The Trauma Unit within the Adult Department began, with a generous helping of ‘seedcorn’ money allocated by Anton Obholzer, eighteen months after the terrible sinking of the Herald of Free Enterprise, in March 1987. The news of this disaster, with the loss of hundreds of lives, had broken as half-a-dozen of us from the Adult Department were celebrating our just-announced qualifications from the Institute of Psychoanalysis. Each of us felt, within the tradition of the Department, that our brand-new qualifications in the field of mental health should have a direct application in the area of external relations, as well as in the intrapsychic world of the individual. The next day, two of us travelled to Dover to offer whatever we could in the way of back-up, support, learning and expertise. What we saw and learned that day (including the blunt fact that ‘helpers’ arriving unasked at the scene of a catastrophe is not the best way to be helpful) was the first stage in the formation of the Unit for the Study of Trauma and its Aftermath.
What was distinctive about the approach taken by the Unit was that it focused upon a psychoanalytic approach to the treatment of traumatised states of mind. We knew that to be caught up in a severely traumatic event would stir up many of the unresolved pains and conflicts of childhood. Thus we attended to the meaning of the events as well as to what had actually taken place, linking the present with the past. We did not believe in the advice, frequently heard, to ‘put it out of your mind.’ When events were remembered and worked through, rather than being encapsulated in a no-go area, there was a chance that they could be incorporated into the whole of the individual’s existence, instead of becoming its central focus – whether consciously or unconsciously.
We offered each patient referred four consultations, in which the practical and the emotional elements of the situation could be put together with the patient’s history. Some patients felt sufficiently helped by this approach to leave it there; and some were then referred on either for group or for individual treatment. However, what seemed to us crucial was that any referral onwards should then be made for the individual, the person, not for the traumatic event itself.
Since Caroline Garland’s retirement in 2008, Dr Jo Stubley has taken over the leadership of the Trauma Unit. Its scope has enlarged primarily to address complex and developmental trauma. This includes work with asylum seekers and refugees, veterans and survivors of childhood abuse – physical and sexual, as well as survivors of interpersonal violence. The Tavistock Trauma Service – as it is now called – still holds a psychoanalytic understanding at the heart of its work, but also makes use of other ways of working. These include the use of trauma-focused cognitive behaviour therapy (tf-CBT), eye-movement desensitization and reprocessing (EMDR), trauma art therapy, trauma psychoeducation groups, and trauma yoga groups. The Trauma Service also engages with the issue of historical child sexual abuse: here it offers specialist groups for men and women, as well as individual work. It maintains a partnership with the British Red Cross, which helps asylum seekers to access the Trauma Service through direct referral by Red Cross caseworkers. The Service also offers consultations to organizations working with traumatized individuals, including a number of frontline services after the Grenfell Fire in 2017. It continues to teach widely, and runs a one-year course on a psychoanalytic approach to trauma.
Thus the Tavistock tradition of applying specialist psychoanalytic knowledge to work with needs within the wider population has been sustained and developed well into the twenty-first century.
Author: Caroline Garland/Jo Stubley 2020