🤜#4: The Body Keeps The Score | Part 2 | by Bessel van der Kolk - Book Summary and Key Takeaways on Healing and Recovery
How do we navigate the paths to healing? How do I find the right therapist? What if I don't want to do "Talk Therapy"? What other options are there? Can I see a Therapy Menu?
Hello and welcome to the fourth edition of the newsletter! ❤️🙏
Last week, we covered Part 1 of The Body Keeps The Score by Bessel van der Kolk (read it here if you missed it!) which focussed on how trauma manifests and appears in our bodies.
This week, Part 2 is all about recovery and healing. 🙌💥
Let’s jump in! All text in italics are quotes taken directly from the book.
🗺 How do we begin to navigate the paths to healing?
One of the central concepts throughout The Body Keeps The Score is that healing and recovery are about reclaiming ownership of your body, your mind and your self.
For many people, this comes about through 4 areas of action:
“(1) finding a way to become calm and focused,
(2) learning to maintain that calm in response to images, thoughts, sounds, or physical sensations that remind you of the past,
(3) finding a way to be fully alive in the present and engaged with the people around you,
(4) not having to keep secrets from yourself, including secrets about the ways that you have managed to survive.” - page 203
Importantly, these are not designed to be followed in order. For every single one of us—our journey, our sequence, our techniques—will be different. (I don’t know about you but I find this notion both liberating and terrifying 😳)
🤔 Do I have to see a psychologist or therapist in order to heal?
The short answer is no, not necessarily. There are plenty of techniques and strategies that you can use to start towards healing on your own, if seeking out a therapist feels too difficult, overwhelming or not the right step for you at a given moment.
That being said, a therapist can help provide you advice and access to many different therapeutic options and can streamline a process that may take you years to figure out on your own.
Many people have also had negative experiences with therapists, but that doesn’t mean the right one isn’t out there for you.
😵💫 How do I find a therapist that’s right for me?
When you are ready to engage with a therapist or psychologist, finding one that’s right for you can feel like an impossible task. If you hold that sentiment, you are not alone!
Not only are there so many different types of therapy, but then there are the different approaches, personalities and backgrounds of each individual practitioner 🤪
So, the best thing we can do is to use a framework for working through the process of finding the right one. Here are the categories to consider:
💪 You—the client—are interviewing them—the therapist—to see if they are right for you. Not the other way around.
What types of therapy are they trained in?
Where did they learn their skills?
What kinds of people and their experiences do they see the best results in for their particular style?
“There is no one “treatment of choice” for trauma, and any therapist who believes that his or her particular method is the only answer to your problems is suspect of being an ideologue rather than somebody who is interested in making sure that you get well.
No therapist can possibly be familiar with every effective treatment, and he or she must be open to your exploring options other than the ones he or she offers. He or she also must be open to learning from you.” - page 212
Finding a great therapist is like a dating process, so don’t be discouraged if you don’t find the right one first time around.
“You need a guide who is not afraid of your terror and who can contain your darkest rage, someone who can safeguard the wholeness of you while you explore the fragmented experiences that you had to keep secret from yourself for so long.” - page 211
👂 After the initial session, ask yourself how comfortable did you feel with the therapist?
This one is huge.
Feeling safe with your therapist is an absolutely non-negotiable condition for therapy to be a success. If you don’t feel safe with them, it will be impossible for you to be able to connect with those difficult experiences and do the work of laying them to rest.
“In my experience patients get better only if they develop positive feelings for their therapists.
Someone who is stern, judgmental, agitated, or harsh is likely to leave you feeling scared, abandoned, and humiliated, and that won’t help you resolve your fears and anxieties.” - page 212
🏳️🌈 Are gender, sexuality or race important factors to consider when choosing a therapist?
If you know that finding a practitioner who shares your background in a particular category will be instrumental to you feeling safe and understood in a therapy session, then 100%, make it one of your selection criteria.
This might mean choosing a female therapist if you don’t feel safe with men.
It might mean finding a queer therapist.
Remember, just because a person has the qualification of “therapist” or “psychologist” doesn’t mean that they will automatically have the right answers and approach for you. (Certainly before I have had the experience in therapy of feeling judged and humiliated by a therapist around a life experience that they clearly had no understanding or concept of, and they were not properly equipped to help me deal with that.)
