The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel A. van der Kolk | Goodreads
The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma (Paperback)
베셀 반 데어 콜크 (지은이)
Penguin Books2015-09-08
464쪽
출판사 제공 책소개
#1 New York Times bestseller
“Essential reading for anyone interested in understanding and treating traumatic stress and the scope of its impact on society.” - Alexander McFarlane, Director of the Centre for Traumatic Stress Studies
A pioneering researcher transforms our understanding of trauma and offers a bold new paradigm for healing in this New York Times bestseller
Trauma is a fact of life. Veterans and their families deal with the painful aftermath of combat; one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Dr. Bessel van der Kolk, one of the world’s foremost experts on trauma, has spent over three decades working with survivors. In The Body Keeps the Score, he uses recent scientific advances to show how trauma literally reshapes both body and brain, compromising sufferers’ capacities for pleasure, engagement, self-control, and trust. He explores innovative treatments?from neurofeedback and meditation to sports, drama, and yoga?that offer new paths to recovery by activating the brain’s natural neuroplasticity. Based on Dr. van der Kolk’s own research and that of other leading specialists, The Body Keeps the Score exposes the tremendous power of our relationships both to hurt and to heal?and offers new hope for reclaiming lives.
저자 및 역자소개
베셀 반 데어 콜크 (Bessel Van Der Kolk, M.D.) (지은이)
464쪽
출판사 제공 책소개
#1 New York Times bestseller
“Essential reading for anyone interested in understanding and treating traumatic stress and the scope of its impact on society.” - Alexander McFarlane, Director of the Centre for Traumatic Stress Studies
A pioneering researcher transforms our understanding of trauma and offers a bold new paradigm for healing in this New York Times bestseller
Trauma is a fact of life. Veterans and their families deal with the painful aftermath of combat; one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Dr. Bessel van der Kolk, one of the world’s foremost experts on trauma, has spent over three decades working with survivors. In The Body Keeps the Score, he uses recent scientific advances to show how trauma literally reshapes both body and brain, compromising sufferers’ capacities for pleasure, engagement, self-control, and trust. He explores innovative treatments?from neurofeedback and meditation to sports, drama, and yoga?that offer new paths to recovery by activating the brain’s natural neuroplasticity. Based on Dr. van der Kolk’s own research and that of other leading specialists, The Body Keeps the Score exposes the tremendous power of our relationships both to hurt and to heal?and offers new hope for reclaiming lives.
저자 및 역자소개
베셀 반 데어 콜크 (Bessel Van Der Kolk, M.D.) (지은이)
의학 박사로, 1970년대부터 외상 후 스트레스 장애(PTSD)를 연구해 온 권위자이자 세계적인 학자다. 하버드 의과대학에서 정신의학을 공부하고 매사추세츠 정신건강 센터에서 정신과 전문의 교육을 받았다. 보스턴 주립병원에서 근무하다가 보훈병원에서 일하며 참전 군인들에 관해 연구한 것이 외상 후 스트레스 장애에 대한 본격적인 연구의 시작이 됐다. 1982년 매사추세츠 정신건강 센터에서 정신약리학을 가르쳤고, 1980년대 중반에 트라우마 센터를 설립했다. PTSD가 뇌에 일으킨 변화를 뇌 신경 영상으로 조사한 최초의 연구에 참여했는데, 이 연구에서 밝혀진 결과는 트라우마 스트레스의 새로운 치료법이 탄생하는 데 중요한 계기가 되었다. 또한 신경 생물학, 뇌 과학 등 다양한 분야와 다각도로 연계해 여러 가지 성과를 이루어 내며 트라우마가 마음과 뇌, 몸의 발달에 끼치는 영향에 관한 광범위한 연구 결과를 발표해 왔고, 특히 정신적 해리와 경계성 인격 장애, 자해를 비롯한 다양한 문제와 트라우마의 연관성을 밝혀냈다. 그리고 트라우마가 발달 과정에 끼치는 영향을 연구하며 외상 후 스트레스 장애 치료에 요가나 뉴로피드백, EMDR, 연극 치료 등을 활용하는 방안을 연구해 그런 치료법들이 뇌에 변화를 일으켜 기능을 향상시킬 수 있다는 사실을 입증했다. 국제 트라우마 스트레스 연구회의 대표직을 역임했고, 현재 보스턴 의과 대학에 정신의학과 교수로 재직 중이며, 매사추세츠 주 브룩클린의 정의자원연구소 내 트라우마 센터에서 의학 책임자, 국립 아동 트라우마 스트레스 센터 소속 복합 트라우마 네트워크의 총책임자를 맡고 있다. 미국 전역의 대학교와 병원에서 강의를 해 왔고 유럽, 아프리카, 러시아, 오스트레일리아, 이스라엘, 중국, 브라질, 일본 등 여러 나라에서 강연했다. 또한 알코올과 약물 중독에 시달리는 트라우마 환자 치료 시설(The Meadows)의 선임연구원으로 치료사들에게 전문적인 지식을 제공하고 있으며, 150여 편의 학술 논문을 발표했다. 저서로는 『심리학적 트라우마』, 『트라우마와 몸: 감각 운동을 활용한 심리 치료』, 알렉산더 맥팔레인, 라스 뷔새스와 함께 낸 『트라우마 스트레스: 감당하기 힘든 경험이 몸과 마음, 사회에 끼치는 영향』 등이 있다. 뉴욕타임스 베스트셀러인 『몸은 기억한다』는 2014년에 출간한 그의 최신작으로, 트라우마에 의한 뇌 영역의 변화를 설명함으로써 트라우마 스트레스에 관한 통념을 바꾸어 놓았다. 또한 혁신적인 치료를 통해 기능이 떨어진 뇌를 다시 활성화시킬 수 있음을 보여 주었다. 접기
최근작 : <몸은 기억한다> … 총 8종 (모두보기)
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The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
by Bessel A. van der Kolk
4.56 · Rating details · 21,175 ratings · 1,964 reviews
A pioneering researcher and one of the world’s foremost experts on traumatic stress offers a bold new paradigm for healing.
Trauma is a fact of life. Veterans and their families deal with the painful aftermath of combat; one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Such experiences inevitably leave traces on minds, emotions, and even on biology. Sadly, trauma sufferers frequently pass on their stress to their partners and children.
Renowned trauma expert Bessel van der Kolk has spent over three decades working with survivors. In The Body Keeps the Score, he transforms our understanding of traumatic stress, revealing how it literally rearranges the brain’s wiring—specifically areas dedicated to pleasure, engagement, control, and trust. He shows how these areas can be reactivated through innovative treatments including neurofeedback, mindfulness techniques, play, yoga, and other therapies. Based on Dr. van der Kolk’s own research and that of other leading specialists, The Body Keeps the Score offers proven alternatives to drugs and talk therapy—and a way to reclaim lives. (less)
A compassionate, intelligent, and transformative book about trauma. As an aspiring clinical psychologist and writer, I look up to Bessel van der Kolk a lot. In The Body Keeps the Score, he infuses empirical, innovative research with hands-on clinical experience to explain trauma in a clear, authentic way. I loved his emphasis on incorporating both biology and social relationships into our understanding of trauma, as awful events affect both the body as well as the actual life of a struggling individual. He clarifies many misconceptions by stressing how many victims of child abuse often go ignored when compared to war veterans, and he argues with much logic that we cannot just use drugs to treat Post-Traumatic Stress Disorder (PTSD) and other mental illnesses. We must treat the whole person.
Dr. van der Kolk steers this book in a hopeful direction by discussing many treatment strategies for PTSD. He includes descriptions and research studies to support a gamut of methodologies, ranging from Cognitive Behavioral Therapy (CBT) to Eye Movement Desensitization Therapy (EMDR) to Neurofeedback, and more. In particular I enjoyed reading about the Internal Family System approach (IFS), a mode of psychotherapy I had never heard of, which I found enlightening and holistic. Dr. van der Kolk emphasizes the importance of getting back in touch with our emotions and our bodies after trauma, and he gives many practical ways to do so, like talk therapy and yoga, just to name a few.
Dr. van der Kolk's genuine heart elevates this book above others. His vulnerability with his own story models a message for all of us to live by: only by confronting and accepting the past can we learn to live in the present. He writes about the importance of de-stigmatizing PTSD and mental illness, and he relates the issue of trauma to several societal factors, like the prolific amount of gun violence in the United States and the lack of socioemotional education given to our kids. Dr. van der Kolk, with great humility and insight, details his admiration for each of his clients - because they have overcome such devastating hardship, and they have had the courage to share their stories with him, and in some cases, others as well.
A stellar book I would recommend to anyone interested in trauma, mental health, or science in general. I noted so many well-written passages and cannot wait to reference this book in the future. I hope more people read The Body Keeps the Score - it would improve our society a lot. (less)
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Sep 16, 2015Charlene rated it it was ok
Shelves: abnormal-psych, neuroscience
This book represents everything that is groundbreakingly wonderful and and pseudoscientifically horrendous about trauma research. Individuals who suffer trauma are in need of actual help. This book contains some of the best, latest, and most effective cures for trauma sufferers, which can steer patients toward the help they need. However, van der Kolk seems wholly unable to engage in critical thinking when it comes to various treatments.
When attending courses in cognitive neuroscience and psychology at the University of Pennsylvania, my favorite professors were those who ripped apart each treatment to examine it for efficacy. The profs held out hope that cures were attainable but put them under the microscope to make damn sure the "cure" would not actually retraumatize and individual or make matters worse. In order to trust a mental health care provider, that provider should demonstrate not only a knowledge of the literature (as van der Kolk does as he repeatedly throws around his MD and Harvard alma marter to assure his reader of his credentials) but also an ability to sort out fact from fiction. van der Kolk seems entirely enamored with outdated findings (that have since been shown to be incorrect) and therapies that have failed to be backed up by empirical support. Most concerning, he seems completely in denial about how easily false memories form and the damage they can do.
On a more positive note, he does a great job championing individuals who are often rejected by the field of psychiatry. Since false memories are real, and they have wreaked havoc on an already traumatized person's fragile life, many aspects that lead to remembering repressed memories have come under fire. This has served to invalidate the real and true experiences suffered by many people during their childhoods and beyond. Under particular scrutiny is dissociation, something that can be particularly difficult for survivors to deal with, is treated as if it doesn't exist. This is certainly a problem and I do not know how to find a middle ground between dissociation deniers and false memory/ personality creating therapists, but I would venture to say that van der Kolk's approach is not it. There has got to be a better way to validate the real, and sometimes repressed traumas while, at the same time, not creating new ones by promoting fictitious experiences that do not exist.
Additionally, there is a lot of study involving a person's perception that never made it into this book. I understand that, again, it is difficult to take on the effects of perception while simultaneously trying to validate what really happened to people. But, perception can really affect mental health and subsequent behavior. Not only that, there is a very real phenomenon in which excused behavior can cause the trauma sufferer to continue to delve out trauma to others. While van der Kolk mildly touched on this at times, he did not do so in any in depth of concrete manner.
This book could have been half as long and, if van der Kolk had stuck to only empirically sound findings and treatments, could have been a great book. Associating words with Harvard and MD doesn't make them true. It just makes people believe them more. Sometimes that is more harmful than helpful.
Despite the foregoing criticisms, this book, with its many chapters on various treatments, might help trauma sufferers seek a treatment that seems right for them. (less)
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Nov 02, 2016Kai rated it it was amazing
I'm not a psychologist, psychiatrist, doctor, social worker or otherwise involved in treatment or research of mental conditions or disorders. What I am is a guy in his mid-twenties who experienced multiple instances of severe medical trauma as a child, in my case open-heart surgeries at the ages of three months, six years and eleven years.
I've spent the majority of my life (read: all of it) doing my best to repress and resist the terror, anger and sadness I felt as a result of having gone through these procedures. And I was able to get by, mostly, though my life always seemed to be a highly fragile construct, where I worked tirelessly to maintain control.
I lost control this year, or maybe part of myself decided it was time to let go of my controlling behaviors and coping mechanisms, which no longer serve to help me, but instead negatively affect the quality of my life. This was a very tough realization, and my default response was to beat up myself for behaving 'wrong' or otherwise being 'a failure' for the way I had been just trying to get by.
That's why this book has been so important for me, because I now realize that the way I've been living isn't bad or wrong--I've been trying to survive, to get to a place where I can truly feel safe, validated and connected to others. But my body doesn't know how to let down, to let go. Much as Dr. van der Kolk points out throughout this book, I'm stuck in these moments of past horror, faced with autonomic imbalances that keep me on the defensive 24/7. And I don't know how to stop.
This book has already proven to be a crucial resource, as it sheds light on much of what I've been struggling with my whole life, showing that there are people out there who really understand. Just as important, it shows me that there is help available. It took me over three months to read this book, because part of me hated that I could identify with so much of what the author describes when discussing the nature of trauma. Oftentimes it just made me profoundly sad. Some of the experiences shared within are also quite harrowing. Usually I couldn't get through a chapter without breaking down. But I kept coming back to it, because I knew it was within my power to help and educate myself.
Thank you, Dr. van der Kolk, for helping me take this step towards healing myself, past and present. I hope to look back on this period one day and recognize how much reading this book helped me to start down the path to recovery, presence of mind and body, and fully engaging with life. (less)
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Aug 25, 2019Alok Vaid-Menon rated it really liked it
As someone who suffers from chronic pain I’ve found it difficult to find resources about the connection between trauma + physical pain. This is because the mind-body connection are (I think intentionally) underdeveloped in Western medicine which so often rehearses the body outside of context.
