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The Body Keeps The Score Review
I spent just a few hours with van der Kolk’s excellent The Body Keeps The Score.
But in that short time it taught me three things:
- That trauma is a more important and widespread problem than I realised;
- That I need and want to get much more sensitive and informed about it; and
- That to get there, I’ll have to spend A LOT more time with this book.
Van der Kolk opens chapter one with a handful of shocking CDC statistics:
- One in five Americans was molested as a child;
- One in four was beaten by a parent;
- One in four grew up with alcoholic relatives (🙋♂️); and
- And one in three couples engages in physical violence.
Conclusion? No matter who you are, where you are or what your background, there’s a good chance, even if you haven’t experienced it first-hand, that someone you know well is at least partly defined by a history of trauma, neglect or abuse.
The short story? The Body Keeps The Score is a must-read. It’ll open your eyes to a hidden epidemic all around us. It’ll make you a better friend, parent and partner. It’ll help you on your journey to becoming kinder and more empathetic self.
I’ll be back for a full The Body Keeps The Score summary later.
But in the meantime, here are some quick, high-level notes below that, quite frankly, fall embarrassingly short of conveying the breadth, depth and power of the insights you’ll find on every page of the original book.
The Body Keeps The Score Summary
The devastating effects of post-traumatic stress disorders (PTSD) caused by violence, abuse and neglect are felt by many more people than just returning veterans and survivors of major accidents.
And yet our standardized go-to tools for diagnosing and treating children, teen and adult sufferers of PTSD in the general population remain woefully blunt and inadequate.
The Body Keeps The Score explores what’s changed in the last 30 years, why those things matter and sets out bold, effective and accessible new strategies for individuals, carers and medical practitioners to diagnose, face and heal from unresolved trauma.
We’ve Learned a Lot About Trauma
We have learned a lot about trauma in the last 30 years, from:
- Returning Vietnam veterans:
- Traumatic events transcend the self as our main lens of seeing the world;
- We often resort to coping mechanisms that add deep shame to the problem;
- Numbness becomes the only way to deal with the trauma and shame;
- We often mistakenly diagnose and try to treat symptoms (alcoholism, substance abuse, schizophrenia) instead of the trauma that fuels them;
- Removing coping strategies without addressing root causes solves nothing, leads to abandoned treatment and can even worsen psychiatric conditions;
- The same phenomena are seen in and the same lessons can be applied to victims of domestic violence, abuse and neglect.
- Breakthroughs in understanding our minds and bodies, especially:
- The triggers (e.g., hypersensitivity to memory cues and their unintended activation during treatment) for psychiatric problems;
- The symptoms and characteristics of psychiatric problems (e.g., flashbacks, dissociation, depersonalisation, hallucinations, learned helplessness);
- The secondary effects (e.g., distorted memories, coping mechanisms, compulsions, shame, self-harm, loss of agency, distorted cognition) that can complicate and prevent psychiatric problems from resolving themselves;
- The diagnosis and classification of psychiatric problems (i.e., the DSM – the Diagnostic and Statistical Manual of Mental Disorders);
- The neural and hormonal imbalances (e.g., adrenaline, dopamine, serotonin, cortisol) in psychiatric problems and their effects (e.g., memory and attention problems, irritability, sleep disorders); and
- The treatment of psychiatric problems (e.g., drugs, the placebo effect, EMDR, group therapy, experiential healing and others).
- Breakthroughs in understanding how traumatic flashbacks and psychosis affect the brain, using brain scanning technology (e.g., PET, fMRI):
- Activation of the right (intuitive, emotional, visual, sensory) side of the brain;
- Activation of the limbic system (emotional centre) and especially the amygdala (fear centre) within it;
- Activation of visual cortex (visual area);
- Deactivation of the left (facts, statistics, logic) side of the brain;
- Deactivation of Broca’s area (speech centre); and
- Deactivation of the thalamus (sensory filtering, integration, sequencing).
Trauma Impacts Both Brain AND Body
We know that trauma significantly impacts both the brain and the body:
- Trauma interferes with the brain’s ability to:
- Pay attention to, decipher and enjoy signals in and around us (dissociation);
- Synchronise with, mirror and engage socially with the people around us;
- Detect, interpret and respond to possible danger (fight/flight/freeze) signals;
- Restore “normal” function once a perceived threat has passed;
- Recognize, engage with or describe emotional states (alexithymia); and
- Learn and adapt effectively to new information.
- Trauma interferes with our body’s ability to:
- Manage/recover from adrenal/stress responses to fight/flight/freeze signals;
- Breathe properly due to hyperactivity of the fight/flight/freeze state;
- Manage basic (e.g., sleep, immune) functions due to prolonged stress;
- Digest food properly due to interference with the function of the viscera.
- Trauma interferes with the ability of our mind to interpret signals from and connect with our bodies, causing:
- A numbed inability to connect physical sensations with emotions or thoughts;
- A lack of sense of responsibility or agency; and
- A lack of a sense of self or of being fully alive.
