🏃♂️#3: The Body Keeps The Score | Part 1 | by Bessel van der Kolk - Book Summary & Key Takeaways
How does trauma appear in our bodies? Our cells? Our memories? Here are the most fascinating stories and studies to provide the answers.
Welcome to the third edition of the newsletter! Thank you to each and every single one of you who have subscribed and are reading, it is so good to be here together!
❤️🙏
The Body Keeps The Score by Bessel has a 5 star rating and a mammoth 32,668 reviews on Amazon. Many people refer to it as the trauma bible, and I have to say I agree with them.
Because it is such a pivotal piece of work, we are going to cover The Body Keeps The Score in two parts. This week, Part 1 focuses on the many different and fascinating ways that trauma expresses in our physical bodies, minds and memories, while Part 2 coming out next week will focus on healing and the paths to recovery - so stay tuned for that one!
So without further ado, let’s dive in.
All sections in italics are quotes taken directly from the book.
How can trauma show up in our physical bodies?
One of the most interesting case studies featured in the first half of the book is that of a married couple, Stan and Ute (pronounced Ooh-da, if you’re wondering like I did 😉).
🚗 Stan and Ute’s Story
They were travelling to work one morning when they found themselves engulfed in fog, unable to see. Stan hit the brakes and they skidded across the road, managing to avoid hitting a semi-trailer. But straight after that, a truck came flying over their car from behind and they were hit again and again by vans and cars in what became the worst road accident in Canadian history, with 87 cars involved in the pileup:
“Stan struggled to open the doors and windows, but the eighteen wheeler that had crushed their trunk was wedged against the car. Suddenly, someone was pounding on their roof. A girl was screaming, “Get me out of here—I’m on fire!” Helplessly, they saw her die.
The next thing they knew, a truck driver […] smashed the windshield to free them and Stan climbed through the opening. Turning around to help his wife, he saw Ute sitting frozen in her seat. Stan and the truck driver lifted her out. Aside from a few cuts, they were found to be physically unscathed.” - page 65
Three months after the accident both Stan and Ute were jumpy, on edge, having flashbacks, nightmares and trouble sleeping so they sought help.
Upon scanning their brains and monitoring their vitals while exposing them to stimuli that were designed to remind them of the accident, this is what they found:
📈 Stan’s response to being exposed to stimuli of the accident:
sharp spike in blood pressure
sharp increase in heart rate
sweating & trembling
areas of the brain were activated—for example the visual cortex— that showed that he was reliving the accident as if it was happening to him at that very moment, not as if it were a past event. He was seeing it and feeling every single part of it.
Stan said that while he was in the scanner, “I felt like I was going to die.”
📉 Ute’s response to being exposed to stimuli of the accident:
heart rate stayed the same
blood pressure stayed the same
almost every area of her brain showed markedly decreased activity
Ute said that while she was in the scanner, “I felt nothing.”
🤔 So do these two extremely different responses mean that Stan was affected by the trauma of their accident, but Ute wasn’t?
The answer is that they were both impacted to a high level, except the physical and neurological symptoms of their distress are seen in polar opposite ways.
It is as if Ute’s brain pulled the plug on her consciousness during the accident, she completely dissociated. The horror and terror too much to bear which is why she had to be lifted out of the car, where Stan could climb out himself. Ute’s response is one example of the survival strategies our brains utilise when we are faced with inescapable trauma.
The book goes on to make a further point about this phenomenon:
“This is a particular problem with traumatized children. The acting-out kids tend to get attention; the blanked-out ones don’t bother anybody and are left to lose their future bit by bit.” - page 72
The better we can understand the various expressions and manifestations of trauma in our brains and bodies, the better we will be equipped to heal them.
Trauma and autoimmune disease
Autoimmune disease is where your body starts attacking itself. It makes the mistake of thinking its own cells or parts of the body are dangerous and foreign, and is the immune system’s equivalent of shooting ourselves in the (perfectly functioning) foot.