Van der Kolk shows how trauma can shape every aspect of our psychology + physiology: making us attracted to dangerous/painful situations, affecting our perception of time + space, dispossessing us of the ability to describe our discomfort, causing chronic muscle pain, headaches, + autoimmune disorders. We live in a world that constantly underemphasizes the emotional trauma even though the same parts of the brain are impacted by emotional pain as by physical violence. Heartbreak, betrayal, neglect, depression physically hurt. This continual undervaluation of emotional stress means that it accumulates, depletes significant energy + attacks our most vulnerable organs.Van der Kolk describes chronic pain as when your brain gets trapped in a pre-programmed escape route, stuck in perpetual fear. For him, the goal is about how to develop coping strategies for trauma that don’t retraumatize us: reintegration, not repression. Healing is possible when we commit to this reintegration. Talk therapy isn’t enough: we can’t just describe the problem, we have to experience “immobilization without fear.”
As a doctor, his book has a clinical bent + outlines various strategies like EMDR + biofeedback which help break trauma cycles. I wish that there had been more discussion of people who have complex trauma where there is no “before” or “after” to the traumatic event. I’m thinking here about how racism + transphobia are continual forms of trauma that we can’t move out of. There was so much important info in the book, but I was kind of turned off by the clinical language where complex people became case studies and cultural rituals became Western mindfulness practices without appreciation for context.
As a survivor of abuse this book can be difficult to get through, so serious content warning. (less)
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Jan 09, 2020Antigone rated it really liked it
Shelves: philosophy-psychology
Dr. van der Kolk's study of trauma treatment is the most respected book lately published on the subject of post-traumatic stress disorder.
Following in the footsteps of Babette Rothschild and Peter Levine, van der Kolk takes as his focus the physical aspects of psychological injury - suggesting that work with the body is the clearest and most effective approach to healing. He is not a fan of the pharmacological. Drugs, while useful in tamping down the flood of fearsome emotional response, do little more than re-establish a basic level of functioning. In his view, medications cannot be considered treatment as they do not lead to a resolution of the condition. Over thirty years of research and clinical practice have led him to alternative methods of care that have shown to produce real results in the lives of those too often relegated to prescriptive numbing and symptom management.
After a bit of a muddled start (that will trigger the vulnerable reader), the doctor locates his footing and begins a guided tour through a series of body-based programs designed to address the fundamental conflict underlying PTSD. Those familiar with trauma are well aware of the sense of being caught in the maelstrom of a past catastrophe and unable to break free. The surreptitious assault of flashback, the tactile immediacy of phantom danger, and the brutal jolt into a fight/flight/freeze posture leaves the psyche in a constant state of high alert as energy levels drop to depletion. Dr. van der Kolk traces the body-brain connection and walks the injury through several alternative treatments - among them EMDR (eye movement desensitization and reprocessing), yoga, IFS (internal family systems therapy - which has nothing to do with families and everything to do with creating a whole of the many different internal parts of a person), psychomotor therapy, neurofeedback, and even theater work. These are the money chapters, and where a substantial amount of hope resides. Merely becoming familiar with the methods may, in fact, set some wheels to turn...and that is helpful.
Dr. van der Kolk is not a writer, but then few in this field throw their skills in a literary direction. What is important to them is what will help you. This book holds that aim as its sole preoccupation. And all I have to say about that is...bravo.
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Nov 15, 2019Elyse Walters rated it it was amazing
Shelves: audiobook
Audiobook....
read by the author: Dr. Bessel van der Kolk.
Kolk is one of the world’s experts on trauma. He spent three decades working with survivors.
This book is packed filled with science, research, experience, and human stories that are phenomenally informative and intense!!!!
Kolk exposes how trauma physically affects changes in the brain and body causing anxiety, rage, depression, the inability to concentrate, problems remembering, flashbacks, trusting, and forming relationships.
He examines trauma caused by childhood neglect, abandonment, sexual or domestic abuse, and war.
....We learn lessons from Vietnam veterans.
....We get a better understanding how the brain works. How PTSD plays out.
....He explains the body-mind connections: losing your body: losing yourself.
....He takes us into the minds of children, and adults - showing how trauma develops over time -turning into PTSD.
We get a grand overview of the ‘historical development’ -academically & intimately - associated with understanding mental health science. I found this book literally fascinating, important, engaging, and helpful.
We get a wide glimpse of how doctors have been educated. (with real life examples of doctor/patient connections),
The stories were incredibly gripping and compelling.....
integrating medical and psychological practices....
....mixing traditional talk therapy,
medications ( many different ones were explore of their effectiveness), new treatments, and alternative therapies such as mindfulness, meditation, breathing exercises, yoga, boxing, tai chi, walking, kick boxing, etc. were also explored.
Towards the end of the book Dr. Kolk outlines healing paths to recovery - letting go of the past and rewiring the brain.
How to choose a doctor - etc.
I can’t express enough how informative and gripping/informative these real life stories exposes. And how sadly PTSD is passed on to our children.
Dr. Kolk shared with us patients trauma....( he’s an amazing advocate for finding solutions) > real healing
treatments, beyond medications, ....and ongoing life healing.
We see why it’s vital to get help!!! Old traumas get stuck in the brain - it takes gentle safe work to unlock them... in order to experience real joy in the present.
I came away with a ‘deeper’ and ‘expanded’ understanding
of the body/mind connection in relationship to trauma.
I also came away with remarkable compassion/admiration - respect - and dignity for people who have dedicated their lives in the field of mental health... and for all those who suffer.
This is an extremely comprehensive book exploring PTSD...(havoc on the brain and body).
Highly recommended to educators, parents, and the rest of us!
Paul & I both found this book exceptional!
One of the most valuable Audiobooks I’ve ever bought!
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Jul 04, 2017Meredith Holley rated it liked it
Shelves: non-fiction, monsters
This book was super okay. I think the title should be changed to, "PTSD for Treatment Professionals: An academic and anecdotal exploration of trauma treatments." So, that was not what I signed up for. I'll say, if you have PTSD, probably don't read this book because it has these very graphic descriptions of patient trauma experiences. I think therapists are the target audience for this book, and it provides an interesting overview of the treatment modalities available for PTSD and the research about them.
One thing I will say about all of the PTSD books I've read lately is that people HATE the DSM. I kind of get it, and I can see how it fucks everything up, especially with kids, but also I kind of think the rage should be turned more to the insurance industry than the DSM. Like the DSM seems more like a symptom of the overall problem where we are more into classifying people than helping them.
My other takeaway is that Bessel A. van der Kolk is super badass. He is one of the early researchers on PTSD, and he describes working in the old mental hospitals and seeing people sprayed down with hoses to clean them. So, that's an example of the type of story he tells that made this book a slow read for me. I will say, I listen to people's trauma stories all day long, but the stories he told in this book were really heavy to me. I had to take a lot of breaks.
In the chapter on EMDR, he talks about his EMDR training. He was in a group training class and was partnered with a person who did not want to talk about his trauma experience during the EMDR. (In EMDR, the way van der Kolk did it, you basically wave your fingers in front of someone's face as they re-experience a trauma memory, and the eye movements process the trauma memory into the regular stream of memory in the brain. It's super magic and also evidence-based.) Van der Kolk was mad that the person didn't want to talk and complained to the instructor. The instructor told him to question whether there was a voyeuristic element to why he became a therapist.
So, that seemed like an insightful perspective, and I thought it made sense with this book. A lot of the stories he told had a voyeuristic element to them in my view. I don't really feel critical about that, but I did not enjoy that aspect of the book.
I appreciated the overview of trauma treatments, though. So far, from everything I've read somatic experiencing and EMDR are the ones I'm most impressed with. (less)
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Amazon review
Top international reviews
Max M
5.0 out of 5 stars Transformative
Reviewed in the United Kingdom on September 5, 2018
Format: PaperbackVerified Purchase
This is the greatest book I have ever read.
It is a lifetime of knowledge (and it is clear that it had taken a very long time to write) from a practising clinician who, as far as I can tell, is THE most well-informed person on the subject, all in one book.
It can be applied to you. Therapy like this would cost thousands, and that is even if you have the good fortune to find a therapist who knows anything about it.
It is perfectly written and laid out, starting with explanations about the problem and ending with explanations of how to recover.
At first it was hard to read because I was only just coming to terms with having childhood trauma, and was still feeling very upset about it. However the great thing about a book is that you can take as long as you like to finish it. As I read more I understood more and more and began to feel more and more free, understood, and positive.
There is SO MUCH information in here, and it is all extremely useful and interesting. I often read one sentence several times because it made such an impact on me, and after some pages (most of them!) I would think for ten minutes until I read more.
This is the most helpful book I have read on the subject, and I have read a lot. It has taken me a long time to read, but recovery takes a long time. I think that if you have not been traumatised and are just reading it for interest that you would read it quickly, as it is such a great book. I feel like it has transformed me.
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Cheese time
5.0 out of 5 stars brilliantReviewed in the United Kingdom on March 8, 2019
Format: PaperbackVerified Purchase
What fascinates me about trauma is what it does to you. It helps you survive whatever has tried to hurt you. It’s a survival instinct.
When you experience trauma your brain protects you, it literally creates a new personality on top of the one you were born with and transforms you. It increases your senses, it makes you more intelligent, but it changes your brain chemistry and that's the big problem. If your chemistry changes then you're not going to benefit in normal everyday situations because your flight, fight and freeze part of your brain is now on over drive, your hypothalamus is now stuck in hyper drive and your prefrontal cortex becomes neglected and undeveloped and in a contradicting to making you more intelligent now makes you less able to learn by constantly injecting stress hormones into your blood stream.
A lot is crammed into this book, over 30 years of research into trauma and I agree with the author, trauma is so important and so relevant in our society. Most people experience some form of trauma throughout their lives, but it seems the younger and more undeveloped you are the more profound the effect is later on in life. It literally passes down from generation to generation and we still don't discuss or treat trauma as a norm. If everyone was more knowledgeable about trauma and how it affects us then I think our medical advice and how we treat people would be far different from what it is today.
I find it easy to notice when someone has experienced trauma. It affects their persona, but there are visual and acoustic clues as well. It helps to know if someone has trauma because you have to adapt to their reasoning and thinking which can often be off kilter.
This book is brilliant for psychologists and people who want to learn more about themselves and trauma. It has a diverse knowledge or different applications which are proven to work. Obviously CBT is the most common, but two more I find very interesting and fascinating for trauma treatment is EMDR and Yoga. Both I think are brilliant and I was aware of before the book, but this book shows just what impact it has on masses.
I genuinely feel like when it comes to psychology and nutritional sciences, the USA is years ahead of everyone else especially the UK. I really hope a lot of this work makes it over here sooner rather than later.
Knowing more about trauma means we can help heal our society, prevent abuse and even enrich ourselves.
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M. Fraser
5.0 out of 5 stars Experienced expert shares what works in overcoming trauma, and it works...Reviewed in the United Kingdom on July 31, 2017
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Steady explanation of the issue of trauma, whether childhood or adult, followed by many varied techniques to deal with it. It armed me with the information I needed to understand what I had repressed, allow it to be there, and then the tools to integrate the traumatised child back into my adult self in a way that helped me to live comfortably.
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Amazon Customer
5.0 out of 5 stars One of the best books I have ever readReviewed in the United Kingdom on March 4, 2018
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One of the best books I have ever read. I couldn’t put it down. The case histories, the neuroscience. ...everything is so eye opening in this book.
I am training to be a play therapist and I would recommend this for any child development or neuroscience enthusiast. It has thrown light in my own personal journey and I felt like parts of this book were written for me... absolutely brilliant and proves that we all have the capacity to heal.
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Doxus
5.0 out of 5 stars Essential reading for humansReviewed in the United Kingdom on December 24, 2018
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Part science, part history, this book spans vdK's experience searching for the reasons some people don't interact well or get sick, and ways to treat them. His career started with working with war veterans and drugs, but since then it has exploded into many areas and treatments. He approaches the field as a scientist who has been involved in many groundbreaking studies, trying to convert the field from studies on rats and theories to human-based data. His criteria for success is results, not money.
vdK explains that there are different subtypes of trauma and various treatment techniques work better with some types of trauma than others. Instead of labelling and trying to treat symptoms, he attempts to diagnose and treat the underlying cause. He tells of his efforts to join the campaign to completely reorient the categories set out in the DSM (the reference manual of the psychatric industry in the USA) which just describes symptoms or manifestations rather than the real causes of people's dysfunction.
At almost 400 pages of small print this is a long, but exciting, read which shows there are alternatives to the conventional pharmacological-first approach. I found this book to be a real page turner, reading it late into the night. vdK also provides many resources and references for further reading. Essential for everyone, even functioning humans, to understand why you or people around you may not behave as you want or expect.
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최근작 : <몸은 기억한다> … 총 8종 (모두보기)
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The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
by Bessel A. van der Kolk
4.56 · Rating details · 21,175 ratings · 1,964 reviews
A pioneering researcher and one of the world’s foremost experts on traumatic stress offers a bold new paradigm for healing.
Trauma is a fact of life. Veterans and their families deal with the painful aftermath of combat; one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Such experiences inevitably leave traces on minds, emotions, and even on biology. Sadly, trauma sufferers frequently pass on their stress to their partners and children.
Renowned trauma expert Bessel van der Kolk has spent over three decades working with survivors. In The Body Keeps the Score, he transforms our understanding of traumatic stress, revealing how it literally rearranges the brain’s wiring—specifically areas dedicated to pleasure, engagement, control, and trust. He shows how these areas can be reactivated through innovative treatments including neurofeedback, mindfulness techniques, play, yoga, and other therapies. Based on Dr. van der Kolk’s own research and that of other leading specialists, The Body Keeps the Score offers proven alternatives to drugs and talk therapy—and a way to reclaim lives. (less)
ardcover, 443 pages
Published September 25th 2014 by Viking (first published June 12th 2014)
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#1 New York Times bestseller
“Essential reading for anyone interested in understanding and treating traumatic stress and the scope of its impact on society.” —Alexander McFarlane, Director of the Centre for Traumatic Stress Studies
A pioneering researcher transforms our understanding of trauma and offers a bold new paradigm for healing in this New York Times bestseller
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Editorial Reviews
Review
“The trauma caused by childhood neglect, sexual or domestic abuse and war wreaks havoc in our bodies, says Bessel van der Kolk in The Body Keeps the Score. . . . Van der Kolk draws on 30 years of experience to argue powerfully that trauma is one of the West's most urgent public health issues. . . . Packed with science and human stories, the book is an intense read. . . . [T]he struggle and resilience of his patients is very moving.”
