I came to this book after seeing Dr. Conti as a guest on the neurobiologist Dr. Andrew Huberman’s podcast. In that interview, I was impressed with Dr. Conti’s sense of compassion, empathy, and the points he made on trauma, so I was really hoping to like this book.
However, I simply can’t recommend it. After reading it, I question how much it will actually help people who are either dealing with trauma themselves, or those who want to know more about its origins and mechanisms. And this is a shame, because I genuinely believe that Dr. Conti wants to help people.
Dr. Conti’s central claim is that unresolved trauma is at the core of so many of the deaths of despair that we are seeing in the US and the world, and is responsible for the high rates of depression, anxiety, alcoholism, and opioid abuse. He states that until we get a handle on the trauma problem, we will continue to suffer as a society.
The first few chapters do a decent job of outlining the various types of trauma people may endure. Then, towards the end of the book, in chapters 11 and 12, he finally gets into a bit more detail on how trauma works in the brain and body. I found these two chapters to be the most valuable in the book, by far. Unfortunately, there’s also a lot of vague, repetitive filler, or topics that are so tenuously related to the causes of trauma (in which no support is provided to bolster the highly subjective claims), that they don’t add much value.
Most of the book is basically an overview of trauma, with anecdotes from Dr. Conti’s own life and those of his patients, as well as interviews he does with other psychiatrists and trauma experts. But the book is very light on providing evidence for most of the claims that either Dr. Conti or his guests make, either in the form of sourced studies or statistics. I found this lack of support to be very odd for a book on psychology. The bibliography consists of 4 sources; one being a book of poems.
The entire middle part of the book (and much of the final chapter) slides into a social commentary revolving around his views on social justice (or lack thereof) and its effect on trauma. While I respect his views, these not only seemed a bit misplaced but occasionally, misinformed.
While Dr. Conti always attempts to tie his views back to the subject of trauma, he, unfortunately, pushes a bit too hard on the identity politics front throughout the entire book. He not only continues to mention the pervasiveness of racism and sexism throughout the book but he seems to be mildly scolding anyone who may not be sufficiently “woke” or sensitive to these issues, and thereby contributing more trauma to the world. While he doesn't come out and actually say this, it seeps through the pages. And even though my views on such issues tend to be left-of-center, and would likely align with his, I found the repetitive banging of this drum to be off-putting. I can only imagine how turned off someone with more conservative views would be to a book that they thought was going to be about healing their personal trauma, and not subtly accusing them of contributing to racism and sexism through their inaction or unconscious thoughts.
Throughout the book, I got the sense of subtle scolding of people who don’t see the world through the lens of ubiquitous injustice, which he sees as a major source of trauma. It’s fine to mention it as a factor in some of the trauma we see, but it seemed like all roads kept leading back to it.
At points in the book where he speaks about having tolerance of various viewpoints, which is admirable, but again, he clearly seems be subtly directing these comments to people on the far-right side of the political spectrum when you read these quotes in context of his talking about racism, sexism, or anti-immigrant sentiment, especially when he says, “Far too many of us have become allergic to people who differ from us and have developed the tendency to turn away from those who don’t resemble us” or “When we put on cognitive blinders, we deem the world fundamentally dangerous, and our blinders show us only where the that’s true”, or “We can believe something quite strongly while at the same time allowing for others to hold different beliefs.” Now, he never actually says, “Trump supporters” or those on the “far-right”, but it’s fairly clear who he’s talking about. And yet, I wonder if he’s aware of just how big this problem of intolerance to other viewpoints has become on the far left of the political spectrum. While people can debate which side is worse, intolerance of different viewpoints is now clearly left/right issue.
Certainly, some Dr. Conti’s views are understandable since he wrote the book during the Trump era and all the ugliness that came with it. But the overwhelming emphasis on trauma caused by systemic racism, sexism, and microaggressions crowds other topics out. This despite the fact that we know much of the long-lasting trauma that follows people throughout their lives originates in the home, in schools with people who share a racial identity, or in one’s immediate environment (neighborhood and close family). Obviously, most of us want to see the scourge of racism and sexism be eliminated in the world, but even if they were wiped out tomorrow, we, unfortunately, would still see an enormous amount of people suffering from childhood trauma that has little do to with these other factors that he keeps coming back to again and again.
