Book Review: The Body Keeps the Score — Brain, mind, and body in the healing of trauma, by Bessel van der Kolk, M.D.
Review by Donna Andersen
Many, many Lovefraud readers say that after your experience with a sociopath, you have post-traumatic stress disorder (PTSD). Even if you haven’t been diagnosed by a professional, you’re probably right. But what, exactly, does that mean? What happens to your brain on PTSD? And what can you do about it?
All the answers are in this book. The Body Keeps the Score — Brain, mind and body in the healing of trauma, is the best explanation I’ve ever seen on the causes, effects and treatment of trauma. I strongly recommend that every mental health professional who reads Lovefraud also read this book. And for those of you who are experiencing PTSD and want to understand it, the book will be extremely helpful, although it also may be triggering to your symptoms.
The author, Bessel van der Kolk, is a psychiatrist who has been researching trauma since the 1970s. He is medical director of the Trauma Center in Brookline, Massachusetts, and a professor of psychiatry at Boston University School of Medicine.
Trauma is caused by terrible, horrific life experiences. But some in the medical profession attempt to treat trauma by dispensing pills. Van der Kolk is well known for advocating a holistic treatment approach, using approaches such as “mindfulness” to address the root cause — so that true healing is possible.
The following quotes from his book show his views:
The theory that mental illness is caused primarily by chemical imbalances in the brain that can be corrected by specific drugs has become broadly accepted, by the media and the public as well as by the medical profession.
In many places drugs have displaced therapy and enabled patients to suppress their problems without addressing the underlying issues.
After conducting numerous studies of medications for PTSD, I have come to realize that psychiatric medications have a serious downside, as they may deflect attention from dealing with the underlying issues. The brain-disease model takes control over people’s fate out of their own hands and puts doctors and insurance companies in charge of fixing their problems.
Early in the book, van der Kolk explains how the brain develops and functions, and how trauma affects it. He explains your built-in fight-flight-or-freeze reaction, and how trauma keeps you alert to danger, and pumps your body full of stress hormones, even when the danger is over or doesn’t exist anymore. He writes:
After trauma, the world is experienced with a different nervous system. The survivor’s energy now becomes focused on suppressing inner chaos, at the expense of spontaneous involvement in their life. These attempts to maintain control over unbearable physiological reactions can result in a whole range of physical symptoms, including fibromyalgia, chronic fatigue, and other autoimmune diseases. This explains why it is critical for trauma treatment to engage the entire organism, body, mind, and brain.
The bottom line is that the threat-perception system of the brain has changed, and people’s physical reactions are dictated by the imprint of the past.
So how do you recover from trauma? Van der Kolk says survivors need to become familiar with the sensations in their bodies. “Physical self-awareness is the first step in releasing the tyranny of the past,” he writes.
The idea is to be able to identify and process physical sensations, so that the emotions attached to them can be released. That’s one of the objectives of mindfulness, which is observing your internal states, without judgment.
Van der Kolk has found other ways that can help — writing, movement such as yoga and dancing, EMDR, and even participating in theater. He writes:
The challenge of recovery is to reestablish ownership of your body and your mind — of your self. This means feeling free to know what you know and to feel what you feel without becoming overwhelmed, enraged, ashamed or collapsed. For most people this involves (1) finding a way to become calm and focused, (2) learning to maintain that calm in response to images, thoughts, sounds, or physical sensations that remind you of the past, (3) finding a way to be fully alive in the present and engaged with the people around you, (4) not having to keep secrets from yourself, including secrets about the ways that you have managed to survive.
Van der Kolk’s book is tremendously insightful. It is backed up by solid research and his own nearly 40 years in the trenches, working with traumatized clients. I could keep quoting passages from The Body Keeps the Score, but that doesn’t begin to do justice to his work.
If you’re wondering why you feel so crazy and out-of-control after your experience with a sociopath, read this book. If you want to understand how trauma has affected you, read this book. If you want suggestions on how you can recover, read this book.
