The Body Keeps the Score Brain, Mind is a word that connotes deep emotional and physical wounds, inflicted by another person or by witnessing another deeply hurt, for example. Though painful memories of such traumas can be overwhelming and persistently present, the good news is that the body keeps the score.
The brain persists in recording deep memories of traumatic experiences; it’s as if our bodies are trying to protect us from future injury by remembering what hurt us before. The feelings associated with those memories often lead to high levels of chronic stress which can dominate our lives and diminish quality of life. But fortunately, with the right help for healing trauma, we can change how we feel about past events and break free from unhealthy patterns.
From the Publisher
Michael Philliber –
After being struck by trauma – combat, auto accident, assault, abuse – why do the dreams come and come and come? From where does the anxiety, distractedness, or outburst originate? Are there reasons for the gut balling up into a knot and the chest squeezing tight and feeling like it will implode when unwanted memories of the distress invade? Why does the recall come in pieces, chunks, or flashes? And then there’s the inability to communicate, the mental shut-down, the emotional-frigidity; what is that all about? Is there any way to move from the trauma and its aftermath to some sense of genuine wellbeing? All of these subjects, and more, are covered by Bessel van der Kolk, founder and medical director of the Trauma Center in Brookline, Massachusetts, professor of psychiatry at Boston University School of Medicine, and director of the National Complex Trauma Treatment Network, in his 464 page paperback, “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma”. This volume is written for both the helping-professions technician and therapist, as well as for the traumatized and their families. With thousands of book reviews already posted and published, I’ll make this review brief.“The Body Keeps the Score” unpacks the way trauma affects us, mind, brain, and body. The author looks at multiple forms of therapy, showing their strengths and limits. He recognizes that there are “fundamentally three avenues [of therapy]: 1) top down, by talking, (re-) connecting with others, and allowing ourselves to know and understand what is going on with us, while processing the memories of the trauma; 2) by taking medicines that shut down inappropriate alarm reactions, or by utilizing other technologies that change the way the brain organizes information, and 3) bottom up: by allowing the body to have experiences that deeply and viscerally contradict the helplessness, rage, or collapse that results from trauma” (3). Van der Kolk addresses each of these approaches while explaining in detail what harrowing ordeals do to people.The author’s proposition through the pages is that the anguish of assault and abuse “changes brain development, self-regulation, and the capacity to stay focused and in tune with others…experiences change the structure and function of the brain – and even affect the genes we pass on to our children…devastates the social-engagement system and interferes with cooperation, nurturing, and the ability to function as a productive member of the clan” (349, 351). One of the aspects that surprised me was how the “ventral vagal complex” – the vagus nerve that interfaces with other nervous systems – takes what my brain is experiencing (even re-experiencing through PTSD, etc.) and mobilizes muscles, heart, lungs and other body parts, so that I feel the alarm – or helplessness – or grief in my brain all the way down into my chest and stomach! Which means my body begins to take on muscle-memory (as we put it in martial arts)! Therefore, if “the memory of trauma is encoded in the viscera, in heartbreaking and gut-wrenching emotions, in autoimmune disorders and skeletal/muscular problems, and if mind/brain/visceral communication is the royal road to emotion regulation, this demands a radical shift in our therapeutic assumptions (88). It’s this “radical shift in therapeutic assumptions” that dominates the authors final eight chapters, where he methodically explains different “paths to recovery”. This is truly a captivating read!Van der Kolk weaves into the technical aspects of the book biographical and autobiographical tales that help the reader to see what has gone on, and not gone on, in the world of psychiatry and psychology regarding trauma. The stories also help to cement into the imagination and comprehension what he is trying to communicate. The book is reasonably technical with neuroscience, brain studies, physiology, professional acronyms and so forth. But the author is careful to not leave anyone in the dark. It is a fascinating read that treats the audience as mature enough to handle the subject and grasp the material. I disagreed with the evolutionary explanations of how the brain develops and found the little political rant in the epilogue disappointing. But beyond these, I was almost mesmerized by the book!“The Body Keeps the Score” is a whole textbook on physiology, brain studies and neuroscience, as well as therapeutic theories. It is not a self-help book, but readers who are looking for help will likely find it beneficial. Helping professionals may also find it advantageous as the author has a plethora of notes on various studies and articles. But I think that the biggest value will be for those who have family members, friends, and parishioners that have been through violent experiences. It gives a bigger and better perspective on what s going on, and they will be able to draw from the various paths to recovery approaches they can take as they seek to be part of the remedy and not the trauma. I highly recommend the book.
