Book Summary: The Body Keeps The Score by Bessel Van Der Kolk
The Body Keeps The Score by Bessel van der Kolk is a must-read for anyone interested in understanding the link between trauma, mental health, and the body. In this, The Body Keeps The Score summary, we look at how trauma can manifest in the body and the mind and how traditional treatments are often not enough to help people heal.
Van der Kolk draws on his own research and clinical experience to explain how trauma affects the brain, body, and soul and how healing can be approached through a combination of traditional treatments, mindfulness, and yoga. He also shares powerful stories of individuals who have overcome trauma and offers a powerful reminder of the resilience of the human spirit.
The Body Keeps The Score Review & Summary
This is an excellent book for anyone interested in how traumas happen and how they can be healed, for professionals and especially for people who suffer a trauma. Let us start with this The Body Keeps The Score summary:
Trauma And The Loss Of Self
Bessel starts his book by explaining how trauma is defined. Suffering from trauma is the loss of self. Even though some of Bessel Van Der Kolk’s patients had been through a traumatic event decades before, they couldn’t see how it related to their lives now.
Trauma is not just something that happened long ago. It’s also how the mind, brain, and body remember what happened. Trauma changes the way the mind and brain handle perceptions fundamentally. It changes not only what we think about and how we think but also our capacity to think.
Understanding The Mind And The Brain
In experiments, Steven Maier and Martin Seligman shocked dogs confined in cages. Two groups of dogs are here. While the cages were locked, the first group of dogs received several electric shocks. Then, after they were shocked once more while the cage was opened, they lay there whimpering and defecating.
The control group, the second group of hounds, received only electric shocks while the cage was open, without being trapped in it before and getting shocked. These dogs immediately run away.
Many traumatized people simply give up. Even with the chance to flee, traumatized people or animals may choose not to follow the path to freedom. Usually, our stress hormone system reacts to danger with lightning speed and then quickly brings us back to equilibrium. But in people with PTSD, the stress hormone system cannot maintain this balancing act.
The signals for “fight,” “flight,” and “freeze” don’t stop when the threat has passed. Stress hormones continue to be secreted by the body. As a result, this severely affects their health, which manifests as agitation and panic.
The Neuroscience Revolution
To investigate what takes place in the minds of individuals who suffer from flashbacks due to trauma, Bessel carried out a few brain imaging studies. In these experiments, the participants were asked to recall the individual components of their experience to create a narrative of their traumatic event, moment by moment. Then, while the participants lay motionless within the scanner, they relived the scene from their traumatic experience.
After analyzing the data, they concluded that the Broca’s Area in the brain had a significantly diminished activity level. This particular area of the brain, known as a speech center, is essential for expressing thoughts and emotions verbally. Without it, one is unable to verbalize their feelings.
When people recall their trauma, the scans demonstrated that their right brain was activated and the left, which includes the Broca’s Area, was shut off. When the left hemisphere is not as active, it affects one’s ability to arrange their experiences into rational arrangements and express their changing emotions and perceptions in words.
When something causes a traumatic memory to resurface, the right brain responds as if it’s happening in the present moment. Unfortunately, because their left brain isn’t working well enough, they might not realize that they’re reliving and recreating their past.
Your Brain On Trauma
When our alarm system is activated, it effectively sets off a chain reaction that leads to some pre-set physical escape plans in the most primitive parts of our brain. This causes our higher brain, the conscious mind, to partially switch off, resulting in the body fleeing, hiding, engaging in combat, or, in some cases, simply freezing.
It’s not uncommon to find ourselves so overwhelmed by a situation that our body starts to react before our brain catches up. Usually, our senses return to us, and our body and mind can recover from the flight or fight response. But, if this isn’t allowed to happen, like if someone is stuck in a war zone, a traumatic car accident, or a rape, the brain continues producing stress hormones.
When faced with a stressful situation, our frontal lobes tend to shut down, which is unfortunate because these lobes are responsible for the qualities that make us stand out from other animals. Like the ability to use language, think abstractly, plan ahead, monitor ourselves, and control our responses to reach a target.
