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

Description: The Body Keeps the Score by Bessel van der Kolk Originally published by Viking Penguin, 2014. FORMAT Paperback LANGUAGE English CONDITION Brand New Publisher Description #1 New York Times bestseller"Essential reading for anyone interested in understanding and treating traumatic stress and the scope of its impact on society." —Alexander McFarlane, Director of the Centre for Traumatic Stress StudiesA pioneering researcher transforms our understanding of trauma and offers a bold new paradigm for healing in this New York Times bestseller Trauma is a fact of life. Veterans and their families deal with the painful aftermath of combat; one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Dr. Bessel van der Kolk, one of the worlds foremost experts on trauma, has spent over three decades working with survivors. In The Body Keeps the Score, he uses recent scientific advances to show how trauma literally reshapes both body and brain, compromising sufferers capacities for pleasure, engagement, self-control, and trust. He explores innovative treatments—from neurofeedback and meditation to sports, drama, and yoga—that offer new paths to recovery by activating the brains natural neuroplasticity. Based on Dr. van der Kolks own research and that of other leading specialists, The Body Keeps the Score exposes the tremendous power of our relationships both to hurt and to heal—and offers new hope for reclaiming lives. Author Biography Bessel van der Kolk, M.D., is the founder and medical director of the Trauma Center in Brookline, Massachusetts. He is also a professor of psychiatry at Boston University School of Medicine and director of the National Complex Trauma Treatment Network. When he is not teaching around the world, Dr. van der Kolk works and lives Boston. Review "The trauma caused by childhood neglect, sexual or domestic abuse and war wreaks havoc in our bodies, says Bessel van der Kolk in The Body Keeps the Score. . . . Van der Kolk draws on thirty years of experience to argue powerfully that trauma is one of the Wests most urgent public health issues. . . . Packed with science and human stories, the book is an intense read. . . . [T]he struggle and resilience of his patients is very moving." —Shaoni Bhattacharya, New Scientist "War zones may be nearer than you think, as the 25 percent of US citizens raised with alcoholic relatives might attest. Psychiatrist Bessel van der Kolk argues, moreover, that severe trauma is encoded in the viscera and demands tailored approaches that enable people to experience deep relief from rage and helplessness. In a narrative packed with decades of findings and case studies, he traces the evolution of treatments from the chemical coshes of the 1970s to neurofeedback, mindfulness and other nuanced techniques." —Nature "An astonishing amount of information on almost every aspect of trauma experience, research, interventions, and theories is brought together in this book, which . . . has a distinctly holistic feel to it. The title suggests that what will be explored is how the body retains the imprints of trauma. However, it delivers much more than this, delving into how the brain is impacted by overwhelming traumatic events, and is studded with sections on neuroscience which draw on the authors own numerous studies as well as that of his peers. In addition, it investigates the effects of adverse childhood attachment patterns, child abuse, and chronic and long-term abuse. . . . [T]his book is a veritable goldmine of information." —European Journal of Psychotraumatology "Dr. van der Kolk . . . has written a fascinating and empowering book about trauma and its effects. He uses modern neuroscience to demonstrate that trauma physically affects the brain and the body, causing anxiety, rage, and the inability to concentrate. Victims have problems remembering, trusting, and forming relationships. They have lost control. Although news reports and discussions tend to focus on war veterans, abused children, domestic violence victims, and victims of violent crime suffer as well. Using a combination of traditional therapy techniques and alternative treatments such as EMDR, yoga, neurofeedback, and theater, patients can regain control of their bodies and rewire their brains so that they can rebuild their lives. The author uses case histories to demonstrate the process. He includes a resource list, bibliography, and extensive notes. This accessible book offers hope and inspiration to those who suffer from trauma and those who care for them. It is an outstanding addition to all library collections. —Medical Library Association, Consumer Connections "[A] wonderful new book that everyone involved with trauma ought to read and have available. . . . [B]eautifully, compellingly and sweepingly written in its grand vision of integrating