S. Rose –
“I think this man is suffering from memories.”So, this book changed my life. No, really. In fact, it’s *saved* it.I have severe PTSD. And despite years of therapy, it seemed to be getting worse instead of better. My flashbacks were occurring more and more often. I was becoming more and more lethargic and frozen in time. And suicide was constantly just *there* in my mind. Constant. I’d even set a date.And then my insurance quit paying for my therapy.As a last, desperate grasp for help, I started to read this book.I have never read anything more validating and more hopeful. To see the brain scans and hear the science that explained *exactly* what has happened to my brain, what is going on during my flashbacks and why I’m always physically sick—all the times I’ve gone to a doctor in pain or feeling like I’m having a heart attack or a stroke only to be told they can’t find anything wrong—brought me to tears. It gave me all the answers I’ve been searching for. It gave everything a scientific, medical explanation—and a path to *healing*.He explained why all of my EMDR therapy wasn’t working—it was because my therapists (bless them!) were doing it wrong. And I’ve been able to take what I’ve learned from my therapists and this book and do EMDR on my own, and today… today I feel more like my old, genuine self, than I have in *years*. The shadow of suicidal thoughts no longer follows me. I feel *light*. And I have *hope*—genuine *hope*—that I actually *can* get better! I’m always telling people *they* can get better and there’s hope for *them*… but I haven’t felt that way about myself. Now, I do. I haven’t had that hope in a long, *long* time. And I even think, after years of struggling and finally making such great progress in such a short time, maybe—just maybe—I can be cured. I never thought I’d say that! The future is so exciting to me now!If you have trauma, do be warned—Dr. van der Kolk talks a lot about his clients and their traumatic experiences and it can be very triggering. Some of the details I felt he definitely could’ve left out, honestly. However, the scientific information, the validation and the information on how to heal trauma, has made this book absolutely *priceless* to me. It’s my trauma bible. I’ll be re-reading it in the future and constantly referring to it.Edit: I keep seeing reviews on here from people who were super upset by the story of the Vietnam vet who murdered a family, raped the mother and left her to die. Honestly, I flipped out at that part, too (aka, had a flashback), in large part because I misunderstood what Dr. van der Kolk was trying to say. I thought for a moment that he was trying to justify what the man did, and had to email my old therapist about it. Of course, she had the book and was able to read the scene. She encouraged me to reread his conclusion, and pointed out to me that he’s actually saying how difficult it was to try to treat him objectively because what the man had done was an absolute atrocity. He never actually justifies it. He calls it an atrocity. It’s just worded weird, and if you’re already triggered by what you’ve just read, it is *easily* misunderstood. I hope he clarifies this in future editions. You have to keep in mind that, van der Kolk’s target audience is actually other therapists. For this reason, it *was* difficult for me to read. I was violently attacked and molested at 5-years-old and repeatedly raped and abused as a teenager. His going over other people’s abuse is overly detailed at times and I had to skip many of those scenes.However, I don’t hold any of this against him at all. The information in this book has changed my life, I feel seen and validated, and I stand by that almost a year after reading it. I keep it right on my writing desk where it’s easily found for reference. Am I cured yet? No. Did my flashbacks stop? Nope. This year has been an unexpected nightmare full of triggers. But I’ve made *so* much progress. And I have hope. And that’s what I need to make it through each day. I sincerely believe that, through a lot of work (which I’m willing to do!), I can be cured in time. And all of that started with this book.
I am not a mental health professional but have spent my fair share of time in their offices to process certain events. Everyone I have come across highly recommends this book, myself included. If you have experienced traumatic events or are struggling you 100% need to give this a read.
Walk into the sunshine; depathologize your less appealing reactions and habits. Look at reality head-on, dismantle your denial castle, and heal. Slowly, with compassion and tenderness toward yourself. This book is an axis shift on the recovery road. I have been studying and looking for answers to my chronic panic and inner agony for over 2 decades and finally stumbled across a friendship with a therapist who wanted a study buddy on her journey to become a trauma specialist. We read this together. I’ve read it now 3 times. This book untangles things better than anything I have ever found. I rate it as #1 for finding answers. It has also provided direction for further branching out into other materials and studies for recovery strategies. I wish every thinking open minded person would read and apply it.
