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

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

by Bessel A. van der Kolk

Full of hard-hitting real-life trauma stories, The Body Keeps the Score transforms your understanding of developmental trauma disorder. It reveals how chronic interpersonal trauma rewires parts of your brain and triggers many disorders that most medical professionals take for granted. This book bucks the trend by providing research on some innovative trauma-healing treatments that can be used as an alternative to drugs and talk therapy.

Summary Notes

Recover Self-Awareness Through Mindfulness

“The challenge of recovery is to reestablish ownership of your body and your mind—of your Self. This means feeling free to know what you know and to feel what you feel without becoming overwhelmed, enraged, ashamed, or collapsed.”

Traumatized people tend to experience unbearable sensations such as tightness in the chest, heartbreak, and a burning feeling in the pit of the stomach. To cope with the pain, they try to disengage from their body sensations. Unfortunately, avoiding these feelings in your body only increases your chances of being overwhelmed by them. In other words, there can be no trauma recovery without regaining your self-awareness. But where do these feelings come from?

These unbearable feelings result from traumatic memories stuck in your emotional brain (amygdala). Even after the traumatic event, the emotional brain still generates sensations that trigger fear and helplessness in the victim. Instead of the perpetrator, these physical sensations now become the enemy. They can be so crippling to the body and mind that the sufferer will do anything to block them. This explains why trauma survivors resort to extreme measures such as compulsive drinking and social isolation to escape their bodies and numb their minds.  

However, you cannot heal trauma by avoiding the memories and pain of your past. Through body awareness, you can reconnect to your feelings of anxiety, anger, or fear. This enables you to consider new options instead of relying on your automatic default reactions. This is where mindfulness comes in. 

Mindfulness helps you stay focused on your bodily sensations as they flow through your body. Over time, you will realize that these negative feelings are transitory products of the past—not the present. Once you learn to observe and tolerate these physical reactions, you can safely revisit your past without the risk of traumatizing yourself again. Only then can you start engaging your trauma and regaining control of your present life. 

Actions to take

Find a Good Support Network

“When we are terrified, nothing calms us down like the reassuring voice or the firm embrace of someone we trust.”

Many acutely traumatic incidents occur every day. Car accidents, assaults, and natural disasters all tend to leave survivors scarred and terrified. Research shows that a good support network of people who love and support you is the most powerful protection against trauma. The right support can help you heal your mind and body so you can let go of the trauma's pain.

A trauma survivor requires the presence of familiar faces and voices, physical contact, and safe shelter. Apart from family and friends, a support network can include social groups such as a religious community, AA (alcoholics anonymous) meetings, or veteran’s associations. Such relationships provide physical and emotional security with no shame or judgment. They also encourage you to face and process your traumatic experience. 

But what if the people who are supposed to love and care for you caused your trauma? The most common traumas occur within relationships, such as child abuse and molestation by caregivers or domestic violence by an intimate partner. These are the most difficult traumas to treat because they strip the victim of the very love and support that is supposed to protect them from being traumatized.

When the people you expect to care for you reject, terrorize or violate you, you learn to disconnect from your emotions. This can lead to addictions, depression, panic attacks, and explosive rage. The shame and fear cause you to avoid opening up to new people. You can even deliberately hurt others because you mistakenly believe they will betray or abandon you. In such situations, you should seek external help from a professional therapist who can guide you along the healing process.

Actions to take

Touch As Therapy

“Just like you can thirst for water, you can thirst for touch. Mindful touch and movement grounds people and allows them to discover tensions that they may have held for so long that they are no longer even aware of them.”

Most doctors rely on drugs such as serotonin reuptake blockers to help patients cope with their intense sensations and unmanageable emotions. They conveniently forget that the most natural way for humans to reduce stress is through touch. Hugging a traumatized person or rocking a distressed child can help them calm down. Touch can thus be used in different bodywork practices such as therapeutic massage, craniosacral therapy, or Feldenkrais.

Mindful touch and movement help traumatized people become comfortable in their skin again. It helps them become aware of the tensions they’ve been holding onto for so long. The tense parts of their body, such as tight shoulders or tense facial muscles, correspond to negative emotions that they’ve bound up inside. They may feel a release of tension, and the bottled-up feelings may flow out after a bodywork session. Their breathing may become deeper, and they may even make sounds that express their pent-up emotions.

Traumatized people need help to regain a sense of where their bodies and boundaries are. Through firm and reassuring touch, they can get a better sense of the boundaries of their external world. They can become conscious of who and where they are, making them feel safe again. 

Actions to take

Write Your Way Out Of Trauma

“The object of writing is to write to yourself, to let yourself know what you’ve been trying to avoid.”

If you study the lives of trauma survivors, you’ll realize that they often feel isolated, ignored, or silenced. They struggle to find the words to express or share their deepest pain and feelings with others. Yet the simple act of fully communicating with another is essential to the healing process. This is why talk therapy is a vital component of helping people overcome their trauma. However, spoken language has limitations that reduce talk therapy effectiveness.

When asked to tell their life story, trauma survivors are often faced with two conflicting choices. They can either provide a logical storyline based only on the facts of their experience or narrate their story with the raw emotions that accompanied the traumatic event. 

If you choose to be logical, you’re likely to tell your psychotherapist what you think they want to hear to avoid the shame or guilt associated with your trauma. But if you choose to express your emotions, you can openly speak about how you felt about your ordeal. Though the latter is the best way to heal, it’s not an easy choice for a trauma survivor to make.   

One effective way to overcome this hurdle is to write a letter to yourself. Writing allows you to express your innermost thoughts and feelings. Since you’re writing to yourself, you don’t have to fear the judgment or doubts of others as you would when talking to someone. Once you complete your letter, you may be surprised to read about memories that you’ve been ignoring for a long time. You may also realize that some of your “normal” experiences were deeply traumatic.

