The Body Keeps the Score

carrying the memory of terror, and the shame of utter weakness and vulnerability.

While we all want to move beyond trauma, the part of our brain that is devoted to ensuring our survival (deep below our rational brain) is not very good at denial. Long after a traumatic experience is over, it may be reactivated at the slightest hint of danger and mobilize disturbed brain circuits and secrete massive amounts of stress hormones. This precipitates unpleasant emotions intense physical sensations, and impulsive and aggressive actions. These posttraumatic reactions feel incomprehensible and overwhelming. Feeling out of control, survivors of trauma often begin to fear that they are damaged to the core and beyond redemption.

       

The first time I remember being drawn to study medicine was at a summer camp when I was about fourteen years old. My cousin Michael kept me up all night explaining the intricacies of how kidneys work, how they secrete the body s waste materials and then reabsorb the chemicals that keep the system in balance. I was riveted by his account of the miraculous way the body functions. Later, during every stage of my medical training, whether I was studying surgery, cardiology, or pediatrics, it was obvious to me that the key to healing was understanding how the human organism works. When I began my psychiatry rotation, however, I was struck by the contrast between the incredible complexity of the mind and the ways that we human beings are connected and attached to one another, and how little psychiatrists knew about the origins of the problems they were treating. Would it be possible one day to know as much about brains, minds, and love as we do about the other systems that make up our organism?

We are obviously still years from attaining that sort of detailed understanding, but the birth of three new branches of science has led to an explosion of knowledge about the effects of psychological trauma, ab

affects the brain and the body, causing anxiety, rage, and the inability to concentrate. Victims have problems remembering, trusting, and forming relationships. They have lost control. Although news reports and discussions tend to focus on war veterans, abused children, domestic violence victims, and victims of violent crime suffer as well. Using a combination of traditional therapy techniques and alternative treatments such as EMDR, yoga, neurofeedback, and theater, patients can regain control of their bodies and rewire their brains so that they can rebuild their lives. The author uses case histories to demonstrate the process. He includes a resource list, bibliography, and extensive notes. This accessible book offers hope and inspiration to those who suffer from trauma and those who care for them. It is an outstanding addition to all library collections.
Medical Library Association, Consumer Connections
 
[A] wonderful new book that everyone involved with trauma ought to read and have available. . . . [B]eautifully, compellingly and sweepingly written in its grand vision of integrating medical, psychological and mixed or alternative approaches, based on a careful reading of the client and a holistic mind-body view. . . . There are very few practitioners who could not learn from this book and become more effective, as well as inspired, by reading and studying it.
Henry Strick van Linschoten, European Society For Trauma And Dissociation Newsletter
 
Psychological trauma can befall anyone, not just soldiers, refugees, or victims of rape. . . . This important and helpful book makes sense of suffering and offers opportunity for healing.
Booklist
 
[C]omprehensive in scope. This valuable work . . . offers hope for the millions of sufferers and their families seeking meaningful treatment and relief from the ongoing pain of trauma.
Library Journal (Starred Review)
 
Dr. van der Kolk s masterpiece combines the boundless curiosity of the scientist, the erudition of the scholar, and the passion of the truth teller.  
Judith Herman, M.D., clinical professor of psychiatry, Harvard Medical School; author of Trauma and Recovery
 
This is an absolutely fascinating and clearly written book by one of the nation s most experienced physicians in the field of emotional trauma. The Body Keeps the Score helps us understand how life experiences play out in the function and the malfunction of our bodies, years later.
Vincent J. Felitti, M.D., chief of preventative medicine, emeritus, Kaiser Permanente San Diego; co-principal investigator, ACE study
 
In this inspirational work which seamlessly weaves keen clinical observation, neuroscience, historical analysis, the arts, and personal narrative, Dr. van der Kolk has created an authoritative guide to the effects of trauma, and pathways to recovery. The book is full of wisdom, humanity, compassion and scientific insight, gleaned from a lifetime of clinical service, research and scholarship in the field of traumatic stress. A must read for mental health and other health care professionals, trauma survivors, their loved ones, and those who seek clinical, social, or political solutions to the cycle of trauma and violence in our society.
Rachel Yehuda, Ph.D., professor of psychiatry and neuroscience; director of the Traumatic Stress Studies Division at the Mount Sinai School of Medicine, New York, NY
 
Breathtaking in its scope and breadth, The Body Keeps the Score is a seminal work by one of the preeminent pioneers in trauma research and treatment. This essential book unites the evolving neuroscience of trauma research with an emergent wave of body-oriented therapies and traditional mind/body practices that go beyond symptom relief and connect us with our vital energy and here-and-now presence.  
Peter A. Levine, Ph.D., author of In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness
 