The DSM was never designed to be used for criminal court cases or insurance purposes, as stated by DSM3 in 1980. It was widely known then that diagnosing a person’s mental states was not as precise as diagnosing a broken leg. Fast forward just three decades later, and that humility as transformed into hubris. The language of the DSM has permeated every facet of our culture with a kind of religious authority: This person is a narcissist; that one is bi-polar. Informal diagnoses abound, as pop psychology articles on the Internet aid and abet an army of armchair psychologists. Professional practice fairs little better: Most talk therapy, regardless of it’s flavor, rarely gets to the heart, or more precisely, the body of the matter.When six months of discussion one hour a week doesn’t yield results, the next action is usually a diagnosis, the treatment of which requires a pharmacological solution. The drugs often do not work, and in the case of SSRIs among others, these medicinal interventions have been shown to be outright harmful to the patient. Big pharma’s profits soar, and the patients remain unwell or worse than when they started treatment.In this environment, Van der Kolk’s work is needed now more than ever. Many of the DSM diagnoses are various flavors of how trauma is manifesting itself in the patient. Trauma is not stored in the linguistic parts of the brain and body, and it therefore must be treated by means others than the linguistic talk-therapy approaches, and not masked with drugs. Van der Kolk takes readers on an exploration of a new landscape of treatment that involves yoga, dance, meditation, and theater, right along with EMDR and neurofeedback, among other newly-researched treatments.I highly recommend this read for anyone who is interested in advancements in the field of psychology, or anyone who is questioning the path of treatment that they or a loved one is currently following.
Of all the non-fiction books I’ve read, this is by far the best one ever. I grew up in a tough way. Lots went wrong. My brother and I believed we were unwanted and we had plenty of evidence to back up our sentiment. We suffered shared abuse and individual abuses of every kind imaginable. When I became an adult, I subscribe to the concepts of people like Rush Limbaugh and drove around listening to his radio show proclaiming that there is no such thing as post-traumatic stress disorder. I believed I could gut it out, that the past was the past and that only weak people needed to talk through their problems. I believed only losers behaved badly as adults due to anything in their childhood or past and that claiming you were affected by any past problem was a crutch to allow you to embrace failure. Frankly, for a time, that approach worked for me. I got married, had some great children (still have them thankfully), built a company. But it didn’t take too long until it all came crashing down. And, when it did, I spent nearly 1.5 decades down. The anxiety that was always in my throat and chest was, to put it mildly, a distraction. It’s very hard to be kind to people, to focus on your work, to love others when all your power is spent trying to pretend you don’t feel like s***. When you can’t sleep because your heart is beating so forcefully that the entire bed is vibrating – at least it feels that way – you not only lose the joy of sleep, but you feel hopeless and miserable and even more so when you’re not able to understand why you feel this way. When you see everything you have go away and can only occasionally find the strength to take care of yourself and your business and need others in your life to carry you from time to time (much to your embarrassment) and yet you think you’re smart and capable and have no understanding of why you are where you are, life becomes a slog. You trudge through it wishing you were dead or that something would kill you even if, like me, you’d never kill yourself. Literally, when I was a believer, I went to bed every night and my prayers went something like this, “Dear Jesus, please have a bus run over me. I will never kill myself but I’m miserable. Please let me die so my family won’t hate me for killing myself but so that I can stop hating the sun coming up. In Jesus name, Amen.” If you’re like I was (and it’s hard to tell you how I was and hold the tears down even now), this book will help you change all that. It will describe in detail what you’re going through and it captures so many of those subtleties as to make it absolutely amazing. For the first time, I don’t have depression (and I don’t take pills). I don’t have anxiety (it still bubbles up on occasion but using mindfulness, it goes nearly as fast as it comes). My life is pointed in the right direction, my business future is hopeful, my love-life is stabilizing, I know I’ll no longer lose friends. I’m finally on track to getting what I want in every area of my life from women to money to friends and deep connections with my family. While I can’t attribute every part of my success to this book alone as it takes many things to get where you want to go (mostly you), I can absolutely attest to the power of this book. If you’ve suffered any sort of major and/or persistent trauma in your life, please buy (and read) this book. You will one day thank yourself for doing so.
Kate from PVD –
As a trauma survivor I have often been confused by myself – my brain, my behavior, just everything about me. Then I read this book and suddenly it all made sense.A must read for those who love and want to understand and support survivors and encouraged (when your ready) for survivors.
