Learn / Healing Trauma, Brain, and Body with Bessel van der Kolk
Healing Trauma, Brain, and Body with Bessel van der Kolk
March 8th, 2024| Clinically Reviewed by
Key Points
- Dr. van der Kolk gained decades of experience at the forefront of trauma treatment.
- His book combines and explains his research and findings.
- Clinicians and the general public use his book to understand trauma and recovery.
In This Article
Dr. Bessel van der Kolk is a psychiatrist, researcher, educator, and author of The Body Keeps the Score. His book, published in 2014, explains how and why trauma stays within—and transforms—the body. Decades of experience and research, much of it outside treatment norms, led Bessel to write his best-selling book, now translated into 43 languages.
Since publishing, clinicians and the general public alike have used his research and insight to develop new understandings of trauma and its effects on the whole body. We’ll dive into the themes and topics covered in van der Kolk’s momentous novel.
Author’s Background
Dr. Bessel van der Kolk began his career in trauma studies/treatment in one of the first-ever clinical research centers studying people with trauma. He began by studying post-traumatic stress disorder (PTSD) and how mental health medications could affect it. Van der Kolk worked directly with traumatized adults, many of them veterans, to study how trauma works and how people heal.
Bessel van der Kolk’s research and treatment focuses on creating safe connections to the self and others and becoming aware of inner emotional states. He’s studied various treatments for trauma, including yoga, eye movement desensitization and reprocessing (EMDR), neurofeedback, and psychedelic therapy.
His book encompasses his years of research, what he discovered about trauma (and narratives he found were false), and what he’s found can help people heal.
Overview of The Body Keeps the Score
The Body Keeps the Score highlights the connection between trauma and the physical body, emotions, and the truth of certain behaviors (like avoidance, substance use, and rage). Bessel’s direct work and study with PTSD patients informed his conclusions, theories, and proven hypotheses.
He describes and explains the symptoms of PTSD, why they develop into risky behaviors, and why traumatic stress affects and dictates neuroscience. Bessel led the forefront of the notion that the mind and body connect—and he proved it on many accounts. His book explains his findings, reasons how and why trauma lives in the body, and how traumatized patients can find genuine healing.
Van der Kolk’s proposed and proven treatments for PTSD veered from pharmacotherapy and traditional therapies, where patients were primarily suggested to talk about their experience until it no longer bothered them. As Bessel and his colleagues found, this could lead to retraumatization, avoidance, and treatment failure as a whole. Somatic approaches, EMDR, psychedelic therapy, and more became his new modes of healing.
Clinicians, patients, and loved ones alike found Bessel van der Kolk’s delivery to be empowering and educational. Despite his book’s clinical complexities and neurological themes, Bessel makes the information easy to read, insightful, and moving for the general public.
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Exploring Trauma and the Brain
Trauma is more than just a feeling or a thing that happened. It has a definable and proven ability to change the brain, altering the way it works until the trauma is treated.
In his studies and experiences with patients, Bessel found people would re-experience the sensations of trauma at a neurological level, which would then affect breathing, heart rate, and other physical responses (Van der Kolk, 2014).
This often begins in the amygdala, which signals fight-or-flight (producing adrenaline) and releases stress hormones. For many traumatized people, their bodies don’t stop secreting these hormones because they don’t often feel safe. Their brains and the many parts within it adapt to respond to perceived threats, which can affect physical health, mental health, and your wellness as a whole.
Neurological Impacts of Trauma
Bessel van der Kolk and colleagues found multiple neurological impacts of trauma. In one instance, they found a traumatized person’s brain activated in the visual cortex, right limbic area, and deactivated in the Broca’s cortex (where language is produced) (Van der Kolk, 2014). Additionally, the “self-sensing” areas of the brain simply did not activate when PTSD patients were asked to sit still and think about nothing, which naturally triggers an awareness of self (Van der Kolk, 2014).
These findings meant patients neurologically responded to the intense emotions of relieving their trauma, as expected, but also went into a state of “speechless horror” (when the Broca’s cortex deactivated). Bessel found this to be the reason why many trauma victims are physically unable to relay what happened to them, and he could see it in real-time on the scan. Many also could not feel a sense of self, instead feeling separated from their body and unaware of sensations like touch.
As long as trauma sensations remain stored in the memory, any activation may trigger the same sensations and feelings; as if the trauma is happening again. Bessel saw this through brain imagery and observing his patients’ reactions to stimuli related to their trauma.
Neuroplasticity for Recovery
Just as the brain can learn to live in a state of arousal, it can also learn to regulate. The areas of the brain, like the amygdala, can go back to healthy functioning. This ability is called neuroplasticity, or “a process that involves adaptive structural and functional changes2 to the brain.”
Neuroplasticity offers hope to those with trauma. In the same way their brains adapted to survive, so they can adapt to live fully.
Trauma’s Manifestation in The Body
Trauma does not go away without treatment. It lingers in sensations, memories, flashbacks, immune diseases, sleep problems, and asthma attacks. Mysterious illnesses without cause may point to the body simply trying to deal with the effects of being in survival mode long after you’ve survived the event. Such strain on the nervous system can eventually lead to mental and physical illness (Van der Kolk, 2014).
