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Damaged: Childhood Trauma, Adult Illness, and the Need for a Health Care Revolution
Childhood adversity that is severe enough to be harmful throughout life is one of the biggest public health issues of our time, yet health care systems struggle to even acknowledge the problem. In Damaged, Dr. Robert Maunder and Dr. Jonathan Hunter call for a radical change, arguing that the medical system needs to be not only more compassionate but more effective at recognizing that trauma impacts everybody's health, from patient to practitioner.
Drawing on decades of experience providing psychiatric care, Maunder and Hunter offer an open and honest window into the private world of psychotherapy. At the heart of the book is the painful yet inspiring story of Maunder's career-long work with a patient named Isaac. In unfiltered accounts of their therapy sessions, we see the many ways in which childhood trauma harms Isaac's health for the rest of his life. We also see how deeply patients can affect the doctors who care for them, and how the caring collegiality between doctors can significantly improve the medicine they practice.
Damaged makes it clear that human relationships are at the core of medicine, and that a revolution in health care must start with the development of safe, respectful, and caring relationships between doctors and patients. It serves as a strong reminder that the way we care for those who suffer most reveals who we are as a society.
Drawing on decades of experience providing psychiatric care, Maunder and Hunter offer an open and honest window into the private world of psychotherapy. At the heart of the book is the painful yet inspiring story of Maunder's career-long work with a patient named Isaac. In unfiltered accounts of their therapy sessions, we see the many ways in which childhood trauma harms Isaac's health for the rest of his life. We also see how deeply patients can affect the doctors who care for them, and how the caring collegiality between doctors can significantly improve the medicine they practice.
Damaged makes it clear that human relationships are at the core of medicine, and that a revolution in health care must start with the development of safe, respectful, and caring relationships between doctors and patients. It serves as a strong reminder that the way we care for those who suffer most reveals who we are as a society.
- GenresNonfictionPsychology
232 pages, Hardcover
Published October 5, 2021
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Displaying 1 - 12 of 12 reviews
November 13, 2021
The road to trauma awareness is a fraught one, filled with struggle. More often than not, both within and outside of medicine, there is a tendency to avoid the disquiet and unease that comes with facing the suffering and toll that emerges from childhood adversity.
Damaged, written by Toronto psychiatrists Robert Maunder and Jon Hunter, brings a deeply human face to childhood trauma, and its effects on the minds and bodies of patients, their caregivers and their families.
Interspersing contemporary knowledge of trauma and the consequences of childhood adversity with a sometimes heartbreaking and always moving clinical case, Damaged brings us - with wisdom and subtlety - to a more intimate view of suffering and of our struggles to both avoid and overcome.
Both of the authors work in liaison psychiatry, assessing patients who often present with concomitant trauma and severe chronic medical illness (the book explains how the two are strongly linked). This provides for a unique vantage point and makes this book a valuable addition to our current literature on trauma.
I admired the balance between sobriety in presenting the most up-to-date information on the lifelong effects of childhood trauma and passion in calling for a health care revolution. And I was deeply moved reading about the evolving therapy relationship between Dr. Maunders and his patient Isaac (in my experience, almost every trauma therapist colleague I know has at least one "Isaac" in their practice, but that's an aside).
The authors clearly note, near the end of this readable and taut book, that they have not written a book about trauma therapy, and you will not find any information here about any of the major trauma therapies. There are many other good books for that.
It is a challenge to assemble and reveal the true and whole face of trauma, and Damaged certainly takes its place in offering an important part of that picture, one that combines head, heart and guts.
It is a gift for both physicians and for the public. We will be proudly adding this book to our recommended reading for our Canadian physician psychotherapy training program.
The authors remind those of us involved in trauma therapy and advocacy that we need one another (with its powerful entries describing how the two authors stood by and supported one another during some of the darker moments - doing trauma work can be profoundly isolating and lonely).
And finally, and most importantly, the authors remind us that not just our mental health care system, and not just our medical system, but our society as a whole desperately requires concerted action to prevent and to address the roots of trauma in child abuse, poverty, racialization, marginalization and lack of economic and emotional support for so many in need.
