“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.
Cover image: 2020 Succession H. Matisse / Artists Rights Society (ARS), New York Courtesty of the Archives Henri Matisse, All rights reserved.
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13 reviews for Amazon.com: The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma (Audible Audio Edition): Bessel van der Kolk M.D., Sean Pratt, Penguin Audio: Audible Books…
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Bianca Alecssia Gaina –
Es un libro que puedes leer sin saber nada de psiquiatría o psicología, trae incluso varios esquemas que explican todo muy bien. Me encanta que no es un libro tipo “superación personal” (que igual no tiene nada de malo), sino uno que relata con fundamento, casos reales y evidencia científica los procesos de trauma y recuperación. Personalmente, el proceso de lectura también sirve mucho para validar tus sentimientos, es muy bello❤️🩹
Elaine Way –
“The Body Keeps the Score” by Bessel van der Kolk is not just a book; it’s a guiding light through the labyrinth of trauma, offering profound insights and practical tools for healing. As someone who has experienced trauma firsthand, this book has been nothing short of life-changing in my journey towards understanding and processing my experiences.
Comprehensive Understanding: One of the most remarkable aspects of this book is its comprehensive exploration of trauma and its effects on the brain, mind, and body. Van der Kolk draws upon decades of research and clinical experience to provide a deep understanding of how trauma manifests physically, emotionally, and psychologically. His insights shed light on the complex interplay between trauma and various mental health conditions, offering clarity and validation to those who have struggled to make sense of their experiences.
Holistic Approach: “The Body Keeps the Score” emphasizes the importance of taking a holistic approach to trauma healing, addressing not only the psychological aspects but also the physiological and relational dimensions of trauma. Van der Kolk explores a range of therapeutic modalities, from traditional talk therapy to innovative approaches such as EMDR and neurofeedback, demonstrating how each can play a vital role in the healing process. This holistic perspective resonated deeply with me, providing a roadmap for integrating mind, body, and spirit in my own healing journey.
Practical Tools: What sets “The Body Keeps the Score” apart is its emphasis on practical tools and techniques for healing. Van der Kolk offers a wealth of exercises and strategies that readers can incorporate into their daily lives to regulate their nervous systems, cultivate self-awareness, and foster resilience in the face of trauma. From mindfulness practices to yoga and creative expression, these tools empower readers to take an active role in their healing journey, offering hope and agency amidst the darkness of trauma.
Validation and Empowerment: Perhaps the most profound impact of “The Body Keeps the Score” is its validation of the trauma survivor’s experience and its message of empowerment. Van der Kolk emphasizes that healing is possible, that survivors are not defined by their trauma, and that they have the capacity to reclaim agency and meaning in their lives. This message of hope and empowerment is a beacon of light for anyone who has felt lost or hopeless in the aftermath of trauma.
In conclusion, “The Body Keeps the Score” is a masterpiece of trauma literature that offers profound insights, practical guidance, and unwavering hope to trauma survivors and professionals alike. It has helped me navigate the darkest corners of my psyche, find solace in the embrace of community, and reclaim a sense of agency and purpose in my life. If you have experienced trauma or work with trauma survivors, I cannot recommend this book highly enough. It has the power to transform lives and ignite a path towards healing, one page at a time.
Billy Bruce –
A traumatic experience is any event or series of events that overwhelms a person’s ability to cope with the present moment, causes intense physical or emotional stress, and leaves a lasting impact on either mental, emotional, and/or physical well-being. Soldiers returning from war, children abused by their caregivers, and people who have experienced a sudden and shocking death or extreme tragedy are all prime candidates for trauma. It rewires our brain and changes “not only how we think and what we think about, but also our very capacity to think.” Trauma encodes itself in our brains, our minds, and our bodies, and after a traumatic incident, the world is experienced with a different nervous system now focused on suppressing inner chaos at the expense of active involvement in life. It burrows deep, and for some people, traumatic experiences can be very difficult to recover from.
This book is filled with both good news and bad news. The good news is that our understanding of trauma and how it affects us mentally, emotionally, and physically has greatly improved, as have the ways in which we treat it. The bad news is that sadly, trauma isn’t as rare as we would like to believe. Research 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.” This, of course, doesn’t include trauma we might experience as an adult like natural disasters, car accidents, or acts of terrorism, and, of course, the most common candidates for trauma: soldiers returning from war.
