• Toby Sinclair

The Body Keeps The Score Summary By Bessel Van Der Kolk

Updated: Jul 6


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⭐ Toby's Rating: 6/10 - Recommended For: Coaches


A fascinating exploration of a wide range of therapeutic treatments shows readers how to take charge of the healing process, gain a sense of safety, and find their way out of the morass of suffering.

— Francine Shapiro, PhD, originator of EMDR therapy


3 Big Ideas 💡


The three big ideas in this The Body Keeps The Score Summary:


  1. For real change to take place, the body needs to learn that the danger has passed and to live in the reality of the present.

  2. Being traumatized is not just an issue of being stuck in the past; it is just as much a problem of not being fully alive in the present.

  3. Nobody can “treat” a war, or abuse, rape, molestation, or any other horrendous event, for that matter; what has happened cannot be undone. But what can be dealt with are the imprints of the trauma on the body, mind, and soul.


2 Best Quotes 💬


The Body Keeps The Score Quotes

Learning how to breathe calmly and remaining in a state of relative physical relaxation, even while accessing painful and horrifying memories, is an essential tool for recovery.
Traumatized children have fifty times the rate of asthma as their non-traumatized peers.

Tobys Top Takeaway


The Body Keeps The Score summary is a fascinating exploration of trauma. I particularly enjoyed the analysis of different approaches such as talk therapy. The Body Keeps The Score shares that talk therapy, although widely used, often does not lead to long term improvement. Instead, a range of other techniques has been proven to make a lasting change. These include mindfulness, relationships and human touch.


Highly recommended for people in helping professions such as coaches, mentors and therapists.

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Big Idea Expanded 💡


The Body Keeps The Score Summary expanded for each of the big ideas.



What is trauma and its effects?


“The task of describing most private experiences can be likened to reaching down to a deep well to pick up small fragile crystal figures while you are wearing thick leather mittens."

- Harvard psychologist Jerome Kagan


dark well

Research from these new disciplines has revealed that trauma produces actual 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


For a hundred years or more, every textbook of psychology and psychotherapy has advised that some method of talking about distressing feelings can resolve them. However, as we’ve seen, the experience of trauma itself gets in the way of being able to do that. No matter how much insight and understanding we develop, the rational brain is basically impotent to talk the emotional brain out of its own reality.


Traumatized people become stuck, stopped in their growth because they can’t integrate new experiences into their lives.


If an organism is stuck in survival mode, its energies are focused on fighting off unseen enemies, which leaves no room for nurture, care, and love. This reduces our ability to imagine, plan, play, learn and pay attention to other people’s needs.


Typical Responses to Trauma:

  • One of the hardest things for traumatized people is to confront their shame about the way they behaved during a traumatic episode, whether it is objectively warranted (as in the commission of atrocities) or not (as in the case of a child who tries to placate her abuser)

  • It can feel as if you are floating in space, lacking any sense of purpose or direction.

  • Traumatized people look at the world in a fundamentally different way from other people. For most of us, a man coming down the street is just someone taking a walk. A rape victim, however, may see a person who is about to molest her and go into a panic.

  • The very event that caused so much pain can also become their sole source of meaning. They feel fully alive only when they revisiting the traumatic past


For real change to take place, the body needs to learn that the danger has passed and to live in the reality of the present.


What's the best approach to trauma?


The challenge: How can people gain control over the residues of past trauma and return to being masters of their own?


Three typical approaches to resolving trauma:


  1. Talk therapy, (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. Medication - To shut down inappropriate alarm reactions, or by utilizing other technologies that change the way the brain organizes information.

  3. Connecting with the Body - by allowing the body to have experiences that deeply and viscerally contradict the helplessness, rage, or collapse that result from trauma.


Here is an example of how play can be used in therapy:


Steve Gross used to run the play program at the Trauma Center. Steve often walked around the clinic with a brightly colored beach ball, and when he saw angry or frozen kids in the waiting room, he would flash them a big smile. The kids rarely responded. Then, a little later, he would return and “accidentally” drop his ball close to where a kid was sitting. As Steve leaned over to pick it up, he’d nudge it gently toward the kid, who’d usually give a halfhearted push in return. Gradually Steve got a back-and-forth going, and before long you’d see smiles on both faces. From simple, rhythmically attuned movements, Steve had created a small, safe place where the social-engagement system could begin to reemerge.

beach ball


Other examples demonstrate this approach to recovery. Severely traumatized people may get more out of simply helping to arrange chairs before a meeting or joining others in tapping out a musical rhythm on the chair seats than they would from sitting in those same chairs and discussing the failures in their life.


Sadly, our educational system, as well as many of the methods that profess to treat trauma, tend to bypass this emotional engagement system and focus instead on recruiting the cognitive capacities of the mind


Be patient toward all that is unsolved in your heart and try to love the questions themselves.... Live the questions now. Perhaps you will gradually, without noticing it, live along some distant day into the answer.

—Rainer Maria Rilke, Letters to a Young Poet



How is trauma and the body connected?


The body keeps the score: Memory of trauma is encoded in the viscera, in heartbreaking and gut-wrenching emotions, in autoimmune disorders and skeletal/muscular problems. This demands a radical shift in our therapeutic assumptions.


There are many examples of where trauma connects to physical symptoms. They can include chronic back and neck pain, fibromyalgia, migraines, digestive problems, spastic colon/irritable bowel syndrome, chronic fatigue, and some forms of asthma. Traumatized children have fifty times the rate of asthma as their non-traumatized peers. Studies have shown that many children and adults with fatal asthma attacks were not aware of having breathing problems before the attacks.


Many traumatized children and adults simply cannot describe what they are feeling because they cannot identify what their physical sensations mean. Psychiatrists call this phenomenon alexithymia—Greek for not having words for feelings.