—Shaoni Bhattacharya, New Scientist
“War zones may be nearer than you think, as the 25% of US citizens raised with alcoholic relatives might attest. Psychiatrist Bessel van der Kolk argues, moreover, that severe trauma is ‘encoded in the viscera’ and demands tailored approaches that enable people to experience deep relief from rage and helplessness. In a narrative packed with decades of findings and case studies, he traces the evolution of treatments from the ‘chemical coshes’ of the 1970s to neurofeedback, mindfulness and other nuanced techniques.”
—Nature
“An astonishing amount of information on almost every aspect of trauma experience, research, interventions, and theories is brought together in this book, which . . . has a distinctly holistic feel to it. The title suggests that what will be explored is how the body retains the imprints of trauma. However, it delivers much more than this, delving into how the brain is impacted by overwhelming traumatic events, and is studded with sections on neuroscience which draw on the author’s own numerous studies as well as that of his peers. In addition, it investigates the effects of adverse childhood attachment patterns, child abuse, and chronic and long-term abuse. . . . [T]his book is a veritable goldmine of information.”
—European Journal of Psychotraumatology
“Dr. van der Kolk . . . has written a fascinating and empowering book about trauma and its effects. He uses modern neuroscience to demonstrate that trauma physically affects the brain and the body, causing anxiety, rage, and the inability to concentrate. Victims have problems remembering, trusting, and forming relationships. They have lost control. Although news reports and discussions tend to focus on war veterans, abused children, domestic violence victims, and victims of violent crime suffer as well. Using a combination of traditional therapy techniques and alternative treatments such as EMDR, yoga, neurofeedback, and theater, patients can regain control of their bodies and rewire their brains so that they can rebuild their lives. The author uses case histories to demonstrate the process. He includes a resource list, bibliography, and extensive notes. This accessible book offers hope and inspiration to those who suffer from trauma and those who care for them. It is an outstanding addition to all library collections.
—Medical Library Association, Consumer Connections
“[A] wonderful new book that everyone involved with trauma ought to read and have available. . . . [B]eautifully, compellingly and sweepingly written in its grand vision of integrating medical, psychological and mixed or alternative approaches, based on a careful reading of the client and a holistic mind-body view. . . . There are very few practitioners who could not learn from this book and become more effective, as well as inspired, by reading and studying it.”
—Henry Strick van Linschoten, European Society For Trauma And Dissociation Newsletter
“Psychological trauma can befall anyone, not just soldiers, refugees, or victims of rape. . . . This important and helpful book makes sense of suffering and offers opportunity for healing.”
—Booklist
“[C]omprehensive in scope. This valuable work . . . offers hope for the millions of sufferers and their families seeking meaningful treatment and relief from the ongoing pain of trauma.”
—Library Journal (Starred Review)
“Dr. van der Kolk's masterpiece combines the boundless curiosity of the scientist, the erudition of the scholar, and the passion of the truth teller.”
—Judith Herman, M.D., clinical professor of psychiatry, Harvard Medical School; author of Trauma and Recovery
“This is an absolutely fascinating and clearly written book by one of the nation’s most experienced physicians in the field of emotional trauma. The Body Keeps the Score helps us understand how life experiences play out in the function and the malfunction of our bodies, years later.”
—Vincent J. Felitti, M.D., chief of preventative medicine, emeritus, Kaiser Permanente San Diego; co-principal investigator, ACE study
“In this inspirational work which seamlessly weaves keen clinical observation, neuroscience, historical analysis, the arts, and personal narrative, Dr. van der Kolk has created an authoritative guide to the effects of trauma, and pathways to recovery. The book is full of wisdom, humanity, compassion and scientific insight, gleaned from a lifetime of clinical service, research and scholarship in the field of traumatic stress. A must read for mental health and other health care professionals, trauma survivors, their loved ones, and those who seek clinical, social, or political solutions to the cycle of trauma and violence in our society.”
—Rachel Yehuda, Ph.D., professor of psychiatry and neuroscience; director of the Traumatic Stress Studies Division at the Mount Sinai School of Medicine, New York, NY
“Breathtaking in its scope and breadth, The Body Keeps the Score is a seminal work by one of the preeminent pioneers in trauma research and treatment. This essential book unites the evolving neuroscience of trauma research with an emergent wave of body-oriented therapies and traditional mind/body practices that go beyond symptom relief and connect us with our vital energy and here-and-now presence.”
—Peter A. Levine, Ph.D., author of In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness
“In The Body Keeps the Score we share the author's courageous journey into the parallel dissociative worlds of trauma victims and the medical and psychological disciplines that are meant to provide relief. In this compelling book we learn that as our minds desperately try to leave trauma behind, our bodies keep us trapped in the past with wordless emotions and feelings. These inner disconnections cascade into ruptures in social relationships with disastrous effects on marriages, families, and friendships. Van der Kolk offers hope by describing treatments and strategies that have successfully helped his patients reconnect their thoughts with their bodies. We leave this shared journey understanding that only through fostering self-awareness and gaining an inner sense of safety will we, as a species, fully experience the richness of life.
—Stephen W. Porges, Ph.D., professor of psychiatry, University of North Carolina at Chapel Hill; author of The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation
“This exceptional book will be a classic of modern psychiatric thought. The impact of overwhelming experience can only be truly understood when many disparate domains of knowledge, such as neuroscience, developmental psychopathology, and interpersonal neurobiology are integrated, as this work uniquely does. There is no other volume in the field of traumatic stress that has distilled these domains of science with such rich historical and clinical perspectives, and arrived at such innovative treatment approaches. The clarity of vision and breadth of wisdom of this unique but highly accessible work is remarkable. This book is essential reading for anyone interested in understanding and treating traumatic stress and the scope of its impact on society.”
—Alexander McFarlane AO, MB BS (Hons) MD FRANZCP, director of the Centre for Traumatic Stress Studies, The University of Adelaide, South Australia.
“This book is a tour de force. Its deeply empathic, insightful, and compassionate perspective promises to further humanize the treatment of trauma victims, dramatically expand their repertoire of self-regulatory healing practices and therapeutic options, and also stimulate greater creative thinking and research on trauma and its effective treatment. The body does keep the score, and van der Kolk’s ability to demonstrate this through compelling descriptions of the work of others, his own pioneering trajectory and experience as the field evolved and him along with it, and above all, his discovery of ways to work skillfully with people by bringing mindfulness to the body (as well as to their thoughts and emotions) through yoga, movement, and theater are a wonderful and welcome breath of fresh air and possibility in the therapy world.”
—Jon Kabat-Zinn, professor of medicine emeritus, UMass Medical School; author of Full Catastrophe Living.
“This is an amazing accomplishment from the neuroscientist most responsible for the contemporary revolution in mental health toward the recognition that so many mental problems are the product of trauma. With the compelling writing of a good novelist, van der Kolk revisits his fascinating journey of discovery that has challenged established wisdom in psychiatry. Interspersed with that narrative are clear and understandable: descriptions of the neurobiology of trauma; explanations of the ineffectiveness of traditional approaches to treating trauma; and introductions to the approaches that take patients beneath their cognitive minds to heal the parts of them that remained frozen in the past. All this is illustrated vividly with dramatic case histories and substantiated with convincing research. This is a watershed book that will be remembered as tipping the scales within psychiatry and the culture at large toward the recognition of the toll traumatic events and our attempts to deny their impact take on us all.”
—Richard Schwartz, originator, Internal Family Systems Therapy
“The Body Keeps the Score is clear, fascinating, hard to put down, and filled with powerful case histories. Van der Kolk, the eminent impresario of trauma treatment, who has spent a career bringing together diverse trauma scientists and clinicians and their ideas, while making his own pivotal contributions, describes what is arguably the most important series of breakthroughs in mental health in the last thirty years. We’ve known that psychological trauma fragments the mind. Here we see not only how psychological trauma also breaks connections within the brain, but also between mind and body, and learn about the exciting new approaches that allow people with the severest forms of trauma to put all the parts back together again.”
—Norman Doidge, author of The Brain That Changes Itself
“Every once in a while, a book comes along that fundamentally changes the way we look at the world. Bessel van der Kolk has written such a book. The arc of van der Kolk’s story is vast and comprehensive, but he is such a skillful storyteller that he keeps us riveted to the page. I could not put this book down. It is, simply put, a great work.”
—Stephen Cope, founder and director, Kripalu Institute for Extraordinary Living; author of Yoga and the Quest for the True Self
“Bessel van der Kolk is unequaled in his ability to synthesize the stunning developments in the field of psychological trauma over the past few decades. Thanks in part to his work, psychological trauma—ranging from chronic child abuse and neglect, to war trauma and natural disasters—is now generally recognized as a major cause of individual, social and cultural breakdown. In this masterfully lucid and engaging tour de force, van der Kolk takes us —both specialists and the general public— on his personal journey and shows what he has learned from his research, from his colleagues and students, and, most importantly, from his patients. The Body Keeps the Score is, simply put, brilliant.”
—Onno van der Hart, Ph.D., Utrecht University, The Netherlands; senior author, The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization
“The Body Keeps the Score articulates new and better therapies for toxic stress based on a deep understanding of the effects of trauma on brain development and attachment systems. This volume provides a moving summary of what is currently known about the effects of trauma on individuals and societies, and introduces the healing potential of both age old and novel approaches to help traumatized children and adults to fully engage in the present.”
—Jessica Stern, policy consultant on terrorism; author of Denial: A Memoir of Terror
“A book about understanding the impact of trauma by one of the true pioneers in the field. It is a rare book that integrates cutting edge neuroscience with wisdom and understanding about the experience and meaning of trauma, for people who have suffered from it. Like its author, this book is wise and compassionate, occasionally quite provocative, and always interesting.”
—Glenn N. Saxe, M.D., Arnold Simon Professor and chairman, Department of Child and Adolescent Psychiatry; director, NYU Child Study Center, New York University School of Medicine
“A fascinating exploration of a wide range of therapeutic treatments shows readers how to take charge of the healing process, gain a sense of safety, and find their way out of the morass of suffering.”
—Francine Shapiro, Ph.D., originator of EMDR therapy, senior research fellow, Emeritus Mental Research Institute, author of Getting Past Your Past
“As an attachment researcher I know that infants are psychobiological beings. They are as much the body as they are of the brain. Without language or symbols infants use every one of their biological systems to make meaning of their self in relation to the world of things and people. Van der Kolk shows that those very same systems continue to operate at every age, and that traumatic experiences, especially chronic toxic experience during early development, produce psychic devastation. With this understanding he provides insight and guidance for survivors, researchers and clinicians alike. Bessel van der Kolk may focus on the body and trauma, but what a mind he must have to have written this book.”
—Ed Tronick, distinguished professor, University of Massachusetts, Boston, author of Neurobehavior and Social Emotional Development of Infants and Young Children
“The Body Keeps the Score eloquently articulates how overwhelming experiences affect the development of brain, mind, and body awareness, all of which are closely intertwined. The resulting derailments have a profound impact on the capacity for love and work. This rich integration of clinical case examples with ground breaking scientific studies provides us with a new understanding of trauma, which inevitably leads to the exploration of novel therapeutic approaches that "rewire" the brain, and help traumatized people to (re)-engage in the present. This book will provide traumatized individuals with a guide to healing and permanently change how psychologists and psychiatrists think about trauma and recovery.”
—Ruth A. Lanius, M.D., Ph.D., Harris-Woodman chair in Psyche and Soma, professor of psychiatry, and director PTSD research at the University of Western Ontario; author of The Impact of Early Life Trauma on Health and Disease
“When it comes to understanding the impact of trauma and being able to continue to grow despite overwhelming life experiences, Bessel van der Kolk leads the way in his comprehensive knowledge, clinical courage, and creative strategies to help us heal. The Body Keeps the Score is a cutting-edge offering for the general reader to comprehend the complex effects of trauma, and a guide to a wide array of scientifically informed approaches to not only reduce suffering, but to move beyond mere survival—and to thrive.”
—Daniel J. Siegel, M.D., clinical professor, UCLA School of Medicine, author of Brainstorm: The Power and Purpose of the Teenage Brain; Mindsight: The New Science of Personal Transformation; and The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are
“In this magnificent book, Bessel van der Kolk takes the reader on a captivating journey that is chock full of riveting stories of patients and their struggles interpreted through history, research, and neuroscience made accessible in the words of a gifted storyteller. We are privy to the author’s own courageous efforts to understand and treat trauma over the past 40 years, the results of which have broken new ground and challenged the status quo of psychiatry and psychotherapy. The Body Keeps the Score leaves us with both a profound appreciation for and a felt sense of, the debilitating effects of trauma, along with hope for the future through fascinating descriptions of novel approaches to treatment. This outstanding volume is absolutely essential reading not only for therapists but for all who seek to understand, prevent, or treat the immense suffering caused by trauma.”
—Pat Ogden Ph.D., Founder/Educational Director of the Sensorimotor Psychotherapy Institute; author of Sensorimotor Psychotherapy: Interventions for Trauma and Attachment
“This is masterpiece of powerful understanding and brave heartedness, one of the most intelligent and helpful works on trauma I have ever read. Dr. van der Kolk offers a brilliant synthesis of clinical cases, neuroscience, powerful tools and caring humanity, offering a whole new level of healing for the traumas carried by so many.”