medical, psychological and mixed or alternative approaches, based on a careful reading of the client and a holistic mind-body view. . . . There are very few practitioners who could not learn from this book and become more effective, as well as inspired, by reading and studying it." —Henry Strick van Linschoten, European Society For Trauma And Dissociation Newsletter "Psychological trauma can befall anyone, not just soldiers, refugees, or victims of rape. . . . This important and helpful book makes sense of suffering and offers opportunity for healing." —Booklist "[C]omprehensive in scope. This valuable work . . . offers hope for the millions of sufferers and their families seeking meaningful treatment and relief from the ongoing pain of trauma." —Library Journal (Starred Review) "Dr. van der Kolks masterpiece combines the boundless curiosity of the scientist, the erudition of the scholar, and the passion of the truth teller." —Judith Herman, M.D., clinical professor of psychiatry, Harvard Medical School; author of Trauma and Recovery "This is an absolutely fascinating and clearly written book by one of the nations most experienced physicians in the field of emotional trauma. The Body Keeps the Score helps us understand how life experiences play out in the function and the malfunction of our bodies, years later." —Vincent J. Felitti, M.D., chief of preventative medicine, emeritus, Kaiser Permanente San Diego; co-principal investigator, ACE study "In this inspirational work which seamlessly weaves keen clinical observation, neuroscience, historical analysis, the arts, and personal narrative, Dr. van der Kolk has created an authoritative guide to the effects of trauma, and pathways to recovery. The book is full of wisdom, humanity, compassion and scientific insight, gleaned from a lifetime of clinical service, research and scholarship in the field of traumatic stress. A must read for mental health and other health care professionals, trauma survivors, their loved ones, and those who seek clinical, social, or political solutions to the cycle of trauma and violence in our society." —Rachel Yehuda, Ph.D., professor of psychiatry and neuroscience; director of the Traumatic Stress Studies Division at the Mount Sinai School of Medicine, New York, NY "Breathtaking in its scope and breadth, The Body Keeps the Score is a seminal work by one of the preeminent pioneers in trauma research and treatment. This essential book unites the evolving neuroscience of trauma research with an emergent wave of body-oriented therapies and traditional mind/body practices that go beyond symptom relief and connect us with our vital energy and here-and-now presence." —Peter A. Levine, Ph.D., author of In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness "In The Body Keeps the Score we share the authors courageous journey into the parallel dissociative worlds of trauma victims and the medical and psychological disciplines that are meant to provide relief. In this compelling book we learn that as our minds desperately try to leave trauma behind, our bodies keep us trapped in the past with wordless emotions and feelings. These inner disconnections cascade into ruptures in social relationships with disastrous effects on marriages, families, and friendships. Van der Kolk offers hope by describing treatments and strategies that have successfully helped his patients reconnect their thoughts with their bodies. We leave this shared journey understanding that only through fostering self-awareness and gaining an inner sense of safety will we, as a species, fully experience the richness of life. —Stephen W. Porges, Ph.D., professor of psychiatry, University of North Carolina at Chapel Hill; author of The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation "This exceptional book will be a classic of modern psychiatric thought. The impact of overwhelming experience can only be truly understood when many disparate domains of knowledge, such as neuroscience, developmental psychopathology, and interpersonal neurobiology are integrated, as this work uniquely does. There is no other volume in the field of traumatic stress that has distilled these domains of science with such rich historical and clinical perspectives, and arrived at such innovative treatment approaches. The clarity of vision and breadth of wisdom of this unique but highly accessible work is remarkable. This book is essential reading for anyone interested in understanding and treating traumatic stress and the scope of its impact on society." —Alexander McFarlane AO, MB BS (Hons) MD FRANZCP, director of the Centre for Traumatic Stress Studies, The University of Adelaide, South Australia. "This book is a tour de force. Its deeply empathic, insightful, and compassionate perspective promises to further humanize the treatment of trauma victims, dramatically expand their