Ellert R.S. Nijenhuis: The Trinity of Trauma: Ignorance, Fragility, and Control. Volume I & II, Vandenhoeck & Ruprecht, 2015, 645 pp, ISBN 978-3-525-45325-4, 99 €.

Ellert R.S. Nijenhuis: The Trinity of Trauma: Ignorance, Fragility, and Control: Volume III, Enactive Trauma Therapy, Vandenhoeck & Ruprecht, 2017, 505 pp, ISBN 978-3-525-45325-4, 79 €.

Published in German as Die Trauma-Trinität: Ignoranz - Fragilität – Kontrolle. Lesen Sie diese Rezension auf Deutsch (pdf).

This opus magnum comprises three weighty volumes in which Ellert R. S. Nijenhuis comprehensively presents his experiences, insights and ideas on dealing with trauma and dissociation. These have grown out of many years of practical and scientific work. The choice of the title Trinity of Trauma –with its allusion to the Christian religious trinity– may alienate some, but it points to one of the most challenging parts of dealing and coping with traumatic experiences: the paradox of separated and dissociated agents in the unity of an embodied person. Additionally the three basic action tendencies of “ignorance”, “fragility” and “control” that Nijenhuis describes actually seem to be something like a universal dynamic pattern of interaction when people are forced to deal with difficult-to-process experiences.

First, a brief overview of the content of the three volumes.

Volume I examines the words and concepts that were used to come to terms with the phenomena of trauma and dissociation in a highly interesting historical study of psychiatric treatment. Solution-focused practitioners are familiar with the fact that diagnostic categories do not have any explanatory value, nor are needed in order to help clients. However, since the meaning of a word - to use Wittgenstein’s words - can sometimes be explained by describing its use in language (Wittgenstein, 1953 #43), an illuminating conceptual clarification can be developed from the description of how words like melancholia, hysteria, trauma, dissociation or conversion were and are used. The aim is a clear understanding of the term trauma and associated concepts.

Volume II has its focus on trauma related dissociation. How can we understand personality, self, self-consciousness and the world, environment and body we live in and ultimately its dissociation in trauma? In doing so, Nijenhuis impressively incorporates both epistemological presuppositions and a wealth of empirical findings. He also makes many concepts – e.g. already developed by Piere Janet – that seem almost forgotten in many areas of psychotherapy accessible again in their topicality and develops the model of prototypical interactions between “ignorance”, “fragility” and “control”. This “trauma trinity” is not only described as an individual attempt at a solution in the face of immeasurable suffering, it also points out how these communication patterns are re-actualised on the macro-level of society’s handling of trauma.

The second book contains the third volume of the trilogy (the first two volumes are published together) in which Nijenhuis develops the therapeutic treatment of people with trauma related dissorders through enactive trauma therapy. This is based on the premise that people are embodied and embedded in their environment and are affectively oriented towards making sense of their experiences in the pursuit of sustaining their existence. Persons enact and realise a phenomenal self in a phenomenal world through self- and world-oriented actions. If interpersonal traumatisation occurs, dissociation of the phenomenal self can be a courageous coping for self-protection, which, however, often entails massive restrictions on the possibilities for action in the further course of life. It is important to meet such people in their unique view of the world in order to support new possibilities for action and syntheses in a process that Nijenhuis compares to a joint dance. All this is described in detail, illustrated with case studies and conceptualised on an abstract level of reflection. All three volumes conclude with a thesis-like summary.

Solution-focused therapists may be interested in the word “enactive”, which is curiously not yet widely used, because solution-focused therapy fits - as Dan Hutto once said (McKergow & Dierolf, 2016) - perfectly with the ideas of enactivism. When I had the opportunity to see Ellert Nijenhuis working therapeutically, it looked to me very solution-focused and solution-oriented towards the micro-phenomenology of co-created interaction. It seems all the more interesting that in the field of solution-focused trauma therapy little is said about the profound work of Nijenhuis, but rather, as far as I can see, he is mainly received by colleagues oriented towards behaviour therapy. Conversely, it is surprising that Nijenhuis, in view of his almost encyclopaedic work, nowhere directly refers to solution-focused therapy. Here there is a lot of potential for mutual inspiration for successful collaboration with clients, but also for professional-political advocacy on how how to shape therapeutic action responsibly.

The interesting differences and similarities extend into the philosophical contexts of reasoning. While Nijenhuis finds the foundation of his approach in Spinoza and Schopenhauer, whom few solution-focused therapists are likely to have read, there is hardly any reflection in relation to Wittgenstein, who is on everyone’s lips at least as a source of plausible quotations in the solution-focused context. Here, too, there would be room for an informed debate, which in my opinion should revolve primarily around the complex - but for enactive therapies central - question of whether and if so how willing occurs at all in a phenomenal world. Neither Spinoza nor Wittgenstein to me seems to have answered this question in the end. Enactivism, as a philosophical foundation, attempts to overcome the categorical split of a dualistic worldview and offers very justified criticism of the prevailing materialism. How, and from which point of view, the alternating determinations of subject and object, the ego and its world, are themselves still determined, remains largely unanswered.

Of course, this question does not necessarily have to be answered for successful psychotherapy. But if one wants to give serious scientific reasons for ones actions, one cannot avoid a philosophical reflection on implicit enactive or solution-focused assertions. Scientifically speaking, then, the difference between an enactive philosophical reflection and a terse solution-focused “it works” may not simply be a matter of taste or acceptable opinion.

In short, the way Nijenhuis reflects on the conceptual presuppositions of our practical action is impressive. It would be desirable if we could encounter the global consequences of abuse and violence practically and theoretically with such clarity and presence for the respective unique counterpart as this work encourages us to do. Despite all the conceptual maps Nijenhuis creates, his central concern remains the unique cooperation between clients and therapists to overcome traumatic experiences.

Read this review in German (pdf)

Author Biography

Matthias Schwab is a solution-focused practitioner, psychologist and artist based in Germany. He is engaged with working within ‘Void’ to create a “language lab of social practice” at the Free International University.