—Jack Kornfied, author of A Path with Heart
“The Body Keeps the Score is masterful in bringing together science and humanism to clearly explain how trauma affects the whole person. Bessel van der Kolk brings deep understanding to the pain and chaos of the trauma experience. The treatment approaches he recommends heal the body and the mind, restoring hope and the possibility of joy. One reads this book with profound gratitude for its wisdom.”
—Alicia Lieberman, Ph.D., Professor of Medical Psychology UCSF, Director of the Child Trauma Research Project, San Francisco General Hospital; author of The Emotional Life of the Toddler
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About the Author
Bessel van der Kolk, M.D., is the founder and medical director of the Trauma Center in Brookline, Massachusetts. He is also a professor of psychiatry at Boston University School of Medicine and director of the National Complex Trauma Treatment Network. When he is not teaching around the world, Dr. van der Kolk works and lives Boston.
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Excerpt. © Reprinted by permission. All rights reserved.
PROLOGUE
FACING TRAUMA
One does not have be a combat soldier, or visit a refugee camp in Syria or the Congo to encounter trauma. Trauma happens to us, our friends, our families, and our neighbors. Research by the Centers for Disease Control and Prevention has shown that one in five Americans was sexually molested as a child; one in four was beaten by a parent to the point of a mark being left on their body; and one in three couples engages in physical violence. A quarter of us grew up with alcoholic relatives, and one out of eight witnessed their mother being beaten or hit.1
As human beings we belong to an extremely resilient species. Since time immemorial we have rebounded from our relentless wars, countless disasters (both natural and man-made), and the violence and betrayal in our own lives. But traumatic experiences do leave traces, whether on a large scale (on our histories and cultures) or close to home, on our families, with dark secrets being imperceptibly passed down through generations. They also leave traces on our minds and emotions, on our capacity for joy and intimacy, and even on our biology and immune systems.
Trauma affects not only those who are directly exposed to it, but also those around them. Soldiers returning home from combat may frighten their families with their rages and emotional absence. The wives of men who suffer from PTSD tend to become depressed, and the children of depressed mothers are at risk of growing up insecure and anxious. Having been exposed to family violence as a child often makes it difficult to establish stable, trusting relationships as an adult.
Trauma, by definition, is unbearable and intolerable. Most rape victims, combat soldiers, and children who have been molested become so upset when they think about what they experienced that they try to push it out of their minds, trying to act as if nothing happened, and move on. It takes tremendous energy to keep functioning while carrying the memory of terror, and the shame of utter weakness and vulnerability.
While we all want to move beyond trauma, the part of our brain that is devoted to ensuring our survival (deep below our rational brain) is not very good at denial. Long after a traumatic experience is over, it may be reactivated at the slightest hint of danger and mobilize disturbed brain circuits and secrete massive amounts of stress hormones. This precipitates unpleasant emotions intense physical sensations, and impulsive and aggressive actions. These posttraumatic reactions feel incomprehensible and overwhelming. Feeling out of control, survivors of trauma often begin to fear that they are damaged to the core and beyond redemption.
• • •
The first time I remember being drawn to study medicine was at a summer camp when I was about fourteen years old. My cousin Michael kept me up all night explaining the intricacies of how kidneys work, how they secrete the body’s waste materials and then reabsorb the chemicals that keep the system in balance. I was riveted by his account of the miraculous way the body functions. Later, during every stage of my medical training, whether I was studying surgery, cardiology, or pediatrics, it was obvious to me that the key to healing was understanding how the human organism works. When I began my psychiatry rotation, however, I was struck by the contrast between the incredible complexity of the mind and the ways that we human beings are connected and attached to one another, and how little psychiatrists knew about the origins of the problems they were treating. Would it be possible one day to know as much about brains, minds, and love as we do about the other systems that make up our organism?
We are obviously still years from attaining that sort of detailed understanding, but the birth of three new branches of science has led to an explosion of knowledge about the effects of psychological trauma, abuse, and neglect. Those new disciplines are neuroscience, the study of how the brain supports mental processes; developmental psychopathology, the study of the impact of adverse experiences on the development of mind and brain; and interpersonal neurobiology, the study of how our behavior influences the emotions, biology, and mind-sets of those around us.
Research from these new disciplines has revealed that trauma produces actual physiological changes, including a recalibration of the brain’s alarm system, an increase in stress hormone activity, and alterations in the system that filters relevant information from irrelevant. We now know that trauma compromises the brain area that communicates the physical, embodied feeling of being alive. These changes explain why traumatized individuals become hypervigilant to threat at the expense of spontaneously engaging in their day-to-day lives. They also help us understand why traumatized people so often keep repeating the same problems and have such trouble learning from experience. We now know that their behaviors are not the result of moral failings or signs of lack of willpower or bad character—they are caused by actual changes in the brain.
This vast increase in our knowledge about the basic processes that underlie trauma has also opened up new possibilities to palliate or even reverse the damage. We can now develop methods and experiences that utilize the brain’s own natural neuroplasticity to help survivors feel fully alive in the present and move on with their lives. There are fundamentally three avenues: 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 result from trauma. Which one of these is best for any particular survivor is an empirical question. Most people I have worked with require a combination.
This has been my life’s work. In this effort I have been supported by my colleagues and students at the Trauma Center, which I founded thirty years ago. Together we have treated thousands of traumatized children and adults: victims of child abuse, natural disasters, wars, accidents, and human trafficking; people who have suffered assaults by intimates and strangers. We have a long tradition of discussing all our patients in great depth at weekly treatment team meetings and carefully tracking how well different forms of treatment work for particular individuals.
Our principal mission has always been to take care of the children and adults who have come to us for treatment, but from the very beginning we also have dedicated ourselves to conducting research to explore the effects of traumatic stress on different populations and to determine what treatments work for whom. We have been supported by research grants from the National Institute of Mental Health, the National Center for Complementary and Alternative Medicine, the Centers for Disease Control, and a number of private foundations to study the efficacy of many different forms of treatment, from medications to talking, yoga, EMDR, theater, and neurofeedback.
The challenge is: How can people gain control over the residues of past trauma and return to being masters of their own ship? Talking, understanding, and human connections help, and drugs can dampen hyperactive alarm systems. But we will also see that the imprints from the past can be transformed by having physical experiences that directly contradict the helplessness, rage, and collapse that are part of trauma, and thereby regaining self-mastery. I have no preferred treatment modality, as no single approach fits everybody, but I practice all the forms of treatment that I discuss in this book. Each one of them can produce profound changes, depending on the nature of the particular problem and the makeup of the individual person.
I wrote this book to serve as both a guide and an invitation—an invitation to dedicate ourselves to facing the reality of trauma, to explore how best to treat it, and to commit ourselves, as a society, to using every means we have to prevent it.
PART ONE
THE REDISCOVERY OF TRAUMA
CHAPTER 1
LESSONS FROM VIETNAM VETERANS
I became what I am today at the age of twelve, on a frigid overcast day in the winter of 1975. . . . That was a long time ago, but it’s wrong what they say about the past. . . . Looking back now, I realize I have been peeking into that deserted alley for the last twenty-six years.
—Khaled Hosseini, The Kite Runner
Some people’s lives seem to flow in a narrative; mine had many stops and starts. That’s what trauma does. It interrupts the plot. . . . It just happens, and then life goes on. No one prepares you for it.
—Jessica Stern, Denial: A Memoir of Terror
The Tuesday after the Fourth of July weekend, 1978, was my first day as a staff psychiatrist at the Boston Veterans Administration Clinic. As I was hanging a reproduction of my favorite Breughel painting, “The Blind Leading the Blind,” on the wall of my new office, I heard a commotion in the reception area down the hall. A moment later a large, disheveled man in a stained three-piece suit, carrying a copy of Soldier of Fortune magazine under his arm, burst through my door. He was so agitated and so clearly hungover that I wondered how I could possibly help this hulking man. I asked him to take a seat, and tell me what I could do for him.
His name was Tom. Ten years earlier he had been in the Marines, doing his service in Vietnam. He had spent the holiday weekend holed up in his downtown-Boston law office, drinking and looking at old photographs, rather than with his family. He knew from previous years’ experience that the noise, the fireworks, the heat, and the picnic in his sister’s backyard against the backdrop of dense early-summer foliage, all of which reminded him of Vietnam, would drive him crazy. When he got upset he was afraid to be around his family because he behaved like a monster with his wife and two young boys. The noise of his kids made him so agitated that he would storm out of the house to keep himself from hurting them. Only drinking himself into oblivion or riding his Harley-Davidson at dangerously high speeds helped him to calm down.
Nighttime offered no relief—his sleep was constantly interrupted by nightmares about an ambush in a rice paddy back in ’Nam, in which all the members of his platoon were killed or wounded. He also had terrifying flashbacks in which he saw dead Vietnamese children. The nightmares were so horrible that he dreaded falling asleep and he often stayed up for most of the night, drinking. In the morning his wife would find him passed out on the living room couch, and she and the boys had to tiptoe around him while she made them breakfast before taking them to school.
Filling me in on his background, Tom said that he had graduated from high school in 1965, the valedictorian of his class. In line with his family tradition of military service he enlisted in the Marine Corps immediately after graduation. His father had served in World War II in General Patton’s army, and Tom never questioned his father’s expectations. Athletic, intelligent, and an obvious leader, Tom felt powerful and effective after finishing basic training, a member of a team that was prepared for just about anything. In Vietnam he quickly became a platoon leader, in charge of eight other Marines. Surviving slogging through the mud while being strafed by machine-gun fire can leave people feeling pretty good about themselves—and their comrades.
At the end of his tour of duty Tom was honorably discharged, and all he wanted was to put Vietnam behind him. Outwardly that’s exactly what he did. He attended college on the GI Bill, graduated from law school, married his high school sweetheart, and had two sons. Tom was upset by how difficult it was to feel any real affection for his wife, even though her letters had kept him alive in the madness of the jungle. Tom went through the motions of living a normal life, hoping that by faking it he would learn to become his old self again. He now had a thriving law practice and a picture-perfect family, but he sensed he wasn’t normal; he felt dead inside.
Although Tom was the first veteran I had ever encountered on a professional basis, many aspects of his story were familiar to me. I grew up in postwar Holland, playing in bombed-out buildings, the son of a man who had been such an outspoken opponent of the Nazis that he had been sent to an internment camp. My father never talked about his war experiences, but he was given to outbursts of explosive rage that stunned me as a little boy. How could the man I heard quietly going down the stairs every morning to pray and read the Bible while the rest of the family slept have such a terrifying temper? How could someone whose life was devoted to the pursuit of social justice be so filled with anger? I witnessed the same puzzling behavior in my uncle, who had been captured by the Japanese in the Dutch East Indies (now Indonesia) and sent as a slave laborer to Burma, where he worked on the famous bridge over the river Kwai. He also rarely mentioned the war, and he, too, often erupted into uncontrollable rages.
As I listened to Tom, I wondered if my uncle and my father had had nightmares and flashbacks—if they, too, had felt disconnected from their loved ones and unable to find any real pleasure in their lives. Somewhere in the back of my mind there must also have been my memories of my frightened—and often frightening—mother, whose own childhood trauma was sometimes alluded to and, I now believe, was frequently reenacted. She had the unnerving habit of fainting when I asked her what her life was like as a little girl and then blaming me for making h
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Goodreads Reviews
Apr 25, 2015Morgan Blackledge rated it it was amazing
The Body Keeps Score is my jam. It's better than that. It's like my slammajam. This is my fave book of the year so far, by a bunch.
It's a rich treasure trove of information from the frontiers of trauma research, etiology, diagnosis and treatment. It's changing the way I do therapy and it's changing the way a interpret human behavior.
And to think. I almost didn't read it.
When I entered the mental health field I had intended to specialize in Somatic Experiencing (SE) trauma therapy. But I quickly rejected the model when I realized it was way outside the mainstream and lacked randomized control trials (RCT) that demonstrated its effectiveness compared to other "first line" treatments such as Cognitive Behavioral Therapy (CBT) and Prolonged Exposure Therapy (PE).
I saw the author Dr. Bessel Van Der Kolk lecture at the Evolution of Psychotherapy conference in 2013. He was awesome, and he really reinvigorated my interest in doing somatically oriented trauma work. But something about the experience as a whole left me feeling woozy.
Perhaps my experience was negativity impacted by the mass, prolonged exposure to the unwashed throngs of other psychotherapists (never a good thing), some of whom were from the San Francisco Bay Area (a deadly combination).
Don't get me wrong. There are lots of mental health professionals (even ones from the Bay Area) that are highly functional, sober, top notch folks.
But there are also a bunch of kooky, crazy as fuck people in the field (Particularly in the Bay Area), and there were a bunch in the crowd, and I think I was feeling a bit (or perhaps a lot) of shame for my profession. A pathological shame that was clearly a sequallia of my own dark hippy shadow.
I myself lived in the Bay Area for around a decade. I came to therapy from an unconventional "hippyish" background. I went to art school as an undergraduate. I have practiced yoga and meditation for over 30 years. Plus I have a couple of crappy tattoos. When I entered the field I was dreadfully afraid no one would take me seriously.
So I somewhat consciously but mostly unconsciously tried to distance myself from my own freaky roots.
I was probably still up in my head about all that when I was listening to Dr. Van Der Kolk. I was loving what he was saying, the parts I could understand any way (he speaks in a thick Dutch accent), but I also remember looking around the room and thinking "I have to distinguish myself from these nutty hippies".
Perhaps it was at that point I unconsciously gripped up and rejected somatic trauma work (again) in favor of the more "masculine" "serious" "evidence based", behaviorally oriented, here and now stuff that I currently practice.
Which, by the way, is Acceptance Comment Therapy (ACT). A mindfulness based variant of CBT which is incidentally a "hippy as fuck" therapeutic modality by many standards.
