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

The speaker, Dr. Bessel van der Kolk, is one of the world’s foremost experts on trauma. In the talk, he covers many of the issues discussed in his incredible book, The Body Keeps the Score. Namely, the lasting effects that trauma has on mind and body, and how those who have experienced trauma can recover.

The talk begins at 0:04:46. My notes are included below.

Excerpt: “You can choose to go to war… if you go to war, more people will kill themselves after coming home, than will be killed on the battlefield.”

Key point: Going to war often destroys soldiers’ ability to love and be intimate.

11:00 — Story about Dr. van der Kolk’s father’s experiences in a concentration camp, and the compassion he was shown by a German soldier.

13:00 — Story of a traumatized Vietnam vet. Any loud noises would drive him into a fit. Only drinking and riding his motorcycle gave him relief. The vet felt the need to serve as a living memorial to his friends who had fallen in battle, and refused to take medication to alleviate his pain.

Key point: We have taken an overly simplistic view of trauma, and often seek to address it using the pharmacological equivalent of blunt instruments.

Dr. van der Kolk did the first study ever on using Prozac to treat PTSD, and participated quite a bit in early drug research. He is not opposed to the use of drugs to treat psychological issues, but feels that they are often prescribed in inappropriate situations.

Key point: Many academic researchers lack a deep understanding of trauma, often due to the fact that they’ve only worked in laboratories and read books, and have never actually worked with traumatized patients.

0:22:40 — Discussion of the first ever neuroimaging studies conducted on traumatized people.

“When people remember their trauma, their whole frontal lobe goes off line. Their speech center goes offline.” (The frontal lobe is highly involved in numerous essential brain functions.)

0:24:15 — Key point: In many instances, yoga appears to be a more effective treatment for traumatized people than pharmacological interventions.

Many ancient practices that Western culture has mocked (such as yoga and meditation) seem to be excellent tools for trauma recovery.

Other cultures have found ways of calming their bodies that do not involve the consumption of chemicals.

27:20 — Anecdote about teaching vipassana meditation in an Alabama jail. After seven days of practicing vipassana meditation, prisoners had better outcomes than those outcomes commonly observed after pharmacological interventions.

Even if a person experienced trauma in the distant past, their bodies can still feel as though the trauma is taking place in the present moment. This illusion can create adverse physiological reactions.

“Trauma results in a fundamental reorganization 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.”

Key point: When a trauma victim tells their story, it can be helpful, but retelling often fails to alleviate their body’s unhelpful and unwarranted responses to past trauma.

30:30: Bessel claims that for true healing, the body must come to realize that the danger has passed. Only then can it engage properly with the present moment.

Key point: Trauma can make a person feel cut off from reality. Dr. van der Kolk claims that this is one of the primary reasons why veterans often commit suicide.

Key point: Revealing secrets that you have keep hidden for years can be incredibly healing.

41:40: Description of EMDR (Eye movement desensitization and reprocessing), a simple therapy that has proven to be very effective.

Dr. van der Kolk is a firm proponent of EMDR. During this section of the lecture, he gives several anecdotes that point to the technique’s efficacy in addressing trauma. Though I’ve never experienced EMDR, a close family remember of mine has and he swears by it.

“My post docs were telling me that after about three or four sessions of it (EMDR) many people had resolved their trauma.” — van der Kolk

48:35: The way you hold your body has an influence on how you feel. Research has confirmed this.

A simple change in posture can lead to a significant change in your state of mind.

Just as posture influences state of mind, state of mind influences posture. Dr. van der Kolk states that trauma victims’ posture often changes significantly after they undergo EMDR therapy.

55:35: Bessel describes a study he conducted to compare the effectiveness of EMDR with the effectiveness of prozac.

• The results of the study suggested that EMDR is far superior to prozac in terms of its ability to combat depression.
• To read the exact results of the study, click here.
• Excerpt from the study: “The psychotherapy intervention was more successful than pharmacotherapy in achieving sustained reductions in PTSD and depression symptoms, but this benefit accrued primarily for adult-onset trauma survivors. At 6-month follow-up, 75.0% of adult-onset versus 33.3% of child-onset trauma subjects receiving EMDR achieved asymptomatic end-state functioning compared with none in the fluoxetine group.”
• “This at this point, still to this day, but maybe not for long, is the most successful outcome study in PTSD. Ever.”

“You don’t want people to just be feeling better. You want people to be cured. You want them to say ‘It’s over.’”

01:02:00 — Bessel points out that the trauma from war often creates very different aftereffects from the trauma associated with one’s upbringing.

EMDR seems to be far more effective for trauma that was sustained during adulthood, than it is for trauma that was sustained during childhood.

“What we need to do is to liberate the natural creativity in traumatized people.”

01:07:00 — Bessel discusses MDMA therapy outcomes, which are comparable in many ways to the outcomes of EMDR therapy (i.e, MDMA seems to be very effective in many situations).

Key point: If you can revisit a traumatizing situation calmly (which MDMA allows one to do) it can help you to integrate that situation and heal.

01:10:00 — Discussion of the fact that during the relaxing yoga pose known as Shavasana, the muscular activation patterns of people who have undergone trauma differ significantly from those of normal patients. The muscles continue to flex as though the trauma victims were being attacked, in spite of the fact that no danger is actually present.

Bessel points out that we often create subconscious associations between certain stimulus that can lead to adverse reactions. For example, if a person were assaulted when an air conditioner was humming in the background, the person might start to have adverse responses whenever they heard the sound of an air conditioner (even if no danger was present).

01:13:00 — Description of the desensitization training that the Marine Corps puts recruits through.

Key point: Animals and humans respond to trauma differently. Animal models can be helpful for understanding how trauma affects humans, but differences should be kept in mind when making comparisons.

“Mindfulness is always at the core of just about any program that I know that works for trauma.”

01:20:00 — Description of an amazing EMDR / mindfulness / self defense, success story. The patient had experienced a significant amount of abuse, became suicidal, and was self harming. After just eight sessions of EMDR, she showed massive improvement.

01:25:00 — Discussion of the limits of language in the processing of trauma and other psychological issues.

1:27:16: “When traumatized people start sitting still, and start paying attention to themselves, (which is what happens during mindfulness mediation) they meet their demons. Being still and doing meditation is excruciatingly difficult for traumatized people.”

1:29:00 — Comparison between brain scans of normal people and traumatized people. The brains of the traumatized group show marked abnormalities in areas involved with self awareness.

1:31:00 — Questions and Answers

Acting can be an excellent healing modality for traumatized veterans. Acting nourishes creativity and imagination, both of which are often damaged and lacking in traumatized people.

Dr. van der Kolk references a study on 9/11 survivors who were pregnant at the time of the attacks, and mentions that their biology was noticeably changed by this trauma.