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IAVA | February 27, 2019

Read: Recommended Reading: The Body Keeps the Score

Here at the RRRP team, we often see the effects of trauma on our clients. Even for clients who do not hold a formal diagnosis of Post Traumatic Stress Disorder (PTSD), the effects of trauma can have a significant impact on our lives. Understanding how the brain and the body are affected by trauma can go a long way to cultivating empathy towards those suffering the effects—whether it is your clients, your friends, your family members, or, most importantly, yourself.

The Body Keeps the Score (2014, Viking) is the result of Bessel van der Kolk’s lifetime of working with trauma survivors synthesized with current trends in research. The book is organized into five sections that are both meaty enough for mental health professionals to expand their understanding and accessible enough for those without mental health backgrounds to become better oriented towards trauma.

The first section is a history lesson beginning with how the Vietnam Veterans experiences were instrumental in the recognition of mental trauma in modern society. Few realize that PTSD was not an official diagnosis until 1980 and the introduction of the Third Edition of the Diagnostic and Statistical Manual of Mental Disorders. While words like “shell shock,” “combat fatigue,” and “soldier’s heart” were thrown around, there was very little formal study or recognition of what traumatic stress was, let alone how to deal with it. By understanding the troubled history of PTSD, we can look to ourselves and our own relationship with the concept and realize that maybe we need to reevaluate it.

The second section explains the neuropsychology and physiology of trauma. I have had many of these concepts explained to me throughout my undergraduate and graduate school courses, but I never felt like I truly understood them until I read this section of the book. So much of how trauma affects us is involuntary and comes from deep within our psyche. Dr. van der Kolk explains these concepts with enough detail to foster a deep understanding, but with clever use of analogy to make these concepts relatable to those without biology/neuroscience backgrounds.

Children are the focus of the third section. In my two years seeing patients at the VA, the deepest, most difficult cases of PTSD to treat were the ones who experienced it throughout their lives, not simply in a war zone. The author shows how the damage to a survivor’s relationships to basic concepts of safety, personal trust, and ability to build social relationships has effects in the near-term and the long-term.

The author approaches the difficulty of working with traumatic memory in the fourth section. The combination of the emotional content of the memory and how it is stored in our brains makes working with traumatic memories difficult and sometimes problematic. This is very important data for trauma survivors and practitioners because by understanding neurologically what is happening, it helps soothe the distrust the survivor feels towards their own memories and feelings surrounding the trauma.

Finally, the fifth section discusses the best practices and future directions of treatment. The treatments van der Kolk has examined include everything from Eye Movement Desensitization and Reprocessing (EMDR) to yoga to neurofeedback to theater and artistic solutions. This variety of solutions empowers survivors to find a path to recovery that suits their individual needs. Many of the RRRP clients have had negative experiences with one modality of treatment or another, so understanding that there might be a program that works better for them can bring them back to treatment.

The Body Keeps the Score has become a seminal text in trauma literature and was required reading in my graduate program. Coworkers from when I was treating patients at the VA found it incredibly useful. I have recommended it to friends with no mental health background and they told me that the insight they gained helped them recover. People looking for specific details for treatment or tools that will help you deal with trauma may not find much to work with. Also, clinicians, like me, with a more dynamic or analytical orientation will note that there is little specific to that approach. However, as a survey of trauma and its mind-body connection, there are few books more qualified than The Body Keeps the Score.

If you or a veteran you know is seeking treatment and needs help getting connected, reach out to our Rapid Response Referral Program (RRRP) today.

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