“Therapy is a collaborative process—a mutual exploration of yourself.” - page 212
What type of “Talk Therapy” was covered in the most detail in the book?
Drumroll please 🥁 … it was:
👨👩👧👧 IFS | Internal Family Systems Therapy
IFS, developed by Robert Schwartz, is a style of therapy that relies on two key foundations:
That every single one of us has a core Self (with a capital S) which is calm, compassionate and undamaged.
That we have developed parts or roles within ourselves, each of them borne out of trying to help us through life and protect us.
(A misconception I had about IFS was that it was about your real life family, but the Family part of IFS actually describes these parts that we have inside ourselves, that is the ‘Internal’ part.)
For example:
“When we are abused, these are the parts that are hurt the most, and they become frozen, carrying the pain, terror, and betrayal of abuse. This burden makes them toxic—parts of ourselves that we need to deny at all costs. Because they are locked away inside, IFS calls them the exiles.
At this point other parts organize to protect the internal family from the exiles. These protectors keep the toxic parts away, but in so doing they take on some of the energy of the abuser. Critical and perfectionistic managers can make sure we never get close to anyone or drive us to be relentlessly productive. Another group of protectors, which IFS calls firefighters, are emergency responders, acting impulsively whenever an experience triggers an exiled emotion.” - page 281
So these roles—the exiles, the managers, the firefighters, the Self—are used to understand and connect with ourselves better, to amplify and encourage the Self and to integrate traumatic experiences and responses.
(IFS is just one form of talk therapy, there are many other styles as well.)
🤐 Do I have to do “Talk Therapy” in order to heal?
If you don’t want to do talk about what happened to you, that makes a lot of sense.
Speaking about our deepest, darkest moments out loud can feel like an insurmountable task, because very often trauma simply cannot be put into words. It is—quite literally—unspeakable. Harvard psychologist Jerome Kagan described it as:
“The task of describing most private experiences can be likened to reaching down to a deep well to pick up small fragile crystal figures while you are wearing thick leather mittens.” - page 237
This is where other types of therapy, ones that don’t require such a level of verbal communication, can be a much more approachable option.
🧘♂️ What are the most successful styles of therapy which don’t rely entirely on talking?
Here is an overview of three therapeutic techniques which had entire chapters (or close to), dedicated to them in The Body Keeps The Score:
👀 EMDR | Eye Movement Desensitisation and Reprocessing Therapy
EMDR is the entire basis of Chapter 15 of the book so this is a biggie. (I can also personally vouch for this style of therapy having given me my life back 😌)
EMDR is facilitated by a trained psychologist. The participant is asked to focus on a certain traumatic memory, while continually moving their eyes to look from side to side. This simulates what happens in our brains during REM sleep, and facilitates deep processing to happen. This process is repeated until the traumatic memory is resolved, with remarkable results being possible even during a single 45 minute session.
“EMDR enables them to observe their experiences in a new way, without verbal give-and-take with another person.
Because EMDR doesn’t require patients to speak about the intolerable or explain to a therapist why they feel so upset, it allows them to stay fully focused on their internal experience, with sometimes extraordinary results.” - page 253
🇨🇳 Bessel has even done EMDR with patients who spoke Swahili, Mandarin, and Breton in which he could only say a few key words in their language, further demonstrating how minimal talking and communication is required.
In one study, they scanned twelve PTSD patients’ brains before and after EMDR treatment:
“After only three EMDR sessions, 8 of the 12 patients had shown a significant decrease in their PTSD scores.
One man reported: “I remember it as though it was a real memory, but it was more distant. Typically, I drowned in it, but this time I was floating on top. I had the feeling that I was in control.” - page 253
1 in 4 patients were cured of their PTSD after eight EMDR sessions.
Most incredibly, nine months later, 60% of them were completely cured with further healing happening even after the therapy sessions were finished.
🧠 Neurofeedback Therapy
Neurofeedback helps patients recover from trauma (as well as treat ADHD, Autism and many other conditions) by positively changing a person’s brainwaves.