An important question to consider is what all of these disparate events have in common in the way they affect us, and the answer is in how the emotions we experience at the time of the trauma stay with us and become encoded in our brains, minds, and bodies. “Ideally our stress hormone system should provide a lightning-fast response to threat, but then quickly return us to equilibrium,” Van der Kolk writes, “in PTSD patients, however, the stress hormone system fails at this balancing act.” When something traumatic occurs it produces 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,”—it literally changes the way we see and understand the world around us and how we interact with it. Then, when something similar triggers us in the future, our brain and body react as if the traumatic event were happening in the present. We may not even be aware that we are re-experiencing and reenacting the past—all we know is that we feel furious, terrified, enraged, ashamed, or frozen. The continued secretion of stress hormones is expressed as agitation and panic and, in the long term, can wreak havoc with our health.
The most common example is the ex-soldier who hears a loud motorcycle and throws himself to the ground for cover because his body reacts as though it’s an enemy tank. It’s also true for the women (and men) who have been sexually assaulted and now can’t stand to be touched by anybody without it feeling like their attacker again. It is likewise true for the adult who was hit by their caregiver as a child and cannot figure out how to connect with others in an intimate way. In each scenario, when the stimulus occurs (a loud motorcycle, someone touching them, or their inability to connect emotionally with others) the brain, mind, and body react as though the original trauma is occurring.
So, what can be done to help people rehabilitate their lives after a traumatic experience? Van der Kolk devotes an entire section of his book to healing and makes a point to include strategies that not only attempt to soften the effects of trauma on the brain and the mind, but also on the body. For some people, talking about the traumatic event with a close friend or therapist is enough to get themselves back to a healthy internal state. The trick is to talk to someone who provides a sense of safety, because “being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives.” Van der Kolk suggests activities like yoga or theater to help us reconnect with ourselves in a physical way. Yoga’s central theme is connecting the breath to the body, which can directly target bodily tension left over from traumatic experiences. When it comes to theater, embodying a fictional character as they tell their story and go through a life transition can aid trauma survivors by helping them vicariously tell their own stories and go through their own transitions. “Traumatized people are afraid of conflict” he writes, and “conflict is central to theater—inner conflicts, interpersonal conflicts, family conflicts, social conflicts, and their consequences.” Performing in a play requires us to use our body, and, similar to yoga, being active in our body can help us locate places where we may hold tension from a previous trauma and help to release it.
An important first step is diagnosing people correctly. All too often patients with horrible histories of trauma are diagnosed with depression and prescribed a medication from a pharmacy which is the equivalent of putting a band-aid on a bullet hole. While depression may be an accurate description, clinicians need to go deeper and uncover what is at the root of the problem in order to treat it successfully because the emotions associated with the traumatic event are stored separately in the mind, brain, and body. Even with a prescription for medication, the right stimulus will send someone with PTSD right back to the pivotal moment in the past when the event first occurred, maintaining their inability to integrate the experience into their sense of self. “Normal memory integrates the elements of each experience into the continuous flow of self-experience by a complex process of association,”—but the problem with PTSD is that memories are dissociated. So getting a prescription from a doctor may block or numb some of the negative feelings, but it doesn’t heal the patient.
Van der Kolk pinpoints childhood as the location of much trauma and describes how “child abuse and neglect is the single most preventable cause of mental illness, the single most common cause of drug and alcohol abuse, and a significant contributor to leading causes of death such as diabetes, heart disease, cancer, stroke, and suicide.” We need caregivers who support and love us in our infancy so that we can develop proper relationships with the other people and experiences we will encounter throughout our lives. This is the same for adults who suffer traumatic experiences—we need people we can trust to support us through the healing process. We need to recognize that trauma imprints itself in our brains, our minds, and our bodies, and that treatment and therapy should target all of these areas so as to best help us heal mentally, emotionally, and physically. It takes the right diagnoses, a proper support network, and the time and perseverance required to do the work. Both individually and collectively, we can heal from trauma, for if all we know is fear, then that’s all we’ll ever know.