Dr. Conti also doesn’t hesitate to put the blame squarely on "a heartless society that looks the other way and blames victims.” I think this is a bit unfair and inaccurate. Most Americans, right or left, have compassion for people who are suffering from the result of trauma, even if they’re transferring that suffering to others. But this harsh indictment of American society fails to mention that many trauma victims will refuse to be helped, even when help is repeatedly made available, especially when it involves drug addiction or severe mental illness. While we could always do more as a society, it's important to note that we do spend an enormous amount of money on mental health resources in the US, and that has increased drastically over the past five years, but these only work if people are willing to avail themselves to them. I think it’s less a result of “turning a blind eye” and more of people simply not knowing what to do. And if the author feels we could do more, it would help if he would outline a specific plan as to what exactly we should do, aside from “being kind to one another.”
Dr. Conti mentions some tools for dealing with trauma, but they’re all rather vague and gentle: be kind to yourself, get good sleep and exercise, stop the negative self-talk, reach out to others, find a good therapist, and call out injustice when you see it so as not to traumatize others. I was surprised to see how many pages in the book were spent on describing what trauma is or creating analogies for it, and how it makes us feel, but how few were spent on tools to try to get us to overcome it.
Dr. Conti talks a lot about the fact that we need “greater compassion, community, and humanity” to heal trauma, which is very admirable, but also vague. The person who is harming themselves or society through their actions, based on past trauma, isn’t likely to wake up one morning and realize they need to embrace the concept of humanity more; unfortunately, neither are their victims.
Lastly, there are parts of the book that simply felt anachronistic, as if they were written in a different time, especially regarding American culture. There are too many to mention here, but when Dr. Conti speaks about American stoicism, systemic racism, inequality, and women being oppressed—all of which certainly still exist— it appears as if the past 3 years in American life (or frankly, the past 30 years), hadn’t happened.
Dr. Conti’s says that social justice is simply being ignored in our country and our culture has just decided “that’s just the way things are.” And yet social justice has been at the forefront of many Americans’ mind for the past 50 years, but no more so than over the past 3 years, since the murder of George Floyd. Much to the dismay of people who may not want to see change happen, social justice discussions are being had every single day in this country at the highest-level institutions, corporations, and entertainment. Policies to combat injustice have been enacted broadly. Corporations and institutions have committed themselves to show the world just how inclusive and diverse they can be. It’s one thing for a person to feel change isn’t happening fast enough, it’s another to claim we’re ignoring it simply accepting it as a culture.
There were other anachronistic aspects in some of Dr. Conti's interviews. In talking about sexual assault in an interview with a German psychologist where she says that, “only 1 in 25 instances of sexual abuse are reported” and that, on average, “a child will report sexual abuse 8 times before anything is done about it.” I don’t know where the doctor was getting the data for her claim from because no source is provided, but it does seem recent. In most US states, schools are required to report any type of abuse that a child mentions to the proper authorities immediately, whether inside or outside the home. They can be fired if they don’t. It’s also difficult to imagine most children would even bother to report an instance of abuse more than once or twice if no action were taken the first two times, let alone 8 times. Dr. Conti also takes issue with the term “sexual assault” because he feels, “it’s used to minimize sexual violence as if the assault were somehow excusable.” I’m not quite sure how the doctor makes this logical leap, but he should at least mention which term he feels would be more appropriate.
In an interview with a Stanford psychiatrist who said that it is beyond dispute that trauma causes biological changes in future generations through epigenetics, I was surprised to see Dr. Conti respond with, “It’s a shame we have to provide data to show what we can already see with our own eyes, but that’s the way the world works.” I don’t know what his intent was with that statement, but clinical observation can count as observable data. And I would think that a doctor would realize that data can be quite important if a hypothesis is to be turned into a feasible theory about the origin of a malady.
Again, I agree with his central claim that trauma is at the root of so much human suffering in the world. I just think he could’ve focused more on the specifics of trauma and its effects on the brain, with data to back it up, and less on his viewpoints of American society. Seeing as how divided we are, leaving out subjective material may have allowed him to reach more people who genuinely need his help.