(Sounds almost alien, right? 👽)
What the research has shown through EEG (electroencephalogram—ignore the big word, it just means they put little electrical sensors on your skull that create a lot of wiggly lines) is that there is a difference between a traumatised and non-traumatised person’s brainwaves.
⚡️That is, the electrical circuits in the brain have literally been changed for the worse due to trauma.
“We can show them the patterns that seem to be responsible for their difficulty focusing or for their lack of emotional control. They can see why different brain areas need to be trained to generate different frequencies and communication patterns. These explanations help them shift from self-blaming attempts to control their behavior to learning to process information differently.” - page 323
🎭 Therapy in the form of common group or individual activities
(Aka treating trauma without using the word trauma, or therapy 🤫)
Sometimes the most effective way to keep moving along the pathway of recovery is to engage with therapeutic activities that might be easily dismissed or overlooked.
The Body Keeps The Score is about 400 pages long, with the last half dedicated to healing. I was certainly surprised by how many of those pages were spent talking about “every day” activities and how they can be extraordinarily helpful.
🧘♀️ Yoga
Yoga is another modality that had an entire chapter dedicated to it, on learning to inhabit the body. One of Bessel’s clients, Annie, said this after going to a couple of yoga sessions and feeling initially overwhelmed:
“I felt the beginning of panic, especially in the breathing pose, like “oh no that’s not a part of my body I want to feel”. But then I was able to stop myself and just 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. I don’t know that I have ever been able to do that in such a conscious way before.” - page 276
After attending yoga sessions for a year, Annie was finally able to start putting her traumatic experiences into words and enabled her to engage with the next stage of her recovery journey, while continuing her practice.
Trauma survivors are usually disconnected from their bodies in some way. Yoga helps connect the broken pieces back together again, and gently wake the parts that have been numb for so long.
🕺 Theatre
Theatre was—for me—yet another entirely unexpected chapter spent in the healing section of the book 😱, which he discovered the power of from his own son:
“Nick spent most of seventh and eighth grade in bed, bloated by allergies and medications that left him too exhausted to go to school. His mother and I saw him becoming entrenched in his identity as a self-hating and isolated kid, and we were desperate to help him.
[…] Unlike his experience with the numerous therapists who had talked with him about how bad he felt, theater gave him a chance to deeply and physically experience what it was like to be someone other than the learning- disabled, oversensitive boy that he had gradually become. Being a valued contributor to a group gave him a visceral experience of power and competence.” - page 330-331
The power of theatre is that it gives people the opportunity to explore potentially powerful and terrifying emotions that may be difficult to approach as themselves, but with extraordinary carryover into real life.
🔄 Sometimes these “alternative” methods of healing enable us to put words to our experience
To come full circle, a common outcome from some of these other styles of therapy is that people slowly are able to speak about what happened to them.
This is extremely meaningful, because when we are able to find the words to describe our experience it means that we can finally share our pain and deepest feelings with another human being.
Without words, it is like being in a cage.
Finally being able to find the words, means that we don’t have to be isolated anymore.
Like many things in life, recovery from trauma is a cycle with different things coming in and out of the forefront as you move through the various phases.
🍔 Have you ever wanted to see a Therapy Menu?
When we don’t know what to eat, looking at the restaurant menu helps us make the decision by easily telling us what’s available.
I have often wanted the same thing, but for healing and recovery from trauma—knowing that there are so many options out there, but if we don’t know what they’re called or what’s out there, how are we supposed to find them?
🙌 Enter, the Therapy Menu!
I have collated a list of every single healing, recovery and therapy technique that was mentioned in The Body Keeps The Score with a brief description, and filed them into helpful categories to help you find what you’re looking for such as Talk Therapies, Non-Talk Therapies, Support Groups, Community Activities and Individual Activities.
This is a special bonus newsletter edition that I will send out to PTG Weekly subscribers on Monday to thank you all for your support! 🙏
I hope this has been helpful to you! 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
This is the website of the Trauma Centre where Bessel van der Kolk is a medical director and there are lots of resources available 👉 www.traumacenter.org
Next week’s book:
Coming out next Friday 25th Feb 2022 is the edition #5 of the newsletter, featuring:
📚 How To Do The Work
by Nicole LePera