repertoire of self-regulatory healing practices and therapeutic options, and also stimulate greater creative thinking and research on trauma and its effective treatment. The body does keep the score, and van der Kolks ability to demonstrate this through compelling descriptions of the work of others, his own pioneering trajectory and experience as the field evolved and him along with it, and above all, his discovery of ways to work skillfully with people by bringing mindfulness to the body (as well as to their thoughts and emotions) through yoga, movement, and theater are a wonderful and welcome breath of fresh air and possibility in the therapy world." —Jon Kabat-Zinn, professor of medicine emeritus, UMass Medical School; author of Full Catastrophe Living. "This is an amazing accomplishment from the neuroscientist most responsible for the contemporary revolution in mental health toward the recognition that so many mental problems are the product of trauma. With the compelling writing of a good novelist, van der Kolk revisits his fascinating journey of discovery that has challenged established wisdom in psychiatry. Interspersed with that narrative are clear and understandable: descriptions of the neurobiology of trauma; explanations of the ineffectiveness of traditional approaches to treating trauma; and introductions to the approaches that take patients beneath their cognitive minds to heal the parts of them that remained frozen in the past. All this is illustrated vividly with dramatic case histories and substantiated with convincing research. This is a watershed book that will be remembered as tipping the scales within psychiatry and the culture at large toward the recognition of the toll traumatic events and our attempts to deny their impact take on us all." —Richard Schwartz, originator, Internal Family Systems Therapy "The Body Keeps the Score is clear, fascinating, hard to put down, and filled with powerful case histories. Van der Kolk, the eminent impresario of trauma treatment, who has spent a career bringing together diverse trauma scientists and clinicians and their ideas, while making his own pivotal contributions, describes what is arguably the most important series of breakthroughs in mental health in the last thirty years. Weve known that psychological trauma fragments the mind. Here we see not only how psychological trauma also breaks connections within the brain, but also between mind and body, and learn about the exciting new approaches that allow people with the severest forms of trauma to put all the parts back together again." —Norman Doidge, author of The Brain That Changes Itself "Every once in a while, a book comes along that fundamentally changes the way we look at the world. Bessel van der Kolk has written such a book. The arc of van der Kolks story is vast and comprehensive, but he is such a skillful storyteller that he keeps us riveted to the page. I could not put this book down. It is, simply put, a great work." —Stephen Cope, founder and director, Kripalu Institute for Extraordinary Living; author of Yoga and the Quest for the True Self "Bessel van der Kolk is unequaled in his ability to synthesize the stunning developments in the field of psychological trauma over the past few decades. Thanks in part to his work, psychological trauma—ranging from chronic child abuse and neglect, to war trauma and natural disasters—is now generally recognized as a major cause of individual, social and cultural breakdown. In this masterfully lucid and engaging tour de force, van der Kolk takes us —both specialists and the general public— on his personal journey and shows what he has learned from his research, from his colleagues and students, and, most importantly, from his patients. The Body Keeps the Score is, simply put, brilliant." —Onno van der Hart, Ph.D., Utrecht University, The Netherlands; senior author, The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization "The Body Keeps the Score articulates new and better therapies for toxic stress based on a deep understanding of the effects of trauma on brain development and attachment systems. This volume provides a moving summary of what is currently known about the effects of trauma on individuals and societies, and introduces the healing potential of both age old and novel approaches to help traumatized children and adults to fully engage in the present." —Jessica Stern, policy consultant on terrorism; author of Denial: A Memoir of Terror "A book about understanding the impact of trauma by one of the true pioneers in the field. It is a rare book that integrates cutting edge neuroscience with wisdom and understanding about the experience and meaning of trauma, for people who have suffered from it. Like its author, this book is wise and compassionate, occasionally quite provocative, and always interesting." —Glenn N. Saxe, M.D., Arnold