On Wednesday the BBC morning News featured a Southampton University student, Hamish, who, as a result of sepsis, lost his four limbs. Amazingly he’s back driving, walking and continuing his philosophy degree. Hamish is living proof that is not the trauma per se that is important but what it is taken to mean for today. Earlier in the week, on ITV, I watched an episode of ‘Long Lost Families’ which featured an unsupported Mum, who as a 15-16 year old gave her 6-month old son up for adoption. The experience had clearly been absolutely devastating for her, but the programme reunited them both. The good news for her was that it had been a good adoption. However, at aged 12 or 13 her son found out that he had been adopted. His world was turned upside down as he viewed his life to that point as having been a ‘fiction’. He became estranged from his adoptive parents and they were devastated, with no appreciation of what had brought about the sharp change in him. This served to underline that is the take on events that is pivotal for outcome, rather than the trauma itself. We are all engaged in mental time travel, going back and forth in our ‘Dr Who, Tardis” collecting items from the past and gauging their utility for today.
But clinicians are often hi-jacked by the drama of the event and not the unfolding story, unnecessarily distressing themselves and their client, with a ‘re-living’ focus. A recent paper by Zoellner et al (2025) suggest that clinicians have overestimated the importance of the trauma and have underestimated the significance of the re-framing processes that occur subsequently. In my self-help book Moving on After Trauma Routledge 2024 and Clinician Handbook Personalising Trauma Treatment: Re-framing and Re-imagining Routledge 2022, I have proposed that it is the centrality accorded to the trauma that is significant and this is where therapeutic efforts need to be targeted. This is a radical departure from the traditional trauma focused treatment. The beauty of a centrality approach is that it is applicable not only to extreme trauma but also to lessor stressors such as bullying at work or being a victim of a Data Breach.
Dr Mike Scott