The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

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Review by Albert Ray, MD

Perm J 2015 Summer; 19(3):e118-e119 [Full Citation]

https://doi.org/10.7812/TPP/14-211

This valuable book is an informative primer about the ways traumatic life events affect us as human beings. The impact of physical and emotional trauma on brain, mind, and body is examined thoroughly by the author, Bessel van der Kolk, MD, through numerous real life examples that arouse our clinical interest. In our modern age, when we so often hear the term "posttraumatic stress disorder," this book takes us back in time to its historic origins and the past efforts of some of the icons of psychiatry who attempted to explain and treat trauma in dealing with their patients. What becomes clear very quickly is that individuals can be forever branded with a historic score that travels with them for the remainder of life. The body indeed keeps that score as a permanent record unless something is done to address its tattoo.  Although we all deal with the results in our practices, the origins are rarely recognized. 

As a result, treatment of such trauma-affected patients today is mostly based on the use of powerful medications to lower the score pharmacologically rather than by exploring underlying causality and thereby creating an individual who feels understood.  On the surface, it would appear to be easier to deliver treatment as a "medicating practitioner" rather than as a "talking practitioner." But unless one gets down into the action through discovering and understanding the patient's experience, one cannot truly help the healing process begin in a successful manner.

On the basis of this foundation, this book explores the ways that both patients and healers can develop the skills to appropriately evaluate historic traumatic events and how to successfully begin treating them. For the scientifically oriented physician, the biochemical, physiologic, and anatomic effects of trauma on the body are well explored in this detailed exposé. What is more importantly emphasized, though, is the invisible mark that is embedded permanently on mind and body by past traumatic events. Through its case examples, this book helps us appreciate this over and over again. It is only with this understanding of the toll on the human being that the score can be altered, resulting in victory. Van der Kolk methodically reviews how our body keeps as a permanent record the history of any "adverse experiences" in a locked account. It is imperative for the clinician to find the key to unlocking that safe, so the individual can remember and emote an experience of past trauma, and deal with it in a healing fashion that is permanent and nonthreatening. It is only in this way that the brain, mind, and body can begin to heal and restart the game with no remnant of points left on the scoreboard. Trauma victims are often unable to recover fully on their own without causal understanding and guidance because our minds and bodies have not been trained to open up new pathways to lead us out of the maze. Instead, patients are often numbed with medications to help them live with the stress of trauma, while numerous unsuccessful visits to health care professionals take place for a myriad of somatic complaints. This has had a major effect on the cost of providing health care. The techniques in this book teach helpful methods that should instead be considered, including mediation, yoga, eye-movement desensitization and reprocessing, neurofeedback, and play, to return the patient to a healthy state of wellness. It is never too late to learn to help a person tap into their inner strength through teaching the use of breathing, movement, and touch as an art for healing.

Ultimately, the goal of this book is to learn how to help traumatized patients, and to guide their healers to bring a feeling of safety, calm, and acceptance to their patients as we assist them with remembering memories of horrible events that they have experienced. Whether that patient is a child, a war veteran, an abused spouse, a sexually traumatized individual, or a victim of poverty, the roadmap for discovery and healing are much the same and can be achieved without the often ineffectiveness of resorting to multiple courses of potent medications or repeated outpatient visits, which avoid the underlying pathology. Those who use this book and who would find its content useful include not only traumatized individuals and their loved ones, but physicians, health care workers, mental health professionals, policy makers, law enforcement, educators, and military personnel. We are all shocked to hear on the daily news, horrific events involving murder and suicide that have past trauma as their underlying etiology. We need a new paradigm to effectively deal with this horror, and this book begins to provide that for us.

The world has advanced and retreated throughout its history as a result of monumental events, many of which have been quite traumatic. Success and defeat, agony and ecstasy are familiar to all of us, collectively or individually. A thorough reading of The Body Keeps the Score offers us a new window to help recognize, interpret, and better comprehend how a traumatic event in the past, based not on genetics but rather caused by life experiences, can be explored and successfully overcome so that the individual is no longer a victim but a hero.

I encourage you to become an active player in the game, and not an observer, by employing the teachings that this enjoyable, easy-to-read book has to offer.  I congratulate the author on taking such a complex subject, making it easy to understand and practical at the same time, so that in the end the brain, mind, and body are healed and no longer have to keep the score.