For those looking for more information about trauma, its symptoms, effects, and how to heal from it, this book is a wonderful place to start.
Expressed Reviews –
It’s a deep, enlightening dive into a wholistic view of how we respond to trauma and the work in progress to address it. Enjoyed it!
Amazon Customer –
One of the rare books that remains in New York best sellers list for years. Still reading it but the book is crucial in psychology and contains heartbreaking stories with a real life hard experience stories some ending with successful relief and just surviving for others.
JBM –
If you struggle with anxiety, panic attacks, or find yourself constantly ruminating and self-sabotaging, this is the most important book you will read. For anyone who has navigated emotional neglect, a chaotic childhood, or trauma—and perhaps uses addiction to cope—this book offers a completely new perspective.
The Body Keeps the Score connects your biology with your biography. It explains how your past experiences physically rewire your brain and nervous system, making sense of the confusing emotions and reactions that can keep you stuck. It validates that these struggles aren’t character flaws; they are physiological responses.
What truly surprised me was Dr. Bessel van der Kolk’s empathy. It is rare to find a scientific text that feels so deeply human. You can tell he genuinely cares about his patients and understands the pain of trauma survivors. It bridges the gap between hard science and human compassion in a way that just clicks.
I am incredibly grateful for this work. It provides clarity, hope, and a roadmap for understanding yourself. A masterpiece for anyone looking to heal.
As for the physical book, the print is slightly on the smaller side and the paper quality is okay but I was too captured by the words to care about the physical quality and you shouldn’t care either.
Skeptic60 –
“I think this man is suffering from memories.”
So, this book changed my life. No, really. In fact, it’s *saved* it.
I have severe PTSD. And despite years of therapy, it seemed to be getting worse instead of better. My flashbacks were occurring more and more often. I was becoming more and more lethargic and frozen in time. And suicide was constantly just *there* in my mind. Constant. I’d even set a date.
And then my insurance quit paying for my therapy.
As a last, desperate grasp for help, I started to read this book.
I have never read anything more validating and more hopeful. To see the brain scans and hear the science that explained *exactly* what has happened to my brain, what is going on during my flashbacks and why I’m always physically sick—all the times I’ve gone to a doctor in pain or feeling like I’m having a heart attack or a stroke only to be told they can’t find anything wrong—brought me to tears. It gave me all the answers I’ve been searching for. It gave everything a scientific, medical explanation—and a path to *healing*.
He explained why all of my EMDR therapy wasn’t working—it was because my therapists (bless them!) were doing it wrong. And I’ve been able to take what I’ve learned from my therapists and this book and do EMDR on my own, and today… today I feel more like my old, genuine self, than I have in *years*. The shadow of suicidal thoughts no longer follows me. I feel *light*. And I have *hope*—genuine *hope*—that I actually *can* get better! I’m always telling people *they* can get better and there’s hope for *them*… but I haven’t felt that way about myself. Now, I do. I haven’t had that hope in a long, *long* time. And I even think, after years of struggling and finally making such great progress in such a short time, maybe—just maybe—I can be cured. I never thought I’d say that! The future is so exciting to me now!
If you have trauma, do be warned—Dr. van der Kolk talks a lot about his clients and their traumatic experiences and it can be very triggering. Some of the details I felt he definitely could’ve left out, honestly. However, the scientific information, the validation and the information on how to heal trauma, has made this book absolutely *priceless* to me. It’s my trauma bible. I’ll be re-reading it in the future and constantly referring to it.
Edit: I keep seeing reviews on here from people who were super upset by the story of the Vietnam vet who murdered a family, raped the mother and left her to die. Honestly, I flipped out at that part, too (aka, had a flashback), in large part because I misunderstood what Dr. van der Kolk was trying to say. I thought for a moment that he was trying to justify what the man did, and had to email my old therapist about it. She read the scene and encouraged me to reread his conclusion, and pointed out to me that he’s actually saying how difficult it was to try to treat him objectively because what the man had done was an absolute atrocity. He never actually justifies it. He calls it an atrocity. It’s just worded weird, and if you’re already triggered by what you’ve just read, it is *easily* misunderstood. I hope he clarifies this in future editions. You have to keep in mind that, van der Kolk’s target audience is actually other therapists. For this reason, it *was* difficult for me to read. I was violently attacked and molested at 5-years-old and repeatedly raped and abused as a teenager. His going over other people’s abuse is overly detailed at times and I had to skip many of those scenes.
