Trauma and the Struggle to Open Up:
From Avoidance to Recovery and Growth

How to navigate the therapeutic relationship
with trauma survivors, to help bring
recovery and growth

(International Society
for the Study of
Trauma & Dissociation)

James Chu

M.D., Consultant in Psychiatry, McLean Hospital; Associate Professor of Psychiatry, Harvard Medical School

“Dr. Robert T. Muller has provided a gem of a book for clinicians working with persons who have experience psychological trauma. It is beautifully written, drawing on the accumulated wisdom of experts in the trauma field, and richly illustrated with descriptions of his work with clients. Dr. Muller explores the complex relational dynamics of work with traumatized patients and charts a thoughtful course to their treatment. His wisdom clearly comes from deep understanding of how his clients have experienced their lives, and his skill in walking with them through the process of recovery.”

Leslie S. Greenberg

PhD, Distinguished Research Professor Emeritus, York University

“An incredibly useful book showing you how to understand and manage therapy with relational trauma. Grounded in attachment theory, trauma theory, and psychotherapy research, it demonstrates the importance of repair of relationship difficulties.”

Kathy Steele

M.N., Past President, International Society for the Study of Trauma & Dissociation

“Every therapist interested in helping clients with developmental trauma should read this book. A jewel of clinical wisdom, it focuses not only the content of trauma, but on the relational process of being with highly traumatized clients, and how to understand and work with the many avoidance strategies to dealing with trauma that we encounter in therapy. An approachable, culturally sensitive, and compassionate book, full of clinical vignettes, it illustrates the neglected but essential need to stay with the process: what a client feels when telling the story, how the client experiences telling the story to someone else, what happens in the therapeutic relationship when the client tells the story. A joy to read.”
Trauma Therapy Resources - Trauma and the Avoidant Client

Trauma and the Avoidant Client:
Attachment-Based Strategies for Healing

How to effectively engage
traumatized clients who avoid
attachment, closeness, & painful feelings

(International Society
for the Study of
Trauma & Dissociation)

Jeremy Holmes

M.D., Professor of Psychological Therapies at the University of Exeter in the UK and author of Exploring in Security

"In this sensitive yet intellectually robust volume Muller shows, in the face of loss and trauma, how self-defeating and health-endangering avoidant strategies can be... A major, highly accessible contribution to the attachment literature and required reading for all mental health clinicians."

Leslie S. Greenberg

Ph.D., Distinguished Research Professor at York University

"Clinically perceptive, theoretically clear, and research-informed, this book is filled with clinical gems."

Clare Pain

M.D., M.Sc., FRCPC, Director of the Psychological Trauma Program at Mount Sinai Hospital

"I very much enjoyed reading this book, and it is rare to find one so practical, focused, and well-researched. Avoidance is a common and notoriously difficult to treat sequelae of trauma, but taking on the challenge, Muller helps readers recognize and use the therapeutic relationship as the key to reaching these clients effectively. Constructed thoughtfully and insightfully around relevant research, his use of case examples, dialogue of key therapy moments, and point summaries all make it an eminently accessible and practical book."