Book – Treating Risky and Compulsive Behaviors in Trauma Survivors

This clinically-focused guide instructs therapists in how to best understand high risk behavior through the lens of complex trauma and survival-based coping.  Briere explains often misunderstood and maligned symptoms – such as self-injury, compulsive sexual behaviors, binge eating, reactive aggression – as distress reduction behaviors.  Illuminating the process through which trauma survivors learn to numb, block, or sooth otherwise intolerable pain, Briere identifies early childhood relational trauma (especially involving child neglect or caregiver disengagement) as a leading area of vulnerability for the development of high-risk behaviors.

Trauma impacted youth find themselves in the midst of chronic, high levels of stress without the supportive care of adults to aid in developing skills to self-regulate.  Meanwhile, disrupted neurobiology from this persistent arousal leaves the nervous system more vulnerable to being easily overwhelmed.  When the distress persists throughout critical years of child development, such individuals often do not develop sufficient skills to reduce distress or tolerate painful memories later in adulthood.  Further, those who have painful interpersonal experiences throughout youth often carry these experiences into adulthood, leaving them more sensitive in their adult relationships to the perception of criticism and rejection.  This dynamic can lead to reactions that often appear out of proportion to the outside observer, perpetuating a cycle of negative relational patterns and behaviors.

This insightful book is a highly useful addition to the complex trauma treatment literature, with a focus on the safety and stabilization.  The author provides both a conceptual frame for formulation and a wealth of tools for clinicians working with high risk clients.  He advocates for a curious clinical stance, and gives practical suggestions and resources for using functional analysis of triggered responses to craft effective treatment plans. Buy the book