The Body Keeps the Score
Mind, Brain and Body in the Transformation of Trauma
Bessel van der Kolk
Having read it
★★★★★
Seriously good, insightful and informative: it’s an honest read and tough to take in at times given what some of the subjects written about have endured and survived.
From its first few chapters you really start to see and appreciate all sides of trauma (survivors and treatment specialists) and see the many blurred lines and experiences that help paint a generalised, yet humanly universal, space for learning, helping and treating survivors of trauma and not just reducing the methods and approaches to helping to a one-size-fits-all approach.
Keeping options open and reacting to experiences is the author’s skill and his colleagues in the many places that he has worked and works; this approach really helps prove, as written about near the book’s last few chapters more so, that it really is all connected; survivors’ stories, while often reduced to a moment by how medicine can help, are the result of a myriad of happenings pretty much always out of the survivor’s hands, that also need to be appreciated, understood and prevented by wider society with better funding, more integrated services and a willingness to see and make issues connected, not isolated like just taking a certain pill and everything will be all right.
‘The ecology of life’, as written in the book, is a great phrase and often under-appreciated when many things in life, to show progress and effectiveness, are reduced to box ticking exercises; drugs can help in certain cases, but they’re really a sticking plaster approach that does nothing to really help and, change for the better, the underlying issues that lead to trauma and why it is important to work on the body, as well as the mind, as it does keep the score... and to end my review, I quote Yogi Berra, who was quoted in the book, ‘You observe a lot by watching.’
A good passage
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 traumatised individuals become hypervigilant to threat at the expense of spontaneously engaging in their day-to-day lives. They also help us understand why traumatised 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.
A second good passage
A psychiatric diagnosis has serious consequences: Diagnosis informs treatment, and getting the wrong treatment can have disastrous effects. Also, a diagnostic label is likely to attach to people for the rest of their lives and have a profound influence on how they define themselves. I have met countless patients who told me that they ‘are’ bipolar or borderline or that they ‘have’ PTSD, as if they had been sentenced to remain in an underground dungeon for the rest of their lives, like the Count of Monte Cristo.
A third good passage
Interventions are successful if they draw on our natural wellsprings of cooperation and on our inborn responses to safety, reciprocity, and imagination. Trauma constantly confronts us with our fragility and with man’s inhumanity to man but also with our extraordinary resilience. I have been able to do this work for so long because it drew me to explore our sources of joy, creativity, meaning, and connection – all the things that make life worth living. I can’t begin to imagine how I would have coped with what many of my patients have endured, and I see their symptoms as part of their strength – the ways they learned to survive. And despite all their suffering many have gone on to become loving partners and parents, exemplary teachers, nurses, scientists, and artists.