It is argued that in the effective psychotherapy of patients suffering with severe trauma, there is always blood that is shed. This blood may be metaphorical but is often literal. In its absence, it is unlikely that anything of real value has occurred.

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Correspondence to George E. Atwood.

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Address correspondence to George E. Atwood, Ph.D., 6 Angell Court, Providence, Rhode Island 02906, USA.

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Atwood, G.E. THERE MUST BE BLOOD. Am J Psychoanal 77, 399–405 (2017).

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  • psychotherapy
  • trauma treatment
  • bloody struggle