This is another example of the many ways in which the body keeps the score following trauma:
🦠 In Bessel’s clinic, they had 3 women within a single year diagnosed with an autoimmune disease that also had a trauma history of incest. They proceeded to run a formalised study to investigate this and found:
“Compared to the control group, the group of incest survivors had abnormalities in their CD45 cells […] This makes the immune system oversensitive to threat, so that it is prone to attacking the body’s own cells.
[…] Our study showed that on a deep level, the bodies on incest victims have trouble distinguishing between danger and safety. The imprint of past trauma does not consist only of distorted perceptions of information from the outside; the organism itself also has a problem knowing how to feel safe.” - page 127
Quite literally, trauma has the capability to change the body on a cellular level and the statement that it is “all in your head” couldn’t be further from the truth.
What is the difference between regular memories and traumatic memories?
When we think of happy memories, they are presented in our minds as a story with a beginning, a middle and an end.
On the other hand,
“Trauma is primarily remembered not as a story, but as isolated sensory imprints: images, sounds, and physical sensations that are accompanied by intense emotions, usually terror and helplessness.” - page 70
⚡️ A singular flash or image from a particular moment during the occurrence of the trauma is a common description.
“Traumatic memories are disorganised. Subjects could remember certain details all too clearly (the smell of a rapist or the wound on a child’s head) but could not recall the sequence of events or other vital details (the first person who arrived to help, whether an ambulance or a police car took them to hospital).
So why are these memories presented so differently in our mind’s eye?
Because when we are experiencing terror, our cortex—that is, the part of our brain that has the ability to tell time, make associations, and critically reason—goes offline 😶.
(If you want to go deeper on this concept, it was covered in last week’s newsletter under the section “Why does it matter if we are regulated or dysregulated?” which you can read here.)
That means we are incapable of being able to accurately “record” the event and may only retain a tiny fraction of what really happened.
From a logical perspective this makes a lot of sense as a protective mechanism, because who would ever want to relive an entire traumatic story in detail from the beginning, to middle, to end?
Many survivors have guilt around not being able to remember the events properly. They may question whether the trauma even really happened, or may wonder if they are making things up.
The truth is, this is the exact nature of traumatic memory. It’s a normal not to have all the pieces and feel as though none of it makes sense, because our bodies are not capable of storing and recording this type of information like we can with our other more positive experiences and memories.
Trauma and Memory Loss - how common is it?
In order to investigate how common it was for people to have something traumatic happen to them, and then have complete loss of memory about the incident, a study was conducted:
“Williams interviewed 206 girls between the ages of ten and twelve who had been admitted to a hospital emergency room following sexual abuse.
Seventeen years later, Williams was able to track down 136 of the children, now adults, with whom she conducted extensive follow-up interviews.”
💥 The results were astounding:
38% did not recall the abuse that was documented in their medical records
12% said that they had never been abused as children
There is a huge amount of evidence that trauma can be forgotten and then remembered years later. This is an important point of awareness to have around why certain symptoms or triggers may make no logical sense, or explain why people may be unable identify if something has happened to them.
Thank you for reading and I hope you gained something for your own personal toolkit or knowledge from this edition! It is always difficult to make the decisions about what topics to highlight and feature from each book, so if you have a particular question or request please let me know. 😌 I’m very excited to be writing next week’s edition already, focussing on healing and pathways to recovery.
As always, I am here for you and am happy to provide a willing ear if you have any thoughts or reflections bubbling up after reading.
Until next week,
❤️🙏 Eleanor
Additional links and resources:
If you are struggling, please reach out to a support service or professional:
🤝 Human Rights list of Mental Health Support Services
Interview with Bessel van der Kolk on How To Academy Mindset about Healing Trauma:
🎥 Watch it here
Next week’s book:
Coming out next Friday 18th Feb 2022 is the edition #4 of the newsletter, featuring:
📚 The Body Keeps The Score - Part 2: Healing and Paths To Recovery
by Bessel van der Kolk
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[Insight into my brain: every time I get a notification that a new subcriber has signed up, it literally makes my day 🥳 and feels like a supportive nudge in the right direction 🥰.]