Bessel van der KolkThe Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

This is the greatest book I have ever read.It is a lifetime of knowledge (and it is clear that it had taken a very long time to write) from a practising clinician who, as far as I can tell, is THE most well-informed person on the subject, all in one book.It can be applied to you. Therapy like this would cost thousands, and that is even if you have the good fortune to find a therapist who knows anything about it.It is perfectly written and laid out, starting with explanations about the problem and ending with explanations of how to recover.At first it was hard to read because I was only just coming to terms with having childhood trauma, and was still feeling very upset about it. However the great thing about a book is that you can take as long as you like to finish it. As I read more I understood more and more and began to feel more and more free, understood, and positive. There is SO MUCH information in here, and it is all extremely useful and interesting. I often read one sentence several times because it made such an impact on me, and after some pages (most of them!) I would think for ten minutes until I read more.This is the most helpful book I have read on the subject, and I have read a lot. It has taken me a long time to read, but recovery takes a long time. I think that if you have not been traumatised and are just reading it for interest that you would read it quickly, as it is such a great book. I feel like it has transformed me.

What fascinates me about trauma is what it does to you. It helps you survive whatever has tried to hurt you. It’s a survival instinct.When you experience trauma your brain protects you, it literally creates a new personality on top of the one you were born with and transforms you. It increases your senses, it makes you more intelligent, but it changes your brain chemistry and that's the big problem. If your chemistry changes then you're not going to benefit in normal everyday situations because your flight, fight and freeze part of your brain is now on over drive, your hypothalamus is now stuck in hyper drive and your prefrontal cortex becomes neglected and undeveloped and in a contradicting to making you more intelligent now makes you less able to learn by constantly injecting stress hormones into your blood stream.A lot is crammed into this book, over 30 years of research into trauma and I agree with the author, trauma is so important and so relevant in our society. Most people experience some form of trauma throughout their lives, but it seems the younger and more undeveloped you are the more profound the effect is later on in life. It literally passes down from generation to generation and we still don't discuss or treat trauma as a norm. If everyone was more knowledgeable about trauma and how it affects us then I think our medical advice and how we treat people would be far different from what it is today.I find it easy to notice when someone has experienced trauma. It affects their persona, but there are visual and acoustic clues as well. It helps to know if someone has trauma because you have to adapt to their reasoning and thinking which can often be off kilter.This book is brilliant for psychologists and people who want to learn more about themselves and trauma. It has a diverse knowledge or different applications which are proven to work. Obviously CBT is the most common, but two more I find very interesting and fascinating for trauma treatment is EMDR and Yoga. Both I think are brilliant and I was aware of before the book, but this book shows just what impact it has on masses.I genuinely feel like when it comes to psychology and nutritional sciences, the USA is years ahead of everyone else especially the UK. I really hope a lot of this work makes it over here sooner rather than later.Knowing more about trauma means we can help heal our society, prevent abuse and even enrich ourselves.