People who are complaining that a book on trauma is recounting trauma need to get help instead of blaming the messenger.Remember, part of the intended audience of this book is comprised of people who poo-poo trauma, especially childhood or female-centric ptsd. By introducing the veteran and linking soldier ptsd to csa-induced ptsd, he is showing us that it all matters.Also, remember that this was written before the trigger-warning craze (and research shows those warnings don’t help anyway).So please don’t knock a book for being what it supposed to be: a serious and courageously enlightening discussion of trauma. As a survivor, dealing with the truth with the right support has been challenging yet healing. This book has served as part of that support for me.
Tom Cloyd, MS MA –
Psychiatrist, professor, world-class researcher, and traumatologist Bessel van der Kolk MD requires no introduction to trauma psychotherapists. My enduring impressions of him over many years is one of relevance, cogency, frankness, and accessibility – served up with a subtle dash of impishness. He tends to be a bit disruptive – something of a provocateur – and everything of his I have ever read has taught me something, confirmed something important, or pushed my thinking in a new direction. When he has something to say, I want to hear it.However, I almost didn’t buy this book: I was put off by the title. Familiar with major reviews of PTSD psychotherapy outcomes research, I know that research support for body-oriented approaches to treating psychological trauma psychopathology is thin at best, and such treatment models simply do not have the research validation of either EMDR (Eye Movement Desensitization and Reprocessing) and PE (Prolonged Exposure), neither of which are especially body-focused.J. Interlandi’s excellent article anticipating publication of this book – “A Revolutionary Approach to Treating PTSD” (New York Times Magazine, 2014.05.22 – available online) – initially supported my fears that for some inexplicable reason van der Kolk was now promoting some treatment model for which we have little confirming research. “Psychomotor therapy is neither widely practiced nor supported by clinical studies,” Interlandi informs us. Provocateur he may be, but I’m strongly biased in favor of paying attention to therapies for which we do have solid empirical validation. Our clients do not deserve to be experimental subjects – maybe not even if they agree to this, as I’m not sure they can ever know enough to make a truly informed consent. Knowledge that PTSD and related disorders are usually highly curable, when using the right treatment protocols, sadly remains the possession of a minority of people, even in the professional psychotherapy world.Yet the account of van der Kolk’s therapy work in Interlandi’s article is gripping. Becoming completely absorbed in the account, I was convinced. (I’ve been here before, reading van der Kolk’s own accounts of his work.) And so the disruption begins! Deeper into the article, he has me. Van der Kolk’s critique of CBT (cognitive behavioral therapy – a general class of therapies) and PE (E. Foa’s exposure therapy model) is withering and correct: neither really work. “Trauma has nothing whatsoever to do with cognition…It has to do with your body being reset to interpret the world as a dangerous place….It’s not something you can talk yourself out of.” Interlandi reports that “That view places him on the fringes of the psychiatric mainstream.”But he’s right, and I can’t stress this enough. Why? Because as a trauma treatment professional I’m well aware of what the trauma treatment outcomes research actually says. The best current summary of this research well may be chapter 2 of Ecker, et al.’s (2012) “Unlocking the emotional brain”. (Buy this book, too!) Ecker et al. brilliantly presents a synthetic summary that encompasses 11 existing therapy models which actually DO cure trauma psychopathology, if done right. In this context, what van der Kolk is doing makes perfect sense. Finally, it appears, the trauma psychotherapy field is moving toward a consensus which has strong credibility.Van der Kolk’s new book has many virtues. Parts One and Two (102 pp) provide a substantial review of the neuropsychology of trauma’s impact on a person. It’s fun, interesting, informative reading, for professional and layperson alike. Part Three (64 pp) surveys childhood development, attachment experience, and “the hidden epidemic of developmental trauma”. Van der Kolk has for years been a leading champion of the idea that there is a type of PTSD which substantially differs from all the rest. It develops in response to chronic child abuse and/or neglect. I completely share his belief that the diagnosis of Developmental Trauma Disorder (sometimes called C-PTSD, with “C” meaning “Complex”) is overdue for formal recognition. I find his review of the struggle to legitimize DTD as gripping and distressing as anything else in the book. It is anguishing to know that a major problem exists, AND that the psychiatric establishment simply refuses to acknowledge it. DTD/C-PTSD is no fantasy. We see and treat these people, as children and adults. They exist, and they are nothing like “ordinary” PTSD treatment clients.Part Four (29 pp) focuses on memory. I’ve