The Body Keeps the Score” by Bessel van der Kolk, M.D.

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This book was on my radar before Tinsley died, but I’ve not been motivated enough to dig into it until now.  I will say the timing was a bit poor, with the news that the author has just been fired from the Trauma Center he helped found because of allegations he bullied employees….nonetheless, he is still a pioneer in the treatment of psychological trauma.

Dr. van der Kolk says he wrote the book “to serve as both a guide and an invitation — an invitation to dedicate ourselves to facing the reality of trauma, to explore how best to treat it, and to commit ourselves, as a society, to using every means we have to prevent it.”

I was in a near-fatal car accident when I was 21, and I suffered severely from PTSD.  I still have serious flashbacks and am triggered while driving.  After Tinsley died, my PTSD around driving flared up significantly.  It’s not uncommon for one trauma to exacerbate or re-trigger another trauma.  I finally started receiving proper treatment for the car accident through EMDR from the therapist I started seeing after Tinsley died.

The chapters on EMDR (15) and Yoga (16) were most relevant and useful to me.  As I’ve shared on this blog, yoga has played an integral role in helping me reconnect to my body.  The psychological madness of carrying your dead baby, laboring with your dead baby, and giving birth to your dead baby, cannot be explained to anyone that has not experienced it.  But trust me when I say, I was appropriately fucked up by and my first defense mechanism was to disconnect from my body.  Yoga has brought me back to inhabiting my body as a safe space, and van der Kolk’s studies confirm my personal experience.

This is a beast of a book.  The most important takeaways for me are a) I’m not crazy, I’m traumatized and b) “Notice that” and “What happens next?”

Excerpts: 

As long as you keep secrets and suppress information, you are fundamentally at war with yourself…The critical issue is allowing yourself to know what you know. That takes an enormous amount of courage.

Traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from their selves.

Psychologists usually try to help people use insight and understanding to manage their behavior. However, neuroscience research shows that very few psychological problems are the result of defects in understanding; most originate in pressures from deeper regions in the brain that drive our perception and attention. When the alarm bell of the emotional brain keeps signaling that you are in danger, no amount of insight will silence it.”

We now know that trauma compromises the brain area that communicates the physical, embodied feeling of being alive. These changes explain why traumatized individuals become hypervigilant to threat at the expense of spontaneously engaging in their day-to-day lives. They also help us understand why traumatized people so often keep repeating the same problems and have such trouble learning from experience. We now know that their behaviors are not the result of moral failings or signs of lack of willpower or bad character–they are caused by actual changes in the brain

Some psychologists have hypothesized that EMDR actually desensitizes people to the traumatic material and thus is related to exposure therapy. A more accurate description would be that it integrates the traumatic material. As our research showed, after EMDR people thought of the trauma as a coherent event in the past, instead of experiencing sensations and images divorced from any context.

Trauma constantly confronts us with our fragility and with man’s inhumanity to man but also with our extraordinary resilience.

Trauma affects the entire human organism—body, mind, and brain. In PTSD the body continues to defend against a threat that belongs to the past.

After trauma the world is experienced with a different nervous system. The survivor’s energy now becomes focused on suppressing inner chaos, at the expense of spontaneous involvement in their life.

I can’t begin to imagine how I would have coped with what many of my patients have endured, and I see their symptoms as part of their strength—the ways they learned to survive. And despite all their suffering many have gone on to become loving partners and parents, exemplary teachers, nurses, scientists, and artists.

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