretical concept of somatic dissociation
• the varied syndromes and medical diseases of trauma and dissociation
• a theoretical analysis or therapy for trauma
• illustrative case histories of trauma and the body
• and more!

The Body Bears the Burden: Trauma, Dissociation, and Disease, Second Edition is valuable information for physicians, psychologists, psychotherapists, social workers, physical, occupational, and speech therapists, nurses, and those lay people looking to better understand the physiologic rationale for a large number of perplexing chronic medical diseases and syndromes.

Doody Review Services

Reviewer:Nicholas Greco IV, MS, BCETS, CATSM(Abbott Laboratories)
Description:This is one of the more purposeful and thought-provoking books on trauma available. The clinical model of the whiplash syndrome affecting both the body and the mind is explored in detail, and the reader is given a well rounded discussion of this fascinating perspective.
Purpose:The purpose is to give both professional and lay readers a new perspective on the complexities of trauma through the use of case vignettes, strong empirical evidence, and appropriate medical and psychological theory.
Audience:The author smartly revised this second edition to make it more accessible for lay readers. He still maintains the strong empirical foundation professional readers would expect, but he has reduced complexity, redundancy, and unneeded jargon. Professionals in the fields of rehabilitation, psychotherapy, patient care, and general medical practice will find this book of most benefit. The author is a highly skilled neurologist who brings 36 years of experience to this book.
Features:Among the highlights are the case vignettes that begin each chapter and are covered within the chapters as well. These vignettes pull the ideas of the chapter together and make for reading that makes the book difficult to put down. The discussion of the whiplash syndrome is broken down into two chapters, and those doubtful of the whiplash syndrome will be hard pressed not to become believers. Especially useful chapters are those on the diseases of traumatic stress and on the sources of trauma.
Assessment:This is a great addition to the field. Simply put, it is one of the finest books I have read in the area of trauma.

Foreword (Bessel A. van der Kolk)
Preface
Acknowledgments
Chapter 1. Concepts of Trauma: The Role of Boundaries
The Concept of Boundaries
The Role of Boundaries in Trauma
Boundaries and Childhood
Conclusion
Chapter 2. Trauma, Instinct, and the Brain: The Fight/Flight/Freeze Response
The Neurophysiology of Trauma
Brain Responses to Stress
Fighting, Fleeing, or Freezing
The Human Anomaly
Conclusion
Chapter 3. The Whiplash Syndrome I: Symptoms in Search for a Meaning
The History of Whiplash
The Clinical Syndrome
Physical Forces and Structural Injury
The Pathophysiology of Whiplash
Conclusion
Chapter 4. The Whiplash Syndrome II: A Model for Traumatization
Memory Mechanisms in Trauma
Declarative versus Nondeclarative Memory
Somatic Responses to Stress
The Meaning of Speed
The Automobile As a Threat
The Physiology of Trauma
Kindling and Trauma
Cognitive Deficits in Trauma
Conclusion
Chapter 5. Trauma and Brain Plasticity
The History of Post-Traumatic Stress Disorder in Psychiatry
The Developing Brain
The Development of Character
Brain Plasticity in Trauma
Objective Measures of Brain Change in Trauma
The Permanence of Post-Traumatic Stress Disorder
Conclusion
Chapter 6. Somatic Dissociation
Examples of Dissociation
Memory in Dissociation
Cognitive and Emotional Features
Dissociative Physical Symptoms
Conversion Hysteria and Dissociation
The Autonomic Nervous System in PTSD
The Concept of Boundaries
The Spectrum of Somatic Dissociation
The Dissociative Capsule
Conclusion
Chapter 7. Diseases of Traumatic Stress
The Pathophysiology of Stress
Stress versus Trauma
The Hypothalamic/Pituitary/Adrenal Axis
Stress, PTSD, and Immune Function
The Diseases of Trauma
Somatic Dissociation and Disease
Reflex Sympathetic Dystrophy
Fibromyalgia/Chronic Fatigue Syndrome
Somatization Disorders
Morbidity and Mortality
Conclusion
Chapter 8. Trauma Reenactment
Introduction
The Roots of Reenactment
Clinical Features
Anniversary Syndrome
Reenactment Through Risk Taking
Conclusion
Chapter 9. Sources of Trauma
The Definition of Traumatic Stress
Exposure to Combat
Child Abuse
Societal Trauma
Medical Trauma
The Role of Past Trauma
Awareness During Anesthesia
Pediatric Medical Trauma
Childhood Medical Trauma
Conclusion
Chapter 10. Trauma Therapy: Essential Ingredients
Cognitive/Verbal Therapy
Exposure and Desensitization Techniques
Somatically Based Therapies
Eye Movement Desensitization and Reprocessing
Somatic Experiencing
Energy Psychology
The Search for the Essential Ingredient
Pharmacotherapy of Post-Traumatic Stress Disorder
Conclusion
Chapter 11. Case Histories: The Somatic Spectrum of Trauma
A State of Vulnerability
Somatic Representations of Prior Trauma
Medical and Forensic Trauma
Multiple Chemical Sensitivities
The Mysterious Piriformis
Disorders of Speech in Trauma
Spasmodic Torticollis: An Aberration of the Orienting Reflex
Dissociation and Reflex Sympathetic Dystrophy
Comments
Epilogue
Notes
Index