A response piece to Ricky Emanuel’s (2021) ‘Changing minds and evolving views: a bio-psycho-social model of the impact of trauma and its implications for clinical work’ published in Issue 47.3 of this Journal

Appreciations first: To the Journal Editors for a fascinating collection of papers about different responses to trauma, to Alexandra de Rementeria for requesting short feedback pieces in response to these papers, and to Ricky Emanuel for his quite excellent paper linking the ‘bio-psycho-social’ aspects of trauma, to which we need to attend. We all learn through experience, and Ricky is indeed honest about what he would have done now, as opposed to then . . . Emanuel dedicates his paper to the memory of the late Alan Shuttleworth. In his 2004 paper ‘A complex mixture of forces’, Shuttleworth argued that psychoanalytic theory by itself is not sufficient in order for us to be able to understand many of the complex, mixed states in children seen by our profession. He looked, for example, at the relationship of Kleinian thinking to attachment theory, and also took into account neuroscientific findings. (These are most admirably unpacked by Emanuel in his paper.) Shuttleworth argued: