The Body Keeps The Score by Dr Bessel Van Der Kolk- Book Summary

This is a kind of long, meaty book. Definitely worth every minute if you or someone very close to you suffered any serious trauma. There should be a trigger warning however, as Dr Van der Kolk shares dozens of stories of trauma that his patients had experienced, all of which were severe. This is actually the reason why I've been really wanting to write this book review: the information from the book is incredibly valuable and I want it to spread and have it be shared and shared. But the traumatic stories within it make it hard for me to recommend, because I don't know people's sensibilities. While the stories do weigh on me, I find it personally important for those of us who can, to hear the hard stories and hold them with those who actually suffered the events. I believe in a collective solidarity and that action to improve what we can in society will only be taken if there are those willing to subject themselves to the dark truths enough to be as informed as possible and be moved to action. Even simple actions like signing a petition, voting for important changes, donating money to a cause, or volunteering for an organization that helps.

So here's the important information as best I can give it:

For this summary, if you want to skip the brain stuff and just get to part about what to do about trauma, jump to the last third.

Book summary:

During traumatic events or in environments of traumatic abuse, our brains get fused with neural pathways that are meant to protect us.

Our brains pick up on sights, sounds, smells, textures and tastes and then remembers them as dangers. Then we literally can't stop our body from reacting in fear and terror whenever our brain is triggered with a sense of danger. It's the amygdala acting as part of our autonomic nervous system, a system that is literally automatic. Sometimes our reaction is to fight (get angry), flight (flee and distance ourselves), or freeze (get quiet and small or literally blank out).

It is not uncommon for people with trauma to have no memory of the events. They may have blanked out during the events or their brains cut the memories out for self preservation.

It's also common for people with traumatic backgrounds to have periods of time outside of the actual trauma, where they blank out and have no memory.

Alternatively they might have vivid memory of the trauma and experience flashbacks that send them into extreme fight or flight response, reliving the trauma over and over and over, and without knowing when it will strike. It causes a constant state of fear, caution, and either disassociation or fast, big emotions.They may act erratic and get angry easily. They may have adhd and not be able to focus. This is all because their sensory intake is alarming their brains so frequently.

Their thalamus brain system, which receives sensory information and then filters the important information to pass on to the rest of the brain, has been trained to receive information associated with their trauma, however benign it actually is, and then activate the fight or flight responses in the body. So their brains are working with all their energy to scan their environment for danger and react to it. Being overly stimulated constantly, they become experts at ignoring their senses; they don't pick up on real warning signs of danger and they exhibit a profound lack of physical coordination. They are in a way, disembodied.

If they experienced childhood trauma, they may have developmental delays. This is due to many reasons: not only do they struggle with the same mental disorders stated above, but they are expending so much energy trying to survive and manage their bodily systems, there is little left for growth and on top of that, the world is not a safe place for play or imagination, an important part of growth.

Childhood trauma is often manifested by extreme behaviors on either end of the spectrum of extreme compliance vs disruptive/ defiant. They are playing out their freeze or fight instincts.

Symptoms of trauma in children and adults include a wide range. Their bodies are often in a push and pull between their worn out sympathetic nervous system (SNS) and then their over-compensating parasympathetic nervous system (PSNS). These systems control heart rate, breathing rate, blood pressure, pupil size, blood flow and digestion. One auto system response speeds them up, getting ready for action, while the other slows them down for rest. This extreme push and pull, causes people living with trauma to frequently be in a state of depression and anxiety. And there are many other long term health problems that arise from the strain on these systems, such as IBS and fibromyalgia. In one study, blood samples from trauma victims revealed a much higher ratio of a specific antibody than the average person has, leading to a hyperactive immune system and consequently, many of them develop autoimmune disorders. Irregular and unpredictable dopamine and endorphin levels also wreak havoc on their mental well being.

Their social life and relationships are also fraught. Aside from attention problems and memory problems, their "danger" sense is over active and consequently, so is their fight or flight response. If they experienced childhood trauma at the hands of a care giver, they most often have difficulty trusting others. Their attachment bonds are not very resilient, and so they give up on relationships easily, and often sabotage the relationship with their trauma induced reactions.