Trauma’s Effects Are Worse for Children
We know that trauma’s effects are often worse for and underreported in children:
- Developmental trauma significantly disrupts the development of:
- Attachment – Forming healthy relationships with others; and
- Attunement – Adapting our behaviour based on cues from other people.
- Children are unable to escape from abuse and neglect;
- They are rarely able to physically escape from abusive caregivers;
- They often feel a strong loyalty to their caregivers, regardless of abuse; and
- They can’t mentally rationalise/separate their abuser’s behaviour.
- Cries for help are often missed or misunderstood by others;
- Children don’t know how to give words to their suffering; and
- Adults are rarely trained to recognise warning signs and symptoms.
Trauma Is Hard to Resurface
And we know that trauma is difficult to surface:
- It’s hard to recall old, repressed memories accurately; and
- Doing so is itself a traumatic experience.
There Are 3 Possible Pathways to Recovery
The good news? Once surfaced, there are three possible pathways to recovery:
- Reconnecting with ourselves and other people:
- Understanding what’s happening in our brains and our bodies;
- Learn to acknowledge, experience and bear what we’ve been through;
- Reconnecting and talking about those experiences with others; and
- Expressing trauma, emotions and ourselves more positively and skilfully through e.g., changing the words we use and theatre.
- Rewiring the brain:
- Strengthen top-down monitoring of signals through e.g., meditation, yoga;
- Change how we organise information through e.g., EMDR, neurofeedback; and
- Using drugs to dampen hyperactive internal alarm systems.
- Reconnecting with and reprogramming the body:
- Reconnecting mindfully and fully with the body (sensations, heart rate, breathing) through e.g., meditation, yoga;
- Learning to connect sensations with emotions with words so we can detect and process them;
- Learning to control “involuntary” responses through breath, movement and touch; and
- Seeking physical experiences that contradict helplessness, rage and collapse.
Trauma isn’t something you have to put up with or numb into submission.
There ARE strategies you can use to get through it.
The Body Keeps The Score Contents
The Body Keeps the Score contains 20 main chapters split over 5 parts…
Prologue: Facing Trauma
Part One: The Rediscovery of Trauma
- Lessons From Vietnam Veterans
- Revolutions in Understanding Mind and Brain
- Looking Into the Brain: The Neuroscience Revolution
Part Two: This Is Your Brain on Trauma
- Running for Your Life: The Anatomy of Survival
- Body-Brain Connections
- Losing Your Body, Losing Your Self
Part Three: The Minds of Children
- Getting on the Same Wavelength: Attachment and Attunement
- Trapped in Relationships: The Cost of Abuse and Neglect
- What’s Love Got to Do With It?
- Developmental Trauma: The Hidden Epidemic
Part Four: The Imprint of Trauma
- Uncovering Secrets: The Problem of Traumatic Memory
- The Unbearable Heaviness of Remembering
Part Five: Paths to Recovery
- Healing From Trauma: Owning Your Self
- Language: Miracle and Tyranny
- Letting Go of the Past: EMDR
- Learning to Inhabit Your Body: Yoga
- Putting the Pieces Together: Self-Leadership
- Filling in the Holes: Creating Structures
- Rewiring the Brain: Neurofeedback
- Finding Your Voice: Communal Rhythms and Theater
Epilogue: Choices to Be Made
Appendix: Consensus Proposed Criteria for Developmental Trauma Disorder
Best The Body Keeps The Score Quotes
These The Body Keeps The Score quotes come from The Art of Living's ever-growing central library of thoughts, anecdotes, notes, and inspirational quotes.
"Traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from their selves."- Bessel van der Kolk, The Body Keeps The Score
"As long as you keep secrets and suppress information, you are fundamentally at war with yourself… The critical issue is allowing yourself to know what you know. That takes an enormous amount of courage."- Bessel van der Kolk, The Body Keeps The Score
"As I often tell my students, the two most important phrases in therapy, as in yoga, are “Notice that” and “What happens next?” Once you start approaching your body with curiosity rather than with fear, everything shifts."- Bessel van der Kolk, The Body Keeps The Score
"Trauma is not just an event that took place sometime in the past; it is also the imprint left by that experience on mind, brain, and body. This imprint has ongoing consequences for how the human organism manages to survive in the present. Trauma results in a fundamental reorganization of the way mind and brain manage perceptions. It changes not only how we think and what we think about, but also our very capacity to think."- Bessel van der Kolk, The Body Keeps The Score
"Beneath the surface of the protective parts of trauma survivors there exists an undamaged essence, a Self that is confident, curious, and calm, a Self that has been sheltered from destruction by the various protectors that have emerged in their efforts to ensure survival. Once those protectors trust that it is safe to separate, the Self will spontaneously emerge, and the parts can be enlisted in the healing process."- Bessel van der Kolk, The Body Keeps The Score
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