Anyway.
When I first saw that the book was released, I was like "hey, that looks pretty good" but then I had a flash back from the psychotherapy conference.
It was an intrusive mental image of a patchouli smelling, chubby middle aged hippy chick in a mauve knit poncho sweater and dream catcher earrings saying "your fifth level is emitting too much teal energy" and I reflexively withdrew my enthusiasm for the whole somatically oriented trauma treatment program.
Anyway. I did eventually get over myself (and my hippy phobia) and got the book and man is it good. It's extremely, extremely triple extremely good. It's like, organically, cosmically, spin your chakras at a dead show good.
And despite Dr. Van Der Kolk's activist agenda, he's actually a pretty reputable (Harvard affiliated) scientist and clinician and widely regarded as one the the worlds foremost authorities on trauma and trauma sequelae (yes I used the term seguelae twice in the same review, actually three times if you count the time I just used sequallia in this parentheses, oops, better make that four).
And, yes, Dr. Van Der Kolk also apparently does yoga and meditation and has probably smoked tons of weed and hung out at Eslen. But I am willing to forgive the man for that because I too have been guilty of similar behavior in my woolly headed, not so distant past.
Before I became a therapist, I was on my own journey to recovery from addiction, trauma, depression, anxiety etc.
BTW: when I hear other therapist start talking about their recovery, I cringe. Please forgive me if you're feeling cringy. But sometimes we all have to go there in order to communicate certain important points.
Anyway.
The foundation of my recovery was self-care. For me, self-care was (and still is) founded on basics such as: healthy sleep, exercise and nutrition. It also included good therapy and a little 12-step. But the rocket fuel of my recovery was yoga, loving kindness meditation and mindfulness meditation.
Now, one of my primary intentions as a therapist is to assist my clients in developing self compassion and embodied mindfulness skills for utilization in their recovery.
While the secular mindfulness revolution thing that has been happening over the past two decades has normalized mindfulness and provided ample scientific evidence for the clinical use value of mindfulness training e.g. Mindfulness Based Stress Reduction (MBSR).
And mindfulness-based psychotherapeutic modalities such as Dialectical Behavioral Therapy (DBT) and Acceptance Commitment Therapy (ACT) have provided evidence-based mindfulness integrated psychotherapeutic frameworks.
The evidence for somatically oriented (embodied) therapeutic modalities has lagged. Dr. Van Der Kolk's work is providing this evidence and is blazing the trail for mainstream acceptance of somatically oriented practices.
Dr. Van Der Kolk's work is also foundational for changing the way the field conceptualizes and diagnoses trauma.
Additionally Dr. Van Der Kolk is lending legitimacy to some cutting-edge and very exciting trauma treatments such as Neural Feedback and Eye Movement Desensitization and Reprocessing (EMDR).
I, like millions of other people, have suffered from Post-Traumatic Stress Disorder (PTSD) symptoms. In early recovery I received lots of good therapy for trauma and I'm happy to report that I am no longer impaired by PTSD symptoms.
Out of all of the therapy I received, anecdotally speaking, I have to say, some of the most effective was EMDR. I had phenomenal results from an equally phenomenally brief treatment time (two, one hour sessions).
This is standard EMDR testimonial. People very commonly report that it works and it works fast.
Again, as a nascent therapist in training, I had intended to train in EMDR. But EMDR is like the dirty redheaded stepchild of psychotherapy. Despite ample evidence of its efficacy, nobody can figure out why it works, so the model has been widely rejected by the mainstream mental health community.
I sort of drank the Kool-Aid and jumped on the anti EMDR bandwagon. But after reading this book, I'm feeling very enthusiastic about treating trauma with EMDR.
I could go on and on, but I'd rather just urge you to do yourself a big favor and read this book. (less)
flag422 likes · Like · 94 comments · see review
Dec 20, 2015Thomas rated it it was amazing
Shelves: five-stars, nonfiction, own-physical, psychology
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#1 New York Times bestseller
“Essential reading for anyone interested in understanding and treating traumatic stress and the scope of its impact on society.” —Alexander McFarlane, Director of the Centre for Traumatic Stress Studies
A pioneering researcher transforms our understanding of trauma and offers a bold new paradigm for healing in this New York Times bestseller
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Editorial Reviews
Review
“The trauma caused by childhood neglect, sexual or domestic abuse and war wreaks havoc in our bodies, says Bessel van der Kolk in The Body Keeps the Score. . . . Van der Kolk draws on 30 years of experience to argue powerfully that trauma is one of the West's most urgent public health issues. . . . Packed with science and human stories, the book is an intense read. . . . [T]he struggle and resilience of his patients is very moving.”
—Shaoni Bhattacharya, New Scientist
“War zones may be nearer than you think, as the 25% of US citizens raised with alcoholic relatives might attest. Psychiatrist Bessel van der Kolk argues, moreover, that severe trauma is ‘encoded in the viscera’ and demands tailored approaches that enable people to experience deep relief from rage and helplessness. In a narrative packed with decades of findings and case studies, he traces the evolution of treatments from the ‘chemical coshes’ of the 1970s to neurofeedback, mindfulness and other nuanced techniques.”
—Nature
“An astonishing amount of information on almost every aspect of trauma experience, research, interventions, and theories is brought together in this book, which . . . has a distinctly holistic feel to it. The title suggests that what will be explored is how the body retains the imprints of trauma. However, it delivers much more than this, delving into how the brain is impacted by overwhelming traumatic events, and is studded with sections on neuroscience which draw on the author’s own numerous studies as well as that of his peers. In addition, it investigates the effects of adverse childhood attachment patterns, child abuse, and chronic and long-term abuse. . . . [T]his book is a veritable goldmine of information.”
—European Journal of Psychotraumatology
“Dr. van der Kolk . . . has written a fascinating and empowering book about trauma and its effects. He uses modern neuroscience to demonstrate that trauma physically affects the brain and the body, causing anxiety, rage, and the inability to concentrate. Victims have problems remembering, trusting, and forming relationships. They have lost control. Although news reports and discussions tend to focus on war veterans, abused children, domestic violence victims, and victims of violent crime suffer as well. Using a combination of traditional therapy techniques and alternative treatments such as EMDR, yoga, neurofeedback, and theater, patients can regain control of their bodies and rewire their brains so that they can rebuild their lives. The author uses case histories to demonstrate the process. He includes a resource list, bibliography, and extensive notes. This accessible book offers hope and inspiration to those who suffer from trauma and those who care for them. It is an outstanding addition to all library collections.
—Medical Library Association, Consumer Connections
“[A] wonderful new book that everyone involved with trauma ought to read and have available. . . . [B]eautifully, compellingly and sweepingly written in its grand vision of integrating medical, psychological and mixed or alternative approaches, based on a careful reading of the client and a holistic mind-body view. . . . There are very few practitioners who could not learn from this book and become more effective, as well as inspired, by reading and studying it.”
—Henry Strick van Linschoten, European Society For Trauma And Dissociation Newsletter
“Psychological trauma can befall anyone, not just soldiers, refugees, or victims of rape. . . . This important and helpful book makes sense of suffering and offers opportunity for healing.”
—Booklist
“[C]omprehensive in scope. This valuable work . . . offers hope for the millions of sufferers and their families seeking meaningful treatment and relief from the ongoing pain of trauma.”
—Library Journal (Starred Review)
“Dr. van der Kolk's masterpiece combines the boundless curiosity of the scientist, the erudition of the scholar, and the passion of the truth teller.”
—Judith Herman, M.D., clinical professor of psychiatry, Harvard Medical School; author of Trauma and Recovery
“This is an absolutely fascinating and clearly written book by one of the nation’s most experienced physicians in the field of emotional trauma. The Body Keeps the Score helps us understand how life experiences play out in the function and the malfunction of our bodies, years later.”
—Vincent J. Felitti, M.D., chief of preventative medicine, emeritus, Kaiser Permanente San Diego; co-principal investigator, ACE study
“In this inspirational work which seamlessly weaves keen clinical observation, neuroscience, historical analysis, the arts, and personal narrative, Dr. van der Kolk has created an authoritative guide to the effects of trauma, and pathways to recovery. The book is full of wisdom, humanity, compassion and scientific insight, gleaned from a lifetime of clinical service, research and scholarship in the field of traumatic stress. A must read for mental health and other health care professionals, trauma survivors, their loved ones, and those who seek clinical, social, or political solutions to the cycle of trauma and violence in our society.”
—Rachel Yehuda, Ph.D., professor of psychiatry and neuroscience; director of the Traumatic Stress Studies Division at the Mount Sinai School of Medicine, New York, NY
“Breathtaking in its scope and breadth, The Body Keeps the Score is a seminal work by one of the preeminent pioneers in trauma research and treatment. This essential book unites the evolving neuroscience of trauma research with an emergent wave of body-oriented therapies and traditional mind/body practices that go beyond symptom relief and connect us with our vital energy and here-and-now presence.”
—Peter A. Levine, Ph.D., author of In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness
“In The Body Keeps the Score we share the author's courageous journey into the parallel dissociative worlds of trauma victims and the medical and psychological disciplines that are meant to provide relief. In this compelling book we learn that as our minds desperately try to leave trauma behind, our bodies keep us trapped in the past with wordless emotions and feelings. These inner disconnections cascade into ruptures in social relationships with disastrous effects on marriages, families, and friendships. Van der Kolk offers hope by describing treatments and strategies that have successfully helped his patients reconnect their thoughts with their bodies. We leave this shared journey understanding that only through fostering self-awareness and gaining an inner sense of safety will we, as a species, fully experience the richness of life.
—Stephen W. Porges, Ph.D., professor of psychiatry, University of North Carolina at Chapel Hill; author of The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation
“This exceptional book will be a classic of modern psychiatric thought. The impact of overwhelming experience can only be truly understood when many disparate domains of knowledge, such as neuroscience, developmental psychopathology, and interpersonal neurobiology are integrated, as this work uniquely does. There is no other volume in the field of traumatic stress that has distilled these domains of science with such rich historical and clinical perspectives, and arrived at such innovative treatment approaches. The clarity of vision and breadth of wisdom of this unique but highly accessible work is remarkable. This book is essential reading for anyone interested in understanding and treating traumatic stress and the scope of its impact on society.”
—Alexander McFarlane AO, MB BS (Hons) MD FRANZCP, director of the Centre for Traumatic Stress Studies, The University of Adelaide, South Australia.
“This book is a tour de force. Its deeply empathic, insightful, and compassionate perspective promises to further humanize the treatment of trauma victims, dramatically expand their repertoire of self-regulatory healing practices and therapeutic options, and also stimulate greater creative thinking and research on trauma and its effective treatment. The body does keep the score, and van der Kolk’s ability to demonstrate this through compelling descriptions of the work of others, his own pioneering trajectory and experience as the field evolved and him along with it, and above all, his discovery of ways to work skillfully with people by bringing mindfulness to the body (as well as to their thoughts and emotions) through yoga, movement, and theater are a wonderful and welcome breath of fresh air and possibility in the therapy world.”
—Jon Kabat-Zinn, professor of medicine emeritus, UMass Medical School; author of Full Catastrophe Living.
“This is an amazing accomplishment from the neuroscientist most responsible for the contemporary revolution in mental health toward the recognition that so many mental problems are the product of trauma. With the compelling writing of a good novelist, van der Kolk revisits his fascinating journey of discovery that has challenged established wisdom in psychiatry. Interspersed with that narrative are clear and understandable: descriptions of the neurobiology of trauma; explanations of the ineffectiveness of traditional approaches to treating trauma; and introductions to the approaches that take patients beneath their cognitive minds to heal the parts of them that remained frozen in the past. All this is illustrated vividly with dramatic case histories and substantiated with convincing research. This is a watershed book that will be remembered as tipping the scales within psychiatry and the culture at large toward the recognition of the toll traumatic events and our attempts to deny their impact take on us all.”
—Richard Schwartz, originator, Internal Family Systems Therapy
“The Body Keeps the Score is clear, fascinating, hard to put down, and filled with powerful case histories. Van der Kolk, the eminent impresario of trauma treatment, who has spent a career bringing together diverse trauma scientists and clinicians and their ideas, while making his own pivotal contributions, describes what is arguably the most important series of breakthroughs in mental health in the last thirty years. We’ve known that psychological trauma fragments the mind. Here we see not only how psychological trauma also breaks connections within the brain, but also between mind and body, and learn about the exciting new approaches that allow people with the severest forms of trauma to put all the parts back together again.”
—Norman Doidge, author of The Brain That Changes Itself
“Every once in a while, a book comes along that fundamentally changes the way we look at the world. Bessel van der Kolk has written such a book. The arc of van der Kolk’s story is vast and comprehensive, but he is such a skillful storyteller that he keeps us riveted to the page. I could not put this book down. It is, simply put, a great work.”
—Stephen Cope, founder and director, Kripalu Institute for Extraordinary Living; author of Yoga and the Quest for the True Self
“Bessel van der Kolk is unequaled in his ability to synthesize the stunning developments in the field of psychological trauma over the past few decades. Thanks in part to his work, psychological trauma—ranging from chronic child abuse and neglect, to war trauma and natural disasters—is now generally recognized as a major cause of individual, social and cultural breakdown. In this masterfully lucid and engaging tour de force, van der Kolk takes us —both specialists and the general public— on his personal journey and shows what he has learned from his research, from his colleagues and students, and, most importantly, from his patients. The Body Keeps the Score is, simply put, brilliant.”
—Onno van der Hart, Ph.D., Utrecht University, The Netherlands; senior author, The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization
“The Body Keeps the Score articulates new and better therapies for toxic stress based on a deep understanding of the effects of trauma on brain development and attachment systems. This volume provides a moving summary of what is currently known about the effects of trauma on individuals and societies, and introduces the healing potential of both age old and novel approaches to help traumatized children and adults to fully engage in the present.”
