The Body Keeps the Score – Bessel Van Der Kolk, MD

Trauma is a fact of life. Trauma results in a fundamental reorganization of the way the mind and brain manage perceptions. It changes not only how we think and what we think about, but also our very capacity to think.

I wanted to learn about various kinds of trauma and the ways we can heal from it. But, I also wanted to learn about trigger points and what causes people to disengage or disassociate from people or themselves. One thing I quickly learned is that this is not light reading for anyone wanting to work through trauma, but it does offer hope.

Dr. Van der Kolk shows just how trauma changes the brain and nervous system and can keep both children and adults in a never-ending cycle of fight or flight. He points out that the fundamental issue in resolving traumatic stress is to restore the proper balance between the rational and emotional brains so that you can feel in charge of how you respond and how you conduct your life. It’s easier said than done, but not impossible.


  1. Traumatic experiences do leave traces, whether on a large scale (on our histories and cultures) or close to home, on our families, with dark secrets being imperceptibly passed down through generations. They also leave traces on our minds and emotions, on our capacity for joy and intimacy, and even on our biology and immune systems.
  2. Trauma, by definition, is unbearable and intolerable.
  3. 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.
  4. They also help us understand why traumatized people o 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.
  5. Some people’s lives seem to flow in a narrative; mine had many stops and starts. That’s what trauma does. It interrupts the plot… it just happens, and then life goes on. No one prepares you for it.
  6. After you have experienced something so unspeakable, how do you learn to trust yourself or anyone else again? Or conversely, how can you surrender to an intimate relationship after you have been brutally violated?
  7. Imagination is absolutely critical to the quality of our lives. Our imagination enables us to leave our routine everyday existence by fantasizing about travel, food, sex, falling in love, or having the last word – all the things that make life interesting. Imagination gives us the opportunity to envision new possibilities – it is an essential launchpad for making our hopes come true. It fires our creativity, relieves our boredom, alleviates our pain, enhances our pleasure, and enriches our most intimate relationships.
  8. Without imagination, there is no hope, no chance to envision a better future, no place to go, no goal to reach.
  9. Children who are endangered in their own homes: This is particularly tragic since it is very difficult for growing children to recover when the source of terror and pain is not enemy combatants their own caretakers.
  10. We have learned that trauma is not just an event that took place sometime in the past; it is also the imprint left by the experience on mind, brain, and body. This imprint has ongoing consequences for how the human organism manages to survive in the present.
  11. Trauma results in a fundamental reorganization of the way the mind and brain manage perceptions. It changes not only how we think and what we think about, but also our very capacity to think.
  12. For real change to take place, the body needs to learn that the danger has passed and to live in the reality of the present.
  13. People can never get better without knowing what they know and feeling what they feel.
  14. The greatest sources of our suffering are the lies we tell ourselves.
  15. Activities that cause fear or pain can later become thrilling experiences.
  16. Addicted to trauma: Are traumatized people condemned to seek refuge in what is familiar? If so, why, and is it possible to help them become attached to places and activities that are safe and pleasurable?
  17. The more intense the visceral, sensory input from the emotional brain, the less capacity the rational brain has to put a damper on it.
  18. The challenge is not so much learning to accept the terrible things that have happened but learning how to gain mastery over one’s internal sensations and emotions. sensing, naming, and identifying what is going on inside is the first step to recovery.
  19. They are not out to get you.
  20. People with PTSD have their floodgates wide open. Lacking a filter, they are on constant sensory overload. In order to cope, they try to shut themselves down and develop tunnel vision and hyperfocus. If they can’t shut down naturally, they may enlist drugs or alcohol to block out the world.
  21. When you can’t be fully here, you go to the places where you did feel alive – even if those places are filled with horror and misery.
  22. We must most of all help our patients to live fully and securely in the present.
  23. Desensitization may make you less reactive, but if you cannot feel satisfaction in ordinary everyday things like taking a walk, cooking a meal, or playing with your kids, life will pass you by.
  24. Being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives.
  25. Being truly heard and seen by the people around us, feeling that we are held in someone else’s mind and heart.
  26. Many traumatized people find themselves chronically out of sync with the people around them.
  27. Many people feel safe as long as they can limit their social contact to superficial conversations, but actual physical contact can trigger intense reactions.
  28. One thing is certain: Yelling at someone who is already out of control can only lead to further dysregulation.
  29. Sometimes we use our minds not to discover facts, but to hide them.
  30. The price for ignoring or distorting the body’s messages is being unable to detect what is truly dangerous or harmful for you and, just as bad, what is safe and nourishing.
  31. Self-regulation depends on having a friendly relationship with your body. Without it, you have to rely on external regulation – from medication, drugs like alcohol, constant reassurance, or compulsive compliance with the wishes of others.
  32. Children become attached to whoever functions as their primary caregiver. But the nature of that attachment – whether it is secure or insecure – makes a huge difference over the course of a child’s life.
  33. The need for attachment never lessens. Most human beings simply cannot tolerate being disengaged from others for any length of time. People who cannot connect through work, friendships, or family usually find other ways to bonding, as through illnesses, lawsuits, or family feuds.
  34. Kids will go to almost any length to feel seen and connected.
  35. No matter what else we learn about ourselves, we will carry that sense with us: that we are basically adorable. But if we are abused or ignored in childhood, or grow up in a family where sexuality is treated with disgust, our inner map contains a different message.
  36. Rage that has nowhere to go is redirected against the self, in the form of depression, self-hatred, and self-destructive actions.
  37. Nothing feels safe – least of all your own body.
  38. The idea that I am worth being worried about by someone I respect and who does understand how deeply I am struggling now.