But keep in mind that reading the book won’t create your healing — it will just point you in the right direction. Van der Kolk writes:
Psychologists usually try to help people use insight and understanding to manage their behavior. However, neuroscience research shows that very few psychological problems are the result of defects in understanding; most originate in pressures from deeper regions in the brain that drive our perception and attention. When the alarm bell of the emotional brain keeps signaling that you are in danger, no amount of insight will silence it.
That means recovery requires action and participation on your part. There is internal work to do, and the best way to do it is with the help and support of someone who is willing to walk with you through the darkness.
Van der Kolk offers advice on choosing a professional therapist. He points out that there is no one “treatment of choice” for trauma — the best treatment is what works for you. His book may give you some ideas on how to proceed.
The Body Keeps the Score Brain, mind, and body in the healing of trauma is available on Amazon.com.
Learn more: How abusive parents affect you and how you can recover
Lovefraud originally published this article on March 28, 2016.
LETTERS TO LOVEFRAUD: It did not feel right, but I dismissed my discomfort
@Wini, thanks for letting us know about this book! It sounds really good. One of the treatments that has helped me with the loudness of PTSD is neurofeedback.
Donna,is there still a way to search by author on the blog? I want to re-read Kathy Hawks articles, and am not sure how to find them.
Thanks,
One joy
One/Joy – Hello – great to see you. The book is really, really, good – I thoroughly recommend it. Van der Kolk is truly an expert, and he shows so much empathy for people who have been traumatized.
If you scroll to the red footer at the bottom of the page, you’ll see the “Post Archives by Category” link. On that page, scroll about halfway down. Articles are organized by category, and the categories are in alphabetical order, by the first word. So Kathy’s articles are under K.
Thanks a lot Donna. I am going to recommend the book to my psychologist, too. She works with a lot of young people at the uni and it would be great to give her more tools.
I like the thrust of this bk but my body is wracked with ptsd so movement is painful. Partly it’s due to hyperinsulinemia and systemic inflammation causing even no movement to still bring about shooting pains, yes just sitting still at night is painful. But to think about sports, dance, etc is a laugh. Stretching might work tho…
How I wish I could just run off this ptsd inhabiting my body for so many decades, inflamed over and over by each new trauma! I would run to the ends of the earth and back again if I had the energy and cooperating body.
Rly good premise to this bk.
Aint, can you sing without exacerbating your pain?
I meant to put:
Rly good premise to this bk, it resonated with me before I was done with the article.
Walking was something Ive always loved, not just the excersise portion but the movement aspect. It cleared my mind. Now I know it was literally clearing!
(my brain fog is deep and pervasive. I now leave out entire phrases, not just a word here and there, sigh.)
Sandra Brown’s Institute is also having a seminar on the neurobiology of the aftermath.
I completely agree with this author. I have had severe PTSD since I was young and was diagnosed as BPD in my twenties. To this day, I am really not sure which one I had or if it was both. Meditation saved my life literally. On the continuous brink of suicide and in constant chaos, I attended a 10-day insight meditation retreat in the Buddhist tradition. It was more powerful than I could ever explain in a post here. The work didn’t stop after the retreat ended. In a way it only just began, because I needed to integrate what I learned and the new perspective into everyday life, which was very very difficult. I imagine there was a lot of guidance out there, but I was severely mistrustful and didn’t have much money. I eventually dropped out of grad school where I was studying Psychology from an Eastern philosophical perspective. I felt I was too mentally unhealthy and unstable to be there. In retrospect, it’s unfortunate that I dropped out. Had I stayed, I would have enjoyed a thriving career as a licensed therapist later in life. I wanted to go back, but the time got away from me, and the statute of limitations had passed to finish the degree. Plus, the money….
Anyway, I bring all this up to voice my agreement of the author – that awareness and some sort of practice to bring awareness is the key to recovery. There are some very gentle forms of therapy/body work that are really good for PTSD. I love cranial sacral work personally. I’ve also had some EMDR. There are many ways to work with PTSD besides pharmaceuticals, which I’ve never been a big fan of. However, if you cannot afford these things, try one session and learn how to do the techniques for yourself. This is what I do, and it does help. I will probably always battle with PTSD, the remnant of an abusive and neglectful childhood. But I was fortunate enough to gain a different perspective on it from the meditation practice.