Toward a Psychology of Uncertainty: Trauma-Centered Psychoanalysis

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Since trauma is a thoroughly relational phenomenon, it is highly unpredictable, and cannot be made to fit within the scientific framework Freud so admired. In Toward a Psychology of Uncertainty: Trauma-Centered Psychoanalysis, Doris Brothers urges a return to a trauma-centered psychoanalysis. Making use of relational systems theory, she shows that experiences of uncertainty are continually transformed by the regulatory processes of everyday life such as feeling, knowing, forming categories, making decisions, using language, creating narratives, sensing time, remembering, forgetting, and fantasizing. Insofar as trauma destroys the certainties that organize psychological life, it plunges our relational systems into chaos and sets the stage for the emergence of rigid, life-constricting relational patterns. These trauma-generated patterns, which often involve denial of sameness and difference, the creation of complexity-reducing dualities, and the transformation of certainty into certitude, figure prominently in virtually all of the complaints for which patients seek analytic treatment.

Analysts, she claims, are no more strangers to trauma than are their patients. Using in-depth clinical illustrations, Dr. Brothers demonstrates how a mutual desire to heal and to be healed from trauma draws patients and analysts into their analytic relationships. She recommends the reconceptualization of what has heretofore been considered transference and countertransference in terms of the transformation of experienced uncertainty. In her view the increased ability of both analytic partners to live with uncertainty is the mark of a successful treatment.

Dr. Brothers’ perspective sheds fresh light on a variety of topics of great general interest to analysts as well as many of their patients, such as gender, the acceptance of death, faith, cult-like training programs, and burnout. Her discussions of these topics are enlivened by references to contemporary cinema and theatre.

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Editorial Reviews

From the Publisher
"How much can one have to say about the idea of uncertainty in living and in clinical practice? With each chapter of this eloquent, deeply personal and yet universally applicable book, I thought that the next chapter would have to be redundant. I was most definitely wrong. Each chapter took me on a journey – sometimes a painful one – that has enriched my own life and has added greatly to my clinical sensitivity and depth. Over and over, I found myself grateful to the author for having the emotional courage to plumb the ‘trauma-generated certitudes,’ for in so doing, I emerge from the reading a more resilient, more open-minded clinician."

- Lynne Jacobs, Ph.D., Psy.D., Training and Supervising Analyst, Institute of Contemporary Psychoanalysis, Los Angeles; Co-Founder, Pacific Gestalt Institute, Los Angeles

"This is a courageous and inspiring book, both scholarly and accessible. Doris Brothers invites and challenges us to bring center-stage in psychoanalytic thinking aspects often marginalized: trauma, uncertainty, gender, faith. We begin to notice personal and institutional methods of reducing life-and-death uncertainties to simplistic and tightly-held "certitudes". These methods, including denial, authoritarianism, rigid categories, and even cult-like relations, may lead to burnout and despair. Brothers’ clinical accounts, illustrating her perspective for psychotherapists of varied theoretical persuasions, are gripping and thought-provoking. A great read."

- Donna Orange, Ph.D., Psy.D., Author, Emotional Understanding: Studies in Psychoanalytic Epistemology

"In bringing a relational systems sensibility to the ubiquitous condition of existential uncertainty, Doris Brothers has created a new and compelling language for the understanding of our traumatic worlds and their therapeutic transformation. This book is a major contribution not only to psychoanalysis but to all the healing disciplines."

- Maxwell S. Sucharov, M.D., Member, International Council for Psychoanalytic Self Psychology

"I think there is a great deal to be learned, thought about, and enjoyed in this book for any members of the broad psychological audience. It is a remarkably frank, clear, and non-presumptuous book, courageously presented by an obviously thoughtful and very caring practitioner. I highly recommend it."

- Edwin L. Hersch, Ph.D., Journal of Phenomenological Psychology 39, 2008

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Product Details

  • ISBN-13: 9780881634785
  • Publisher: Taylor & Francis
  • Publication date: 11/28/2007
  • Series: Psychoanalytic Inquiry Book Series , #27
  • Pages: 240
  • Product dimensions: 5.90 (w) x 8.80 (h) x 0.60 (d)

Meet the Author

Doris Brothers, Ph.D., a psychologist and psychoanalyst with a private practice in New York City, is a cofounder and training and supervising analyst at The Training and Research Institute for Self Psychology. Her previous publications include Falling Backwards: An Exploration of Trust and Self Experience (W. W. Norton, 1995) and The Shattered Self: A Psychoanalytic Study of Trauma (Analytic Press, 1988), which she wrote with Richard B. Ulman.

She is currently participating in an online discussion group based on her recent paper "Trust, Uncertainty, and Therapeutic Alliance in Trauma-Centered Treatment" (

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Table of Contents

The Laboratory and the Labyrinth: An Introduction. Making the Unbearable Bearable: Regulation, Expectation and the Experience of Existential Uncertainty. Trauma as Exile: Terror, Shame and the Destruction of Certainty. Sanctuary on the Ledge: Trauma-Centered Treatment. Muting the Sirens of Certainty: Beyond Dichotomous Gender and the Oedipus Complex. To Die with Our Dead: Ghosts, Ghouls and the Denial of Life. Faith, False Gods and the Surrender of Certitude. In the Ashes of Burnout: Lost (and Found) Faith. Epilogue: Rewinding the Thread.

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