However, I don’t hold any of this against him at all. The information in this book has changed my life, I feel seen and validated, and I stand by that almost a year after reading it. I keep it right on my writing desk where it’s easily found for reference. Am I cured yet? No. Did my flashbacks stop? Nope. This year has been an unexpected nightmare full of triggers. But I’ve made *so* much progress. And I have hope. And that’s what I need to make it through each day. I sincerely believe that, through a lot of work (which I’m willing to do!), I can be cured in time. And all of that started with this book.
Cody Allen –
This is unquestionably the finest and most useful book ever written on the subject of trauma. Bessel van der Kolk M.D. has the incredible gift of being able to write a book on the subject of PTSD, and doing so in a way that is useful for clinicians, as well as for the general population. He does so in a matter of fact way, and makes the reader feel as if he/she is sitting by his side listening to him telling a story. He has the extremely rare ability to get through to the masses, and to do so without any pretense whatsoever. He seems like the kind of guy you could become friends with after meeting for just 5 minutes.
The author speaks unequivocally about the dangers of trauma, and the lifelong suffering of individuals. He provides concrete solutions and a plethora of resources to help those who’ve been suffering for years, decades or even lifetimes.
His ability to simplify the complex, is the cornerstone of this watershed book. Without doubt, the material presented by the author will be life changing, in that it provides brilliantly written examples of patients who’ve suffered from PTSD, and having been cured by using his methodologies.
This book is living proof that it’s possible to present vital information in a format that provides for easy assimilation by a person suffering from PTSD, and enabling them to adapt to a new environment of freedom from harrowing nightmares and flashbacks. A seemingly impossible or at least improbable resolution to the above issues is made a whole lot easier by following the guidelines of the author.
The writing style of Bessel van der Kolk M.D., is one of empathy and compassion throughout. There are no condescending remarks, nor anything other than some of the most useful and accessible information that I’ve ever come across. This is not just a brilliant book, it’s a once in a lifetime read, that in my opinion will be the go to resource on the subject of trauma and PTSD for generations to come.
The author goes out of his way to provide easy to understand and follow explanations that will be universally helpful to both patients and mental health professionals. This is hands down, the most readable and accessible book about PTSD ever made available to the general population.
Having a background in psychology, I was in total awe at the material presented in this book. It’s a must read for all clinicians in the field, and is written in such an accessible style that patients suffering from PTSD will find it the most valuable resource they’ve ever been presented with. It’s simplicity and usability leaves material listed in lesser books in the dust. It takes an exceptional talent to be able to write a book that is equally valuable for both clinicians and their patients. This is a book for the ages.
Not just providing case histories and methodologies for conquering the devastating effects of PTSD, this book also provides invaluable resources for both clinicians and patients. Bessel van der Kolk M.D. has written the most informative, and highly readable book on PTSD ever published, period. Look no further, this is as good as it gets, a truly impressive and exceptionally well written book.
Junaid –
Trauma touches plenty of people worldwide (way too many, sadly); it affects our brain, behavior, emotions, decisions, social interactions and of course, as the title of the book states, “the body keeps the score”.
Dr. Bessel van der Kolk shares such valuable and intriguing information about trauma and the long and complex healing process, I wouldn’t even be able to pick the most important parts, as everything written is so interesting and useful to know.
I learned a lot; just to make an example, irrational behaviors of traumatized people I encountered in the past started to make sense while I was reading, because trauma can make people act in ways that look illogical from the outside.
It has also been very helpful to better decipher myself, my own brain and my reactions to specific situations.
I wouldn’t say, even if I had some, that previous knowledge in psychology and psychiatry is required to comprehend this book, as the author is very skilled when it comes to explaining difficult concepts in a clear and understandable way.
Even if you haven’t experienced trauma yourself, it’s more than likely someone close to you, unfortunately, has; this book can be really helpful to better understand how trauma works, how it can make people feel like they don’t even exist, and you might find the explanation to others’ actions and responses that you considered unreasonable, exaggerated, disproportionate or aggressive.
Needless to say, I obviously recommend this book!
S. Rose –
Must read for anyone who has experienced trauma, which is all of us, really, to some degree.
He tackles some big ideas in accessible language and gives people some tools to work on.
Tom Cloyd, MS MA –
I bought this book once before and couldn’t get into it. Now that I’m processing my trauma it really resonates. I think a person needs to be in a state of mind that allows research and data to sink in.
This book starts at the beginning of a doctor’s career and follows his path to research. He’s a real guy who studies the connection between the mind and the body and how it all relates to past trauma. I have severe PTSD and I can totally relate how my body manifests trauma and even more so after reading some of this book. It’s a very readable research book and I look forward to continuing my read.
Billy Bruce –
Like millions of others, I read The Body Keeps the Score and felt seen for the first time in my life. It is a masterpiece of artistic and poetic observation—a heartbreakingly accurate description of what it feels like to live with a hijacked nervous system. But when I got to the solutions section, I felt utterly exhausted. Yoga?! Theater?! Chanting?! These are wonderful “soft therapies”, but asking a person with severe PTSD to meditate their way out of a panic attack is like asking someone with a broken leg to run a mile in four minutes.
I was left with the question: Okay, the body keeps the score… but how do we wipe the scoreboard clean?
Dino Garner’s Silent Scars, Bold Remedies is the answer to that question. I looked him up on LinkedIn. Very impressive background in many areas, all of which he brought to bear in his landmark book, Silent Scars, Bold Remedies. I heard a podcast of him telling the audience how he taught medical school and discovered that not a single student who was to become a psychiatrist knew anything about physics, or chemistry or basic mathematics, not much less basic neurochemistry. When I heard that it made sense that Dr. van der Kolk spoke in metaphors and poetry. He truly didn’t know anything about the hard science that Garner brings to bear in
Silent Scars, Bold Remedies.
If van der Kolk wrote the biography of the ghost in the machine, Dino Garner has written the schematic, checklists and training manuals for the machine itself. His book moves beyond the poetry of suffering and gets straight into the hard engineering of the injury. And Dino Garner also includes MANY beautiful charcoal drawings and first-hand accounts and stories from people of all walks of life. Garner’s book is “van der Kolk’s book gone nuclear”, you ask this old guy.
Here is the forensic difference that blew my mind:
The Old Paradigm (van der Kolk): Focuses heavily on the Vagus Nerve (the body’s “brake pedal”) and tries to strengthen it through breathing and mindfulness.
Garner’s Paradigm: Recognizes that if the “gas pedal” (the Stellate Ganglion) is physically jammed to the floor, pumping the brakes won’t work. You have to pop the hood and fix the stuck accelerator.
This was the lightbulb moment for me. Garner dives deep into the molecular and biophysical basis of trauma—specifically chemical things like Nerve Growth Factor and cytokines and neuroinflammation and sympathetic nerve sprouting—concepts that are completely absent in The Body Keeps the Score. Garner was a biophysics researcher for many years and an expert in the hard sciences that psychiatrists lack. Garner explains that PTSI (and he rightly calls it an Injury, not a Disorder) is a hardware failure, not a character flaw as van der Kolk says in so many pages.
The sections on the Dual Sympathetic Reset are revolutionary. Garner explains how a precise medical intervention can do in 15 minutes what years of talk therapy failed to achieve. It’s not magic, guys, this is realife biophysics in action. Garner also has around 200 pages of recent references and citations, from books to reviews to scientific papers. Those sections I’ve never seen in any other book on PTSD. Garner also included a SUMMARY for each book and paper. That was worth the price of admission!!!!!!
Do not get me wrong—The Body Keeps the Score is a necessary book and beautifully written in such artistic form. It validates the pain. But Dino Garner’s Silent Scars, Bold Remedies discovers, researches, analyzes, and validates the actual cure. It is the missing second half of van der Kolk’s poetic trauma conversation.
If you are tired of “managing” your symptoms and want to understand the mechanics of actually fixing them, skip the yoga mat and read Dino Garner’s book. As if not enough, Garner launched a new series of books, Silent Scars, Bold Remedies – The Emerging Science Series, as ebooks. They’re here on amazon. They go deeper into specifics about ketamine therapy, weaning yourself off antidepressants, the vagus nerve, and stellate ganglion block and dual sympathetic reset treatments.
For those of us not properly schooled in math, physics and chemistry, Dino Garner has also presented Healing In Plain Sight, a book that is the reduced version of Silent Scars, Bold Remedies. Garner took out almost all the science, medicine, technology stuff and hardcore text that would probably drive people who failed chemistry in high school crazy. Healing In Plain Sight is chock full of all the beautiful charcoals, stories, If-Then and Take The Step guidances, and special stories at the end of each chapter.
One again, I loved reading Dr. van der Kolk’s The Body Keeps the Score! I highly recommend it to all. But if you want to heal your biological body and mind, read and study Dino Garner’s Silent Scars, Bold Remedies!!!!!
Cody Allen –
Psychiatrist, professor, world-class researcher, and traumatologist Bessel van der Kolk MD requires no introduction to trauma psychotherapists. My enduring impressions of him over many years is one of relevance, cogency, frankness, and accessibility – served up with a subtle dash of impishness. He tends to be a bit disruptive – something of a provocateur – and everything of his I have ever read has taught me something, confirmed something important, or pushed my thinking in a new direction. When he has something to say, I want to hear it.
However, I almost didn’t buy this book: I was put off by the title. Familiar with major reviews of PTSD psychotherapy outcomes research, I know that research support for body-oriented approaches to treating psychological trauma psychopathology is thin at best, and such treatment models simply do not have the research validation of either EMDR (Eye Movement Desensitization and Reprocessing) and PE (Prolonged Exposure), neither of which are especially body-focused.
J. Interlandi’s excellent article anticipating publication of this book – “A Revolutionary Approach to Treating PTSD” (New York Times Magazine, 2014.05.22 – available online) – initially supported my fears that for some inexplicable reason van der Kolk was now promoting some treatment model for which we have little confirming research. “Psychomotor therapy is neither widely practiced nor supported by clinical studies,” Interlandi informs us. Provocateur he may be, but I’m strongly biased in favor of paying attention to therapies for which we do have solid empirical validation. Our clients do not deserve to be experimental subjects – maybe not even if they agree to this, as I’m not sure they can ever know enough to make a truly informed consent. Knowledge that PTSD and related disorders are usually highly curable, when using the right treatment protocols, sadly remains the possession of a minority of people, even in the professional psychotherapy world.
Yet the account of van der Kolk’s therapy work in Interlandi’s article is gripping. Becoming completely absorbed in the account, I was convinced. (I’ve been here before, reading van der Kolk’s own accounts of his work.) And so the disruption begins! Deeper into the article, he has me. Van der Kolk’s critique of CBT (cognitive behavioral therapy – a general class of therapies) and PE (E. Foa’s exposure therapy model) is withering and correct: neither really work. “Trauma has nothing whatsoever to do with cognition…It has to do with your body being reset to interpret the world as a dangerous place….It’s not something you can talk yourself out of.” Interlandi reports that “That view places him on the fringes of the psychiatric mainstream.”
But he’s right, and I can’t stress this enough. Why? Because as a trauma treatment professional I’m well aware of what the trauma treatment outcomes research actually says. The best current summary of this research well may be chapter 2 of Ecker, et al.’s (2012) “Unlocking the emotional brain”. (Buy this book, too!) Ecker et al. brilliantly presents a synthetic summary that encompasses 11 existing therapy models which actually DO cure trauma psychopathology, if done right. In this context, what van der Kolk is doing makes perfect sense. Finally, it appears, the trauma psychotherapy field is moving toward a consensus which has strong credibility.
