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

by Bessel van der Kolk

The best way to overcome ingrained patterns of submission is to restore a physical capacity to engage and defend.

People cannot put traumatic events behind until they are able to acknowledge what has happened and start to recognize the invisible demons they’re struggling with.

CBT has not done so well for traumatized individuals, particularly those with histories of childhood abuse.

The poorest outcome in exposure treatments occurs in patients who suffer from “mental defeat”—those who have given up.42

Being traumatized is not just an issue of being stuck in the past; it is just as much a problem of not being fully alive in the present.

We can only “process” horrendous experiences if they do not overwhelm us.

However, drugs cannot “cure” trauma; they can only dampen the expressions of a disturbed physiology. And they do not teach the lasting lessons of self-regulation. They can help to control feelings and behavior, but always at a price—because

Silence about trauma also leads to death—the death of the soul. Silence reinforces the godforsaken isolation of trauma.

When Adam was put in charge of the animal kingdom in the Book of Genesis, his first act was to give a name to every living creature. If you’ve been hurt, you need to acknowledge and name what happened to you.

Feeling listened to and understood changes our physiology;

As long as you keep secrets and suppress information, you are fundamentally at war with yourself.

his road to recovery required learning to tell the truth, even if that truth was brutally painful.

Communicating fully is the opposite of being traumatized.

One system creates a story for public consumption, and if we tell that story often enough, we are likely to start believing that it contains the whole truth. But the other system registers a different truth: how we experience the situation deep inside. It is this second system that needs to be accessed, befriended, and reconciled.

writing about upsetting events improves physical and mental health.

the object of writing is to write to yourself, to let your self know what you have been trying to avoid.

We don’t avoid confronting the details, but we teach our patients how to safely dip one toe in the water and then take it out again, thus approaching the truth gradually.

trauma makes people feel like either some body else, or like no body. In order to overcome trauma, you need help to get back in touch with your body, with your Self.

In contrast, EMDR, as well as the treatments discussed in subsequent chapters—internal family systems, yoga, neurofeedback, psychomotor therapy, and theater—focus not only on regulating the intense memories activated by trauma but also on restoring a sense of agency, engagement, and commitment through ownership of body and mind.

The sleeping brain reshapes memory by increasing the imprint of emotionally relevant information while helping irrelevant material fade away.

Yoga is about looking inward instead of outward and listening to my body, and a lot of my survival has been geared around never doing those things.

alexithymia, the technical term for not being able to identify what is going on inside oneself.16 People who suffer from alexithymia tend to feel physically uncomfortable but cannot describe exactly what the problem is.

Yoga turned out to be a terrific way to (re)gain a relationship with the interior world and with it a caring, loving, sensual relationship to the self.

If you are not aware of what your body needs, you can’t take care of it.

Once you start approaching your body with curiosity rather than with fear, everything shifts.

Body awareness also changes your sense of time. Trauma makes you feel as if you are stuck forever in a helpless state of horror. In yoga you learn that sensations rise to a peak and then fall.

Awareness that all experience is transitory changes your perspective on yourself.

I understood that the words were a trigger and not terrible words that no one should say.”

notice that this part of your body is holding experiences and then just let it go. You don’t have to stay there but you don’t have to leave either, just use it as information.

if I notice without being so afraid, it will be easier for me to believe myself.”

Many behaviors that are classified as psychiatric problems, including some obsessions, compulsions, and panic attacks, as well as most self-destructive behaviors, started out as strategies for self-protection.

It is much more productive to see aggression or depression, arrogance or passivity as learned behaviors: Somewhere along the line, the patient came to believe that he or she could survive only if he or she was tough, invisible, or absent, or that it was safer to give up.

Knowing how much energy the sheer act of survival requires keeps me from being surprised at the price they often pay: the absence of a loving relationship with their own bodies, minds, and souls.

At the core of IFS is the notion that the mind of each of us is like a family in which the members have different levels of maturity, excitability, wisdom, and pain. The parts form a network or system in which change in any one part will affect all the others.

As Schwartz states: “If one accepts the basic idea that people have an innate drive toward nurturing their own health, this implies that, when people have chronic problems, something gets in the way of accessing inner resources. Recognizing this, the role of therapists is to collaborate rather than to teach, confront, or fill holes in your psyche.”

The first step in this collaboration is to assure the internal system that all parts are welcome and that all of them—even those that are suicidal or destructive—were formed in an attempt to protect the self-system, no matter how much they now seem to threaten it.

If, as a therapist, teacher, or mentor, you try to fill the holes of early deprivation, you come up against the fact that you are the wrong person, at the wrong time, in the wrong place.

we met the managers first. Their job was to prevent humiliation and abandonment and to keep her organized and safe. Some managers may be aggressive, like Joan’s critic, while others are perfectionistic or reserved, careful not to draw too much attention to themselves. They may tell us to turn a blind eye to what is going on and keep us passive to avoid risk. Internal managers also control how much access we have to emotions, so that the self-system doesn’t get overwhelmed.

Firefighters will do anything to make emotional pain go away.

Managers are all about staying in control, while firefighters will destroy the house in order to extinguish the fire.

The struggle between uptight managers and out-of-control firefighters will continue until the exiles, which carry the burden of the trauma, ar...

Anyone who deals with survivors will encounter those firefighters. I’ve met firefighters who shop, drink, play computer games addictively, have imp...

Exiles are the toxic waste dump of the system. Because they hold the memories, sensations, beliefs, and emotions associated with trauma, it is hazardous to release them. They contain the “Oh, my God, I’m done for” experience—the essence of inescapable shock—and with it, terror, collapse, and accommodation. Exiles may reveal themselves in the form of crushing physical sensations or extreme numbing, and they offend both the reasonableness of the managers and the bravado of the firefighters.

When exiles overwhelm managers, they take us over—we are nothing but that rejected, weak, unloved, and abandoned child. The Self becomes “blended” with the exiles, and every possible alternative for our life is eclipsed.

One day he told me that he’d spent his adulthood trying to let go of his past, and he remarked how ironic it was that he had to get closer to it in order to let it go.

Nobody grows up under ideal circumstances—as if we even know what ideal circumstances are.

every life is difficult in its own way.

in order to become self-confident and capable adults, it helps enormously to have grown up with steady and predictable parents; parents who delighted in you, in your discoveries and explorations; parents who helped you organize your comings and goings; and who se...

Most people are hesitant to go into past pain and disappointment—it only promises to bring back the intolerable. But as they are mirrored and witnessed, a new reality begins to take shape.

Accurate mirroring feels completely different from being ignored, criticized, and put down. It gives you permission to feel what you feel and know what you know—one of the essential foundations of recovery.