Creating Sanctuary

Toward the Evolution of Sane Societies

Sandra L. Bloom, M.D.

1997. New York: Routledge

"Creating Sanctuary is that rare, original, once-in-a-lifetime book that could save lives."

Gloria Steinem

The Sanctuary Model"Is our society traumatized? In Creating Sanctuary: Toward the Evolution of Sane Societies, Dr. Sandra Bloom suggests that we stop thinking about how to prevent violence and focus instead on the active creation of nonviolent organizations, institutions, and societies. She believes that our society is suffering from the long-term unresolved effects of multigenerational trauma: we are emotionally numb, addicted to violence, alienated from ourselves and each other and trapped in a vicious cycle of destructive behavior. By applying the successes of her treatment programs with traumatized adults, Dr. Bloom believes that we can generalize what we have learned about the profound impact of violent experiences to larger social, political and cultural institutions. Combining psychobiology, social psychiatry and a feminist relational model, Creating Sanctuary will profoundly change our understanding of society."

“To save our families, nothing is more important than ending the spiral of violence. Here at last is a psychiatrist and activist whose programs can help adults to uproot the original trauma, and stop repeating the violence that was done to them. Creating Sanctuary shows us how to save future children from abuse, empty our over-crowded jails, and rescue this nation from leaders who see violence as normal”
– Gloria Steinem

Introduction

Toxic Social Structures & The Climate of Trauma

By Dr. Ian Irvine, co-editor The Animist: Creating Sanctuary is a powerful piece of writing by an almost extinct professional breed - the psychiatrist/psychologist prepared to examine the bigger picture in regards to the causes of psychic distress in modern Western societies. The book undoubtably belongs to a long tradition of humanistic and Freudian writings on mental illness as produced by modern Western social structures. The title itself recalls Fromm's book 'The Sane Society' and I would argue that in many ways Bloom has given us a powerful update on themes covered in that now classic work. One also thinks of works by Arthur Janov (especially his work on trauma suppression), Alice Miller, De Mauss, Mickel Adzema, Wilhelm Reich (and the Bioenergetic tradition), Stanislav Grof and many others who have applied Freudian and Humanistic ideas to the social arena. In this sense the work is also in a kind of refracted dialogue with that great Freudian text Civilisation and its Discontents. The picture of modern society - particularly modern American society - painted for us by Bloom is not a pretty one. Sanity and psychic health is seen as a virtual impossibility in the face of a normalised climate of repression and institutionalised trauma creation. The central obsessions of our consumeristic, violence and money obsessed modern world are described in terms of a general malaise polluting and undermining the psychic integrity of individuals and collectives alike. Bloom accurately describes to us a world characterised by institutional harshness, denial (that there even is a crisis!) and outright disinterest in the truly important issues to do with trauma and violence that now shape our collective social psyches. In this climate, psychiatrists, psychologists, social workers and other health care professionals seem all but unable to act in the best interests of their clients. In this sense, Bloom criticises the faceless bureacrats, lawyers and insurance moguls who increasingly shape and infringe upon the client patient relationship: often forcing psychiatrists to opt for functionalist alienated treatment regimes over potentially more humane and effective ones. The insight that society is not so much interested in curing people who have fallen victim to the collective (in)humanity we call a society, as in making money out of the later life effects of trauma suppression is a disturbing under-current to the book. There is a great deal to this book, far more than I could cover in a short review like this. The work is groundbreaking in its merged sociological and psychological methodology. More importantly, however, it stands as powerful indictment of the way in which modern societies act to undermine and subtly traumatise large sections of their populations. A must read.

Customer Review: 5 out of 5

The most important book I have read this year!

A very moving account of the impact of violence on our lives and what it takes to create an environment where we can recover from our wounds. Dr. Bloom's call for a therapeutic approach to violence stands in stark contrast to popular proposals for meeting violence with more violence. In a violence-traumatized society, Creating Sanctuary belongs at the top of our social agenda.

Customer Review: 5 out of 5

Excellent book that is very clearly written.

