How do you decide when a problem is not rooted in early experience? While developing Coherence Therapy, Bruce Ecker, coauthor of Unlocking the Emotional Brain, spent a lot of time uncovering the differences between attachment-related problems and those that mimic them in therapy.

Stephen makes it clear that hard scientific evidence now exists for what most therapists instinctively know: successful therapy depends utterly on establishing a safe, caring, mutually trustworthy, stable relationship with a client.

The increasing ability of modern medicine to arrest or slow terminal illness means that never before has death been such an extended process for so many. But as a culture, we’re only just beginning to face the deep ambivalence that reality creates for both patient and family.

Neuroscience was brought into the field of trauma by the outspoken (and sometimes controversial) psychiatrist Bessel van der Kolk. Ever since his work with the Veterans Administration in the 1970s put him on the path to studying trauma, he’d begun to challenge the conventional psychiatric framework of trauma treatment.

In the past few decades, we’ve made important strides in our ability to help overwhelmed and hopeless people overcome the stigma previously attached to trauma symptoms, learn new thinking and self-regulation skills, and even find a new sense of restored well-being. But then they go home, and far more often than we’d like, when they’re back in their daily lives with family, friends, and coworkers, they don’t do so well.

Over the last 20 or 30 years, probably no other diagnosis has been more alluring to the therapy profession, more interesting to the general public, and more prone to evoking fervid discussion than trauma.

Back in the late 1970s, a motley crew of Vietnam War vets, sympathetic psychiatrists, antiwar activists, and church groups undertook a crusade to have a hastily assembled new diagnosis almost completely void of scientific research included in the DSM-III.

How can therapists acquire neuroscientific knowledge without becoming brain scientists themselves? Even more pressing, what real-life practical therapeutic implications, if any, can truly be drawn from neuroscience?

It’s in working with deeply troubled, unattached people who victimize others that we can learn some fundamental lessons about trauma work and the possibility of transformation, even for those whose apparent cruelty and indifference to the suffering of others seems to take them beyond the reach of psychotherapy.

Rick Hanson challenges psychotherapy’s focus on all the pain, trauma, and suffering that are so endemic to our human species. His clinical premise is that we therapists are too drawn to exploring the deep muddy of whatever psychic mess clients bring in.