The Body Keeps the Score by Bessel van der Kolk emphasizes on the links between trauma, brain, memory, and the body. I picked up the book in a second-hand bookstore; I’d seen some talk of it on social media and I was curious (about both, the bookstore and the book).
The author could’ve begun the book on a better note than stories of American veterans from the Vietnam war. I can understand why it was included; trauma in veterans is well-known, even if it was not always acknowledged as such. While the author doesn’t expect the readers to sympathize with the patients, it’s difficult to concentrate on what the author actually wants to say about the psychological aspects. The jarring admittance of war crimes made me want to drop the book. Nonetheless, I forged ahead, curious about the rest of the content and now doubly curious as to why this book is popular.
We begin the book by looking at cases of PTSD in veterans and then in patients of varying backgrounds. PTSD was considered a formal diagnosis only in 1980 and the author goes on to illustrate that PTSD is not limited to war veterans but also applies to adults and children with history of abuse. When doctors label a patient as “difficult” or try to treat only the resulting behaviours of trauma, such as violent outbursts, engaging in dangerous activities, and anxiety and panic attacks, misdiagnosis and subsequent damage can create only more problems instead of healing the patient. The author writes how trauma reshapes brain activities, dis-regulates the nervous system, and causes other physical issues that may not seem related to the trauma. In certain cases, this can also lead to chronic illnesses. The brain and the body cannot be seen as disparate entities.
A patient’s childhood and upbringing is a key aspect that can affect a patient’s responses to trauma. Was there something in the person’s history that made them more susceptible to reacting in a certain way? What makes one person’s trauma reaction different from another’s, even when they’ve been through the same circumstances? What were some of the major differentiating factors? Here we get into childhood experiences, family dynamics, and, inevitably, Freud.
The book largely talks about trauma and how we can get stuck in the past, how our present is contaminated by the past, and how we can feel unsafe by mundane encounters and situations. The author stresses on creating a better relationship with ourselves, our bodies, and our past so we can be mindful about our thoughts and emotions and react to situations in a regulated manner in the present.
From here the author describes various methods to learn how to do this, reinforcing on being engaged in our own lives, being the driver behind our own decisions. This can be done by incorporating movement and joy in our daily lives. Activities like yoga, breath-work, sport, singing, and dancing are common ways of positively occupying the mind and body. These are also very human activities and you don’t need to be a professional to include them in your life. The author also brings up several other ways, including participating in theatre, EMDR, neurofeedback, and working with animals. Patients are demonstrated to respond well to a combination of treatments including drugs, there’s no one-size solution.
An essential part of a person’s healing journey is community. One person can only do so much on their own, and having safe and supportive relationships is integral for the person to feel more secure, to instill courage and hope for the future.
The author uses a combination of previous research and stories of real people from his experience to draw conclusions and provide suggestions. The book is targeted at both laypeople and his peers in the field of psychology and neuroscience. Through the examples and referenced research, the author asks us to look at the root causes of harmful behaviour instead of directly handling these by talk therapy and prescribed medications. Context and nuance is important in any discourse, and the author urges us not to just work with textbook definitions, but to also look at the specific patient’s story in order to address the resulting behaviour and physical symptoms in a holistic manner.
We cannot not include the political and economic conditions that also impact each of us. The author includes this point in the latter section of the book. Therapists must be open to learning from their patients, about their survival strategies, and how much their gender, race, and economic state play a role in them feeling safe and understood.
There’s lot more that the author talks about in the book, and a lot of it can be boiled down to how children were treated in their formative years. Applying concepts of neuroplasticity can help to rewire the brain in later years so the adults grown from difficult childhoods can learn to live fully. However, the damage occurs on a much larger scale than one can imagine. While the author only talks about the statistics in the US, child abuse is a global issue, a lot of which is perpetrated by parents and other relations. Abuse can be physical and emotional, it can be too much attention and complete neglect, it can be small grievances piling up in a dysfunctional family. At times, schools can worsen the injury.
