Saturday, December 29, 2018
"The Body Keeps the Score" by Bessel van der Kolk, M.D. A Review
The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
Bessel van der Kolk, M.D.
ISBN: 9780143127741; $18.00
5 Stars of 5 Stars
After being struck by trauma – combat, auto accident, assault, abuse – why do the dreams come and come and come? From where does the anxiety, distractedness, or outburst originate? Are there reasons for the gut balling up into a knot and the chest squeezing tight and feeling like it will implode when unwanted memories of the distress invade? Why does the recall come in pieces, chunks, or flashes? And then there’s the inability to communicate, the mental shut-down, the emotional-frigidity; what is that all about? Is there any way to move from the trauma and its aftermath to some sense of genuine wellbeing? All of these subjects, and more, are covered by Bessel van der Kolk, founder and medical director of the Trauma Center in Brookline, Massachusetts, professor of psychiatry at Boston University School of Medicine, and director of the National Complex Trauma Treatment Network, in his 464 page paperback, “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma”. This volume is written for both the helping-professions technician and therapist, as well as for the traumatized and their families. With thousands of book reviews already posted and published, I’ll make this review brief.
“The Body Keeps the Score” unpacks the way trauma affects us, mind, brain, and body. The author looks at multiple forms of therapy, showing their strengths and limits. He recognizes that there are “fundamentally three avenues [of therapy]: 1) top down, by talking, (re-) connecting with others, and allowing ourselves to know and understand what is going on with us, while processing the memories of the trauma; 2) by taking medicines that shut down inappropriate alarm reactions, or by utilizing other technologies that change the way the brain organizes information, and 3) bottom up: by allowing the body to have experiences that deeply and viscerally contradict the helplessness, rage, or collapse that results from trauma” (3). Van der Kolk addresses each of these approaches while explaining in detail what harrowing ordeals do to people.
The author’s proposition through the pages is that the anguish of assault and abuse “changes brain development, self-regulation, and the capacity to stay focused and in tune with others…experiences change the structure and function of the brain – and even affect the genes we pass on to our children…devastates the social-engagement system and interferes with cooperation, nurturing, and the ability to function as a productive member of the clan” (349, 351). One of the aspects that surprised me was how the “ventral vagal complex” – the vagus nerve that interfaces with other nervous systems – takes what my brain is experiencing (even re-experiencing through PTSD, etc.) and mobilizes muscles, heart, lungs and other body parts, so that I feel the alarm – or helplessness – or grief in my brain all the way down into my chest and stomach! Which means my body begins to take on muscle-memory (as we put it in martial arts)! Therefore, if “the memory of trauma is encoded in the viscera, in heartbreaking and gut-wrenching emotions, in autoimmune disorders and skeletal/muscular problems, and if mind/brain/visceral communication is the royal road to emotion regulation, this demands a radical shift in our therapeutic assumptions (88). It’s this “radical shift in therapeutic assumptions” that dominates the authors final eight chapters, where he methodically explains different “paths to recovery”. This is truly a captivating read!
Van der Kolk weaves into the technical aspects of the book biographical and autobiographical tales that help the reader to see what has gone on, and not gone on, in the world of psychiatry and psychology regarding trauma. The stories also help to cement into the imagination and comprehension what he is trying to communicate. The book is reasonably technical with neuroscience, brain studies, physiology, professional acronyms and so forth. But the author is careful to not leave anyone in the dark. It is a fascinating read that treats the audience as mature enough to handle the subject and grasp the material. I disagreed with the evolutionary explanations of how the brain develops and found the little political rant in the epilogue disappointing. But beyond these, I was almost mesmerized by the book!
“The Body Keeps the Score” is a whole textbook on physiology, brain studies and neuroscience, as well as therapeutic theories. It is not a self-help book, but readers who are looking for help will likely find it beneficial. Helping professionals may also find it advantageous as the author has a plethora of notes on various studies and articles. But I think that the biggest value will be for those who have family members, friends, and parishioners that have been through violent experiences. It gives a bigger and better perspective on what is going on, and they will be able to draw from the various paths to recovery approaches they can take as they seek to be part of the remedy and not the trauma. I highly recommend the book.
· You can purchase the book here: The Body Keeps the Score