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

"Reading The Body Keeps the Score was a eureka moment for me, in that it provided an explanation for the symptoms—the flashbacks, the hyper-vigilance, the paranoia—that I witnessed among the veterans that I’d been speaking to. For a hundred years, our approach to psychotherapy has been primarily through the mind, talking about our problems and trying to arrive at new understandings. The genius in Bessel van der Kolk’s book is that he manages to set out how our memories and experiences live on in the body and how, in his phrase, ‘the body keeps the score.’ “ The problem in Britain is that many people in the psychotherapy and psychiatry profession simply don’t have a good grasp of the neurobiology at all.” If we’re going to heal trauma—rather than just treat it—we need to find ways to work with the deepest layers of the brain and the oldest, most primitive parts of the nervous system where those traumatic reactions reside. I saw, at first hand, that most of the therapy that is offered, certainly in Britain, isn’t up to the job of doing that. Bessel’s book is a manifesto for how we might start to think about treating trauma afresh. I think they can be significantly addressed. I’ve never used the word ‘cure’ when talking about PTSD because it makes it sound like some sort of disease. I like to see it as an injury at the level of the soul, but also of the body and the mind. Certainly, certain techniques that Bessel and others, who see trauma through this prism, work with show a lot of promise in adjusting the fight or flight mechanism in the brain, which is at the core of a lot of the symptoms. The problem in Britain is that many people in the psychotherapy and psychiatry profession simply don’t have a good grasp of the neurobiology at all. I think that if we’re going to do a better job at healing survivors of PTSD, then we really need to be embracing these ideas and opening our minds. It’s unfortunate that there’s still a great deal of resistance in the medical establishment in Britain to this kind of new thinking. There’s a great deal of complacency. There’s a huge number of people suffering from trauma symptoms in the UK. It’s not just soldiers, but workers in the emergency services, police, ambulance crews, and also civilians who’ve been through childhood abuse or other experiences that have coloured their entire lives. As Bessel says, in The Body Keeps the Score, such people can feel they are damaged to their very core and beyond redemption. Too often, in the current system, if people don’t respond to the standard talking therapy offered, they are written off as ‘treatment resistant,’ which is a bit like blaming the patient for the therapist’s failing. The people who have the loudest voices in this world aren’t shouting loudly enough that we need to be rethinking the whole system and taking a 21st century approach to trauma, rather than one that is still rooted in the work of Freud, from the end of the 19th century. It makes me very angry, actually, the sluggishness with which the system in Britain is changing. I think we could be doing a far better job if there was greater political will. Without a great deal more money, we could be doing a far better job of giving people a shot at resolving many of their symptoms, rather than just trying to teach them to cope with them."