In The Body Keeps the Score we share the author s courageous journey into the parallel dissociative worlds of trauma victims and the medical and psychological disciplines that are meant to provide relief. In this compelling book we learn that as our minds desperately try to leave trauma behind, our bodies keep us trapped in the past with wordless emotions and feelings. These inner disconnections cascade into ruptures in social relationships with disastrous effects on marriages, families, and friendships. Van der Kolk offers hope by describing treatments and strategies that have successfully helped his patients reconnect their thoughts with their bodies. We leave this shared journey understanding that only through fostering self-awareness and gaining an inner sense of safety will we, as a species, fully experience the richness of life.
Stephen W. Porges, Ph.D., professor of psychiatry, University of North Carolina at Chapel Hill; author of The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation
 
This exceptional book will be a classic of modern psychiatric thought. The impact of overwhelming experience can only be truly understood when many disparate domains of knowledge, such as neuroscience, developmental psychopathology, and interpersonal neurobiology are integrated, as this work uniquely does. There is no other volume in the field of traumatic stress that has distilled these domains of science with such rich historical and clinical perspectives, and arrived at such innovative treatment approaches. The clarity of vision and breadth of wisdom of this unique but highly accessible work is remarkable. This book is essential reading for anyone interested in understanding and treating traumatic stress and the scope of its impact on society.
Alexander McFarlane AO, MB BS (Hons) MD FRANZCP, director of the Centre for Traumatic Stress Studies, The University of Adelaide, South Australia.

This book is a tour de force. Its deeply empathic, insightful, and compassionate perspective promises to further humanize the treatment of trauma victims, dramatically expand their repertoire of self-regulatory healing practices and therapeutic options, and also stimulate greater creative thinking and research on trauma and its effective treatment. The body does keep the score, and van der Kolk s ability to demonstrate this through compelling descriptions of the work of others, his own pioneering trajectory and experience as the field evolved and him along with it, and above all, his discovery of ways to work skillfully with people by bringing mindfulness to the body (as well as to their thoughts and emotions) through yoga, movement, and theater are a wonderful and welcome breath of fresh air and possibility in the therapy world.
Jon Kabat-Zinn, professor of medicine emeritus, UMass Medical School; author of Full Catastrophe Living.
 
This is an amazing accomplishment from the neuroscientist most responsible for the contemporary revolution in mental health toward the recognition that so many mental problems are the product of trauma. With the compelling writing of a good novelist, van der Kolk revisits his fascinating journey of discovery that has challenged established wisdom in psychiatry. Interspersed with that narrative are clear and understandable: descriptions of the neurobiology of trauma; explanations of the ineffectiveness of traditional approaches to treating trauma; and introductions to the approaches that take patients beneath their cognitive minds to heal the parts of them that remained frozen in the past. All this is illustrated vividly with dramatic case histories and substantiated with convincing research. This is a watershed book that will be remembered as tipping the scales within psychiatry and the culture at large toward the recognition of the toll traumatic events and our attempts to deny their impact take on us all.
Richard Schwartz, originator, Internal Family Systems Therapy

The Body Keeps the Score is clear, fascinating, hard to put down, and filled with powerful case histories. Van der Kolk, the eminent impresario of trauma treatment, who has spent a career bringing together diverse trauma scientists and clinicians and their ideas, while making his own pivotal contributions, describes what is arguably the most important series of breakthroughs in mental health in the last thirty years. We ve known that psychological trauma fragments the mind. Here we see not only how psychological trauma also breaks connections within the brain, but also between mind and body, and learn about the exciting new approaches that allow people with the severest forms of trauma to put all the parts back together again.
Norman Doidge, author of The Brain That Changes Itself
 
Every once in a while, a book comes along that fundamentally changes the way we look at the world. Bessel van der Kolk has written such a book. The arc of van der Kolk s story is vast and comprehensive, but he is such a skillful storyteller that he keeps us riveted to the page. I could not put this book down. It is, simply put, a great work.  
Stephen Cope, founder and director, Kripalu Institute for Extraordinary Living; author of Yoga and the Quest for the True Self

Bessel van der Kolk is unequaled in his ability to synthesize the stunning developments in the field of psychological trauma over the past few decades. Thanks in part to his work, psychological trauma ranging from chronic child abuse and neglect, to war trauma and natural disasters is now generally recognized as a major cause of individual, social and cultural breakdown. In this masterfully lucid and engaging tour de force, van der Kolk takes us both specialists and the general public on his personal journey and shows what he has learned from his research, from his colleagues and students, and, most importantly, from his patients. The Body Keeps the Score is, simply put, brilliant.
Onno van der Hart, Ph.D., Utrecht University, The Netherlands; senior author, The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization

The Body Keeps the Score articulates new and better therapies for toxic stress based on a deep understanding of the effects of trauma on brain development and attachment systems. This volume provides a moving summary of what is currently known about the effects of trauma on individuals and societies, and introduces the healing potential of both age old and novel approaches to help traumatized children and adults to fully engage in the present.
Jessica Stern, policy consultant on terrorism; author of Denial: A Memoir of Terror

A book about understanding the impact of trauma by one of the true pioneers in the field. It is a rare book that integrates cutting edge neuroscience with wisdom and understanding about the experience and meaning of trauma, for people who have suffered from it. Like its author, this book is wise and compassionate, occasionally quite provocative, and always interesting.
Glenn N. Saxe, M.D., Arnold Simon Professor and chairman, Department of Child and Adolescent Psychiatry; director, NYU Child Study Center, New York University School of Medicine

A fascinating exploration of a wide range of therapeutic treatments shows readers how to take charge of the healing process, gain a sense of safety, and find their way out of the morass of suffering.
Francine Shapiro, Ph.D., originator of EMDR therapy, senior research fellow, Emeritus Mental Research Institute, author of Getting Past Your Past

As an attachment researcher I know that infants are psychobiological beings. They are as much the body as they are of the brain. Without language or symbols infants use every one of their biological systems to make meaning of their self in relation to the world of things and people. Van der Kolk shows that those very same systems continue to operate at every age, and that traumatic experiences, especially chronic toxic experience during early development, produce psychic devastation. With this understanding he provides insight and guidance for survivors, researchers and clinicians alike. Bessel van der Kolk may focus on the body and trauma, but what a mind he must have to have written this book.
Ed Tronick, distinguished professor, University of Massachusetts, Boston, author of Neurobehavior and Social Emotional Development of Infants and Young Children

The Body Keeps the Score eloquently articulates how overwhelming experiences affect the development of brain, mind, and body awareness, all of which are closely intertwined. The resulting derailments have a profound impact on the capacity for love and work. This rich integration of clinical case examples with ground breaking scientific studies provides us with a new understanding of trauma, which inevitably leads to the exploration of novel therapeutic approaches that rewire the brain, and help traumatized people to (re)-engage in the present. This book will provide traumatized individuals with a guide to healing and permanently change how psychologists and psychiatrists think about trauma and recovery.
Ruth A. Lanius, M.D., Ph.D., Harris-Woodman chair in Psyche and Soma, professor of psychiatry, and director PTSD research at the University of Western Ontario; author of The Impact of Early Life Trauma on Health and Disease

When it comes to understanding the impact of trauma and being able to continue to grow despite overwhelming life experiences, Bessel van der Kolk leads the way in his comprehensive knowledge, clinical courage, and creative strategies to help us heal. The Body Keeps the Score is a cutting-edge offering for the general reader to comprehend the complex effects of trauma, and a guide to a wide array of scientifically informed approaches to not only reduce suffering, but to move beyond mere survival and to thrive.
Daniel J. Siegel, M.D., clinical professor, UCLA School of Medicine, author of Brainstorm: The Power and Purpose of the Teenage Brain; Mindsight: The New Science of Personal Transformation; and The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are

In this magnificent book, Bessel van der Kolk takes the reader on a captivating journey that is chock full of riveting stories of patients and their struggles interpreted through history, research, and neuroscience made accessible in the words of a gifted storyteller. We are privy to the author s own courageous efforts to understand and treat trauma over the past 40 years, the results of which have broken new ground and challenged the status quo of psychiatry and psychotherapy. The Body Keeps the Score leaves us with both a profound appreciation for and a felt sense of, the debilitating effects of trauma, along with hope for the future through fascinating descriptions of novel approaches to treatment. This outstanding volume is absolutely essential reading not only for therapists but for all who seek to understand, prevent, or treat the immense suffering caused by trauma.
Pat Ogden Ph.D., Founder/Educational Director of the Sensorimotor Psychotherapy Institute; author of Sensorimotor Psychotherapy: Interventions for Trauma and Attachment
 
This is masterpiece of powerful understanding and brave heartedness, one of the most intelligent and helpful works on trauma I have ever read. Dr. van der Kolk offers a brilliant synthesis of clinical cases, neuroscience, powerful tools and caring humanity, offering a whole new level of healing for the traumas carried by so many.
Jack Kornfied, author of A Path with Heart

The Body Keeps the Score is masterful in bringing together science and humanism to clearly explain how trauma affects the whole person. Bessel van der Kolk brings deep understanding to the pain and chaos of the trauma experience. The treatment approaches he recommends heal the body and the mind, restoring hope and the possibility of joy. One reads this book with profound gratitude for its wisdom.
Alicia Lieberman, Ph.D., Professor of Medical Psychology UCSF, Director of the Child Trauma Research Project, San Francisco General Hospital; author of The Emotional Life of the Toddler