This no-brainer came out of the conjunction of three things: the offer of writing a chapter for a book on PTSD, the requirement to write an essay for my intermediate training in Family and Systemic Therapy, and the recollection of a clinical vignette.

Well, and a fourth thing – a friend returning from the borders of Rwanda where she had been working with Medecins Sans Frontiers. She and a couple of colleagues had been overwhelmed by refugees, and then an outbreak of Cholera in the refugee camp. She described squeezing through the first bag of IV fluid, putting up the second (with no drip-stands) and moving on to the next patient, knowing she was unlikely to see the person again. Her trauma was palpable, as well as her need to disseminate it, diluting it in doing so – the clearest illustration of the “ripples of trauma” I have ever seen – or felt.

It seemed perfectly clear that trauma does not only exist in individuals, but is communicated and therefore exists between them. I found some literature that supported the idea, and the essay was well-received. I have no idea if anyone read the book. Perhaps this is an indication – I have had none of the over-solicitous emails inviting me as an “expert” in PTSD, in the way that I have, so many times, in relation to a single co-authored paper on constipation.