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If you’ve experienced a traumatic event, you know the symptoms that follow.  It could be physical or emotional pain directly related to the trauma, but also symptoms in response to reminders of the event once you’re physically healed.  You might be dealing with panic or out-of-control flashbacks that pull you into re-experiencing the trauma.  You may have trouble putting words to what happened to you, with gaps in your memory or difficulty placing a beginning, middle, and end to your experience.

Bessel van der Kolk, in his 2014 book The Body Keeps the Score, describes the experience of holding trauma in our bodies both through changes to the structures of our brain and effects of trauma on daily living for those who have experienced traumatic events.

In his 40+ years of clinical experience as a psychiatrist, van der Kolk has done extensive research on the effects of trauma on brains and bodies of children and adults.  His focus on neuroscience and attachment form the basis of his points in his book.  

HOW TRAUMA AFFECTS THE BRAIN AND BODY

Van der Kolk begins the book giving background information about trauma and how it impacts both the structures of the brain and interpersonal relationships.  He discusses how trauma activates your fight-or-flight response in the amygdala, or emotional center of your brain.  This affects not only how you remember and tell the story (typically more images than biographical details), and it also changes how that information is stored in your brain.

He normalizes traumatized individuals’ difficulty improving, not because they don’t want to, but because of the impact of the symptoms and the weight of self-blame they carry in response.  This can cause physical symptoms and reactions in the body that echo long after the traumatic event has ended.  It can affect their lives as they lose their ability to focus or concentrate, they dissociate or disconnect emotionally, and they have difficulty feeling safe with other people.
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“When the subject of blame arises, the central issue that needs to be addressed is usually self-blame – accepting that the trauma was not their fault, that it was not caused by some defect in themselves, and that no one could ever have deserved what happened to them.

— Bessel van der Kolk

THE IMPACT OF TRAUMA IN CHILDHOOD

Next he moves on to discuss the impact of childhood trauma and insecure attachment on adults.  He highlights insights from research with children and teens to highlight the detrimental effects of trauma and how it can be reversed.

One insight he shares is that how we cope with trauma as children usually translates into how we cope as adults.  We learn to survive amidst chaos using certain strategies, some of which can include addiction, destructive relationships, or other unhealthy patterns.  Recognizing where these patterns originated can release some of the self-blame you carry.
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“Many traumatized children and adults simply cannot describe what they are feeling because they cannot identify what their physical sensations mean…trauma victims cannot recover until they become familiar with and befriend the sensations in their bodies.

— Bessel van der Kolk

HOW TO TREAT TRAUMA

Luckily, trauma is not a death sentence, because our brains are designed with healing mechanisms in place.  During this section, van der Kolk highlights several different methods of psychotherapy that can help heal the effects of trauma, such as EMDR (eye movement desensitization and reprocessing), yoga, internal family systems therapy, writing, theater, psychomotor therapy, group therapy, and others.

He speaks about using an approach to trauma treatment that focuses both on top-down interventions (strengthening the control center of the brain with activities such as mindfulness and yoga) and bottom-up interventions (regulating the emotional brain through breathing, touch, and movement).  He emphasizes that revisiting the trauma is an essential part of this process, but it needs to be done when you are feeling safe and grounded in the present moment.  Ultimately, he believes (and I agree) that experiential knowledge is much more powerful than intellectual knowledge, and therapy should incorporate these aspects.
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“More than anything else, being able to feel safe with other people defines mental health; safe connections are fundamental to meaningful and satisfying lives.

— Bessel van der Kolk

HOW TO USE THIS BOOK

If you are someone who has experienced trauma or helps others who have been traumatized, The Body Keeps the Score will be a helpful resource to put words and explanations to what you feel and experience.  You might discover a completely new perspective on your story of trauma as a result.

Begin with the first section of the book if you are curious to understand how trauma affects the brain.  His anecdotes about individuals who have experienced trauma coupled with images of brain scans illustrate the connection between trauma and the brain.  My guess is that you’ll find your story to be more common than you realized.

In particular, I think the first section of the book is helpful for women who have experienced sexual assault or other violent crimes.  He speaks at length about the freeze response of the brain that shuts down and inhibits the victim’s ability to fight back against their attacker.  This survival response often becomes a source of self-blame after the traumatic event.  Knowing it is a natural biological reality to shut down can lift some of that blame.

If you’re interested in the concept of attachment and how trauma during childhood can affect development, read the middle section of the book, where van der Kolk shares research insights into the impact of attachment on children.  He speaks about the impact of a caregiver’s ability to emotionally attune to their children and respond to their needs so that children can learn to self-regulate.  Children who don’t receive that attunement can grow up to be anxious (feeling too much) or avoidant (not feeling at all).

If you want to learn more about a particular type of therapy to treat your trauma, jump ahead to Section Five of the book, where van der Kolk outlines the different methods of therapy that have been helpful in his experience of treating trauma.  As an EMDR practitioner, I enjoyed how he described the way a typical EMDR session works, as that can give you an idea of what to expect.

Overall, I think the combination of personal anecdotes, research, and hope this book offers make it an invaluable resource for therapists who work with traumatized clients, but also for those who are seeking to heal from their personal stories of trauma.

‍by Elizabeth Van Sickel