—Jessica Stern, policy consultant on terrorism; author of Denial: A Memoir of Terror
“A book about understanding the impact of trauma by one of the true pioneers in the field. It is a rare book that integrates cutting edge neuroscience with wisdom and understanding about the experience and meaning of trauma, for people who have suffered from it. Like its author, this book is wise and compassionate, occasionally quite provocative, and always interesting.”
—Glenn N. Saxe, M.D., Arnold Simon Professor and chairman, Department of Child and Adolescent Psychiatry; director, NYU Child Study Center, New York University School of Medicine
“A fascinating exploration of a wide range of therapeutic treatments shows readers how to take charge of the healing process, gain a sense of safety, and find their way out of the morass of suffering.”
—Francine Shapiro, Ph.D., originator of EMDR therapy, senior research fellow, Emeritus Mental Research Institute, author of Getting Past Your Past
“As an attachment researcher I know that infants are psychobiological beings. They are as much the body as they are of the brain. Without language or symbols infants use every one of their biological systems to make meaning of their self in relation to the world of things and people. Van der Kolk shows that those very same systems continue to operate at every age, and that traumatic experiences, especially chronic toxic experience during early development, produce psychic devastation. With this understanding he provides insight and guidance for survivors, researchers and clinicians alike. Bessel van der Kolk may focus on the body and trauma, but what a mind he must have to have written this book.”
—Ed Tronick, distinguished professor, University of Massachusetts, Boston, author of Neurobehavior and Social Emotional Development of Infants and Young Children
“The Body Keeps the Score eloquently articulates how overwhelming experiences affect the development of brain, mind, and body awareness, all of which are closely intertwined. The resulting derailments have a profound impact on the capacity for love and work. This rich integration of clinical case examples with ground breaking scientific studies provides us with a new understanding of trauma, which inevitably leads to the exploration of novel therapeutic approaches that "rewire" the brain, and help traumatized people to (re)-engage in the present. This book will provide traumatized individuals with a guide to healing and permanently change how psychologists and psychiatrists think about trauma and recovery.”
—Ruth A. Lanius, M.D., Ph.D., Harris-Woodman chair in Psyche and Soma, professor of psychiatry, and director PTSD research at the University of Western Ontario; author of The Impact of Early Life Trauma on Health and Disease
“When it comes to understanding the impact of trauma and being able to continue to grow despite overwhelming life experiences, Bessel van der Kolk leads the way in his comprehensive knowledge, clinical courage, and creative strategies to help us heal. The Body Keeps the Score is a cutting-edge offering for the general reader to comprehend the complex effects of trauma, and a guide to a wide array of scientifically informed approaches to not only reduce suffering, but to move beyond mere survival—and to thrive.”
—Daniel J. Siegel, M.D., clinical professor, UCLA School of Medicine, author of Brainstorm: The Power and Purpose of the Teenage Brain; Mindsight: The New Science of Personal Transformation; and The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are
“In this magnificent book, Bessel van der Kolk takes the reader on a captivating journey that is chock full of riveting stories of patients and their struggles interpreted through history, research, and neuroscience made accessible in the words of a gifted storyteller. We are privy to the author’s own courageous efforts to understand and treat trauma over the past 40 years, the results of which have broken new ground and challenged the status quo of psychiatry and psychotherapy. The Body Keeps the Score leaves us with both a profound appreciation for and a felt sense of, the debilitating effects of trauma, along with hope for the future through fascinating descriptions of novel approaches to treatment. This outstanding volume is absolutely essential reading not only for therapists but for all who seek to understand, prevent, or treat the immense suffering caused by trauma.”
—Pat Ogden Ph.D., Founder/Educational Director of the Sensorimotor Psychotherapy Institute; author of Sensorimotor Psychotherapy: Interventions for Trauma and Attachment
“This is masterpiece of powerful understanding and brave heartedness, one of the most intelligent and helpful works on trauma I have ever read. Dr. van der Kolk offers a brilliant synthesis of clinical cases, neuroscience, powerful tools and caring humanity, offering a whole new level of healing for the traumas carried by so many.”
—Jack Kornfied, author of A Path with Heart
“The Body Keeps the Score is masterful in bringing together science and humanism to clearly explain how trauma affects the whole person. Bessel van der Kolk brings deep understanding to the pain and chaos of the trauma experience. The treatment approaches he recommends heal the body and the mind, restoring hope and the possibility of joy. One reads this book with profound gratitude for its wisdom.”
—Alicia Lieberman, Ph.D., Professor of Medical Psychology UCSF, Director of the Child Trauma Research Project, San Francisco General Hospital; author of The Emotional Life of the Toddler
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About the Author
Bessel van der Kolk, M.D., is the founder and medical director of the Trauma Center in Brookline, Massachusetts. He is also a professor of psychiatry at Boston University School of Medicine and director of the National Complex Trauma Treatment Network. When he is not teaching around the world, Dr. van der Kolk works and lives Boston.
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Excerpt. © Reprinted by permission. All rights reserved.
PROLOGUE
FACING TRAUMA
One does not have be a combat soldier, or visit a refugee camp in Syria or the Congo to encounter trauma. Trauma happens to us, our friends, our families, and our neighbors. Research by the Centers for Disease Control and Prevention has shown that one in five Americans was sexually molested as a child; one in four was beaten by a parent to the point of a mark being left on their body; and one in three couples engages in physical violence. A quarter of us grew up with alcoholic relatives, and one out of eight witnessed their mother being beaten or hit.1
As human beings we belong to an extremely resilient species. Since time immemorial we have rebounded from our relentless wars, countless disasters (both natural and man-made), and the violence and betrayal in our own lives. But traumatic experiences do leave traces, whether on a large scale (on our histories and cultures) or close to home, on our families, with dark secrets being imperceptibly passed down through generations. They also leave traces on our minds and emotions, on our capacity for joy and intimacy, and even on our biology and immune systems.
Trauma affects not only those who are directly exposed to it, but also those around them. Soldiers returning home from combat may frighten their families with their rages and emotional absence. The wives of men who suffer from PTSD tend to become depressed, and the children of depressed mothers are at risk of growing up insecure and anxious. Having been exposed to family violence as a child often makes it difficult to establish stable, trusting relationships as an adult.
Trauma, by definition, is unbearable and intolerable. Most rape victims, combat soldiers, and children who have been molested become so upset when they think about what they experienced that they try to push it out of their minds, trying to act as if nothing happened, and move on. It takes tremendous energy to keep functioning while carrying the memory of terror, and the shame of utter weakness and vulnerability.
While we all want to move beyond trauma, the part of our brain that is devoted to ensuring our survival (deep below our rational brain) is not very good at denial. Long after a traumatic experience is over, it may be reactivated at the slightest hint of danger and mobilize disturbed brain circuits and secrete massive amounts of stress hormones. This precipitates unpleasant emotions intense physical sensations, and impulsive and aggressive actions. These posttraumatic reactions feel incomprehensible and overwhelming. Feeling out of control, survivors of trauma often begin to fear that they are damaged to the core and beyond redemption.
• • •
The first time I remember being drawn to study medicine was at a summer camp when I was about fourteen years old. My cousin Michael kept me up all night explaining the intricacies of how kidneys work, how they secrete the body’s waste materials and then reabsorb the chemicals that keep the system in balance. I was riveted by his account of the miraculous way the body functions. Later, during every stage of my medical training, whether I was studying surgery, cardiology, or pediatrics, it was obvious to me that the key to healing was understanding how the human organism works. When I began my psychiatry rotation, however, I was struck by the contrast between the incredible complexity of the mind and the ways that we human beings are connected and attached to one another, and how little psychiatrists knew about the origins of the problems they were treating. Would it be possible one day to know as much about brains, minds, and love as we do about the other systems that make up our organism?
We are obviously still years from attaining that sort of detailed understanding, but the birth of three new branches of science has led to an explosion of knowledge about the effects of psychological trauma, abuse, and neglect. Those new disciplines are neuroscience, the study of how the brain supports mental processes; developmental psychopathology, the study of the impact of adverse experiences on the development of mind and brain; and interpersonal neurobiology, the study of how our behavior influences the emotions, biology, and mind-sets of those around us.
Research from these new disciplines has revealed that trauma produces actual physiological changes, including a recalibration of the brain’s alarm system, an increase in stress hormone activity, and alterations in the system that filters relevant information from irrelevant. We now know that trauma compromises the brain area that communicates the physical, embodied feeling of being alive. These changes explain why traumatized individuals become hypervigilant to threat at the expense of spontaneously engaging in their day-to-day lives. They also help us understand why traumatized people so often keep repeating the same problems and have such trouble learning from experience. We now know that their behaviors are not the result of moral failings or signs of lack of willpower or bad character—they are caused by actual changes in the brain.
This vast increase in our knowledge about the basic processes that underlie trauma has also opened up new possibilities to palliate or even reverse the damage. We can now develop methods and experiences that utilize the brain’s own natural neuroplasticity to help survivors feel fully alive in the present and move on with their lives. There are fundamentally three avenues: 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 result from trauma. Which one of these is best for any particular survivor is an empirical question. Most people I have worked with require a combination.
This has been my life’s work. In this effort I have been supported by my colleagues and students at the Trauma Center, which I founded thirty years ago. Together we have treated thousands of traumatized children and adults: victims of child abuse, natural disasters, wars, accidents, and human trafficking; people who have suffered assaults by intimates and strangers. We have a long tradition of discussing all our patients in great depth at weekly treatment team meetings and carefully tracking how well different forms of treatment work for particular individuals.
Our principal mission has always been to take care of the children and adults who have come to us for treatment, but from the very beginning we also have dedicated ourselves to conducting research to explore the effects of traumatic stress on different populations and to determine what treatments work for whom. We have been supported by research grants from the National Institute of Mental Health, the National Center for Complementary and Alternative Medicine, the Centers for Disease Control, and a number of private foundations to study the efficacy of many different forms of treatment, from medications to talking, yoga, EMDR, theater, and neurofeedback.
The challenge is: How can people gain control over the residues of past trauma and return to being masters of their own ship? Talking, understanding, and human connections help, and drugs can dampen hyperactive alarm systems. But we will also see that the imprints from the past can be transformed by having physical experiences that directly contradict the helplessness, rage, and collapse that are part of trauma, and thereby regaining self-mastery. I have no preferred treatment modality, as no single approach fits everybody, but I practice all the forms of treatment that I discuss in this book. Each one of them can produce profound changes, depending on the nature of the particular problem and the makeup of the individual person.
I wrote this book to serve as both a guide and an invitation—an invitation to dedicate ourselves to facing the reality of trauma, to explore how best to treat it, and to commit ourselves, as a society, to using every means we have to prevent it.
PART ONE
THE REDISCOVERY OF TRAUMA
CHAPTER 1
LESSONS FROM VIETNAM VETERANS
I became what I am today at the age of twelve, on a frigid overcast day in the winter of 1975. . . . That was a long time ago, but it’s wrong what they say about the past. . . . Looking back now, I realize I have been peeking into that deserted alley for the last twenty-six years.
—Khaled Hosseini, The Kite Runner
Some people’s lives seem to flow in a narrative; mine had many stops and starts. That’s what trauma does. It interrupts the plot. . . . It just happens, and then life goes on. No one prepares you for it.
—Jessica Stern, Denial: A Memoir of Terror
The Tuesday after the Fourth of July weekend, 1978, was my first day as a staff psychiatrist at the Boston Veterans Administration Clinic. As I was hanging a reproduction of my favorite Breughel painting, “The Blind Leading the Blind,” on the wall of my new office, I heard a commotion in the reception area down the hall. A moment later a large, disheveled man in a stained three-piece suit, carrying a copy of Soldier of Fortune magazine under his arm, burst through my door. He was so agitated and so clearly hungover that I wondered how I could possibly help this hulking man. I asked him to take a seat, and tell me what I could do for him.
His name was Tom. Ten years earlier he had been in the Marines, doing his service in Vietnam. He had spent the holiday weekend holed up in his downtown-Boston law office, drinking and looking at old photographs, rather than with his family. He knew from previous years’ experience that the noise, the fireworks, the heat, and the picnic in his sister’s backyard against the backdrop of dense early-summer foliage, all of which reminded him of Vietnam, would drive him crazy. When he got upset he was afraid to be around his family because he behaved like a monster with his wife and two young boys. The noise of his kids made him so agitated that he would storm out of the house to keep himself from hurting them. Only drinking himself into oblivion or riding his Harley-Davidson at dangerously high speeds helped him to calm down.
Nighttime offered no relief—his sleep was constantly interrupted by nightmares about an ambush in a rice paddy back in ’Nam, in which all the members of his platoon were killed or wounded. He also had terrifying flashbacks in which he saw dead Vietnamese children. The nightmares were so horrible that he dreaded falling asleep and he often stayed up for most of the night, drinking. In the morning his wife would find him passed out on the living room couch, and she and the boys had to tiptoe around him while she made them breakfast before taking them to school.
Filling me in on his background, Tom said that he had graduated from high school in 1965, the valedictorian of his class. In line with his family tradition of military service he enlisted in the Marine Corps immediately after graduation. His father had served in World War II in General Patton’s army, and Tom never questioned his father’s expectations. Athletic, intelligent, and an obvious leader, Tom felt powerful and effective after finishing basic training, a member of a team that was prepared for just about anything. In Vietnam he quickly became a platoon leader, in charge of eight other Marines. Surviving slogging through the mud while being strafed by machine-gun fire can leave people feeling pretty good about themselves—and their comrades.
