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 important, from his patients. The Body Keeps the Score is, simply put, brilliant. Onno van der Hart, PhD, Utrecht University, The Netherlands; senior author, The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization
The above quote represents one of many rave reviews for trauma expert/researcher/therapist Bessel van der Kolk‘s The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma (2014). Van der Kolk is the founder and medical director of the Trauma Center in Boston.
Examples of the types of therapy he endorses for trauma survivors include psychomotor therapy (which a dancer originated), yoga, karate, emotional freedom technique (also known as tapping), and EMDR for acute cases such as those that stem from single incidents.
Jeneen Interlandi, New York Times, explains the author’s view of trauma and the body:
Trauma victims, van der Kolk likes to say, are alienated from their bodies by a cascade of events that begins deep in the brain with an almond-shaped structure known as the amygdala. When faced with a threat, the amygdala triggers a fight-or-flight response, which includes the release of a flood of hormones. This response usually persists until the threat is vanquished. But if the threat isn’t vanquished — if we can’t fight or flee — the amygdala, which can be thought of as the body’s smoke detector, keeps sounding the alarm. We keep producing stress hormones, which in turn wreak havoc on the rest of our bodies…
Among other things, Van der Kolk is working currently on redefining trauma, according to Interlandi, which includes not viewing all trauma-involved conditions as cases of PTSD. For instance, he and his colleagues call one chronic form of traumatic stress “developmental trauma disorder,” a diagnosis they tried but failed to get accepted into the newest DSM. They persevere, however, in educating others about this and other facets of their trauma research.
We have learned that trauma is not just an event that took place sometime in the past; it is also the imprint left by that experience on mind, brain, and body.
Being traumatized means continuing to organize your life as if the trauma were still going on—unchanged and immutable—as every new encounter or event is contaminated by the past.
Trauma affects the entire human organism—body, mind, and brain. In PTSD the body continues to defend against a threat that belongs to the past. Healing from PTSD means being able to terminate this continued stress mobilization and restoring the entire organism to safety.
Trauma victims cannot recover until they become familiar with and befriend the sensations in their bodies. Being frightened means that you live in a body that is always on guard. Angry people live in angry bodies. The bodies of child-abuse victims are tense and defensive until they find a way to relax and feel safe. In order to change, people need to become aware of their sensations and the way that their bodies interact with the world around them. Physical self-awareness is the first step in releasing the tyranny of the past.
Many of our patients are barely aware of their breath, so learning to focus on the in and out breath, to notice whether the breath was fast or slow, and to count breaths in some poses can be a significant accomplishment.
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