Simon Professor and chairman, Department of Child and Adolescent Psychiatry; director, NYU Child Study Center, New York University School of Medicine "A fascinating exploration of a wide range of therapeutic treatments shows readers how to take charge of the healing process, gain a sense of safety, and find their way out of the morass of suffering." —Francine Shapiro, Ph.D., originator of EMDR therapy, senior research fellow, Emeritus Mental Research Institute, author of Getting Past Your Past "As an attachment researcher I know that infants are psychobiological beings. They are as much the body as they are of the brain. Without language or symbols infants use every one of their biological systems to make meaning of their self in relation to the world of things and people. Van der Kolk shows that those very same systems continue to operate at every age, and that traumatic experiences, especially chronic toxic experience during early development, produce psychic devastation. With this understanding he provides insight and guidance for survivors, researchers and clinicians alike. Bessel van der Kolk may focus on the body and trauma, but what a mind he must have to have written this book." —Ed Tronick, distinguished professor, University of Massachusetts, Boston, author of Neurobehavior and Social Emotional Development of Infants and Young Children "The Body Keeps the Score eloquently articulates how overwhelming experiences affect the development of brain, mind, and body awareness, all of which are closely intertwined. The resulting derailments have a profound impact on the capacity for love and work. This rich integration of clinical case examples with ground breaking scientific studies provides us with a new understanding of trauma, which inevitably leads to the exploration of novel therapeutic approaches that rewire the brain, and help traumatized people to (re)-engage in the present. This book will provide traumatized individuals with a guide to healing and permanently change how psychologists and psychiatrists think about trauma and recovery." —Ruth A. Lanius, M.D., Ph.D., Harris-Woodman chair in Psyche and Soma, professor of psychiatry, and director PTSD research at the University of Western Ontario; author of The Impact of Early Life Trauma on Health and Disease "When it comes to understanding the impact of trauma and being able to continue to grow despite overwhelming life experiences, Bessel van der Kolk leads the way in his comprehensive knowledge, clinical courage, and creative strategies to help us heal. The Body Keeps the Score is a cutting-edge offering for the general reader to comprehend the complex effects of trauma, and a guide to a wide array of scientifically informed approaches to not only reduce suffering, but to move beyond mere survival—and to thrive." —Daniel J. Siegel, M.D., clinical professor, UCLA School of Medicine, author of Brainstorm: The Power and Purpose of the Teenage Brain; Mindsight: The New Science of Personal Transformation; and The Developing Mind: How Relationships and the Brain Interact to Shape Who We Are "In this magnificent book, Bessel van der Kolk takes the reader on a captivating journey that is chock full of riveting stories of patients and their struggles interpreted through history, research, and neuroscience made accessible in the words of a gifted storyteller. We are privy to the authors own courageous efforts to understand and treat trauma over the past 40 years, the results of which have broken new ground and challenged the status quo of psychiatry and psychotherapy. The Body Keeps the Score leaves us with both a profound appreciation for and a felt sense of, the debilitating effects of trauma, along with hope for the future through fascinating descriptions of novel approaches to treatment. This outstanding volume is absolutely essential reading not only for therapists but for all who seek to understand, prevent, or treat the immense suffering caused by trauma." —Pat Ogden Ph.D., Founder/Educational Director of the Sensorimotor Psychotherapy Institute; author of Sensorimotor Psychotherapy: Interventions for Trauma and Attachment "This is masterpiece of powerful understanding and brave heartedness, one of the most intelligent and helpful works on trauma I have ever read. Dr. van der Kolk offers a brilliant synthesis of clinical cases, neuroscience, powerful tools and caring humanity, offering a whole new level of healing for the traumas carried by so many." —Jack Kornfied, author of A Path with Heart "The Body Keeps the Score is masterful in bringing together science and humanism to clearly explain how trauma affects the whole person. Bessel van der Kolk brings deep understanding to the pain and chaos of the trauma experience. The treatment approaches he recommends heal the body and the mind, restoring hope and the possibility of joy. One