At the end of his tour of duty Tom was honorably discharged, and all he wanted was to put Vietnam behind him. Outwardly that’s exactly what he did. He attended college on the GI Bill, graduated from law school, married his high school sweetheart, and had two sons. Tom was upset by how difficult it was to feel any real affection for his wife, even though her letters had kept him alive in the madness of the jungle. Tom went through the motions of living a normal life, hoping that by faking it he would learn to become his old self again. He now had a thriving law practice and a picture-perfect family, but he sensed he wasn’t normal; he felt dead inside.
Although Tom was the first veteran I had ever encountered on a professional basis, many aspects of his story were familiar to me. I grew up in postwar Holland, playing in bombed-out buildings, the son of a man who had been such an outspoken opponent of the Nazis that he had been sent to an internment camp. My father never talked about his war experiences, but he was given to outbursts of explosive rage that stunned me as a little boy. How could the man I heard quietly going down the stairs every morning to pray and read the Bible while the rest of the family slept have such a terrifying temper? How could someone whose life was devoted to the pursuit of social justice be so filled with anger? I witnessed the same puzzling behavior in my uncle, who had been captured by the Japanese in the Dutch East Indies (now Indonesia) and sent as a slave laborer to Burma, where he worked on the famous bridge over the river Kwai. He also rarely mentioned the war, and he, too, often erupted into uncontrollable rages.
As I listened to Tom, I wondered if my uncle and my father had had nightmares and flashbacks—if they, too, had felt disconnected from their loved ones and unable to find any real pleasure in their lives. Somewhere in the back of my mind there must also have been my memories of my frightened—and often frightening—mother, whose own childhood trauma was sometimes alluded to and, I now believe, was frequently reenacted. She had the unnerving habit of fainting when I asked her what her life was like as a little girl and then blaming me for making h
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Goodreads Reviews
Apr 25, 2015Morgan Blackledge rated it it was amazing
The Body Keeps Score is my jam. It's better than that. It's like my slammajam. This is my fave book of the year so far, by a bunch.
It's a rich treasure trove of information from the frontiers of trauma research, etiology, diagnosis and treatment. It's changing the way I do therapy and it's changing the way a interpret human behavior.
And to think. I almost didn't read it.
When I entered the mental health field I had intended to specialize in Somatic Experiencing (SE) trauma therapy. But I quickly rejected the model when I realized it was way outside the mainstream and lacked randomized control trials (RCT) that demonstrated its effectiveness compared to other "first line" treatments such as Cognitive Behavioral Therapy (CBT) and Prolonged Exposure Therapy (PE).
I saw the author Dr. Bessel Van Der Kolk lecture at the Evolution of Psychotherapy conference in 2013. He was awesome, and he really reinvigorated my interest in doing somatically oriented trauma work. But something about the experience as a whole left me feeling woozy.
Perhaps my experience was negativity impacted by the mass, prolonged exposure to the unwashed throngs of other psychotherapists (never a good thing), some of whom were from the San Francisco Bay Area (a deadly combination).
Don't get me wrong. There are lots of mental health professionals (even ones from the Bay Area) that are highly functional, sober, top notch folks.
But there are also a bunch of kooky, crazy as fuck people in the field (Particularly in the Bay Area), and there were a bunch in the crowd, and I think I was feeling a bit (or perhaps a lot) of shame for my profession. A pathological shame that was clearly a sequallia of my own dark hippy shadow.
I myself lived in the Bay Area for around a decade. I came to therapy from an unconventional "hippyish" background. I went to art school as an undergraduate. I have practiced yoga and meditation for over 30 years. Plus I have a couple of crappy tattoos. When I entered the field I was dreadfully afraid no one would take me seriously.
So I somewhat consciously but mostly unconsciously tried to distance myself from my own freaky roots.
I was probably still up in my head about all that when I was listening to Dr. Van Der Kolk. I was loving what he was saying, the parts I could understand any way (he speaks in a thick Dutch accent), but I also remember looking around the room and thinking "I have to distinguish myself from these nutty hippies".
Perhaps it was at that point I unconsciously gripped up and rejected somatic trauma work (again) in favor of the more "masculine" "serious" "evidence based", behaviorally oriented, here and now stuff that I currently practice.
Which, by the way, is Acceptance Comment Therapy (ACT). A mindfulness based variant of CBT which is incidentally a "hippy as fuck" therapeutic modality by many standards.
Anyway.
When I first saw that the book was released, I was like "hey, that looks pretty good" but then I had a flash back from the psychotherapy conference.
It was an intrusive mental image of a patchouli smelling, chubby middle aged hippy chick in a mauve knit poncho sweater and dream catcher earrings saying "your fifth level is emitting too much teal energy" and I reflexively withdrew my enthusiasm for the whole somatically oriented trauma treatment program.
Anyway. I did eventually get over myself (and my hippy phobia) and got the book and man is it good. It's extremely, extremely triple extremely good. It's like, organically, cosmically, spin your chakras at a dead show good.
And despite Dr. Van Der Kolk's activist agenda, he's actually a pretty reputable (Harvard affiliated) scientist and clinician and widely regarded as one the the worlds foremost authorities on trauma and trauma sequelae (yes I used the term seguelae twice in the same review, actually three times if you count the time I just used sequallia in this parentheses, oops, better make that four).
And, yes, Dr. Van Der Kolk also apparently does yoga and meditation and has probably smoked tons of weed and hung out at Eslen. But I am willing to forgive the man for that because I too have been guilty of similar behavior in my woolly headed, not so distant past.
Before I became a therapist, I was on my own journey to recovery from addiction, trauma, depression, anxiety etc.
BTW: when I hear other therapist start talking about their recovery, I cringe. Please forgive me if you're feeling cringy. But sometimes we all have to go there in order to communicate certain important points.
Anyway.
The foundation of my recovery was self-care. For me, self-care was (and still is) founded on basics such as: healthy sleep, exercise and nutrition. It also included good therapy and a little 12-step. But the rocket fuel of my recovery was yoga, loving kindness meditation and mindfulness meditation.
Now, one of my primary intentions as a therapist is to assist my clients in developing self compassion and embodied mindfulness skills for utilization in their recovery.
While the secular mindfulness revolution thing that has been happening over the past two decades has normalized mindfulness and provided ample scientific evidence for the clinical use value of mindfulness training e.g. Mindfulness Based Stress Reduction (MBSR).
And mindfulness-based psychotherapeutic modalities such as Dialectical Behavioral Therapy (DBT) and Acceptance Commitment Therapy (ACT) have provided evidence-based mindfulness integrated psychotherapeutic frameworks.
The evidence for somatically oriented (embodied) therapeutic modalities has lagged. Dr. Van Der Kolk's work is providing this evidence and is blazing the trail for mainstream acceptance of somatically oriented practices.
Dr. Van Der Kolk's work is also foundational for changing the way the field conceptualizes and diagnoses trauma.
Additionally Dr. Van Der Kolk is lending legitimacy to some cutting-edge and very exciting trauma treatments such as Neural Feedback and Eye Movement Desensitization and Reprocessing (EMDR).
I, like millions of other people, have suffered from Post-Traumatic Stress Disorder (PTSD) symptoms. In early recovery I received lots of good therapy for trauma and I'm happy to report that I am no longer impaired by PTSD symptoms.
Out of all of the therapy I received, anecdotally speaking, I have to say, some of the most effective was EMDR. I had phenomenal results from an equally phenomenally brief treatment time (two, one hour sessions).
This is standard EMDR testimonial. People very commonly report that it works and it works fast.
Again, as a nascent therapist in training, I had intended to train in EMDR. But EMDR is like the dirty redheaded stepchild of psychotherapy. Despite ample evidence of its efficacy, nobody can figure out why it works, so the model has been widely rejected by the mainstream mental health community.
I sort of drank the Kool-Aid and jumped on the anti EMDR bandwagon. But after reading this book, I'm feeling very enthusiastic about treating trauma with EMDR.
I could go on and on, but I'd rather just urge you to do yourself a big favor and read this book. (less)
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Dec 20, 2015Thomas rated it it was amazing
Shelves: five-stars, nonfiction, own-physical, psychology
A compassionate, intelligent, and transformative book about trauma. As an aspiring clinical psychologist and writer, I look up to Bessel van der Kolk a lot. In The Body Keeps the Score, he infuses empirical, innovative research with hands-on clinical experience to explain trauma in a clear, authentic way. I loved his emphasis on incorporating both biology and social relationships into our understanding of trauma, as awful events affect both the body as well as the actual life of a struggling individual. He clarifies many misconceptions by stressing how many victims of child abuse often go ignored when compared to war veterans, and he argues with much logic that we cannot just use drugs to treat Post-Traumatic Stress Disorder (PTSD) and other mental illnesses. We must treat the whole person.
Dr. van der Kolk steers this book in a hopeful direction by discussing many treatment strategies for PTSD. He includes descriptions and research studies to support a gamut of methodologies, ranging from Cognitive Behavioral Therapy (CBT) to Eye Movement Desensitization Therapy (EMDR) to Neurofeedback, and more. In particular I enjoyed reading about the Internal Family System approach (IFS), a mode of psychotherapy I had never heard of, which I found enlightening and holistic. Dr. van der Kolk emphasizes the importance of getting back in touch with our emotions and our bodies after trauma, and he gives many practical ways to do so, like talk therapy and yoga, just to name a few.
Dr. van der Kolk's genuine heart elevates this book above others. His vulnerability with his own story models a message for all of us to live by: only by confronting and accepting the past can we learn to live in the present. He writes about the importance of de-stigmatizing PTSD and mental illness, and he relates the issue of trauma to several societal factors, like the prolific amount of gun violence in the United States and the lack of socioemotional education given to our kids. Dr. van der Kolk, with great humility and insight, details his admiration for each of his clients - because they have overcome such devastating hardship, and they have had the courage to share their stories with him, and in some cases, others as well.
A stellar book I would recommend to anyone interested in trauma, mental health, or science in general. I noted so many well-written passages and cannot wait to reference this book in the future. I hope more people read The Body Keeps the Score - it would improve our society a lot. (less)
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Sep 16, 2015Charlene rated it it was ok
Shelves: abnormal-psych, neuroscience
This book represents everything that is groundbreakingly wonderful and and pseudoscientifically horrendous about trauma research. Individuals who suffer trauma are in need of actual help. This book contains some of the best, latest, and most effective cures for trauma sufferers, which can steer patients toward the help they need. However, van der Kolk seems wholly unable to engage in critical thinking when it comes to various treatments.
When attending courses in cognitive neuroscience and psychology at the University of Pennsylvania, my favorite professors were those who ripped apart each treatment to examine it for efficacy. The profs held out hope that cures were attainable but put them under the microscope to make damn sure the "cure" would not actually retraumatize and individual or make matters worse. In order to trust a mental health care provider, that provider should demonstrate not only a knowledge of the literature (as van der Kolk does as he repeatedly throws around his MD and Harvard alma marter to assure his reader of his credentials) but also an ability to sort out fact from fiction. van der Kolk seems entirely enamored with outdated findings (that have since been shown to be incorrect) and therapies that have failed to be backed up by empirical support. Most concerning, he seems completely in denial about how easily false memories form and the damage they can do.
On a more positive note, he does a great job championing individuals who are often rejected by the field of psychiatry. Since false memories are real, and they have wreaked havoc on an already traumatized person's fragile life, many aspects that lead to remembering repressed memories have come under fire. This has served to invalidate the real and true experiences suffered by many people during their childhoods and beyond. Under particular scrutiny is dissociation, something that can be particularly difficult for survivors to deal with, is treated as if it doesn't exist. This is certainly a problem and I do not know how to find a middle ground between dissociation deniers and false memory/ personality creating therapists, but I would venture to say that van der Kolk's approach is not it. There has got to be a better way to validate the real, and sometimes repressed traumas while, at the same time, not creating new ones by promoting fictitious experiences that do not exist.
Additionally, there is a lot of study involving a person's perception that never made it into this book. I understand that, again, it is difficult to take on the effects of perception while simultaneously trying to validate what really happened to people. But, perception can really affect mental health and subsequent behavior. Not only that, there is a very real phenomenon in which excused behavior can cause the trauma sufferer to continue to delve out trauma to others. While van der Kolk mildly touched on this at times, he did not do so in any in depth of concrete manner.
This book could have been half as long and, if van der Kolk had stuck to only empirically sound findings and treatments, could have been a great book. Associating words with Harvard and MD doesn't make them true. It just makes people believe them more. Sometimes that is more harmful than helpful.
Despite the foregoing criticisms, this book, with its many chapters on various treatments, might help trauma sufferers seek a treatment that seems right for them. (less)
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Nov 02, 2016Kai rated it it was amazing
I'm not a psychologist, psychiatrist, doctor, social worker or otherwise involved in treatment or research of mental conditions or disorders. What I am is a guy in his mid-twenties who experienced multiple instances of severe medical trauma as a child, in my case open-heart surgeries at the ages of three months, six years and eleven years.
I've spent the majority of my life (read: all of it) doing my best to repress and resist the terror, anger and sadness I felt as a result of having gone through these procedures. And I was able to get by, mostly, though my life always seemed to be a highly fragile construct, where I worked tirelessly to maintain control.
I lost control this year, or maybe part of myself decided it was time to let go of my controlling behaviors and coping mechanisms, which no longer serve to help me, but instead negatively affect the quality of my life. This was a very tough realization, and my default response was to beat up myself for behaving 'wrong' or otherwise being 'a failure' for the way I had been just trying to get by.
That's why this book has been so important for me, because I now realize that the way I've been living isn't bad or wrong--I've been trying to survive, to get to a place where I can truly feel safe, validated and connected to others. But my body doesn't know how to let down, to let go. Much as Dr. van der Kolk points out throughout this book, I'm stuck in these moments of past horror, faced with autonomic imbalances that keep me on the defensive 24/7. And I don't know how to stop.
