The Body Keeps the Score, A Review

The Body Keeps the ScoreBessel van der Kolk is a Dutch psychiatrist with 30 years of experience and infinitely more compassion. Reading his work felt like a hug, firm against my railing and flailing but not constricting or threatening. I have a friend who met him, and that’s apparently how talking to him “in the face” (a concatenation of “in person” and “face to face” I made when I was young) feels, too. I’m tempted to simply repost all the quotes I’d put up on Facebook, in an effort to be seen and known, while I was reading this book, right here because they really are the best reasons to read this book. You don’t have to be a therapist or doctor to benefit from this book; its technical precision and ‘shop’ language don’t obscure the message for the lay reader and his gentle yet urgent tone belies his deep concern for those who suffer, both at the hands of those who are supposed to care for them and under the care of the system that is supposed to help them heal.

It should not be a radical thing to say that we need each other. “We barely exist as individuals” is the way van der Kolk says it. And in other cultures, it’s not. But that’s why The Body Keeps The Score is such an essential book for this one: our individualism leads us to think we owe nothing to one another, that we are not responsible to each other, that being busy is an acceptable excuse to let relationships drop.  But page after page, van der Kolk affirms the necessity of relationships, not just in healing, but in being and remaining healthy at all. “”Being validated by feeling heard and seen is a precondition for feeling safe,” he writes, “which is critical when we explore the dangerous territory of trauma and abandonment.”

Here is another way Brother van der Kolk is an urgent balm to our closed-off, shutdown, just-go-shopping culture: “Communicating fully [and being understood] is the opposite of being traumatized….We may think we can control our grief, our terror and our shame by remaining silent, but naming offers the possibility of a different kind of control. When Adam was put in charge of the animal kingdom in the Book of Genesis, his first act was to give a name to every living creature. If you have been hurt, you need to acknowledge and name what happened to you.” There are a few moments where what he’s saying could be construed as victim-blaming, but he’s just so affirming of the need for relationships that it’s clear what he means.

And, though he sometimes prescribes medications to his patients, here are his right-on thoughts about psych drugs: “Yes, we can take drugs that blunt our emotions or we can learn to desensitize ourselves. As medical students, we learned to stay analytical when we had to treat children with third-degree burns. But, as neuroscientist Jean Decety at the University of Chicago has shown, desensitization to our own or other people’s pain tends to lead to an overall blunting of emotional sensitivity…Drugs cannot ‘cure’ trauma; they can only dampen the expressions of a disturbed physiology, and they do no teach the lasting lessons of self-regulation. They can help to control feelings and behavior, but always at a price – because they work by blocking the chemical systems that regulate engagement, motivation, pain and pleasure.”

Finally, I love that, for this doctor who is practicing medicine with compassion, who owns that his profession is in fact part of the problem when it comes to abiding healing, trauma and its resolution are ultimately about social justice. Hurt people hurt people, he says and he has to fight despair over the state of the world and the way our systems are deepening, rather than alleviating it, too. I’ll leave you with this in hopes that it will spur you to read Bessel van der Kolk’s so-very-needed book:

“And yet, attending the wake for another teenager who was killed in a drive-by shooting in the Blue Hill Avenue section of Boston or after reading about the latest school budget cuts in impoverished cities and towns, I find myself close to despair. In many ways, we seem to be regressing, with measures like the callous congressional elimination of food stamps for kids whose parents are unemployed or in jail; with the stubborn opposition to universal health care in some quarters; with psychiatry’s obtuse refusal to make connection between psychic suffering and social conditions; with the refusal to prohibit the sale or possession of weapons whose only purpose is to kill large numbers of human beings; and with our tolerance for incarcerating a huge segment of our population, wasting their lives as well as our resources.

Discussions of PTSD still tend to focus on recently returned soldiers, victims of terrorist bombings or survivors of terrible accidents. But trauma remains a much larger public health issue, arguably the greatest threat to our national wellbeing. Since 2001, far more Americans have died at the hands of their partners or other family members than in the wars in Iraq and Afghanistan. American women are twice as likely to suffer domestic violence as breast cancer. The American Academy of Pediatrics estimates that firearms kill twice as many children as cancer does. All around Boston I see signs advertising the Jimmy Fund, which fights children’s cancer, and for marches to fund research on breast cancer and leukemia, but we seem too embarrassed or discouraged to mount a massive effort to help children and adults learn to deal with the fear, rage and collapse, the predictable consequences of having been traumatized.” Thank you, Brother van der Kolk, for leading the way towards making such efforts on behalf of the hurt, the unhealed and the forgotten.

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