reads this book with profound gratitude for its wisdom." —Alicia Lieberman, Ph.D., Professor of Medical Psychology UCSF, Director of the Child Trauma Research Project, San Francisco General Hospital; author of The Emotional Life of the Toddler Review Quote "The trauma caused by childhood neglect, sexual or domestic abuse and war wreaks havoc in our bodies, says Bessel van der Kolk in The Body Keeps the Score . . . . Van der Kolk draws on thirty years of experience to argue powerfully that trauma is one of the Wests most urgent public health issues. . . . Packed with science and human stories, the book is an intense read. . . . [T]he struggle and resilience of his patients is very moving." --Shaoni Bhattacharya, New Scientist "War zones may be nearer than you think, as the 25 percent of US citizens raised with alcoholic relatives might attest. Psychiatrist Bessel van der Kolk argues, moreover, that severe trauma is encoded in the viscera and demands tailored approaches that enable people to experience deep relief from rage and helplessness. In a narrative packed with decades of findings and case studies, he traces the evolution of treatments from the chemical coshes of the 1970s to neurofeedback, mindfulness and other nuanced techniques." -- Nature "An astonishing amount of information on almost every aspect of trauma experience, research, interventions, and theories is brought together in this book, which . . . has a distinctly holistic feel to it. The title suggests that what will be explored is how the body retains the imprints of trauma. However, it delivers much more than this, delving into how the brain is impacted by overwhelming traumatic events, and is studded with sections on neuroscience which draw on the authors own numerous studies as well as that of his peers. In addition, it investigates the effects of adverse childhood attachment patterns, child abuse, and chronic and long-term abuse. . . . [T]his book is a veritable goldmine of information." --European Journal of Psychotraumatology "Dr. van der Kolk . . . has written a fascinating and empowering book about trauma and its effects. He uses modern neuroscience to demonstrate that trauma physically affects the brain and the body, causing anxiety, rage, and the inability to concentrate. Victims have problems remembering, trusting, and forming relationships. They have lost control. Although news reports and discussions tend to focus on war veterans, abused children, domestic violence victims, and victims of violent crime suffer as well. Using a combination of traditional therapy techniques and alternative treatments such as EMDR, yoga, neurofeedback, and theater, patients can regain control of their bodies and rewire their brains so that they can rebuild their lives. The author uses case histories to demonstrate the process. He includes a resource list, bibliography, and extensive notes. This accessible book offers hope and inspiration to those who suffer from trauma and those who care for them. It is an outstanding addition to all library collections. --Medical Library Association, Consumer Connections "[A] wonderful new book that everyone involved with trauma ought to read and have available. . . . [B]eautifully, compellingly and sweepingly written in its grand vision of integrating medical, psychological and mixed or alternative approaches, based on a careful reading of the client and a holistic mind-body view. . . . There are very few practitioners who could not learn from this book and become more effective, as well as inspired, by reading and studying it." -- Henry Strick van Linschoten, European Society For Trauma And Dissociation Newsletter "Psychological trauma can befall anyone, not just soldiers, refugees, or victims of rape. . . . This important and helpful book makes sense of suffering and offers opportunity for healing." -- Booklist "[C]omprehensive in scope. This valuable work . . . offers hope for the millions of sufferers and their families seeking meaningful treatment and relief from the ongoing pain of trauma." -- Library Journal (Starred Review) "Dr. van der Kolks masterpiece combines the boundless curiosity of the scientist, the erudition of the scholar, and the passion of the truth teller." --Judith Herman, M.D., clinical professor of psychiatry, Harvard Medical School; author of Trauma and Recovery "This is an absolutely fascinating and clearly written book by one of the nations most experienced physicians in the field of emotional trauma. The Body Keeps the Score helps us understand how life experiences play out in the function and the malfunction of our bodies, years later." --Vincent J. Felitti, M.D., chief of preventative medicine, emeritus, Kaiser Permanente San Diego; co-principal investigator, ACE study "In this inspirational work which seamlessly weaves keen clinical observation, neuroscience, historical