Near the end of their book, they write:
"Trauma-informed care, healing and prevention require that we open our eyes to what is right before us and that we tell the truth about it. We don't need any more evidence about how these experiences affect well-being throughout life.
We need change."
My hope, and belief, is that this book will assist in catalyzing awareness and change, moving us closer to a world where individuals like Isaac will be recognized and cared for by doctors and nurses who will see the person behind the symptoms and their desperate attempts to create inner safety and who will more readily meet them with patience, compassion and understanding.
Damaged, written by Toronto psychiatrists Robert Maunder and Jon Hunter, brings a deeply human face to childhood trauma, and its effects on the minds and bodies of patients, their caregivers and their families.
Interspersing contemporary knowledge of trauma and the consequences of childhood adversity with a sometimes heartbreaking and always moving clinical case, Damaged brings us - with wisdom and subtlety - to a more intimate view of suffering and of our struggles to both avoid and overcome.
Both of the authors work in liaison psychiatry, assessing patients who often present with concomitant trauma and severe chronic medical illness (the book explains how the two are strongly linked). This provides for a unique vantage point and makes this book a valuable addition to our current literature on trauma.
I admired the balance between sobriety in presenting the most up-to-date information on the lifelong effects of childhood trauma and passion in calling for a health care revolution. And I was deeply moved reading about the evolving therapy relationship between Dr. Maunders and his patient Isaac (in my experience, almost every trauma therapist colleague I know has at least one "Isaac" in their practice, but that's an aside).
The authors clearly note, near the end of this readable and taut book, that they have not written a book about trauma therapy, and you will not find any information here about any of the major trauma therapies. There are many other good books for that.
It is a challenge to assemble and reveal the true and whole face of trauma, and Damaged certainly takes its place in offering an important part of that picture, one that combines head, heart and guts.
It is a gift for both physicians and for the public. We will be proudly adding this book to our recommended reading for our Canadian physician psychotherapy training program.
The authors remind those of us involved in trauma therapy and advocacy that we need one another (with its powerful entries describing how the two authors stood by and supported one another during some of the darker moments - doing trauma work can be profoundly isolating and lonely).
And finally, and most importantly, the authors remind us that not just our mental health care system, and not just our medical system, but our society as a whole desperately requires concerted action to prevent and to address the roots of trauma in child abuse, poverty, racialization, marginalization and lack of economic and emotional support for so many in need.
Near the end of their book, they write:
"Trauma-informed care, healing and prevention require that we open our eyes to what is right before us and that we tell the truth about it. We don't need any more evidence about how these experiences affect well-being throughout life.
We need change."
My hope, and belief, is that this book will assist in catalyzing awareness and change, moving us closer to a world where individuals like Isaac will be recognized and cared for by doctors and nurses who will see the person behind the symptoms and their desperate attempts to create inner safety and who will more readily meet them with patience, compassion and understanding.
This entire review has been hidden because of spoilers.
November 7, 2024
A challenging, but enlightening, look at the impact of adverse childhood experiences on physical health.
April 2, 2023
Groundbreaking. Likely one of the first of its kind to comprehensively encompass both treatment in the office in the form of a case study and novel research on ACE events that allows clinicians and laypeople alike to obtain an understanding of just how seriously adverse events early in an individuals life may impact their health and even their lifespan.
Impressive to note that authors referenced studies on telomere damage as this presents an opportunity to cross reference this text with other texts of a more scientific nature.
Impressive to note that authors referenced studies on telomere damage as this presents an opportunity to cross reference this text with other texts of a more scientific nature.
December 4, 2021
Maunder's book, based on his research with his own patients, looks at the nature of childhood trauma and how that influences adult care and illness. Using the history of one his own patients to illustrate how trauma informs later life, Maunder with his colleague, Jonathan Hunter, also describes larger research into the nature of trauma and our healthcare system. It is an important book for patients, and healthcare providers.
