How the body keeps the score on trauma | Bessel van derKolk for Big Think+
Bessel Van Der Kolk MD, psychiatrist, neuroscientist, has studied trauma for
about 50 years. The approach of
mainstream psychotherapy is that “there is something wrong with you, and I need
to fix you”. Trauma requires a very
different approach. Trauma can look
like- people flying off the handle, people shutting down, drug or alcohol
addiction, explosive anger, passivity and “spacing out”, seeming to be “stuck
in the past” and unable to be meaningfully involved in the present. Difficulty regulating/modulating responses to
the environment.
1941 book by Dr Abram Kardiner, a psychoanalyst, noted of
soldiers in world war that they have a “physioneurosis. Their bodies continue to re-experience that
very terrible, frightening situation, and that event keeps coming back in terms
of images, behaviors, and physical sensations.”
Definition of PTSD “These people have been exposed to an extraordinary
event that’s outside of normal human experience.” WRONG- trauma is NOT unusual. “The nature of trauma is that an experience
enters into your ears, into your skin, into your eyes, and it goes down into a
very primitive part of your brain that automatically interprets what’s going
on.” The amygdala? It tried to figure out if you’re safe or in
danger, and when there’s nothing you can do to stop the inevitable from
happening, you go into fight/flight or collapse (freeze). In the long term you react to mild stressors
as if your life is in danger. Basically
your brain hasn’t figured out yet that the danger is over. Most people have no idea that their reactions
to things, that are overblown from trauma, have anything to do with the past
and not just what’s present.
“The tradition in mental health is to dismiss the reality of
people’s lives.” Things such as poverty,
racism, unemployment, affect people’s behavior and those behaviors don’t
respond well to drugs or other medical treatment. (The idea that they
should is eugenics- you are happy and well-adjusted when you are in your
“proper place”.) “I need to take
care of the wounds that I’m carrying inside of me”. Self-compassion is important for trauma.
Trauma is not what happened to you, it’s how you
respond. One of the most important
factors, especially when you are a child, is if someone is there for you to
help you. If they can make you feel
understood and bring safety and comfort.
Dr. Bessel van der Kolk | The Body Keeps the Score:Restoring an Inner Sense of Safety
Survivors can become stuck in fight/flight/freeze, and the resulting stress
hormones can severely affect the immune system and organs. “When you go into trauma, you lose your
frontal lobe. You become
dumbfounded.” The impact of trauma is on
your limbic system- it’s in charge of the housekeeping of your body. Trauma is an experience of horror. You cannot tell your trauma story, your whole
body keeps getting overwhelmed. You feel
trauma in your body (but what about dissociation?). It affects every part of your biology- your
sleep, your eating. You try to numb
yourself. When you shut down, you can’t
learn and take in new experiences. People
use substances to try to control their bodies.
After the trauma is over, will people be able to function? It’s very hard to treat trauma.
How to move through trauma and recover- establish a
community of people, who have your back.
Who are there for you no matter what.
We are social animals and we need people around us who believe in us
when we are in distress. Create
community. Tell your story if you can. Trauma can make you feel helpless and
collapse. Healing includes building a
sense of agency, that you CAN do things.
You need to learn to regulate yourself.
In his study, yoga did better than any traditional psychiatric
medications in treating trauma. Dancing
and music. Boxing requires you be in
tune with the people around you. When
you’re traumatized you get scared of yourself.
You need to learn to access yourself.
You’re afraid of your internal reactions and memories. You need to meet yourself and learn to
tolerate yourself. Also neurofeedback
and psychedelics.
Trauma Has NO Quick-Fix | Dr Bessel van der Kolk on theBody Keeps the Score.
“Trauma overwhelms your capacity to filter, focus, and concentrate.” Different treatments work for different
people. Stay curious. How can you help someone lead a more
satisfying life? How to re-establish a
sense of safety? Neglect- people need to
be known and seen- that’s where safety starts.
If you’ve been neglected and abused, you may not know yourself. One of the prerequisites to healing is
learning to manage your own state.
What trauma does to your brain and body | Bessel van derKolk
Stress is different than trauma, when it’s over it’s over, but trauma
isn’t.
The Mind Hides the Score | Dr Bessel van der Kolk onTrauma and the Mind.
Our attachment system is a major determinant of how we respond to traumatic
events. What’s more important than what
happened to you is who was there for you?
Kids with secure attachments react very differently to severe burns than
kids whose parents are absent or traumatized.
