Medical Books
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The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
#1 New York Times bestseller
"Essential reading for anyone interested in understanding and treating traumatic stress and the scope of its impact on society." -Alexander McFarlane, Director of the Centre for Traumatic Stress Studies
A pioneering researcher transforms our understanding of trauma and offers a bold new paradigm for healing in this New York Times bestseller
Trauma is a fact of life. Veterans and their families deal with the painful aftermath of combat; one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Dr. Bessel van der Kolk, one of the world's foremost experts on trauma, has spent over three decades working with survivors. In The Body Keeps the Score, he uses recent scientific advances to show how trauma literally reshapes both body and brain, compromising sufferers' capacities for pleasure, engagement, self-control, and trust. He explores innovative treatments-from neurofeedback and meditation to sports, drama, and yoga-that offer new paths to recovery by activating the brain's natural neuroplasticity. Based on Dr. van der Kolk's own research and that of other leading specialists, The Body Keeps the Score exposes the tremendous power of our relationships both to hurt and to heal-and offers new hope for reclaiming lives.
"Essential reading for anyone interested in understanding and treating traumatic stress and the scope of its impact on society." -Alexander McFarlane, Director of the Centre for Traumatic Stress Studies
A pioneering researcher transforms our understanding of trauma and offers a bold new paradigm for healing in this New York Times bestseller
Trauma is a fact of life. Veterans and their families deal with the painful aftermath of combat; one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Dr. Bessel van der Kolk, one of the world's foremost experts on trauma, has spent over three decades working with survivors. In The Body Keeps the Score, he uses recent scientific advances to show how trauma literally reshapes both body and brain, compromising sufferers' capacities for pleasure, engagement, self-control, and trust. He explores innovative treatments-from neurofeedback and meditation to sports, drama, and yoga-that offer new paths to recovery by activating the brain's natural neuroplasticity. Based on Dr. van der Kolk's own research and that of other leading specialists, The Body Keeps the Score exposes the tremendous power of our relationships both to hurt and to heal-and offers new hope for reclaiming lives.
Editorial Reviews
"The trauma caused by childhood neglect, sexual or domestic abuse and war wreaks havoc in our bodies, says Bessel van der Kolk in The Body Keeps the Score. . . . Van der Kolk draws on 30 years of experience to argue powerfully that trauma is one of the West's most urgent public health issues. . . . Packed with science and human stories, the book is an intense read. . . . [T]he struggle and resilience of his patients is very moving."
-Shaoni Bhattacharya, New Scientist
"War zones may be nearer than you think, as the 25% of US citizens raised with alcoholic relatives might attest. Psychiatrist Bessel van der Kolk argues, moreover, that severe trauma is ‘encoded in the viscera' and demands tailored approaches that enable people to experience deep relief from rage and helplessness. In a narrative packed with decades of findings and case studies, he traces the evolution of treatments from the ‘chemical coshes' of the 1970s to neurofeedback, mindfulness and other nuanced techniques."
-Nature
"An astonishing amount of information on almost every aspect of trauma experience, research, interventions, and theories is brought together in this book, which . . . has a distinctly holistic feel to it. The title suggests that what will be explored is how the body retains the imprints of trauma. However, it delivers much more than this, delving into how the brain is impacted by overwhelming traumatic events, and is studded with sections on neuroscience which draw on the author's own numerous studies as well as that of his peers. In addition, it investigates the effects of adverse childhood attachment patterns, child abuse, and chronic and long-term abuse. . . . [T]his book is a veritable goldmine of information."
-European Journal of Psychotraumatology
"Dr. van der Kolk . . . has written a fascinating and empowering book about trauma and its effects. He uses modern neuroscience to demonstrate that trauma physically 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 t...
-Shaoni Bhattacharya, New Scientist
"War zones may be nearer than you think, as the 25% of US citizens raised with alcoholic relatives might attest. Psychiatrist Bessel van der Kolk argues, moreover, that severe trauma is ‘encoded in the viscera' and demands tailored approaches that enable people to experience deep relief from rage and helplessness. In a narrative packed with decades of findings and case studies, he traces the evolution of treatments from the ‘chemical coshes' of the 1970s to neurofeedback, mindfulness and other nuanced techniques."
-Nature
"An astonishing amount of information on almost every aspect of trauma experience, research, interventions, and theories is brought together in this book, which . . . has a distinctly holistic feel to it. The title suggests that what will be explored is how the body retains the imprints of trauma. However, it delivers much more than this, delving into how the brain is impacted by overwhelming traumatic events, and is studded with sections on neuroscience which draw on the author's own numerous studies as well as that of his peers. In addition, it investigates the effects of adverse childhood attachment patterns, child abuse, and chronic and long-term abuse. . . . [T]his book is a veritable goldmine of information."