Writing to yourself helps you increase your self-understanding and may reveal secrets you’ve probably never told anyone. You can share your letter with a professional therapist who can use it to help you go deeper into resolving your trauma. Writing about your trauma improves your health, boosts your mood, makes you more optimistic, and gives you the peace of mind that you may have been seeking for a long time.  

Actions to take

Reconnect To Your Body

“People who feel safe in their bodies can begin to translate the memories that previously overwhelmed them into language.”

Severe trauma can be so shocking that it disconnects you from your own body. The traumatic event leaves you with a deep and seemingly perpetual sense of helplessness. As a result, your brain rewires to perceive everyday situations as life-threatening. This manifests as hyper- or hypo-arousal. Hyperarousal is where you easily lose emotional control and fight or flee a perceived threat. Hypo-arousal refers to feeling detached from your body or unable to engage with others fully.

In both cases, the feeling of helplessness is stored as muscle tension or a sense of disconnection from the affected body part. For example, an accident victim may store tension in the head, limbs, or back to brace against the impact of the trauma. A sexual abuse victim may feel disconnected from their rectal or vaginal area to neutralize the sensory experience of being violated. A trauma survivor will dampen these intolerable sensations through alcohol, drugs, overeating, gambling, over-exercising, or even cutting themselves to numb emotional pain.

But there are safer and more effective ways of reconnecting to your body. Specialized body movements such as yoga can teach you how to feel comfortable in your body again. Yoga is effective because it combines breath practices with stretches and meditation. This is important because most trauma survivors are unaware that they are taking shallow and irregular breaths. Yoga teaches you how to variate the speed and depth of your breathing. It also enhances your awareness of your body movements and the rhythm between the different muscles. 

Yoga for trauma therapy isn’t about getting the poses right. The goal is to help the trauma survivor consciously perceive their body in the present moment during their daily life. By getting accustomed to yoga's mindfulness, you can gradually learn to relax and feel physically in control of your body.  You begin to look inward and listen to what your body is saying instead of ignoring it.

Actions to take

Healing Your Subpersonalities

“The sense of being inhabited by warring impulses or parts is common to all of us but particularly to traumatized people who had to resort to extreme measures in order to survive. Exploring—even befriending—those parts is an important component of healing.”

We all hate feeling shamed or rejected. To avoid such traumatic experiences, we adopt survival strategies that enable us to go about our everyday lives. Some of these coping mechanisms include repressing our emotions, becoming overly critical, or even gaining massive wealth and power so that nobody will ever mess with us again. These self-protection mechanisms help you to deny or ignore painful memories. Unfortunately, you cannot fully heal your trauma without uncovering these dark aspects of your mind. 

Your mind is a complex mechanism with multiple parts. For example, you may be reading a book, but part of you wants to take a nap. You may have a polite personality, but part of you can be quite condescending. These different aspects of Self—or subpersonalities—all coexist as an internal family to make you who you are. You have an internal leadership system that caters to all your subpersonalities’ needs. Each aspect of your mind should be allowed to express itself healthily without dominating or sabotaging the others.   

However, this harmonious state of mind changes after you experience extreme childhood trauma. Trauma breaks down your self-governing system and causes the different aspects of your personality to clash. If you’re abused as a child, your light-hearted aspect becomes terrified and carries the greatest burden of the trauma. As a result, this aspect becomes toxic, is rejected by the other aspects, and becomes an exile. 

To protect the internal family from the exiles, the other aspects appoint managers. Unfortunately, these managers adopt the same energy as that of your abuser. Managers become excessively critical or perfectionistic to prevent you from forming close relationships, just to protect you from potential betrayal. Then there are the firefighters whose role is to use uncontrollable rage or emotional shutdown whenever an exiled emotion is triggered.  

Internal Family Systems (IFS) therapy is an approach that seeks to integrate all your aspects. When traumatized children grow up, their subpersonalities live independently and may even be unaware of each other’s existence. A traumatized person often hates parts of their personality that are too dominant and destructive, e.g., angry, critical, or suicidal aspects. IFS can help you identify, understand and accept that these aspects were only formed to protect your internal family. To begin the healing process, you have to make peace with them and ask them to help you liberate your true Self from your past trauma.   

Actions to take

Use Communal Action to Confront Trauma

“The essence of trauma is feeling godforsaken, cut off from the human race. Theater involves a collective confrontation with the realities of the human condition.”

Whenever we engage in communal movement and singing, we create a bigger context for our lives. Life becomes more about a collective rather than an individual fate. Music and movement have the power to unite those who might otherwise be too terrified to confront the painful realities of life. Think of the people who marched and sang during the struggle for civil rights in America. Synchronizing their songs and body movements gave them the courage, purpose, and solidarity to face up to the brutality of the police.

Increasing research suggests that collective ceremonies such as theatrical plays and musicals can help alleviate trauma.  Modern society trains us to disconnect from our feelings. However, theater and role-playing allow actors to not only connect to their deep emotions but also convey them to the audience. This can be especially therapeutic for traumatized individuals because they are usually terrified of experiencing deep emotions.

Instead of feeling cut off from others, theater encourages trauma survivors to face their reality and openly share the pain they’ve been withholding. Trauma survivors fear conflict, but since conflict is a central theme of theater, it allows them to act out their inner conflicts. The theater will enable you to reenact your traumatic memories so that you can finally find your voice and speak to your abuser via the play. Best of all, you’re able to write a new script for your life and create the happy ending you’ve always wanted. 

Actions to take

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