The Body Keeps Score is one of those books that I don’t know how to write a post about. Trauma is a difficult subject. Everyone knows someone that has lived through trauma, if you have not yourself lived through trauma. And trauma impacts different people differently and may impact the same person differently over time.
Dr van der Kolk started his medical career working for the Veteran’s Administration with Vietnam vets. There was virtually nothing really known about trauma at the time. The concept of shell shock or similar ideas was present, but not really understood. Although as the book points out, early psychologists have understood some of the impacts of trauma for over a century. Over the past 30 or 40 years, the medical and psychological research into trauma, its cause, and treatment has significantly expanded the understanding.
The Body Keeps Score tracks the growth of that knowledge, partially through van der Kolk’s own career and research, but also through the story of many trauma survivors. This is frequently a difficult book to read because in order to discuss trauma it is necessary to discuss traumatic events. And even in the first 200 pages that established the concept and history of the understanding of trauma, the stories of war, rape, molestation, neglect, abuse, and accidents can be difficult to process as and outsider, let alone for the person that they actually happened to.
Trauma is common. The Adverse Childhood Experiences (ACE) studies (fact sheet) I think are the easiest place for many people to think about the importance of studying and dealing with trauma. The initial big ACE study showed that a number of different traumatic events as children, when combined, are correlated with not just physical or psychological effects into adulthood, but also diverse effects in a range of areas such as life time income, potential for abusing or neglecting their own children, early death, having premature births, autoimmune diseases, drug or alcohol dependencies, and being a victim or perpetrator of violence, and more. 60 Minutes had a good 11 minute story on what treatment of ACE looks like and its importance.
The last half of the book is about various treatments of trauma and the research supporting those treatments. While I think the book as a whole is important, I think the last half of the book is more geared toward practitioners and if you do not want to read the whole book I think the first 200 pages are worth reading even if you don’t want to delve into the detailed research into treatment.
The Body Keeps Score’s main theme is that the effects of trauma show that the body, mind, and brain are more connected than what many have understood in diverse fields that often separate the physical, mental, spiritual, and emotional areas of research or practice. Teaching for instance focuses on dealing with mental processing. But for children with trauma, they often cannot process concepts mentally if they have a traumatic background because their body (broadly) is protecting itself from the trauma in the ways that it can. So teaching needs to learn to understand trauma, not because it is going to medically treat children, but because it needs to understand how to teach children differently because they have a traumatic background.
In my head I kept connecting this to a book that I read decades ago, Pain the Gift that Nobody Wants by Philip Yancey and Paul Brand. It has been published under a couple of names, but book in a somewhat similar way to The Body Keeps Score, tracks Paul Brand’s research into leprosy. Yancey and Brand suggest that pain, while not something anyone wants serves a necessary function in our body to protect us. Dr van der Kolk keeps showing that the treatment of trauma has to deal with the ways that the body (broadly including mind, brain and emotions) continue to act in protective ways that are no longer needed. The point isn’t that those defense mechanisms are bad inherently, but that when they continue they often inhibit relationships or normal functioning because they are acting beyond the trauma. I am not sure this is a helpful connection to anyone else. But seeing how traumatic survivors are attempting to survive the best they can I think it can help treatment and relational networks to view the negatives behaviors, emotions, or physical manifestations as attempts at protection and not intent to harm themselves or their relational network .
One negative that I have seen by some that don’t really understand trauma is to view the research into trauma or its treatment as something that perpetuates trauma. In a ‘pull yourself up by your bootstraps’ biased world, this is a blaming the victim for being a victim mentality. The reality is that helping to facilitate treatment is the way that we help society break cycles of trauma which often lead to many societal problems like multi generational poverty or poor health outcomes or crime.
I have picked up a couple other books that I think will help round out some of these concepts. I am not sure what is the best introduction to the material, but I would probably start with the 60 Minutes story linked above for now. The Body Keeps Score is certainly worth reading. But as I read more there may be better on-ramps into trauma as a concept for different populations. I do think that even though this is a fairly medical book, those that deal with people that have had trauma, like pastors and teachers and other people focuses fields, would benefit from a better understanding of trauma.