The Body Keeps The Score
Somatic symptoms without a clear physical cause commonly affect traumatized adults and children. Examples include:
- Autoimmune disorders
- Sleep disorders and insomnia
- Skeletal/muscular problems
- Asthma
- Numbness
- Migraine headaches
- Fibromyalgia
- Chronic fatigue
- Irritable bowel syndrome
- Chronic back and neck pain
In one example from Van der Kolk’s book, a woman with asthma attacks requiring hospitalization eventually realized she was experiencing a physical manifestation of intense emotions (related to childhood trauma). By focusing on the connection between them and addressing the emotions, she stopped having the attacks and needing hospitalization. This highlights the powerful connection between mind and body.
Therapeutic Approaches to Recovery
Dr. van der Kolk found and practiced multiple therapeutic approaches for trauma. He initially sought something other than the suggested mode of trauma healing: talking about it until it lost its effect. Bessel found avoidance, retraumatization, “speechless horror”, and other somatic effects of trauma often made this approach ineffective.
Though his patients sometimes reaped benefits from bringing their trauma to light, Bessel rightly thought they needed to do more than just become desensitized to verbalizing it.
Mindfulness and Somatic Experiencing
To help his patients first feel what was going on in their bodies, as many traumatized people are unable to do, Bessel practiced mindfulness with them (Van der Kolk, 2014). This strengthens the body’s natural ability to notice what’s going on within it.
You can practice mindfulness in many ways. One of the most simple ways is through breathing exercises—you can count the seconds you breathe in, hold the breath, and exhale. Becoming aware of basic functions like these can help ground you in the moment and experience the present. By connecting his patients into the present, Bessel aimed to tell their brains, “that [the trauma] was then, this is now.” (Van der Kolk, 2014, p. 181).
Similarly, somatic experiencing aims to help patients notice the physical sensations related to traumatic memories (Van der Kolk, 2014). They would then work on calming the body, mitigating hyperarousal, before ever wading into the trauma itself. Doing so offered a safe, stable baseline to begin parsing through memories. If done in a state of panic or arousal, attempting to relive the memories could cause retraumatization.
Eye Movement Desensitization and Reprocessing (EMDR)
Dr. van der Kolk soon adopted EMDR as one of his treatment modalities, though hesitantly at first. It seemed odd—tracking objects (like the therapist’s fingers) back and forth while recalling a traumatic memory allowed people to process it and heal? Bessel van der Kolk soon found that to be the case.
He found EMDR an effective way to orient trauma back to the past, rather than lugging it along into the present. Patients could radically improve in just a few sessions.
In examples from the book, Bessel guided assault, rape, and other trauma victims through rapid back-and-forth eye movements as they recalled their trauma. Vivid memories and sensations arose almost immediately, but his patients didn’t need to describe them to process them; only notice it. In one example, his patient/fellow student didn’t have to say a word to feel profoundly healed. That’s what Bessel found to be such an intriguing and effective aspect of EMDR: even those plagued by speechless, intolerable horrors could truly heal (Van der Kolk, 2014).
Studies highlighted in The Body Keeps the Score showed EMDR could be a much more effective treatment for PTSD than medications, or therapies like cognitive behavioral therapy (CBT) (Van der Kolk, 2014).
Yoga
Van der Kolk found yoga to be another way his patients could reorient themselves in their present body. It served as a mindfulness tool, a gentle form of exercise, and something his patients could grow an affinity for.
Poses and breathing techniques helped his patients reconnect to their bodies and feel comfortable being present. Bessel found yoga could be especially helpful for victims of rape and sexual assault as they began to grow more comfortable experiencing physical sensations (Van der Kolk, 2014).
Yoga also helped his patients become more attuned to their emotional states and passing sensations, ultimately helping them separate from past traumas and hold tight to the present.
Many other holistic and alternative therapies were found to alleviate trauma and help patients process it, including theater, psychedelic therapy, neurofeedback, and other forms of creative expression.
Impact on Mental Health Professionals
As one of the pioneers in trauma studies and healing, Bessel van der Kolk influenced many treatment providers and continues to do so. Many found success with their own patients after adopting a mind-body-connection ideology and focusing on helping trauma victims come into the present.
The revelations found in The Body Keeps the Score ultimately proved what many treatment providers suspected: talking about trauma didn’t cure it; and while prescribed medications could help with symptoms, they weren’t a cure-all either. It also gave them concrete insights and tools into what was found and proven to work.
Bessel effectively proved how and why traditional therapies didn’t always work for trauma, and how they could even do more harm than good (such as retraumatization). His accumulation of 30 year’s clinical work creates a manual, so to speak, for anyone wanting to deeply understand how people heal. Quotes from appreciative healthcare professionals include:
“With the compelling writing of a good novelist, van der Kolk revisits his fascinating journey of discovery that has challenged established wisdom in psychiatry. … This is a watershed book that will be remembered as tipping the scales within psychiatry and the culture at large towards the recognition of the toll traumatic events and our attempts to deny their impact take on us all.”
-Richard Schwartz, originator of internal family systems (IFS) therapy
“This outstanding volume is absolutely essential reading not only for therapists but for all who seek to understand, prevent, or treat the immense suffering caused by trauma.”
-Pat Ogden, PhD
“This book will provide traumatized individuals with a guide to healing and permanently change how psychologists and psychiatrists think about trauma and recovery.”
-Ruth A. Lanius, MD, PhD
Lighting The Path to a New Future
Books like The Body Keeps the Score effectively help change how society views trauma. As many reviews state, Dr. van der Kolk’s clinical findings have the power to change how the world sees trauma and trauma recovery.
To see rehabs treating trauma, you can browse our collection of trauma treatment providers with photos, reviews, pricing information, and more.
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