-European Journal of Psychotraumatology
"Dr. van der Kolk . . . has written a fascinating and empowering book about trauma and its effects. He uses modern neuroscience to demonstrate that trauma physically 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 t...
Readers Top Reviews
Maggie
If I had not written my name in this book before trying to read it, I would have returned it. The text is TINY and so I struggled to read it. I have now ordered a hardback copy from elsewhere in the hope that I will be able to read it more comfortably. If you are familiar with text sizes, it's looking about size 8 which is way below accessibility requirements today. These are either 11 or 12 on the basic fonts such as Times New Roman, which is what this seems to be. The photo of the book cover probably illustrates the font size best: the line of text below the italics, beneath the graphic, in block capitals is similar in size to the text within the whole book. Excluding the Index, the book comprises 421 pages; and I wonder if the reduced font was in order to reduce the number of pages...? It's a shame, this book has been recommended to me by my counsellor; so I am rather disappointed and shocked, it has to be said, by my inability to see the text comfortably enough to read it.
M. Fraser
Steady explanation of the issue of trauma, whether childhood or adult, followed by many varied techniques to deal with it. It armed me with the information I needed to understand what I had repressed, allow it to be there, and then the tools to integrate the traumatised child back into my adult self in a way that helped me to live comfortably.
Cheese time
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.
Max M
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.
Short Excerpt Teaser
PROLOGUE
FACING TRAUMA
One does not have be a combat soldier, or visit a refugee camp in Syria or the Congo to encounter trauma. Trauma happens to us, our friends, our families, and our neighbors. Research by the Centers for Disease Control and Prevention has shown that one in five Americans was sexually molested as a child; one in four was beaten by a parent to the point of a mark being left on their body; and one in three couples engages in physical violence. A quarter of us grew up with alcoholic relatives, and one out of eight witnessed their mother being beaten or hit.1
As human beings we belong to an extremely resilient species. Since time immemorial we have rebounded from our relentless wars, countless disasters (both natural and man-made), and the violence and betrayal in our own lives. But 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.
Trauma affects not only those who are directly exposed to it, but also those around them. Soldiers returning home from combat may frighten their families with their rages and emotional absence. The wives of men who suffer from PTSD tend to become depressed, and the children of depressed mothers are at risk of growing up insecure and anxious. Having been exposed to family violence as a child often makes it difficult to establish stable, trusting relationships as an adult.
Trauma, by definition, is unbearable and intolerable. Most rape victims, combat soldiers, and children who have been molested become so upset when they think about what they experienced that they try to push it out of their minds, trying to act as if nothing happened, and move on. It takes tremendous energy to keep functioning while 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, abuse, and neglect. Those new disciplines are 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; and interpersonal neurobiology, the study of how our behavior influences the emotions, biology, and mind-sets of those around us.
Research from these new disciplines has revealed that trauma produces actual physiological changes, including a recalibration of the brain's alarm system, an increase in stress hormone activity, and alterations in the system that filters relevant information from irrelevant. 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 spontaneou...
FACING TRAUMA
One does not have be a combat soldier, or visit a refugee camp in Syria or the Congo to encounter trauma. Trauma happens to us, our friends, our families, and our neighbors. Research by the Centers for Disease Control and Prevention has shown that one in five Americans was sexually molested as a child; one in four was beaten by a parent to the point of a mark being left on their body; and one in three couples engages in physical violence. A quarter of us grew up with alcoholic relatives, and one out of eight witnessed their mother being beaten or hit.1
As human beings we belong to an extremely resilient species. Since time immemorial we have rebounded from our relentless wars, countless disasters (both natural and man-made), and the violence and betrayal in our own lives. But 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.
Trauma affects not only those who are directly exposed to it, but also those around them. Soldiers returning home from combat may frighten their families with their rages and emotional absence. The wives of men who suffer from PTSD tend to become depressed, and the children of depressed mothers are at risk of growing up insecure and anxious. Having been exposed to family violence as a child often makes it difficult to establish stable, trusting relationships as an adult.
Trauma, by definition, is unbearable and intolerable. Most rape victims, combat soldiers, and children who have been molested become so upset when they think about what they experienced that they try to push it out of their minds, trying to act as if nothing happened, and move on. It takes tremendous energy to keep functioning while 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, abuse, and neglect. Those new disciplines are 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; and interpersonal neurobiology, the study of how our behavior influences the emotions, biology, and mind-sets of those around us.
Research from these new disciplines has revealed that trauma produces actual physiological changes, including a recalibration of the brain's alarm system, an increase in stress hormone activity, and alterations in the system that filters relevant information from irrelevant. 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 spontaneou...
