The Body Keeps the Score

The role of the body in personal transformation and healing is no secret for practitioners of spiritual disciplines. The Body Keeps Score is an explanation of modern discoveries about the brain and body as well as a broad review of techniques discovered in the course of van der Kolk’s career as a trauma therapist. In the last decades, these techniques have broken through the psychiatric paradigm showing the lasting value of engaging trauma with non-chemical means. That these techniques broadly align with spiritual practices across time and space while at the same time being augmented by modern technologies (such as EEG) is of interest to those who would challenge the materialist paradigm.

The story begins with van der Kolk’s engagement with Vietnam veterans in the early 1980s and an overview of the history of diagnosing Post Traumatic Stress Disorder (PTSD), starting with the first cases of shell shock in the First World War. Advances in brain science and a deeper understanding of the functions of the brain stem (basic housekeeping), the limbic brain (embodiment and emotion) as well as the prefrontal cortex (time, context and empathy) explain PTSD as dysfunction and disjunction between these functions. The body and the brain can no longer find a healthy response to the original stress – the artillery fire, the car crash, the abuse. Hyperarousal reactivated as a response prevents this. How the individual responds to a traumatic situation – focussed, collapsed or frantic – is regulated deep in the body by the vagus nerve, a nerve that stretches from the colon to the brain, registering heartbreak and gut-wrenching feelings. Hearts can be literally broken.

In the author’s eyes, developmental trauma is a ‘hidden epidemic’. A significant focus of the work falls on childhood trauma, abuse and neglect and how this can lead to disorganised relationship maps and a disorganised, dissociated self, at points so far gone as unable to recognise oneself in a mirror. To address these traumas, one needs to understand how basic attachment and deep emotional attunement through ritual (both individual and communal) can help restore a broken self to a more coherent person, an agent. It is important to understand how foundational the visceral and kinesthetic sensation of our bodies is key to a sense of self and what we experience as ‘real’. It is this understanding of self and trauma that opens the way to treatment and healing.

Another key in unlocking trauma can be found by better understanding the difference between the memory that tells the story of the trauma and the memory that stores the trauma in images. Here too, as with the body and mind, a bridge needs building. One key finding made here is that the “talking cure” will not always help, that finding words can be transformative but that action, too, is needed. The truth may be unspeakable and it will take time to allow oneself to know what one knows, gently, oscillating between remembering the past and living the present.

Having shown the latest scientific findings on the nature of trauma, van der Kolk shows how different practices can help return to the body to find a place of healing and proceeds to review ‘paths to recovery’ and methods to regain self-leadership. He recommends befriending the emotional brain and dealing with hyperarousal by learning to train the brain via the body - breathing, chanting and moving and strengthening the body self-awareness through mindfulness puts us in touch with the inner world. Relationships with others, a guide or a mentor, to help understand the “inner music” and indeed communal involvement can help here too.

The book concludes with a review of recent discoveries such as eye movement desensitisation and reprocessing (EMDR), neurofeedback, yoga and an articulation of the need for self-leadership, an enhanced form of agency: ways and means of bringing the dissonant voices and body together and developing some sense of coherence and ownership.

The body therefore not only stores the trauma but also provides the means to resolve the trauma. The body keeps the score but we can understand and manage the accounting. Deep body work – meditation, trance, yoga and ritual – allows the traumatised to access, see, integrate and live with trauma. As in times past, pharmacology can help. There is much sadness in this book, as each case study unfolds, but also much room for optimism.

This work is particularly valuable as it picks up a thread of shamanic practices identified from within the paradigm and constraints of contemporary Western psychiatry. Interestingly, it is predicated on basic principles such as the psyche as a self-regulating system. This system may need an intervention of sorts to resolve blockages and reconcile opposites, such as the opposition between mind and body in initial disassociative phases of trauma, but also those in our memories, both narrative and traumatic. I am reminded of Kalsched’s work and the second union of alchemy, bringing soul, spirit and body together, and would recommend this book to all who would like to better understand the role of the body in trauma, the healing of trauma and seeing a rediscovery of ancient practices in our times, from within Western paradigms.

Having studied Philosophy and Religious Studies, Damian Spendel now works in finance and practises martial arts in his spare time.