I enjoyed this book tremendously. This is the most understandable and clearly written text I have ever read relating to the psychology field. There is no "psycho babble" here, folks. Anybody with an eighth grade education should be able to understand what the author is trying to say.
The author obviously believes in treating patients with tremendous dignity and respect. While this program is mainly inpatient focused to benefit those of us who are unfortunate enough to need more than a little help in carrying our life's baggage, as it were, reading this book makes very clear to me the way in which many situations I faced as a child effect my adult life that I have never really completely understood. The author says, in the most compassionate and definitive way, IT IS NOT YOUR FAULT! The author should be commended for her fine work and that of her team of obviously exceptional and gifted health care providers. The author must be one of the "real doctors" in todays environment, and they are darned hard to find.

Robbins Book Review of Creating Sanctuary

Tandy Book Review

TABLE OF CONTENTS:

  • ACKNOWLEDGMENTS
  • PREFACE
  • INTRODUCTION: DAWN
  • CHAPTER ONE: TRAUMA THEORY - DECONSTRUCTING THE SOCIAL
    • THROUGH A GLASS DARKLY: THE THEORY OF TRAUMA
      • Background
    • THE PHYSICAL RESPONSE TO DANGER
      • Fight-or-flight
      • Chronic Hyperarousal
      • Stress-Related Physical Symptoms And Disease
    • THE COGNITIVE RESPONSE TO DANGER
      • Learned Helplessness
      • Decision making
      • Learning Under Stress - State-dependent Learning
      • Remembering Under Stress
      • Ordering Reality Under Stress
      • Dissociation
      • A Cast for a Broken Heart
      • Dissociation in Childhood
      • Long-term Effects of Chronic Dissociation
    • THE EMOTIONAL RESPONSE TO DANGER
      • Basic affect theory
      • Role of emotions
      • Cognitive role of emotions
      • Social Role of Emotion
      • emotional contagion
      • Emotional Arousal
      • Interference With Thought
      • Expression  and Inhibition of Emotion
      • Numbing and Loss of Modulation
      • Psychosomatic And Stress-Related Disorders
      • Impaired Social Role of Emotions
    • THE SOCIAL RESPONSE TO DANGER
      • Need for social connectness
      • Trauma-Bonding
      • Social Skills
      • Scapegoating
    • THE BEHAVIORAL RESPONSE TO DANGER
      • Habits
      • Relational behavior
      • Creative Expression
      • Humor and Play
      • Fixation To Trauma
      • Self-destructive Behavior And Traumatic Addiction
      • Endorphins and Stress - Addiction to Trauma
      • Traumatic Reenactment
      • Until Death Do Us Part
      • Multigenerational Transmission of Traumatic reenactment
      • The "Sins" of the Fathers to the Third Generation
    • CONSEQUENCES OF THE RESPONSE TO DANGER - MAKING MEANING
      • Destroying the assumptive world
      • Loss of Benevolence
      • Loss of Justice
      • Loss of Order
      • Loss of Meaning
      • Loss of Comfort from Others
      • Loss of Faith
    • TRAUMA-ORGANIZED BEHAVIOR
  • CHAPTER TWO: ATTACHMENT - CONSTRUCTING THE SOCIAL
    • ATTACHMENT AND SEPARATION
      • Response To Separation
      • Protest, Despair, Death, or Detachment
    • LESSONS FROM OUR ANCESTORS - PRIMATE RESEARCH Protest, Despair, and Dysfunction: Harlow's Monkeys
      • Motherless Monkeys Grown Up
    • MOM AND DAD AS BRAIN MODULATORS
      • The Immature Brain
      • The Face Shows All        
      • Affect States and Brain Development
      • The Beginnings Of Moral Development
      • Gendered Caregiving And Receiving
      • The Beginnings Of Autoregulation
    • DISRUPTED ATTACHMENTS
      • Disorganized attachment