"Frederick Douglas-a former of slave who became a US statesman and social reformer-has been credited with saying, "It is easier to build strong children than to repair broken men." 3
"But as health care professionals, we don't actually spend much of your money or our time curing diseases. They are spent on two much more common health problems: chronic diseases that chip away at a person's vitality over the years, and illnesses that elude any effective identification or treatment. The distinction between disease and illness is important. Disease is a biological thing. It refers to molecules, cells, and organs that are not doing what they should...Illness, on the other hand, is an experience. Illness is what it feels like to be sick." 31
"From the patient's perspective, it is illness rather than disease that matters most." 32
"Dr.Lawrence Kirmayer, a psychiatrist at McGill University, calls these unexplained symptoms "a social and clinical predicament, not a specific disorder," in that they represent "a situation in which the meaning of distress is contested." 33
"Not being believed is toxic." 47
"Trauma leads to narrative incoherence." 62
"Frederick Douglas-a former of slave who became a US statesman and social reformer-has been credited with saying, "It is easier to build strong children than to repair broken men." 3
"But as health care professionals, we don't actually spend much of your money or our time curing diseases. They are spent on two much more common health problems: chronic diseases that chip away at a person's vitality over the years, and illnesses that elude any effective identification or treatment. The distinction between disease and illness is important. Disease is a biological thing. It refers to molecules, cells, and organs that are not doing what they should...Illness, on the other hand, is an experience. Illness is what it feels like to be sick." 31
"From the patient's perspective, it is illness rather than disease that matters most." 32
"Dr.Lawrence Kirmayer, a psychiatrist at McGill University, calls these unexplained symptoms "a social and clinical predicament, not a specific disorder," in that they represent "a situation in which the meaning of distress is contested." 33
"Not being believed is toxic." 47
"Trauma leads to narrative incoherence." 62
July 18, 2022
While parts of this book are more on the technical side, it is worth reading as a nonprofessional, especially since you most likely know someone who fits into this story. In learning about the ACE (Adverse Childhood Experiences) scale, I learned a lot about myself, why I react to things the way I do, why I parented the way I did, and why so many of the lies formed in my childhood are still my truth in adulthood.
May 9, 2025
This book should be required reading for all medical professionals and therapists. If you've read "The Body Keeps the Score", you have had a great education on how trauma affects all parts of life, including physical health, but this book dives deeper into that idea and presents its findings empathetically, clearly, and concisely.
February 5, 2022
Concentrates on healthcare as experienced by Adverse Childhood Experiences (ACE).
February 25, 2022
Simply perfect
April 18, 2023
Dr. Hunter is one of the two best therapists I've ever had. Please take this opportunity to learn even a little bit from him, Dr. Maunder, and Isaac.
June 23, 2025
This was a really solid book. Isaac's story was magnetic, and made for a much more interesting read than if the authors had just talked about dry facts and figures. They kept making points about trauma, the way it shows up, and the social factors that lead to it that had me nodding along and going "mm" out loud. There wasn't a lot that I hadn't heard before, but it was expressed very well. I will say that I didn't love the chapters of conversations between Bob and Jon; those felt a little contrived and didn't communicate too much useful information. I understand that the authors wanted to give us a break from Isaac's story from time to time, but I think it could have been formatted more effectively. Still, overall, very good read; I recommend it to anyone who's in the medical field or just has an interest in learning more about trauma in a holistic way.
April 29, 2023
Provides examination and insight of how trauma informed care is imperative within healthcare.
August 22, 2022
I have been recommending this to my nrsg students and (psychiatric) nrsg (educator) colleagues. I like how the authors have aptly renamed medical specialists 'partialists'. As people age and chronic conditions prevail, we do pts a disservice with out current structure and rules. The authors remind us that when you are mulling over the incidence of trauma (I'll go with 1/3 of the population) that health care providers (or any other grouping) likewise have about 1/3 of their number affected by trauma....what are the implications or considerations for that. I highly recommend this book. The ACEs questionnaire is included in the book to inform or refresh your info on the tool.
Displaying 1 - 12 of 12 reviews