Van der Kolk’s new book has many virtues. Parts One and Two (102 pp) provide a substantial review of the neuropsychology of trauma’s impact on a person. It’s fun, interesting, informative reading, for professional and layperson alike. Part Three (64 pp) surveys childhood development, attachment experience, and “the hidden epidemic of developmental trauma”. Van der Kolk has for years been a leading champion of the idea that there is a type of PTSD which substantially differs from all the rest. It develops in response to chronic child abuse and/or neglect. I completely share his belief that the diagnosis of Developmental Trauma Disorder (sometimes called C-PTSD, with “C” meaning “Complex”) is overdue for formal recognition. I find his review of the struggle to legitimize DTD as gripping and distressing as anything else in the book. It is anguishing to know that a major problem exists, AND that the psychiatric establishment simply refuses to acknowledge it. DTD/C-PTSD is no fantasy. We see and treat these people, as children and adults. They exist, and they are nothing like “ordinary” PTSD treatment clients.
Part Four (29 pp) focuses on memory. I’ve long thought that much writing on treating psychological trauma seems to miss the point: trauma memory is what causes the problem. Deal with that and the symptoms vanish. Why is this so hard to understand? Yet, it is not a common understanding at all. Explaining how trauma memory works is invariably enlightening to my clients. And experiencing what happens when we change the nature of trauma memory is revelatory to someone who’s lived with it for years, if not decades. As he does throughout the book, van der Kolk offers fine stories about clients who have experienced exactly what I’ve seen happen in my clients, making excellent use of what cognitive research tells us: people understand things best through narratives. Offer a good narrative and you convince.
Psychological trauma therapy is complex, but we are now well prepared to launch into the book’s core content – Part Five (154 pp), “Paths to Recovery”. He gets right to it: we cannot undo the trauma, but we CAN undo its effect on us, and so get our “self” back. Ch. 13 reviews existing therapies. His approach is to repair “Descartes’ Error” (see Damásio’s 1994 book of that title) by viewing mind and body as a single coherent functional unit. His topical coverage is complete and his critique of current therapies acute – not to be missed.
He then writes of the importance of language (Ch. 14). We construct our narrative mainly in words, and the words we choose are critical. But language is not enough (this anticipates his next two chapters). Our senses encompass a larger world, and it’s center is our body, where all our sensory receptors are located. Then he introduces the treatment model he’s long advocated: EMDR (Eye Movement Desensitization and Reprocessing). I’m trained in EMDR, and in fact van der Kolk and I had the same instructor for our advanced training: Gerald Puk PhD. Van der Kolk tells an amusing and self-deprecating story about his advanced training experience, in which Puk was able to provide a strong corrective to his approach to clients. This is typical van der Kolk – he’s a truth-teller, even when it may put him in a poor light! And,after all, at this point he has nothing to prove to anyone.
Finding an EMDR therapist is not hard (see his “Resources” section). Nor is it hard to find a yoga instructor, and yoga is what he advises for helping a trauma victim get back into their body. Yoga is a wise choice, because it is available, already widely known, and adaptable to a wide range of individuals and capabilities.
There is much more in Part Five, and the focus is on self-empowerment. “Victim no more!” as they say. Most trauma therapists have a keen interest in seeing their clients leave therapy charged up and ready to fully embrace their life – that certainly is my own emphasis. Van der Kolk’s thoughts on self-empowerment for those in recovery from psychological trauma will be invaluable to any trauma psychotherapy client.
For psychotherapy professionals, this book will be both delightful and confirming. For everyone else, it will be a readable, gripping, highly educational tour of topics all of which are critical to a successful transition back from the impact of psychological trauma. That he gives prominent though not dominating emphasis to developmental trauma disorders is entirely appropriate. Our society has yet to grasp that child abuse and neglect is a more often chronic than not, and that its impact is largely ignored and poorly treated, if at all. This does not have to be. Get educated (this book will do that), then commit to being an advocate for children as well as for adults impacted by trauma. They all deserve the chance to be healed, and we can now do that. Van der Kolk shows us how.
The physical book: Jacket design is pleasant and interesting. Binding is less so: color of spine wrapping is semi-florescent, and of paper, not cloth. The book feels substantial and pleasant to hold and look at.
Organization –
* 6 pp: prefatory praise by peers and related luminaries (interesting comments from some important people in the field);
* 2 pp: Table of Contents;
* 356 pp: actual text;
* 4 pp: Appendix: Consensus proposed criteria for developmental trauma disorder
* 3 pp: Resources
* 4 pp: Further reading
* 51 pp: Notes
* 21 pp: Index