Bessel Van Der Kolk describes a body led approach to explore trauma:

In my practice I begin the process by helping my patients to first notice and then describe the feelings in their bodies—not emotions such as anger or anxiety or fear but the physical sensations beneath the emotions: pressure, heat, muscular tension, tingling, caving in, feeling hollow, and so on. I also work on identifying the sensations associated with relaxation or pleasure. I help them become aware of their breath, their gestures and movements. I ask them to pay attention to subtle shifts in their bodies, such as tightness in their chests or gnawing in their bellies, when they talk about negative events that they claim

What is the role of safety and attachment?


The most natural way for human beings to calm themselves when they are upset is by clinging to another person. This means that patients who have been physically or sexually violated face a dilemma: They desperately crave touch while simultaneously being terrified of body contact


Attachment is the secure base from which a child moves out into the world. Having a safe haven promotes self-reliance and instils a sense of sympathy and helpfulness to others in distress. From the intimate give-and-take of the attachment bond children learn that other people have feelings and thoughts that are both similar to and different from theirs. In other words, they get “in sync” with their environment and with the people around them and develop the self-awareness, empathy, impulse control, and self-motivation that make it possible to become contributing members of the larger social culture


A secure attachment combined with the cultivation of competency builds an internal locus of control, the key factor in healthy coping throughout


Attachment patterns often persist into adulthood. Anxious toddlers tend to grow into anxious adults, while avoidant toddlers are likely to become adults who are out of touch with their own feelings and those of others. (As in, “There’s nothing wrong with a good spanking. I got hit and it made me the success I am today.”) In school avoidant children are likely to bully other kids, while the anxious children are often their victims.


The Path To Recovery


Nobody can “treat” a war, or abuse, rape, molestation, or any other horrendous event, for that matter; what has happened cannot be undone. But what can be dealt with are the imprints of the trauma on body, mind, and soul: the crushing sensations in your chest that you may label as anxiety or depression; the fear of losing control; always being on alert for danger or rejection; the self-loathing; the nightmares and flashbacks; the fog that keeps you from staying on task and from engaging fully in what you are doing; being unable to fully open your heart to another human being.

Trauma robs you of the feeling that you are in charge of yourself: The challenge of recovery is to reestablish ownership of your body and your mind—of yourself. This means feeling free to know what you know and to feel what you feel without becoming overwhelmed, enraged, ashamed, or collapsed.


path


This path to recovery involves:


  1. Finding a way to become calm and focused

  2. Learning to maintain that calm in response to images, thoughts, sounds, or physical sensations that remind you of the past

  3. Finding a way to be fully alive in the present and engaged with the people around you

  4. Not having to keep secrets from yourself, including secrets about the ways that you have managed to survive


In order to regain control over yourself, you need to revisit the trauma: Sooner or later you need to confront what has happened to you, but only after you feel safe and will not be retraumatized by it. The first order of business is to find ways to cope with feeling overwhelmed by the sensations and emotions associated with the past.


Understanding why you feel a certain way does not change how you feel. But it can keep you from surrendering to intense reactions.


Learning how to breathe calmly and remaining in a state of relative physical relaxation, even while accessing painful and horrifying memories, is an essential tool for recovery.


Handling the emotional brain


A key skill to learn on the road to recovery is how to manage your emotional brain. Unless you learn to manage the emotional brain people remain trapped.


In this The Body Keeps the Score Summary there are 6 tactics:


Tactics:

  1. Staying Calm

  2. Mindfulness

  3. Relationships

  4. Community

  5. Touch

  6. Taking Action


Staying Calm


Learning how to breathe calmly and remaining in a state of relative physical relaxation, even while accessing painful and horrifying memories, is an essential tool for recovery.


In research supported by the National Institutes of Health, my colleagues and I have shown that ten weeks of yoga practice markedly reduced the PTSD symptoms of patients who had failed to respond to any medication or to any other treatment.


Mindfulness


At the core of recovery is self-awareness. The most important phrases in trauma therapy are “Notice that” and “What happens next?”


Allow your mind to focus on your sensations and notice how, in contrast to the timeless, ever-present experience of trauma, physical sensations are transient and respond to slight shifts in body position, changes in breathing, and shifts in thinking. Once you pay attention to your physical sensations, the next step is to label them, as in “When I feel anxious, I feel a crushing sensation in my chest.” "Focus on that sensation and see how it changes when you take a deep breath out, or when you tap your chest just below your collarbone, or when you allow yourself to cry.”


Practising mindfulness calms down the sympathetic nervous system so that you are less likely to be thrown into fight-or-flight.



Relationships


Study after study shows that having a good support network constitutes the single most powerful protection against becoming traumatized


After an acute trauma, like an assault, accident, or natural disaster, survivors require the presence of familiar people, faces, and voices; physical contact; food; shelter and a safe place; and time to sleep.


Community


Finding a responsive community in which to tell your truth makes recovery possible


When we play together, we feel physically attuned and experience a sense of connection and joy. Improvisation exercises also are a marvellous way to help people connect in joy and exploration. The moment you see a group of grim-faced people break out in a giggle, you know that the spell of misery has broken.


Touch


However, the most natural way that we humans calm down our distress is by being touched, hugged, and rocked. This helps with excessive arousal and makes us feel intact, safe, protected, and in charge


Taking Action


People who actively do something to deal with a disaster—rescuing loved ones or strangers, transporting people to a hospital, being part of a medical team, pitching tents or cooking meals—utilize their stress hormones for their proper purpose and therefore are at much lower risk of becoming traumatized.


Being traumatized is not just an issue of being stuck in the past; it is just as much a problem of not being fully alive in the present.