What is the book about?In this excellent volume, BVDK gives an overview of the knowledge about the effects of psychological trauma, abuse, and neglect based on three emerging disciplines:• Neuroscience: the study of how the brain supports mental processes.• Developmental psychopathology: the study of the impact of adverse experiences on the development of mind and brain.• Interpersonal neurobiology: the study of how our behaviour influences the emotions, biology, and mind-sets of those around us.What are the books’ key messages?Trauma is not just the event(s) that took place sometime in the past. It is also the imprint left on mind, brain, and body. This imprint has on-going consequences for how the human organism manages to survive in the present. Trauma results in a fundamental reorganisation of the way mind and brain manage perceptions. It changes not only how we think and what we think about, but also our very capacity to think. What has happened – the events themselves – cannot be undone. This leaves us with a series of challenges:• Finding a way to become calm and focused.• Learning to maintain that calm in response to images, thoughts, sounds, or physical sensations that remind you of the past.• Finding a way to be fully alive in the present and engaged with the people around you.• Not having to keep secrets from yourself, including secrets about the ways that you have managed to survive.These goals are not steps to be achieved, one by one, in some fixed sequence. They overlap, and some may be more difficult than others, depending on individual circumstances.Narrowing down to developmental trauma, BVDK provides a good summary of the original 1990’s ACE study. In the years since TBKTS’ publication in 2014 this has been widely disseminated. The section concludes with a valuable re-frame: the idea of the problem being a solution, while understandably disturbing to many, is certainly in keeping with the fact that opposing forces routinely coexist in biological systems… What one sees, the presenting problem, is often only the marker for the real problem, which lies buried in time, concealed by patient shame, secrecy and sometimes amnesia – and, frequently clinician discomfort.Following a refreshing discussion of the DSM’s weaknesses is a summary of BVDKs’ as-yet unsuccessful, attempts to establish developmental trauma as its own recognised diagnosis. Readers are led to recognise that two hurdles need to conquered: (1) PTSD, C-PTSD, and developmental trauma each need to be recognised as their own diagnoses and (2) the blinkered brain disease model summarised below needs to be replaced with multi-modal helping approaches blending BVDKs’ three avenues (as below) to best suit the individuals’ needs.The brain’s own natural neuroplasticity can be developed to help survivors feel fully alive in the present and move on with their lives. There are fundamentally three avenues to follow:• Top down, by talking, (re-)connecting with others, and allowing ourselves to know and understand what is going on with us, while processing the memories of the trauma.• By taking medicines that shut down inappropriate alarm reactions, or by utilizing other technologies that change the way the brain organises information.• Bottom up: by allowing the body to have experiences that deeply and viscerally contradict the helplessness, rage, or collapse that result from trauma.What BVDK referred to as the the brain-disease model ignores four fundamental truths – we ignore them at our peril:• Our evolutionary legacy provides us with a set of capabilities – and constraints. The more we – or others - push those boundaries, the more likely we are to suffer. This is central to restoring and sustaining our well-being.• Our intelligence gives us the potential to develop ourselves, others, our environments, and our responses.• We have the capability to regulate aspects of our own physiology, including some of the so-called involuntary functions of the body and brain, through such basic activities as breathing, moving, and touching.• We can, collectively, change social conditions to create environments aligned with our evolutionary needs and expectations within which we can feel safe and where we can thrive.When we ignore these basic truths of our humanity, we deprive ourselves of ways to both prevent maladies in the first place and to heal when they do occur. We may subordinate our agency and render ourselves patients of the healthcare system, rather than exercise our agency to drive our healing process. Connecting with – rather than disconnecting from – what makes us incredible.Seeing issues with our mental health as internal processes, grants us much-needed agency – that feeling of being in control of our lives: being able to make the decisions that will lead us to our chosen future. If we consider the causes of mental health issues as external factors, something that happens to or around us – or as a biochemical anomaly - then it becomes a piece of history we can never dislodge. If, on the other hand, mental health issues are what take place inside us, resultant of what happened, then healing becomes a credible possibility. Trying to keep mental health issues at bay – or subcontracting them out to the medics (the doctor is responsible for resolving that issue while I get on with my life) hobbles our capacity to know ourselves better – to develop our agency.What are its weak-spots?Due to its very nature, the content runs the risk of triggering some readers: it’s difficult to see an easy solution to this.TBKTS delivers on its intentions to disseminate knowledge about the effects of psychological trauma, abuse, and neglect based on the three emerging disciplines of neuroscience, developmental psychopathology, and interpersonal neurobiology. It was not intended as a self-help ‘how to heal yourself’ which may leave some readers looking for more.While not a weakness, TBKTS was published around ten years ago. Given the pace of research, I wonder if there is scope or plans for a revised edition.How does this relate to my practice with Solution Focused Hypnotherapy?BVDK refers to one of the key underpinning theories of SFH – the triune (three phase) theory of human brain evolution. With that theory understood, we introduce two further key concepts: (1) the existence of a dynamic equilibrium between evolutionary phases and (2) developing the capability to manage that dynamic equilibrium to our advantage. Academically, these two concepts are supported by the generally accepted Broaden & Build theory (Frederickson.)Trauma – among other things - can shift the dynamic equilibrium to limit our options and plunge us in to vicious cycles of anger, and or anxiety and or depression (which can manifest in a myriad of ways.) Additionally, developmental trauma can lead to neurobiological effects in the hippocampus, amygdala, and pre-frontal cortex.Without downplaying the seriousness of this, there are counter-balancing positive factors. To varying degrees, we each have four capabilities: Self-Awareness (interoception), Imagination, Conscience and Free-will, as articulated by Viktor Frankl. These sit at the root of us developing our sense of agency. The same process of neuroplasticity that shaped our developing neurology as children can support us in developing our adulthoods. Through the work of BVDK and many others, we have an emerging understanding of the lifelong effects of developmental trauma, and an ever-growing understanding of how these can be mitigated.Solution Focused Hypnotherapy can be highly effective in helping those at threshold (motivated, and responsible for their outcomes) with anger, anxiety, and depression. Adding the body of knowledge supporting the PERMA model (this profound model is the reason I call my practice Perma Hypnotherapy) creates a solid platform for developing and sustaining wellbeing for those in the acceptance and action areas of the awareness / acceptance / action spectrum. Those in the earlier – awareness, acceptance – areas would benefit more from the traditional analytical / counselling approaches to helping.Who would benefit from reading this book?With the caveat that some readers may find elements of the content triggering, this is an ideal read for those who have ever wondered if events of their childhood are negatively affecting their present.For those experiencing developmental trauma, and those living with and supporting those who are – this is one of the must reads.