Content Warning: This section contains references to child abuse and substance misuse.

At the beginning, Gildiner explains that what unites the five patients she has selected to profile is their exemplification of heroism. All five, although their circumstances differ, survived particularly traumatic childhoods. In all cases, this trauma involved some form of abuse by a parent (or, in the case of Danny, authority figures in the absence of parents). The abuses endured by the five patients are objectively shocking. Gildiner stresses that, despite these painful circumstances, none of the patients gave up on themselves or their lives; instead, they developed unconscious coping mechanisms. In all cases, too, it is not the childhood experiences or abuse that causes the patient to seek out (or be referred to) therapy initially, but the effects of these coping mechanisms that are shaping their adult lives, and which are becoming obstacles for them. For Laura, this is stress; for Peter, erectile dysfunction; and for Madeline, an irrational fear of flying. These coping mechanisms have become unsustainable for the patients but they are not framed as simply negative or non-normative responses: The patients’ creation of these responses has been key to their survival as “heroes.” It is as Gildiner uncovers the extent of the patient’s respective trauma that she and the patient are able to address and remedy the negative impacts of that trauma on the patient’s present life.