  39. Erasing awareness and cultivating denial is often essential to survival, but the price is that you lose track of who you are, of what you are feeling, and of what and whom you can trust.
  40. When children feel pervasively angry or guilty or are chronically frightened about being abandoned, they have come by such feelings. They have repeatedly been threatened with abandonment.
  41. 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.
  42. Childhood abuse isn’t something you “get over.” It is an evil that we must acknowledge and confront if we aim to do anything about the unchecked cycle of violence in this country.
  43. Memories: They are always full of quietness, that is the most striking thing about them, even when things weren’t like that in reality, they still seem to have that quality.
  44. We all know how fickle memory is; our stories change and are constantly revised and updated.
  45. Traumatized people simultaneously remember too little and too much.
  46. As long as memory is inaccessible, the mind is unable to change it. But as soon as the story starts being told, particularly if it’s told repeatedly, it changes – the act of telling itself changes the tale. The mind cannot help but make meaning out what it knows, and the meaning we make of our lives changes how and what we remember.
  47. Nobody wants to remember trauma.
  48. In order to understand trauma, we have to overcome our natural reluctance to confront that reality and cultivate the courage to listen to the testimonies of survivors.
  49. What has happened cannot be undone. But what can be dealt with are the imprints of the trauma on body, mind, and soul; the crushing sensations in your chest that you may label as anxiety or depression; the fear of losing control; always being alert for danger or rejection; the self-loathing; the nightmares and flashbacks; the fog that keeps you from staying on task and from engaging fully in what you are doing; being unable to fully open your heart to another human being.
  50. Trauma robs you of the feeling that you are in charge of yourself.
  51. Understanding why you feel a certain way does not change how you feel.
  52. The more frazzled we are, the more our rational brains take a backseat to our emotions.
  53. At the core of recovery is self-awareness.
  54. Traumatized people are often afraid of feelings. It is not so much the perpetrators but their own physical sensations that now are the enemy.
  55. When we are terrified, nothing calms us down like the reassuring voice or the firm embrace of someone we trust.
  56. Relief does not come until they are able to acknowledge what has happened and recognize the invisible demons they’re struggling with.
  57. Unresolved trauma can take a terrible toll on relationships.
  58. You have to find someone you can trust enough to accompany you, someone who can safely hold your feelings and help you listen to the painful messages from your emotional brain. You need a guide who is not afraid of your terror and who can contain your darkest rage, someone who can safeguard the wholeness of you while you explore the fragmented experiences that you had to keep secret from yourself for so long. You need an anchor.
  59. When the physical tension is released, the feelings can be released.
  60. The first place I might touch someone is their hand and forearm because that’s the safest place to touch anybody, the place where they can touch you back.
  61. Touch lets them know that they are safe.
  62. Telling a story about the event does not guarantee that the traumatic memories will be laid to rest.
  63. Being traumatized is not just an issue of being stuck in the past; it is just as much a problem of not being fully alive in the present.
  64. As long as you keep secrets and suppress information, you are fundamentally at war with yourself.
  65. Hiding your core feelings takes an enormous amount of energy. It saps your motivation to pursue worthwhile goals, and it leaves you feeling bored and shut down. Meanwhile, stress hormones keep flooding your body, leading to headaches, muscle aches, problems with your bowels or sexual functions – and irrational behaviors that may embarrass you and hurt people around you.
  66. Only after you identify the source of these responses can you start using your feelings as signals of problems that require your urgent attention.
  67. Getting perspective on your terror and sharing it with others can establish the feeling that you are a member of the human race.
  68. Anyone who enters talk therapy almost immediately confronts the limitations of language.
  69. The object of writing is to write to yourself, to let yourself know what you have been trying to avoid.
  70. Trauma makes people feel like either some body else , or like no body. In order to overcome trauma, you need help to get back in touch with your body, with yourself.
  71. You really need to know the difference between your desire to hear stories and your patient’s internal process of healing.
  72. EDMR loosens up something in the mind/brain that gives people rapid access to loosely associated memories and images from their past.
  73. Heart Rate Variability: HRV is important because when our autonomic nervous system is well balanced, we have a reasonable degree of control over our response to minor frustrations and disappointments, enabling us to calmly assess what is going on when we feel insulted or left out.
  74. It’s difficult for traumatized people to feel completely relaxed and physically safe in their bodies.
  75. We do not truly know ourselves unless we can feel and interpret our physical sensations. While numbing may make life tolerable, the pricy you pay is that you lose awareness of what is going on inside your body, and with that, the sense of being fully, sensually alive.
  76. Trauma makes you feel as if you are stuck forever in a helpless state of horror. In yoga, you learn that sensations rise to a peak and then fall.
  77. People can learn o control and change their behavior, but only if they feel safe enough to experiment with new solutions.
  78. The body keeps the score: If trauma is encoded in heartbreaking and gut-wrenching sensations, then our first priority is to help people move out of fight-or-flight states, reorganized their perception of danger, and manage relationships.
  79. Child abuse and neglect is the single most preventable cause of mental illness, the single most common cause of drug and alcohol abuse, and a significant contributor to leading causes of death such as diabetes, heart disease, cancer, stroke, and suicide.
  80. Being in control of ourselves requires becoming familiar with our inner world and accurately identifying what scares, upsets, or delights us.
  81. Emotional intelligence starts with labeling your own feelings and attuning to the emotions of the people around you.
  82. Resilience is the product of agency: knowing that what you can do can make a difference.
We have learned that trauma is not just an event that took place sometime in the past; it is also the imprint left by the experience on mind, brain, and body. This imprint has ongoing consequences for how the human organism manages to survive in the present.
*I take no credit for any of these points.

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