long thought that much writing on treating psychological trauma seems to miss the point: trauma memory is what causes the problem. Deal with that and the symptoms vanish. Why is this so hard to understand? Yet, it is not a common understanding at all. Explaining how trauma memory works is invariably enlightening to my clients. And experiencing what happens when we change the nature of trauma memory is revelatory to someone who’s lived with it for years, if not decades. As he does throughout the book, van der Kolk offers fine stories about clients who have experienced exactly what I’ve seen happen in my clients, making excellent use of what cognitive research tells us: people understand things best through narratives. Offer a good narrative and you convince.Psychological trauma therapy is complex, but we are now well prepared to launch into the book’s core content – Part Five (154 pp), “Paths to Recovery”. He gets right to it: we cannot undo the trauma, but we CAN undo its effect on us, and so get our “self” back. Ch. 13 reviews existing therapies. His approach is to repair “Descartes’ Error” (see Damásio’s 1994 book of that title) by viewing mind and body as a single coherent functional unit. His topical coverage is complete and his critique of current therapies acute – not to be missed.He then writes of the importance of language (Ch. 14). We construct our narrative mainly in words, and the words we choose are critical. But language is not enough (this anticipates his next two chapters). Our senses encompass a larger world, and it’s center is our body, where all our sensory receptors are located. Then he introduces the treatment model he’s long advocated: EMDR (Eye Movement Desensitization and Reprocessing). I’m trained in EMDR, and in fact van der Kolk and I had the same instructor for our advanced training: Gerald Puk PhD. Van der Kolk tells an amusing and self-deprecating story about his advanced training experience, in which Puk was able to provide a strong corrective to his approach to clients. This is typical van der Kolk – he’s a truth-teller, even when it may put him in a poor light! And,after all, at this point he has nothing to prove to anyone.Finding an EMDR therapist is not hard (see his “Resources” section). Nor is it hard to find a yoga instructor, and yoga is what he advises for helping a trauma victim get back into their body. Yoga is a wise choice, because it is available, already widely known, and adaptable to a wide range of individuals and capabilities.There is much more in Part Five, and the focus is on self-empowerment. “Victim no more!” as they say. Most trauma therapists have a keen interest in seeing their clients leave therapy charged up and ready to fully embrace their life – that certainly is my own emphasis. Van der Kolk’s thoughts on self-empowerment for those in recovery from psychological trauma will be invaluable to any trauma psychotherapy client.For psychotherapy professionals, this book will be both delightful and confirming. For everyone else, it will be a readable, gripping, highly educational tour of topics all of which are critical to a successful transition back from the impact of psychological trauma. That he gives prominent though not dominating emphasis to developmental trauma disorders is entirely appropriate. Our society has yet to grasp that child abuse and neglect is a more often chronic than not, and that its impact is largely ignored and poorly treated, if at all. This does not have to be. Get educated (this book will do that), then commit to being an advocate for children as well as for adults impacted by trauma. They all deserve the chance to be healed, and we can now do that. Van der Kolk shows us how.The physical book: Jacket design is pleasant and interesting. Binding is less so: color of spine wrapping is semi-florescent, and of paper, not cloth. The book feels substantial and pleasant to hold and look at.Organization -* 6 pp: prefatory praise by peers and related luminaries (interesting comments from some important people in the field);* 2 pp: Table of Contents;* 356 pp: actual text;* 4 pp: Appendix: Consensus proposed criteria for developmental trauma disorder* 3 pp: Resources* 4 pp: Further reading* 51 pp: Notes* 21 pp: Index
Ashley Renae –
I’ve been an Amazon prime user for as long as I can remember. Financially, I have spent countless dollars on a variety of products. I have never written a review.The Body Keeps the Score is the sweet relief that I didn’t know I’ve needed.I’m a registered nurse, have four beautiful daughters and I’m thankful for every day—However I’m suffering. My family has a long history with mental I’ll see, physical abuse, drug abuse, and much more. I had a marriage over 10 years fall apart suddenly do to infidelity. I was homeless and broken, raising four kids one. I watched my mother go in and out of psychiatric facilities.I’ve been strong, but scared.I’m suffering from depression every day. Like a toothache, or an itch you can’t scratch.This book makes me feel unattainable, understood and places what I’m feeling internally into words.The Body Keeps the Score is powerful, moving and let’s you understand the basics of how the brain works, why we feel what we do and guides coping.If you have any doubt about purchasing, please do. It’s a great read.