book review: the body keeps the score by bessel van der kolk
07 Feb 2023
The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk
What are the main ideas?
- trauma is how the body copes with overwhelming experiences
- before psychoactive chemicals were discovered, the view of the mind was a balance between electrical signals and chemicals. in the 1960s when chemicals started to be found to affect brain functions, they vastly overshadowed the awareness of electrical stuff. we are still suffering the ripples of the outsized view of the importance of chemical impacts on the brain (mostly because of the profitability of the pharmaceutical industry).
- trauma can result from physically intense experiences (accidental or intentional/abusive) as well as neglectful circumstances. we vastly underestimate the significance of neglect in creating trauma
- childhood trauma is the single largest creator of poor outcomes for adults in the US today
- when overwhelming experience pushes the body into survival mode, the part of the brain that processes incoming information and helps it decide what’s important and what’s not shuts down. “as a result, the imprints of traumatic experiences are organized not as coherent logical narratives but in fragmented sensory and emotional traces: images, sounds, and physical sensations.” ordinarily, experiences get stored as regular memory and integrated into the rest of our memories. this doesn’t happen with trauma. it is those non-integrated traces that, when a similar situation arises (a smell, an emotion, a sight, a sound) our mind brings us back to the previous moment but because it hasn’t hbeen stored in memory, we have no story about where we’re going back to (this is a flashback). this is what it means for trauma to be triggered.
- in order to resolve trauma, the mind and body must move through the action/behavior that was intending to create survival but was thwarted or failed. this moving through can happen in a variety of ways. many of those ways don’t even require knowing the specifics of the event that created the trauma. as long as the body and mind can process the previous situation as no longer present, the mind can then process the sensory experience into regular memory.
- medications and body-oriented approaches to trauma healing can both help people recover from trauma. however, medication tends to only quell symptoms while the client is still taking the medication. other therapies [such as eye movement desensitization and reprocessing (EMDR), internal family systems therapy, sensorimotor psychotherapy, yoga, meditation, mindfulness, psychomotor therapy, group theatre and music, and neurofeedback] have been found to be more effective as well as time-limited (as in once you do it the therapy and resolve the trauma, you don’t need to do it anymore).
- some types of trauma, and especially complex trauma, is immune to talk therapy. this is because trauma is stored in the body and if you can’t find words to talk about the experience, they won’t help you resolve the trauma. sometimes this is because the trauma occured in the client before they learned to speak. in other cases, it’s just because the traumatic experience was just too overwhelming.
If I implemented one idea from this book right now, which one would it be?
start doing a body-oriented type of therapy as well as talk therapy to help resolve my own trauma.
How would I describe the book to a friend?
dang. i can’t believe i waited ten years to read this book. this is a treasure trove of science and story that explains in vivid detail what trauma is, how it is created in the body and mind, explorations of what we can do to tend to it (individually and collectively), and the societal implications of doing (or not doing) that tending. it’s a biggie, for sure, but absolutely worth its weight in gold. it also is pretty explicit and intense regarding the specific stories and examples of people’s traumatic experiences. as i learned from the book, just hearing about someone else’s trauma is actually not likely to be triggering (because triggers are about the sensory experiences the feel like the overwhelming experience that caused the trauma in the person being triggered), but it’s still pretty intense and often upsetting stuff. handle with care and caution.
note: van der kolk was fired for allegations of misconduct in 2018. the situation was settled out of court so very little is publicly known about what happened. i don’t quite know what to make of this but here’s some articles in case you’re curious and want to be informed:
- https://www.bostonglobe.com/metro/2018/03/07/allegations-employee-mistreatment-roil-renowned-trauma-center/sWW13agQDY9B9A1rt9eqnK/story.html
- 3 Things Bessel van der Kolk Did To Help Him Through His Recent Trauma - Smart Couple Podcast 191 - interview where he describes his termination
- https://www.uua.org/midamerica/news/blog/update-dismantling-systemic-white-supremacy-resources-and-work
- https://www.theguardian.com/society/2021/sep/20/trauma-trust-and-triumph-psychiatrist-bessel-van-der-kolk-on-how-to-recover-from-our-deepest-pain
reminder: book review structure
words / writing / post-processing
714w / 32min / 20min