Audio-book Review
By Chet Yarbrough

Website: chetyarbrough.com

The Body Keeps the Score: Brain, Mind, and Body in the Healing of TraumaThe Body Keeps the Score

Written by: Bessel van der Kolk, MD

Narration by:  Sean Pratt


Dr. Bessel van der Kolk argues that trauma has a neurological connection between mind, body, and time.   Van der Kolk offers numerous examples of patients who suffer from the trauma of war, rape, accident, and childhood experience to support a belief that “The Body Keeps the Score” and human consciousness pays the price.


In a limited sense, van der Kolk’s argument is convincing.  The limited sense is in one’s definition of trauma.  Trauma that clinically demonstrates disconnection between mind, body, and time, as proposed by van der Kolk, is a credible argument.  However, in reading/listening to books by Steven Pinker, a part of van der Kolk’s argument seems overdrawn.  Steven Pinker is an American psychologist, cognitive scientist, and linguist.  He is a Professor in the Department of Psychology at Harvard University.

Pinker argues that human beings primarily become who they are from genetics and life experience; largely exclusive of parenting.  In contrast, van der Kolk suggests parenting plays a significant role in a child’s consciousness as a mature adult. van der Kolk argues that parents who make their children feel safe have a significant impact on their psychological health.  Van der Kolk argues that the trauma of parental abuse, neglect, and egoistic child’ indulgence form mind-body-time’ disconnects that profoundly affect children who become adults.  Van der Kolk’s parenting arguments fly in the face of studies cited by Pinker that suggest less than one percent of a parent’s upbringing makes a difference in a child’s adulthood.

This may be a distinction without a difference if one accepts van der Kolk’s references to experience and sociological studies that show juvenile delinquency is credibly correlated with childhood trauma from incest, neglect of basic human needs like food or water, or hyper-vigilant (smothering) parental attention to children who sometimes just want to be left alone.

What van der Kolk argues is that trauma often becomes imprinted mind /body’ experiences disconnected from time.  Modern acceptance of PTSD in veterans of combat reinforces van der Kolk’s argument.  The generally accepted definition of PTSD by the American Psychological Association “…is an anxiety problem that develops in some people after extremely traumatic events, such as combat, crime, an accident or natural disaster.”  This broad definition is expanded by van der Kolk in two significant ways.

One, those suffering from PTSD are riven with anxiety by a trauma that is stuck in time; i.e. time that stands still.  Van der Kolk explains that a PTSD sufferer recalls a past trauma as though it is happening now and his/her body reacts in the same way it did when the trauma first occurred.  The body’s chemical and hormonal reaction is the same as though a past trauma is happening now.  The chemical and hormonal reaction is based on flashes of the trauma rather than a complete replay of the trauma. Van der Kolk’s second significant expansion is belief that children experience the equivalent of PTSD from parents’ psychological and physical abuse during childhood.  A child’s chemical and hormonal response to childhood trauma repeats itself.  In sum, time stands still when triggered by a flash of the traumatic event and the body repeats its physiological response.

Van der Kolk infers that the psychological maladies of adults can be significantly reduced by better parenting.  The difficulty one has in accepting this argument is that documentary proof lies in anecdotal evidence from psychiatrist interviews of patients and sociological surveys of defined populations, both of which are inherently biased.  Psychiatric interviews rely on patients’ remembrance of things past which are historically unreliable.  Sociological surveys cannot be done without the bias of a person or group that selects the subject population, and designs questions that are asked of a person answering a survey.

Van der Kolk may be correct but there is enough reservation in the Psychiatric community to deny van der Kolk’s request for a psychiatric diagnosis of Developmental Trauma Disorder for children or children who have become adults.  This is a frustrating issue because there are unquestionably millions of children that are abused and neglected in the world.  These children are often not treated for their psychological problems because insurance is not available for un-diagnosed patients.  If van der Kolk is correct, a diagnosis would be a first step in developing a course of medical treatment that is at least partially covered by insurance.

There is also the tangential argument made by psychologists like Steven Pinker that do not believe parenting has much to do with who children become as adults.  Nevertheless, one’s heart goes out to those children that are abused by their parents or are deprived of the basic needs of life.

Van der Kolk recommends that patients who suffer from trauma, whether falsely or accurately recalled, should take up meditation exercises to mitigate damaging physiological responses that cause psychological and physiological distress.  Deep breathing exercises, massage therapy, and meditation have been shown to improve patient psychological health in scientific studies and in van der Kolk’s medical practice.  Van der Kolk, like some recovering war veterans, acknowledges that so-called talk therapy can aggravate rather than mediate PTSD symptoms.  Sufferers of PTSD may become more rather than less stressed by recalling the details of trauma.

Van der Kolk’s argument that trauma has a neurological connection between mind, body, and time is convincing.  An additional argument made by van der Kolk that medication is often mis-prescribed, is equally convincing because drugs can mask true causes, and delay or deny potential curative treatment for psychological imbalance.  Still, parental treatment of children as a principal cause of adult neurosis or psychosis is less convincing. Science is not presently adequate to the task of proof.

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