The author raises valid points and the information on brain activities, the nervous system, and the consequent effects on the body was educational. I took my time reading this book, one chapter at a time, and taking notes as well. I came away knowing a little more about my self in the process. However, I’m not without complaints. Coming back to the topic of war veterans, it can be argued that this book is not about the ethics and morality of the author’s patients. I disagree. The author is clearly trying to help his patients live better lives, whatever that looks like for them. The author states the politics and people’s lives cannot be separate. The following excerpt is from the epilogue:
When I give presentations on trauma and trauma treatment, participants sometimes ask me to leave out the politics and confine myself to talking about neuroscience and therapy. I wish I could separate trauma from politics, but as long as we continue to live in denial and treat only trauma while ignoring its origin, we are bound to fail. In today’s world, your ZIP code, even more than your genetic code, determines whether you will lead a safe and healthy life. People’s income, family structure, housing, employment, and educational opportunities affect not only their risk of developing traumatic stress but also their access to effective help to address it. Poverty, unemployment, inferior schools, social isolation, widespread availability of guns, and substandard housing all are breeding grounds for trauma. Trauma breeds further trauma; hurt people hurt other people.
In the next paragraph, the author says the following:
My most profound experience with healing from collective trauma was witnessing the work of the South African Truth and Reconciliation Commission, which was based on the central guiding principle of Ubuntu, a Xhosa word that denotes sharing what you have, as in “My humanity is inextricably bound up in yours.” Ubuntu recognizes that true healing is impossible without recognition of our common humanity and our common destiny.
All well and good. So why am I bothered by the first chapter? In it, the author says: I could easily image how Tom’s (the veteran patient) rage about his friend’s death had led to the calamity that followed. It took him months of dealing with his paralyzing shame before he could tell me about it. Since time immemorial veterans, like Achilles in Homer’s Iliad, have responded to the death of their comrades with unspeakable acts of revenge. The day after the ambush Tom went into a frenzy to a neighboring village, killing children, shooting an innocent farmer, and raping a Vietnamese woman. After that it became truly impossible for him to go home again in any meaningful way. How can you face your sweetheart and tell her that you brutally raped a woman just like her, or watch your son take his first step when you are reminded of the child you murdered?
The author asks this as a doctor about his patient and wants to say that all people involved on all sides deserve a chance at life. Both the perpetrator and the victim. I don’t think this is valid in all cases. Especially not this one. We also have to ask ourselves why this was the veteran’s idea of taking revenge? Why did his friend have to die? Because the US government sent them, and they went. Probably believing the untruths that socialism in Vietnam is somehow a threat to America. Who killed his friend then? We know who killed the Vietnamese children. War is not an inevitable side effect of humanity. These are calculated decisions taken by a few at the expense of many.
How can you help veterans without going up against their own beliefs of war and their government’s actions? Call it radicalization if you must. Otherwise, the cycle keeps repeating with only more traumatized veterans and victims. I thought that the author would understand this since he “grew up in postwar Holland, playing in bombed-out buildings, the son of a man who had been such an outspoken opponent of the Nazis that he had been sent to an internment camp.“
It seems the author tries to walk a thin line of diplomacy. There was also no need to bring Achilles in the picture, a “great warrior and hero”. The reference doesn’t sit well in this context.
The book also faces criticism about pseudo-scientific claims from fellow psychologists and researchers. Some readers also thought that the author tends to victim-blame. The article What the Most Famous Book About Trauma Gets Wrong quotes multiple researchers who say that the author distorted their research results.
Having seen the critiques, I was left feeling a little deflated. I cannot say whether the claims are valid or not. I thought that a lot of the information was helpful, helping me take another look at my own behaviour, validating some of my own independent efforts to participate in my own life. Reading more books on similar topics and listening to other experts is one way to broaden my views and not consider one source as the holy grail. Nonetheless, I’d say this book is certainly informational, expanding the few ideas I had about the human psyche.
I may be digressing a bit but I also want to mention one of the side effects of consuming too much pop-psychology content: looking at every person’s actions and choices as something to do with their trauma or their upbringing. It definitely plays a huge role in who we are, and who knows just how much of our daily lives and interactions are ruled by our subconscious mind. Introspection is well and good but too much of anything is harmful. We may find ourselves unhelpfully engaging in mental gymnastics trying to understand ourselves or someone else. This bleeds into our everyday language and can create more friction when used incorrectly, as we see with “therapy-speak”, which can propagate misinformation, further stigma, or we can end up victimizing ourselves or others. To me, it also looks like the person using such language is trying to by-pass the actual issue.
Ultimately, it depends. There are times when understanding the various ways in which disorders can occur helps you understand other people’s motivations and sympathize with them. At the same time, it is unfair to think of people as only by-products of something that happened to them.
Humans can be so alluring and so disheartening.
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