The frontal lobes are the hub of our capacity to empathize, which is necessary to comprehend trauma. When someone has gone through trauma, their frontal lobes don’t function properly, leading to reliving the painful event instead of just recollecting it. If the traumatic components are constantly repeated, the accompanying stress hormones make those memories even more embedded in their mind.
Day-to-day occurrences can become less and less interesting. It can be difficult to feel the satisfaction of the little things in life and to focus on the duties that need to be done. Not being in the moment can trap people in their past. Emotions like anger, rage, and even numbness may arise, and these reactions may not be easily managed.
If this continues for a while, individuals can become dissociated from themselves as a method of self-protection. Many people who have not been treated for trauma may initially experience intense flashbacks and eventually become dissociated – they detach from themselves.
When an organism is always on high alert, its energy is concentrated on defending itself against unknown threats. But, unfortunately, constantly defending itself means it can’t nurture, take care of, or love anyone. So feeling safe with other people is likely the most crucial component of mental well-being.
Losing Your Body, Losing Yourself
The Bessel Van Der Kolk investigation group has concluded that extended mental mistreatment and neglect can be as damaging as physical harm and sexual violation. As a result, many patients reported to Van Der Kolk that they were unable to experience feeling in some parts of their bodies.
When you’re not thinking about anything in particular, you begin to focus on yourself. The default mode activates the parts of the brain that construct your individual sense of “self.” Studies show that those who experience traumatic events have significantly less activity in the areas of the brain that make up their self-awareness.
These people have learned to turn off the parts of the brain that evoke the intense emotions and sensations associated with fear. Not being conscious of yourself isn’t just a result of inattention. The areas in charge of self-awareness are disabled, as well as the regions related to self-experience.
Before we understand why we feel something, we must first become aware of our emotions. We need to be able to pay attention to what is going on inside us. Mindfulness is essential for healing from trauma. And mindfulness practice is the cornerstone of recovery from trauma.
The self can exist without the body, like a ghost. But trauma sufferers won’t heal until they form an understanding and connection between their minds and the physical sensations within their bodies. In other words, they need to learn to be aware and in the moment.
The Minds Of Children
As children develop, the nature of their early experiences can significantly impact the rest of their lives. Youngsters are willing to do almost anything to feel noticed and connected with their primary caregiver. Depending on whether their parent or caregiver is loving, kind, detached, insensitive, rejecting, or cruel, children will create a method of dealing with their circumstances to fulfill some of their needs.
Mary Ainsworth and Mary Main conducted extensive research over a long time, examining the response of infants when separated temporarily from their mothers:
- Infants with a strong bond with their mothers become distressed when she leaves them, but they demonstrate joy when she returns. After a quick check to gain assurance, they become tranquil and continue their activity.
- Certain kids with an unsupportive or rejecting primary caregiver tend to be persistently disturbed and demand attention from their mothers. Additionally, some of them are more passive and secluded. The mother is incapable of calming them down, and they do not resume playing happily compared to those with a secure attachment.
The emotional bonds we form in childhood can tend to carry over into our adult lives. For example, those who experienced high anxiety levels during childhood are more likely to be anxious adults. In contrast, those who were more avoidant in their formative years may become individuals who have difficulty connecting with their own emotions and those of others. But, of course, life has a way of throwing curveballs, and experiences throughout our lives have the potential to alter these courses.
The Cost Of Abuse And Neglect
Bessel van der Kolk and Nina Fish-Murray conducted an experiment to compare the responses of traumatized children to those of a group of children without any trauma. They presented both groups with the same visual stimulus. They showed the participants the image below:
Every child in the study commented on the man’s peril under the automobile. The control group responded by saying that the car would be repaired, and then they could go to McDonald’s. The children who experienced trauma, however, had much more horrifying accounts. For example, one of the boys told of how he would kick the jack away, and the car would crush his father, while the other girl was close to smashing a hammer into her father’s head.
Another example is a female who finds it difficult to let people enter her personal space. As a result, it’s difficult for her to contact others physically or even engage in intimate activities. When Bessel questioned her about her past, she assumed she “probably had a cheerful childhood.” Yet, she was unable to recall much before her twelfth year. He then requested her to draw a family picture. This is what she drew in the image below:
This is called Auden’s rule. Even though she must have had a happy childhood, she drew such a horrific picture. But she could not allow herself to recognize what her own picture revealed. After working with her, the fragments returned where her father regularly abused her.
