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The European countries have a long history of exposure to large-scale trauma. In the early 1990s the increasing awareness of the consequences of trauma within the mental health community led to the foundation of local societies for psychotraumatology across Europe and the European Society of Traumatic Stress Studies (ESTSS), which celebrated its 25th anniversary in 2018. The focus of this article is to describe the current state of care for survivors of trauma in the 15 European countries where ESTSS member societies have been established. Brief descriptions on the historical burden of trauma in each country are followed by an overview of the care system for trauma survivors in the countries, the state-of-the-art of interventions, current challenges in caring for survivors and the topics that need to be most urgently addressed in the future. The reports from the different countries demonstrate how important steps towards a better provision of care for survivors of trauma have been made in Europe. Given the cultural and economic diversity of the continent, there are also differences between the European countries, for instance with regard to the use of evidence-based treatments. Strategies to overcome these differences, like the new ESTSS training curricula for care-providers across Europe, are briefly discussed.

THIS ARTICLE STATES THAT NOWHER IS THE INABILITY OF THE SOVIET STATE TO UPHOLD ITS PART OF THE SOCIAL CONTRACT WITH ITS SITIZENS DEMONSTRATED MORE GRAPHICALLY AS IN HEALTH CARE. THE DUAL ILLNESS THAT PARALYZES THE SOVIET ECONOMY AND SOCIETY MATERIAL PVERTY AND EXHAUSTION ON ONE HAND AND THE TOTAL BREAKDOWN OF LABOR MORE ON THE OTHER-IS LEAVING DEEP SCARS ON SOVIET MEDICINE.

The historian Samuel Hynes has observed that World War I was not only the greatest military and political event of its time but also the greatest imaginative event. Soldiers and civilians struggled to comprehend the war's devastation and the changes it produced while medical practitioners and artists examined the war as a site of extraordinary trauma. My project explores two of the many archives of trauma: the medical discourse through which trauma was defined; and representations of trauma in a variety of English language novels from the early and mid-twentieth century. I begin with a historical survey of the medical discourse of trauma and its relationship to literary texts in the modernist period, continuing into the period following World War II. I show how the contemporary discourse of trauma has tended to reduce this complex experience to a limited narrative. In this dominant formulation, many different events, incidents or processes may cause psychological trauma, but they all produce a debilitated, devastated, damaged psyche unable to express or heal itself. This narrative began taking shape after 1980, when Post-Traumatic Stress Disorder was included in the DSM. My analysis challenges several aspects of contemporary trauma theory. I propose alternatives to the ways in which trauma is used in literature and the way trauma theory is used in literary analysis. I focus on the relationship among combatants, noncombatants, and civilians in order to show that trauma is not the only response to combat and that combat is not the only source of trauma—even war-related trauma. I conclude by arguing that a rigorous exploration of the ethics of aesthetic representations of trauma can expose a number of conventional and misleading assumptions about trauma, war, and war narratives.

The telling of stories is how we make sense of our lives. With trauma, our understandings of our stories are dramatically altered and somewhat reduced. This is particularly so when a patient has a near-death experience, multiple serious injuries and must be passive in order to survive. There is a need to rebuild a narrative in which the person is active, congruent and competent. My story starts with falling off a balcony on the first night of a holiday. Initially I adapted poorly to the loss of agency that is essential to recovery. I clashed with the intensive-care nurses as I fought to protect myself from pain within a state of sedation, delirium and confusion. Trauma deeply disturbs and destabilises a person's sense of themselves. It can permanently impair many facets of our lives and damage our relationships to family and community. The collaborative and interactional process of narrative therapy can rebuild agency and empower trauma survivors. It can help prevent the patient from extending trauma-related vulnerability, damage and passivity into the future. It can assist with processing trauma and gently fostering new stories to incorporate the uniqueness, depth and complexity of trauma and human lives.