1. “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma” by Bessel van der Kolk
My Feelings About Reading the Book: The examples in the book were tough and required maintaining a calm demeanor.
The Book’s Content for Me: This is a very important book for therapists who deal with trauma work. It contains a lot of research, scientific information, and examples of how different therapy formats affect the brain, body, and reactions. Additionally, it offers various other options and their results. The book provides a thorough treatment of trauma work, explaining how trauma affects neural connections, brain function, body reactions, and what exactly happens when trauma occurs within a person.
Some Passages from the Book: “Trauma always involves not being seen, mirrored, or considered. This is related to mirror neurons.”
“Emotional brain = mammalian brain = limbic brain. The development of this brain area begins after the child is born. It is the seat of emotions, the threat monitor, the judge of what is pleasant and what is frightening, and the evaluator of what is important for survival and what is not. It is the central command center for coping with the challenges posed by our complex social networks.”
“When a person feels protected and loved, the brain develops skills in consideration, play, and cooperation; when a person feels scared and unwanted, the brain tunes into managing feelings of fear and abandonment.”
“Treatment must reactivate the ability to safely mirror others and be mirrored by them, while also resisting the pull of others’ negative emotions.”
“Without flexible, active frontal lobes, people become victims of habit, and their relationships become superficial and routine. Innovation and exploration, wonder and curiosity—all are missing in traumatized individuals.”
“The more intense the internal sensory signal from the emotional brain, the less capable the rational brain is of suppressing it.”
“Signals come to the thalamus through the five senses, an area within the limbic system. The thalamus blends all sensory perceptions into a coherent autobiographical soup—an integrated and coherent experience that says, ‘This is happening to me now.’ This is then sent downwards to 1) the amygdala (low road)—it is in the subconscious brain—this pathway is extremely fast. 2) It is sent upward to the frontal lobes (high road), which takes several milliseconds longer in a dangerous situation. The thalamus may also fail. Then, images, sounds, smells, and touches are encoded as isolated fragments, and normal memory function collapses. Time stands still, and the current threat seems to last forever.”
“Reprogramming works from the bottom up, that is, through the reptilian brain, through breathing, movement, and touch (body psychotherapy).”
“Emotionality and rationality are not opposites; emotions assign value to experiences and are thus the foundation of reason (rationality). A person’s sense of self is the result of a balance between the rational and emotional brain. When these two systems are balanced, we feel like ourselves.”
“The core of trauma is disconnection. Healing is not so much about accepting terrible events that happened, but about regaining control over inner sensations and emotions. Sensing, naming, and defining what is happening inside is the first step towards healing.”
“A blank stare, scattered consciousness is an external expression of a biological freeze state. Depersonalization is one symptom of extensive dissociation caused by trauma (e.g., a person often says they feel nothing). A shut-down client—most (if not all) of their brain areas are silent; they likely cannot think much, feel deep emotions, remember, or understand what is really happening. Standard psychotherapy is virtually useless in this situation. Here, bottom-up therapy works—changing the client’s physiology (starting with the reptilian brain and simple functions like breathing, movement, touch), that is, their relationship with bodily sensations. Plus, teaching the client to live in the present, improve quality of life, and revive shut-down brain areas.”
“When the organism is in survival mode (partially or fully, as is often the case with traumatized clients), its energy is focused on repelling invisible enemies, leaving no room for tenderness, care, and love. This means that close relationships with oneself and others are at risk. Also at risk are the abilities to plan, imagine, be creative, play, learn, and notice the needs of others.”
“The heart, intestines, and brain communicate intimately via the vagus nerve. Therefore, these three are strongly affected in the case of strong emotions. The heart and intestines are the two most important organs. As long as we control emotions in our heads, we ignore emotions in our bodies. We do this by numbing ourselves (e.g., substances) or by releasing emotions by harming ourselves (e.g., cutting). This relationship between the body and mind is a two-way communication!”
“Trauma surfaces in fragments, piece by piece. It does not come in order as if there were no beginning or end.”
“Life events can change gene behavior but do not affect gene structure. Life events can trigger biochemical messages that turn gene behaviors on or off, attaching methyl groups (which are heritable—this process is called epigenetics, where the body keeps track at a deeper level) to the gene surface, making the gene more or less responsive to signals from the organism.”
“The more adrenaline released into the body, the more precisely the event is remembered. Emotional overload determines the detail accuracy of the memory, but only up to a certain limit. When faced with horror—especially ‘inevitable horror,’ this system becomes overloaded and stops functioning.”
“The rational brain helps us understand where emotions come from (e.g., my father hit me, so I do not trust any man). However, the rational brain cannot cancel emotions, sensations, or thoughts. Understanding why you feel a certain way does not change how you feel, but it can save you from giving in to those intense reactions. Nevertheless, the more devastated a person is, the more the rational brain falls behind emotions. The rational and analytical brain does not have a direct connection to the emotional brain, where most trauma traces are located. However, the medial prefrontal cortex, the center of self-awareness, does have this connection.”
“The core of trauma healing is awareness. Body awareness leads to contact with one’s inner world, the landscape of one’s organism. Merely noticing your reaction (irritation, anxiety, etc.) opens up alternative solutions to automatic reactions. This helps shift the sense of perspective. By paying more attention to bodily sensations, we can monitor the rise and fall of our emotions and thereby increase control over ourselves. A traumatized person fears their emotions because their bodily sensations have become enemies. The emotional brain generates these sensations over and over until they are addressed. Learning to observe and understand (and tolerate) your bodily reactions is a prerequisite for safely visiting the past.”
As this short excerpt from the book shows, it contains a lot of crucial information for working with trauma and understanding what happens in the brain, body, and organism. For me, the balance of offering solutions and different work options while scientifically, therapeutically, and humanely explaining them was very well done. The book is multifaceted, densely packed with information, and definitely worth the money. It’s a must-have book on a therapist’s work shelf.
Enjoy your reading experience!