This book has already proven to be a crucial resource, as it sheds light on much of what I've been struggling with my whole life, showing that there are people out there who really understand. Just as important, it shows me that there is help available. It took me over three months to read this book, because part of me hated that I could identify with so much of what the author describes when discussing the nature of trauma. Oftentimes it just made me profoundly sad. Some of the experiences shared within are also quite harrowing. Usually I couldn't get through a chapter without breaking down. But I kept coming back to it, because I knew it was within my power to help and educate myself.
Thank you, Dr. van der Kolk, for helping me take this step towards healing myself, past and present. I hope to look back on this period one day and recognize how much reading this book helped me to start down the path to recovery, presence of mind and body, and fully engaging with life. (less)
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Aug 25, 2019Alok Vaid-Menon rated it really liked it
As someone who suffers from chronic pain I’ve found it difficult to find resources about the connection between trauma + physical pain. This is because the mind-body connection are (I think intentionally) underdeveloped in Western medicine which so often rehearses the body outside of context.
Van der Kolk shows how trauma can shape every aspect of our psychology + physiology: making us attracted to dangerous/painful situations, affecting our perception of time + space, dispossessing us of the ability to describe our discomfort, causing chronic muscle pain, headaches, + autoimmune disorders. We live in a world that constantly underemphasizes the emotional trauma even though the same parts of the brain are impacted by emotional pain as by physical violence. Heartbreak, betrayal, neglect, depression physically hurt. This continual undervaluation of emotional stress means that it accumulates, depletes significant energy + attacks our most vulnerable organs.Van der Kolk describes chronic pain as when your brain gets trapped in a pre-programmed escape route, stuck in perpetual fear. For him, the goal is about how to develop coping strategies for trauma that don’t retraumatize us: reintegration, not repression. Healing is possible when we commit to this reintegration. Talk therapy isn’t enough: we can’t just describe the problem, we have to experience “immobilization without fear.”
As a doctor, his book has a clinical bent + outlines various strategies like EMDR + biofeedback which help break trauma cycles. I wish that there had been more discussion of people who have complex trauma where there is no “before” or “after” to the traumatic event. I’m thinking here about how racism + transphobia are continual forms of trauma that we can’t move out of. There was so much important info in the book, but I was kind of turned off by the clinical language where complex people became case studies and cultural rituals became Western mindfulness practices without appreciation for context.
As a survivor of abuse this book can be difficult to get through, so serious content warning. (less)
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Jan 09, 2020Antigone rated it really liked it
Shelves: philosophy-psychology
Dr. van der Kolk's study of trauma treatment is the most respected book lately published on the subject of post-traumatic stress disorder.
Following in the footsteps of Babette Rothschild and Peter Levine, van der Kolk takes as his focus the physical aspects of psychological injury - suggesting that work with the body is the clearest and most effective approach to healing. He is not a fan of the pharmacological. Drugs, while useful in tamping down the flood of fearsome emotional response, do little more than re-establish a basic level of functioning. In his view, medications cannot be considered treatment as they do not lead to a resolution of the condition. Over thirty years of research and clinical practice have led him to alternative methods of care that have shown to produce real results in the lives of those too often relegated to prescriptive numbing and symptom management.
After a bit of a muddled start (that will trigger the vulnerable reader), the doctor locates his footing and begins a guided tour through a series of body-based programs designed to address the fundamental conflict underlying PTSD. Those familiar with trauma are well aware of the sense of being caught in the maelstrom of a past catastrophe and unable to break free. The surreptitious assault of flashback, the tactile immediacy of phantom danger, and the brutal jolt into a fight/flight/freeze posture leaves the psyche in a constant state of high alert as energy levels drop to depletion. Dr. van der Kolk traces the body-brain connection and walks the injury through several alternative treatments - among them EMDR (eye movement desensitization and reprocessing), yoga, IFS (internal family systems therapy - which has nothing to do with families and everything to do with creating a whole of the many different internal parts of a person), psychomotor therapy, neurofeedback, and even theater work. These are the money chapters, and where a substantial amount of hope resides. Merely becoming familiar with the methods may, in fact, set some wheels to turn...and that is helpful.
Dr. van der Kolk is not a writer, but then few in this field throw their skills in a literary direction. What is important to them is what will help you. This book holds that aim as its sole preoccupation. And all I have to say about that is...bravo.
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Nov 15, 2019Elyse Walters rated it it was amazing
Shelves: audiobook
Audiobook....
read by the author: Dr. Bessel van der Kolk.
Kolk is one of the world’s experts on trauma. He spent three decades working with survivors.
This book is packed filled with science, research, experience, and human stories that are phenomenally informative and intense!!!!
Kolk exposes how trauma physically affects changes in the brain and body causing anxiety, rage, depression, the inability to concentrate, problems remembering, flashbacks, trusting, and forming relationships.
He examines trauma caused by childhood neglect, abandonment, sexual or domestic abuse, and war.
....We learn lessons from Vietnam veterans.
....We get a better understanding how the brain works. How PTSD plays out.
....He explains the body-mind connections: losing your body: losing yourself.
....He takes us into the minds of children, and adults - showing how trauma develops over time -turning into PTSD.
We get a grand overview of the ‘historical development’ -academically & intimately - associated with understanding mental health science. I found this book literally fascinating, important, engaging, and helpful.
We get a wide glimpse of how doctors have been educated. (with real life examples of doctor/patient connections),
The stories were incredibly gripping and compelling.....
integrating medical and psychological practices....
....mixing traditional talk therapy,
medications ( many different ones were explore of their effectiveness), new treatments, and alternative therapies such as mindfulness, meditation, breathing exercises, yoga, boxing, tai chi, walking, kick boxing, etc. were also explored.
Towards the end of the book Dr. Kolk outlines healing paths to recovery - letting go of the past and rewiring the brain.
How to choose a doctor - etc.
I can’t express enough how informative and gripping/informative these real life stories exposes. And how sadly PTSD is passed on to our children.
Dr. Kolk shared with us patients trauma....( he’s an amazing advocate for finding solutions) > real healing
treatments, beyond medications, ....and ongoing life healing.
We see why it’s vital to get help!!! Old traumas get stuck in the brain - it takes gentle safe work to unlock them... in order to experience real joy in the present.
I came away with a ‘deeper’ and ‘expanded’ understanding
of the body/mind connection in relationship to trauma.
I also came away with remarkable compassion/admiration - respect - and dignity for people who have dedicated their lives in the field of mental health... and for all those who suffer.
This is an extremely comprehensive book exploring PTSD...(havoc on the brain and body).
Highly recommended to educators, parents, and the rest of us!
Paul & I both found this book exceptional!
One of the most valuable Audiobooks I’ve ever bought!
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Jul 04, 2017Meredith Holley rated it liked it
Shelves: non-fiction, monsters
This book was super okay. I think the title should be changed to, "PTSD for Treatment Professionals: An academic and anecdotal exploration of trauma treatments." So, that was not what I signed up for. I'll say, if you have PTSD, probably don't read this book because it has these very graphic descriptions of patient trauma experiences. I think therapists are the target audience for this book, and it provides an interesting overview of the treatment modalities available for PTSD and the research about them.
One thing I will say about all of the PTSD books I've read lately is that people HATE the DSM. I kind of get it, and I can see how it fucks everything up, especially with kids, but also I kind of think the rage should be turned more to the insurance industry than the DSM. Like the DSM seems more like a symptom of the overall problem where we are more into classifying people than helping them.
My other takeaway is that Bessel A. van der Kolk is super badass. He is one of the early researchers on PTSD, and he describes working in the old mental hospitals and seeing people sprayed down with hoses to clean them. So, that's an example of the type of story he tells that made this book a slow read for me. I will say, I listen to people's trauma stories all day long, but the stories he told in this book were really heavy to me. I had to take a lot of breaks.
In the chapter on EMDR, he talks about his EMDR training. He was in a group training class and was partnered with a person who did not want to talk about his trauma experience during the EMDR. (In EMDR, the way van der Kolk did it, you basically wave your fingers in front of someone's face as they re-experience a trauma memory, and the eye movements process the trauma memory into the regular stream of memory in the brain. It's super magic and also evidence-based.) Van der Kolk was mad that the person didn't want to talk and complained to the instructor. The instructor told him to question whether there was a voyeuristic element to why he became a therapist.
So, that seemed like an insightful perspective, and I thought it made sense with this book. A lot of the stories he told had a voyeuristic element to them in my view. I don't really feel critical about that, but I did not enjoy that aspect of the book.
I appreciated the overview of trauma treatments, though. So far, from everything I've read somatic experiencing and EMDR are the ones I'm most impressed with. (less)
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Amazon review
Top international reviews
Max M
5.0 out of 5 stars Transformative
Reviewed in the United Kingdom on September 5, 2018
Format: PaperbackVerified Purchase
This is the greatest book I have ever read.
It is a lifetime of knowledge (and it is clear that it had taken a very long time to write) from a practising clinician who, as far as I can tell, is THE most well-informed person on the subject, all in one book.
It can be applied to you. Therapy like this would cost thousands, and that is even if you have the good fortune to find a therapist who knows anything about it.
It is perfectly written and laid out, starting with explanations about the problem and ending with explanations of how to recover.
At first it was hard to read because I was only just coming to terms with having childhood trauma, and was still feeling very upset about it. However the great thing about a book is that you can take as long as you like to finish it. As I read more I understood more and more and began to feel more and more free, understood, and positive.
There is SO MUCH information in here, and it is all extremely useful and interesting. I often read one sentence several times because it made such an impact on me, and after some pages (most of them!) I would think for ten minutes until I read more.
This is the most helpful book I have read on the subject, and I have read a lot. It has taken me a long time to read, but recovery takes a long time. I think that if you have not been traumatised and are just reading it for interest that you would read it quickly, as it is such a great book. I feel like it has transformed me.
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Cheese time
5.0 out of 5 stars brilliantReviewed in the United Kingdom on March 8, 2019
Format: PaperbackVerified Purchase
What fascinates me about trauma is what it does to you. It helps you survive whatever has tried to hurt you. It’s a survival instinct.
When you experience trauma your brain protects you, it literally creates a new personality on top of the one you were born with and transforms you. It increases your senses, it makes you more intelligent, but it changes your brain chemistry and that's the big problem. If your chemistry changes then you're not going to benefit in normal everyday situations because your flight, fight and freeze part of your brain is now on over drive, your hypothalamus is now stuck in hyper drive and your prefrontal cortex becomes neglected and undeveloped and in a contradicting to making you more intelligent now makes you less able to learn by constantly injecting stress hormones into your blood stream.
A lot is crammed into this book, over 30 years of research into trauma and I agree with the author, trauma is so important and so relevant in our society. Most people experience some form of trauma throughout their lives, but it seems the younger and more undeveloped you are the more profound the effect is later on in life. It literally passes down from generation to generation and we still don't discuss or treat trauma as a norm. If everyone was more knowledgeable about trauma and how it affects us then I think our medical advice and how we treat people would be far different from what it is today.
I find it easy to notice when someone has experienced trauma. It affects their persona, but there are visual and acoustic clues as well. It helps to know if someone has trauma because you have to adapt to their reasoning and thinking which can often be off kilter.
This book is brilliant for psychologists and people who want to learn more about themselves and trauma. It has a diverse knowledge or different applications which are proven to work. Obviously CBT is the most common, but two more I find very interesting and fascinating for trauma treatment is EMDR and Yoga. Both I think are brilliant and I was aware of before the book, but this book shows just what impact it has on masses.
I genuinely feel like when it comes to psychology and nutritional sciences, the USA is years ahead of everyone else especially the UK. I really hope a lot of this work makes it over here sooner rather than later.
Knowing more about trauma means we can help heal our society, prevent abuse and even enrich ourselves.
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133 people found this helpful
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M. Fraser
5.0 out of 5 stars Experienced expert shares what works in overcoming trauma, and it works...Reviewed in the United Kingdom on July 31, 2017
Format: Kindle EditionVerified Purchase
Steady explanation of the issue of trauma, whether childhood or adult, followed by many varied techniques to deal with it. It armed me with the information I needed to understand what I had repressed, allow it to be there, and then the tools to integrate the traumatised child back into my adult self in a way that helped me to live comfortably.
165 people found this helpful
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Amazon Customer
5.0 out of 5 stars One of the best books I have ever readReviewed in the United Kingdom on March 4, 2018
Format: PaperbackVerified Purchase
One of the best books I have ever read. I couldn’t put it down. The case histories, the neuroscience. ...everything is so eye opening in this book.
I am training to be a play therapist and I would recommend this for any child development or neuroscience enthusiast. It has thrown light in my own personal journey and I felt like parts of this book were written for me... absolutely brilliant and proves that we all have the capacity to heal.
73 people found this helpful
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Doxus
5.0 out of 5 stars Essential reading for humansReviewed in the United Kingdom on December 24, 2018
Format: PaperbackVerified Purchase
Part science, part history, this book spans vdK's experience searching for the reasons some people don't interact well or get sick, and ways to treat them. His career started with working with war veterans and drugs, but since then it has exploded into many areas and treatments. He approaches the field as a scientist who has been involved in many groundbreaking studies, trying to convert the field from studies on rats and theories to human-based data. His criteria for success is results, not money.
vdK explains that there are different subtypes of trauma and various treatment techniques work better with some types of trauma than others. Instead of labelling and trying to treat symptoms, he attempts to diagnose and treat the underlying cause. He tells of his efforts to join the campaign to completely reorient the categories set out in the DSM (the reference manual of the psychatric industry in the USA) which just describes symptoms or manifestations rather than the real causes of people's dysfunction.
At almost 400 pages of small print this is a long, but exciting, read which shows there are alternatives to the conventional pharmacological-first approach. I found this book to be a real page turner, reading it late into the night. vdK also provides many resources and references for further reading. Essential for everyone, even functioning humans, to understand why you or people around you may not behave as you want or expect.
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40 people found this helpful
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