The attachment system trumps the trauma system. If you are in fight/flight, you are less able
to care for your offspring, and they become less resilient. Predatory abusive priests knew how to choose
a target and seduce them by telling them they’re safe with them. Physical immobilization is amajor factor in
an event becoming traumatic. It matters
if you were able to do something, can you activate your stress hormones? Trauma is not an “event” -it makes you live
in a completely different world. Your
body doesn’t differentiate between a physical trauma (an injury, a toxin) and
an emotional trauma. Your body can feel
helpless in the face of a disease or toxic exposure. The first thing is to make it safe to feel
what you feel. Touch is the greatest
comfort that people can have.
Therapist Shares 8 Signs of Trauma | The Body Keeps theScore
Bessel Van Der Kolk is a medical doctor who talks about the brain and talks
about trauma.
1) Dissociation, numbing. Parasympathetic
functions have shut down. Can be
physical, is usually emotional. Often
describes as feeling “out of body”.
2) Body always in an aroused state. In
constant state of perceived danger. Means
high adrenaline and cortisol levels. The
mind/brain doesn’t know that the danger is over. People then turn to manual or external ways
to calm down including drugs, alcohol, masturbation, starvation, or cutting
(self-harm).
3) Self-loathing. People often blame
themselves for their traumas.
4) Rigidly stuck in the past. Involves
thalamus and pre-frontal cortex. Thalamus
is sensory interpretation and processing.
Pre-frontal cortex is time-keeper, processes events
chronologically.
5) Speechless terror. Becoming mute in
certain situations.
6) Loss of self. This also means a
difficulty identifying what it is “other”.
This can result in confusing whether the danger is someone else or
inside yourself.
7) Physical immobility. A perpetrator
may actually tell you not to move, or there can be other reasons why you might
learn that it is safer to stay still than to move and then freeze up when
triggered.
8) Difficulty learning new
information. This can look like learning
something and making progress, only to find yourself back where you started
having to learn it again. Sometimes
people’s growth and learning can be stopped at the age when they experienced
trauma, and this can make them seem immature.
Therapist Shares How to Heal from Trauma | The Body Keepsthe Score
Acupuncture and yoga can help address the trauma in the body without having to
talk about it. Building community,
“communal techniques”- trauma can be isolating and make us feel cut off from
others, so activities such as synchronized dancing and singing together can
help, and joining a community such as a church can help you feel like you have
a place where you belong and that you’re a part of something bigger. “Re-engaging with the outside world.” These things help to bring your body and
brain back on line “in a way that is cohesive to living a fully functional
life.”
Imagination is important for recovering from trauma and
finding a way out of the stuckness in the past, including flashbacks,
nightmares, and struggling to make sense of what is happening in the
present. People can stay in what’s
familiar, even if it’s unpleasant, because it’s predictable. Doing improv can build the imagination and
help build connection with others. Art
can be therapeutic and help us process our trauma and take control of the
narrative, and maybe to see it in a new way, and separate from the experience
in the past. Theater is similar, but
also involves learning that you can have the same moment over and over and also
have it be different every time. “Your job is not to be “shrinks”, your job is
to be mind-openers.” – Bessel Van Der Kolk in the training. A good therapist wull help you see your worth
and build your self-esteem.
More direct trauma therapies can include role-playing and
“psychodrama” in which you act out what the ideal reaction would have been when
you told someone what happened to you, as a way to re-work your narrative about
the trauma. EMDR = Eye Movement
Desensitization and Reprocessing. EMDR
helps to reduce or eliminate the physiological symptoms such as sweating,
racing heartbeat, that can happen when talking about your trauma. EMDR is more appropriate for “one time” or
single event trauma, when you need to think about it without symptoms, but not
as appropriate for complex trauma.
Other ideas from her practice include writing a letter to
someone who traumatized you or failed to protect you, telling them what
happened from your point of view, how it made you feel, and how it has impacted
you to the present. You can destroy or
keep the letter, but if you want to send it to the person, she suggests
including what that person could do now to help you have closure or repair the
relationship- do you want an apology? An
explanation? Acknowledgement? For youself, you can write the event as you
wished it had happened, or including the ways you wished you could have
responded and protected yourself. Slowly
start re-exposing yourself to things that remind you of someone you lost or who
betrayed you, such as places, things, music, etc. This is so that people can start “reclaiming
aspects of their life that they have been denying themselves since the
traumatic event.” People often find that
the actual experience isn’t nearly as bad as they expected it to be.
Being traumatized in the way that qualifies for a PTSD
diagnosis, usually means that are life is “stopped in its tracks” and not
progressing, and we are not functioning or able to work towards our goals. Not everyone is “traumatized”.