      • Intergenerational Transmission
    • ATTACHMENT IN ADULTS: THE CONTINUING NEED FOR SOCIAL SUPPORT
  • CHAPTER THREE: REMEMBERING THE SOCIAL IN PSYCHIATRY
    • DEVIANCE
    • A BRIEF HISTORY
    • MORAL TREATMENT
    • THE SOCIAL PHILOSOPHERS
    • PSYCHIATRY AND THE SOCIAL
    • SOCIAL PSYCHIATRY
    • GENERAL SYSTEMS THEORY AND FEMINIST CRITIQUES
    • THE THERAPEUTIC MILIEU
    • CREATING A LIVING-LEARNING ENVIRONMENT
      • Unresponsive Problems
      • Readiness for Change
    • BEGINNING TO MAKE A SHIFT
  • CHAPTER FOUR:
    • CREATING SANCTUARY - RECONSTRUCTING THE SOCIAL 
    • CREATING A SAFE SPACE
      • Psychological Safety
      • Social Safety
    • SHARED ASSUMPTIONS
    • SHARED GOALS
      • Shared Goal Setting
    • SHARED PRACTICE
      • Addressing Unconscious Conflicts and Conflict Resolution
      • Decision making
      • Group Consciousness
      • Managing Emotions
      • The Problem of Violence
      • Boundaries, Both Large and Small
      • Living-Learning Environments and a Role For Creativity
      • An Environment For Us All
    • WHO WE TREATED
      • Borderline Personality Disorder
      • Multiple Personality Disorder
      • The Men and the Perpetrators
      • The Strong and the Brave and the Astute
    • STARTING THE PROCESS OF RECOVERY
      • Safety: community management of destructive behaviors
    • RECONSTRUCTION: THE STORY EMERGES
      • remembrance
      • Reconnection
    • HOW WE TOOK CARE OF OURSELVES
      • Compassion Fatigue
      • The Responsibility to Care
      • Continuity of Care - Sharing the Burden
      • Communing Through Laughter
      • Power Distribution and Leadership
    • WHERE WE FAILED
      • Burnout
      • Damage of Developmental Trauma   
      • Our Limitations
    • WHERE WE SUCCEEDED
      • Patients have changed
      • We have all changed.
      • Survival, Growth, Propagation
    • WORK TO BE DONE
      • Survival Under Conditions Of Abuse
      • Building A New Generation      
      • Finding More Effective Self-help Treatment Modalities
      • Prevention
    • CONCLUSIONS
  • CHAPTER FIVE: TOWARDS THE EVOLUTION OF SANE SOCIETIES
    • GOING BY THE NUMBERS: A TRAUMA-ORGANIZED SOCIETY
      • Violence to Children
      • Violence to Women
      • Violence to Men
      • Violence At School
      • Violence At Work
      • Guns
      • Substance Abuse
      • Pornography
      • Media Violence
      • Prisons
      • Economics
      • Everybody
    • SANE SOCIETIES?
      • disrupted Attachment
      • Unmodulated Affect
      • Unmanageable Anger
      • Abusive Authority
      • Awareness
      • Multiple Addictions
      • Automaticity Repetition
      • Avoidance of Feelings and Accountability
      • Alienation From Self and Others
    • LESSONS FROM THE SANCTUARY MODEL AND MORAL SAFETY  
      • moving toward an ecological viewpoint - it’s all a matter of balance
      • fostering groups, fostering communities
      • Establishing Safety: First and Foremost
      • Containing the Infection of Intergenerational Trauma: investing in families
      • Trauma Debriefing               
      • Creating Sanctuary in the Classroom
      • Changing the Process of Doing Business
      • Justice as Sanctuary
      • Producing an Emotionally Literate Population
      • Getting Straight and Growing Up
      • A Bill of Responsibilities to Children           
      • The “Responsibility to Care” and the Bystander Effect
      • Bearing Witness, Not Grudges
      • Creating Democracy
    • THE CREATIVE LIFE AS SANCTUARY
      • Hearing the Voice of the Artist
      • Emergent Wholeness, Moral Safety and Moral Integrity
      • Magic, The Mystical ,and the Life of the Spirit