Kids don’t have the freedom to pick their parents, and they don’t understand when their mom or dad is too sad, angry, or distracted to be there for them. Moreover, they don’t comprehend that their parent’s behavior has nothing to do with them. Additionally, children are naturally inclined to stay faithful to the people taking care of them, even when they abuse them. Anxiety leads to needing attachment, even if the source of comfort is also the source of fear.
The ACE (Adverse Childhood Experiences) study was extensive and studied particular categories of emotional rejection and family issues. Results showed that child abuse was the most expensive public health concern. The costs associated with it were greater than those of cancer or heart disease.
Eliminating child abuse in the US would reduce depression by more than half, alcohol abuse by two-thirds, and drug abuse and suicide by three-quarters. Additionally, it would significantly affect work productivity and decrease the need for incarceration.
The Problem Of Traumatic Memory
Jean-Martin Charcot carefully examined the physical and neurological links of hysteria in people of both genders, highlighting the idea of retained memory and the lack of language. As an illustration, in 1889, he revealed the case of a person called Lelog who, after being involved in a collision with a carriage, got paralysis in his legs.
Although Lelog fell and lost consciousness, his legs didn’t seem injured, and no neurological signals could explain this paralysis. Charcot discovered that shortly before Lelog fell unconscious, he spotted the carriage wheels coming at him and was convinced he would be run over.
Much like many others, Lelog expressed his experience physically instead of recalling the crash. It is usual for individuals to alter their memories. Yet, those experiencing PTSD cannot move on from the original occurrence.
Dissociation stops the trauma from being included in the memory. Integrating the separated elements of the trauma into one’s life is necessary to treat dissociation, allowing the patient to recognize that the past is done and this is the present. The mind cannot modify the memory as long as it is unreachable. But once a story is told, especially if spoken several times, it is altered – the act of storytelling transforms the narrative.
Paths to Recovery
The path to recovery from trauma can be long and difficult, but the good news is that there are paths to recovery. Bessel Van Der Kolk outlined in his book several methods to overcome trauma. While there is no one-size-fits-all approach to recovery, these paths to recovery can be powerful tools in the journey toward healing.
Owning Your Self
According to research conducted by neuroscientist Joseph LeDoux and his team, the only way to get in touch with our emotions is by cultivating self-awareness and activating the medial prefrontal cortex. This part of the brain recognizes what’s happening inside us and allows us to experience what we feel.
Most of our conscious mind is devoted to understanding the outer environment: interacting with others and creating plans for the future. Nevertheless, that does not aid us in regulating our own selves. Neuroscience studies reveal that we can only alter our emotions by being aware of our inner feelings and learning to accept what is happening within our minds.
The National Institutes of Health funded a study by Bessel and his team, demonstrating that a 10-week yoga program significantly affected patients with PTSD who had been unresponsive to other treatments or medications. The basis of recovery is self-awareness.
The most relevant statements in trauma therapy are “Notice that” and “What happens next?”. Practicing mindfulness soothes the sympathetic nervous system, limiting the possibility of triggering a flight or fight response. Moreover, mindfulness has positively influenced various psychiatric, psychosomatic, and stress-related issues, such as depression and chronic pain.
Besides being mindful, it has been demonstrated time and time again that having solid relationships is the most effective way to avoid being traumatized. For instance, children who are removed from their parents after a traumatic occurrence often endure long-term negative consequences.
Writing To Your Self
Expressing the sensation of losing yourself can be hard to articulate. The language center of the brain is about as far removed from the center for experiencing one’s self as is geographically possible. We are usually better at sharing information about someone else than ourselves. One of the most powerful methods to reach our inner emotions is writing.
When you write to yourself, you do not have to stress about other people’s opinions – listen to your own ideas and let them guide you. Whenever you reread what you wrote, you may come across astonishing facts.
Free writing is a popular practice. You can use any object to start a train of ideas. Then, write whatever pops into your head when you see the item in front of you and keep writing continuously without stopping, rereading, or erasing. For example, a wooden spoon on the tabletop could call to mind recollections of making tomato sauce with your grandmother – or being punished as a kid.
