The Lived Experience of Violation: How Abused Children Become Unhealthy Adults | Anna Luise Kirkengen

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This powerful book documents in compelling detail, and with great compassion, the long-term consequences of early life abuse and neglect as they affect health throughout life. The book highlights the importance of eliciting each person’s story as a means of achieving relief from the emotional and physiological consequences of early life adversity. In so doing, the book also provides a provocative reflection upon the relationship between brain and mind. Furthermore, it argues that modern biomedical science needs to elaborate a more sophisticated appraisal of an individual’s reflections upon salient lifetime experiences, since they are key for understanding how these experiences affect health through biological pathways that, on the one hand, promote adaptation and, on the other hand, can be dysregulated and cause damage. (Bruce McEwen, Ph.D., Alfred E. Mirsky Professor, Rockefeller University, New York) Dr. Kirkengen has produced a remarkable and revolutionary work. She has validated the personal experiences of abused persons in a totally new way. She has drawn upon a philosophy of phenomenology to establish the truth of the “lived experience&'. She brings the “phenomena&' of lived experience closer to the “noumena&' that might have been observed by uninvolved witnesses had such persons been secretly watching the abusive events that affected the people she describes. This book discards conventional clinical processes and conventional medical research processes for the assessment of sick persons and their conditions. Conventional epidemiology, also takes its lumps. Conventional medical thinkers may have some difficulty with digestion of Kirkengen’s conceptualizations. This book should be read by all medical doctors, who have an interest in violence and abuse. Most of them will find it very useful in framing the problems that their patients bring to them. It will also be useful in producing precise definitions of the specific acts that our society must learn to prevent if we are to get healthy. (David L. Chadwick, MD, Director emeritus, founder of the Chadwick Center for Children and Families, Rady Children’s Hospital and Health Center, San Diego, USA) The Lived Experience of Violation will probably be the decade’s preeminent text on comprehensive medical practice. Case-based and elegantly written by a physician with superb interviewing skills, it advances the earlier work of Alvarez, Balint, Magraw, Engel, and Barbour, taking us beyond the pattern recognition of conversion reactions or the mechanisms of psychophysiologic reaction, and into the depths of personal illness: abusive life experiences that are common, yet comfortably unrecognized in medical practice as being basic causes. The numerous citations are a major asset in supporting our evolving understanding of the progression from life experience to structural disease. This is a clinically relevant, erudite, and philosophically profound book that challenges us to reach our full capability as physicians. (Vincent J. Felitti, MD, Clinical professor of medicine, University of California, San Diego, and principal investigator of the Adverse Childhood Experience Study, ACE Study) In The Lived Experience of Violation, Dr. Kirkengen shows incisively how the mind-body dualism inherent in medical thinking leads to decontextualizing the understanding of health problems from their...

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