DM: I do appreciate your evaluation and in fact, I have been quite pleased in how this volume has been received and reviewed. I have been a consultant for a number of years and in each setting I am called upon to give presentations or supervise cases. Given my obsessive-compulsive academic style and my commitment to science, I would put together various handouts on PTSD, depression, anger or addictive behaviors, etc. People would ask me about assessment instruments and interventions. In response, I would put together a rather extensive handout. TheClinical Handbookis the collection of these handouts integrated into a format that hopefully people will find helpful. You asked about the most anxiety-producing feature of putting together thePTSD Handbook. In each of the books that I had written previously, I had given them to a publisher. In this case, I decided to publish theClinical Handbookmyself. This led to some anxiety and I had to convince my wife that this high risk activity would not turn out to be a Criterion A event! In fact, it took an initial outlay of a large set of funds. In publishing it myself, the proceeds from the Handbook are now going toward the development of a research and clinical training institute. So I now have been able to use the royalties generated by the Handbook to support graduate students, innovative research, and expand training materials that clinicians may be able to use. My dream is that we will eventually computerize the Handbook so that clinicians will be able to access this on a CD-ROM and call up specific clinical problems, assessment issues, treatment concerns, and even watch CD-ROM movies of master clinicians demonstrating each of the core tasks of psychotherapy.
JSV:You have described how the "art of questioning is the most critical skill" for clinicians to develop. Why do you believe this is the case and how do you apply this skill in treating trauma survivors?
DM: If you go back to my comments on the constructive narrative perspective, then the therapist's "art of questioning" is critical in eliciting and changing clients'narratives. It is important to encourage clients to "tell their stories" of what they have experienced and the impact on them, their families and communities. It is also important that the therapist elicit what Paul Harvey, the radio commentator, calls the "rest" of the story. Namely, what has the client been able to accomplishin spite ofthe trauma? A way to facilitate this disclosure is to have clients use a timeline (or life chart) where they can indicate when various traumatic events occurred in their lives. On a second time line, the clients can indicate what they have been able to accomplishin spite ofthese traumatic events. The therapist can not only elicit such accounts, but can then ask clients to describe in more detailwhatthey had accomplished andhowthey were able to do this. "How" questions are especially helpful because they "pull" for the nature of the strengths that individuals have and they highlight the instrumental acts that individuals, couples, groups and communities have been able to implement to affect change. Thus, from my point of view, the "art of questioning" not only serves the function of assessment, but it sets the direction for change in the clients' narratives. Finally, it is hopeful that therapy will result in clients becoming their own therapists - taking the clinician's "voice" with them. I will often ask clients if they ever find themselves out there in the real world, asking themselves the kinds of questions that we ask each other right here in therapy? We want clients to "internalize" the therapist's art of questioning.
JSV:Although many people are exposed to traumatic experiences in their lifetime, most do not develop posttraumatic stress disorder (PTSD). What factors do you believe "buffer" a person from developing full-blown PTSD?
DM:WhenIgiveworkshops,IreviewfourclassesoffactorsthatIthinkdistingui
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