Book Review: The Body Keeps the Score, Bessel Van der Kolk (2014)

Finished 19 January 2021

trauma, PTSD, self-help, psychology, psychiatry, treatment, EMDR, therapy, movement, embodiment

This was a personal read after a long time of being recommended it. It was well worth the read and I only regret waiting as long as I did to read it. As informative about trauma as it is transformative, this book left me changed – more empathetic towards the flaws of others, and more accepting of my own.

In The Body Keeps the Score Bessel van der Kolk, a trauma expert and psychiatrist, helps readers understand the ways in which trauma manifests in the brain and body of survivors.

In the first part of the book, ‘The Rediscovery of Trauma’, he explains the origins of his interest in trauma as having come about while he was working with Vietnam veterans in the late 1970s. He covers a little bit of the history of how trauma and mental health have been clinically handled since the second half of the 20th century, addressing the rise of pharmacological treatments in a balanced way. By ‘balanced’ I mean that he shares the excitement of the medical community when it first became apparent how helpful drugs could be in treating poor mental health and PTSD in particular, as well as his disappointment when medication grew to such prominence that it now overshadows other treatment methods.

The second section of the book, ‘This is Your Brain on Trauma’, is in a sense the most scientifically detailed. Van der Kolk describes the various ways in which survivors of trauma continue to be impacted by their experiences. He pays particular attention to physiological responses (i.e. explaining how the parasympathetic nervous system is effectively ‘rewired’ by trauma, and how a lot of chronic pain can be traced back to traumatic experiences), but without neglecting the behavioural manifestations of living as a trauma survivor (i.e. the compulsion to return to traumatic contexts as abuse may the only place in which you feel truly alive) and the disconnection/depersonalisation that can come about between the body and the self.

In the third and fourth sections, ‘The Minds of Children’ and ‘The Imprint of Trauma’, van der Kolk covers some familiar topics such as attachment theory and repressed memories, as well as extensive consideration of how our early experiences will shape the kind of treatment we accept from others in adulthood. What makes the content come to life is his interweaving of client stories with clinical explanations, which in turn allows us to see the mechanics of how a survivor, for instance, might unwittingly enlist their partner, colleagues, friends or even therapist to re-enact their trauma.

The final section, ‘Paths to Recovery’, takes a different format as van der Kolk lays out some examples of alternative non-pharmacological therapies which can help trauma survivors to integrate their experiences and find some peace and freedom: talking therapy, EMDR, yoga, neurofeedback, community theatre, scenes etc.

This last section was both the most interesting for me, in the sense of added information to my brain, and the least personally resonant. I learned a lot about new treatments, as well as reading about treatments that have already helped me. The parts of the book that will really stay with me, however, are the middle sections. Perhaps one of the things which struck me reading this book was the way in which van der Kolk manages to express not just empathy but admiration and pride for his clients. He constantly reminds the reader that “many behaviors that are classified as psychiatric problems … started out as strategies for self-protection” and that “in an effort to shut of terrifying sensations, [trauma survivors] also deadened their capacity to feel alive”. For van der Kolk, the goal of treatment is to move beyond survival to a free and unfettered capacity to think, to play, to imagine and to feel joy. It is this focus on joy and the capacity to feel fully alive which made the book so powerful to me – here is someone who doesn’t just want me to be docile and non-suicidal, but someone who is passionate about allowing me to feel it all, and not just cope but thrive.

Some people I know found parts of the book too technical, but I really enjoyed the diagrams of the vagus, the fMRI scans and the discussion of whether mental activity is best understood in a chemical or electrical paradigm. I really struggle to find anything to critique about the book, so I won’t push myself to do so.

P.S. The line “most research is me-search” slayed me. See: this third culture kid that moved a lot as a child obsessively researching place, home and belonging.

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