And so with a record of broken relationships and fear inducing situations, traumatized individuals view the world as a place of danger and rejection. It has been consistently observed that these individuals have a lack of imagination. They simply can't see a hopeful way forward.

In a surprising study of children and their mothers, starting at the child's infancy and followed over 20 years, it was found that the most damaging treatment of babies from their mothers, was not the hypothesis of physical harm to them, but rather neglect that had the worst affect. If a child

The largest network in the parasympathetic nervous system is the Vegas nervous system. This Vagus nerve is responsible for changes in our our voice box, our lungs, our

There is real hope for victims of trauma to find healing and peace. Van der Kolk discusses three different approaches to treatment.

1. Top Down: Talking, connecting with others, and connecting with our emotions.

2. Treating Symptoms: Medicines and treating each disorder as it's own problem, without addressing the trauma.

3. Bottom Up: Providing the body with experiences that allow the person to synchronize with others, re-calibrate their sensory intake, and challenge/ contradict the helplessness they experienced during their trauma, completing the cycle of the brain's arousal because of danger, action, and then return to safety.

Top Down Treatments:

This involves revisiting the trauma and it's details with language and then expressing the feelings drawn out. This can be transformative in some ways, but has limitations. A study of brain scans of people while they experience traumatic flashbacks, showed that the area of the brain on the left hemisphere in charge of speech, called Broca's area, shuts down during trauma or flashbacks. While areas on the right, in charge of sensory registry, called Brodmann's area lit up during the traumatic flashbacks. Through other studys of different talking treatments, it was concluded that while language expression can be helpful, reasoning and understanding does not make much of a difference for symptoms of trauma.

Cognative Behavioral Therapy, or CBT is one variation of a talking therapy. It has shown success for those with irrational fears that are not associated with trauma, such as fear of heights or fear of spiders. But is much less successful for treating trauma. For those with PTSD, only 1 in 3 showed improvement after 6 months of CBT, and of those, they still struggled with many symptoms. It is particularly not helpful for those with histories of childhood abuse.

Treating Symptoms:

People are most frequently diagnosed with disorders without a doctor asking any questions about any history of trauma. So traumatized individuals often have a list of disorders, and medications for each one. This approach is by far the most common. While Van der Kolk witnessed the amazing results for patients with the advent of incredible medicinal breakthroughs like prozac, he also witnessed the medical world turn away from other psychological approaches and treat everything with medication. But unfortunately, medications come with many unhelpful side effects, and they are essentially only a bandaid for an underlying problem. And while this definitely has its place in the world, to help individuals function and have better quality of life temporarily, they would need to continue for one's life in many cases, causing many other health problems, relationship problems, job problems, and costing time and money without an end, never getting to the root of the problem.

Bottom Up:

This brings us to the many methods that Van der Kolk has seen transform PTSD patients from having extreme symptoms that interfere with the persons all of the time, to resolution with the past and peace with their feelings and their life. And in many cases, this occurred in only one session. These are treatments that involve movement of the body designed to re-establish proper connections with bodily sensations and synchronize with other individuals, feeling loved by someone while being fully understood about their traumatic story, and physically, viscerally replaying the trauma with a way to play out a different ending so that the person can experience in 3 dimensions the expression of their own power, and overcome the feeling of helplessness.

Treatments:

EMDR. Eye Movement Desensitization and Reprocessing is a technique that involves a patient moving their eyes back and forth, as happens during a rapid eye movement cycle of sleep, or using a rhythmic motion on the body while recounting their past trauma and reprocessing it with a therapist. This is a form of talk therapy mixed with bodily connection. It has shown impressively good results for PTSD patients, particularly those who expereienced trauma as an adult. For those with histories of trauma as a child, especially from a caregiver, the results are mixed.

Drama (acting as another person with feeling and empathy).

2. Group support 3d representation of childhood figures.

3. Body rhythm through dance or song or drumming or yoga

4. Breath work

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