Much research has been conducted on this subject, where members wrote for 15 minutes each on four consecutive days. These studies showed that writing about their most profound thoughts and emotions about traumas improved their mental state and generated a more positive outlook and better physical health.
EMDR stands for eye movement desensitization and reprocessing. EMDR is a relatively new therapy technique that focuses on helping you overcome traumatic events or other upsetting occurrences. It involves using specific eye movements while you review the memory. Bessel Van Der Kolk conducted research that revealed incredibly beneficial outcomes for those who used EMDR compared to those who used Prozac or a placebo.
Once a memory is created, it goes through a lengthy transformation. This unconscious process occurs in the mind without any involvement of the conscious self. When the memory is assimilated with other life experiences, it no longer has an independent existence. In PTSD, however, this process doesn’t happen. Instead, the memory is left raw and unprocessed.
A variety of therapeutic interventions, such as EMDR, yoga, neurofeedback, psychomotor therapy, and theater, are all designed to help regulate the intense memories associated with trauma and help to establish a sense of control and agency. Unlike traditional exposure treatment, EMDR does not spend an extended amount of time going over the traumatizing event. The trauma is still the initial point of focus. However, the main objective is to spark and open up the associative process.
Dr. Bessel and his staff conducted many investigations regarding yoga’s effects on the mind and body. Yoga is demonstrated to alter heart rate variability (HRV), a measure of the fluctuation in the intervals between each heartbeat.
This variability is regulated by the autonomic nervous system (ANS) – a primitive area of the nervous system that functions invisibly. The autonomic nervous system manages our heart rate, blood pressure, respiration, and digestion, among other vital activities.
HRV is an indicator of overall wellness. For example, those with a high heart rate variability are usually more relaxed and content. Bessel achieved great triumphs with yoga and created a therapeutic yoga program at their Trauma Center. After twenty weeks of practicing yoga, women who had experienced chronic trauma showed an increase in the insula and medial prefrontal cortex, both of which are associated with self-regulation.
Practitioners of yoga direct their awareness to their breathing and the sensations they experience from one moment to the next. As a result, they become aware of the link between their feelings and their body. People who took part in Bessel’s yoga research commented that:
- My emotions feel more powerful. Maybe it’s just that I can recognize them now.
- I can express my feelings more because I can recognize them more. I feel them in my body, recognize them, and address them.
- I now see choices and multiple paths. I can decide, and I can choose my life. It doesn’t have to be repeated or experienced like a child.
- I was able to move my body and be in my body in a safe place without hurting myself or getting hurt.
Those who feel secure in their physical selves can start to express memories that previously caused them too much distress.
Neurofeedback is a process of monitoring and responding to brain activity. Brain activity is measured by an electroencephalogram (EEG). Signals from the EEG are transferred to a computer and then converted into an auditory or visual representation.
This representation is then linked to a rewarding system on the computer, teaching the brain new ways of behaving. The training is beneficial, as it can help regulate the brain’s various functions, leading to improved states of arousal, focus, and calm.
Numerous studies have revealed that neurofeedback is a successful and time-limited treatment for ADHD and is as helpful as traditional medications. The advantage is once the brain has been trained to create the new electrical signals, no additional treatment is necessary. Compared to drugs, they only work while the patient takes them. Neurofeedback had one of the best outcomes ever recorded for PTSD.
The Body Keeps The Score Summary PDF
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There is no one-size-fits-all approach to healing from trauma. Each person will heal in a unique way. For them to do so, it is essential that individuals are involved in a supportive environment that supports their recovery.
Read inspiring quotes by Bessel Van Der Kolk: 36 Best The Body Keeps The Score Quotes
The most important thing is to remember that healing from trauma is possible and that you deserve to live a life free of the pain that trauma has caused you. After all, we are all created with the capacity to heal. When we can overcome the effects of long-term trauma and lead a meaningful life, we can give hope to those who are still suffering.
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- van der Kolk M.D., Bessel (Author)
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Although sometimes it may feel like the mental scars of trauma will never fully heal, with the right tools and support, we can begin to find peace and learn to love ourselves again. I hope you learn something from The Body Keeps The Score summary.
I wish you the best! Fabian
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