analysis, the arts, and personal narrative, Dr. van der Kolk has created an authoritative guide to the effects of trauma, and pathways to recovery. The book is full of wisdom, humanity, compassion and scientific insight, gleaned from a lifetime of clinical service, research and scholarship in the field of traumatic stress. A must read for mental health and other health care professionals, trauma survivors, their loved ones, and those who seek clinical, social, or political solutions to the cycle of trauma and violence in our society." --Rachel Yehuda, Ph.D., professor of psychiatry and neuroscience; director of the Traumatic Stress Studies Division at the Mount Sinai School of Medicine, New York, NY "Breathtaking in its scope and breadth, The Body Keeps the Score is a seminal work by one of the preeminent pioneers in trauma research and treatment. This essential book unites the evolving neuroscience of trauma research with an emergent wave of body-oriented therapies and traditional mind/body practices that go beyond symptom relief and connect us with our vital energy and here-and-now presence." --Peter A. Levine, Ph.D., author of In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness "In The Body Keeps the Score we share the authors courageous journey into the parallel dissociative worlds of trauma victims and the medical and psychological disciplines that are meant to provide relief. In this compelling book we learn that as our minds desperately try to leave trauma behind, our bodies keep us trapped in the past with wordless emotions and feelings. These inner disconnections cascade into ruptures in social relationships with disastrous effects on marriages, families, and friendships. Van der Kolk offers hope by describing treatments and strategies that have successfully helped his patients reconnect their thoughts with their bodies. We leave this shared journey understanding that only through fostering self-awareness and gaining an inner sense of safety will we, as a species, fully experience the richness of life. --Stephen W. Porges, Ph.D., professor of psychiatry, University of North Carolina at Chapel Hill; author of The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation "This exceptional book will be a classic of modern psychiatric thought. The impact of overwhelming experience can only be truly understood when many disparate domains of knowledge, such as neuroscience, developmental psychopathology, and interpersonal neurobiology are integrated, as this work uniquely does. There is no other volume in the field of traumatic stress that has distilled these domains of science with such rich historical and clinical perspectives, and arrived at such innovative treatment approaches. The clarity of vision and breadth of wisdom of this unique but highly accessible work is remarkable. This book is essential reading for anyone interested in understanding and treating traumatic stress and the scope of its impact on society." --Alexander McFarlane AO, MB BS (Hons) MD FRANZCP, director of the Centre for Traumatic Stress Studies, The University of Adelaide, South Australia. "This book is a tour de force. Its deeply empathic, insightful, and compassionate perspective promises to further humanize the treatment of trauma victims, dramatically expand their repertoire of self-regulatory healing practices and therapeutic options, and also stimulate greater creative thinking and research on trauma and its effective treatment. The body does keep the score, and van der Kolks ability to demonstrate this through compelling descriptions of the work of others, his own pioneering trajectory and experience as the field evolved and him along with it, and above all, his discovery of ways to work skillfully with people by bringing mindfulness to the body (as well as to their thoughts and emotions) through yoga, movement, and theater are a wonderful and welcome breath of fresh air and possibility in the therapy world." --Jon Kabat-Zinn, professor of medicine emeritus, UMass Medical School; author of Full Catastrophe Living. "This is an amazing accomplishment from the neuroscientist most responsible for the contemporary revolution in mental health toward the recognition that so many mental problems are the product of trauma. With the compelling writing of a good novelist, van der Kolk revisits his fascinating journey of discovery that has challenged established wisdom in psychiatry. Interspersed with that narrative are clear and understandable: descriptions of the neurobiology of trauma; explanations of the ineffectiveness of traditional approaches to treating trauma; and introductions to the approaches that take patients beneath their cognitive minds to Excerpt from Book PROLOGUE FACING TRAUMA One does not have be a combat soldier, or visit a refugee camp in Syria or the Congo to encounter trauma. Trauma happens to us, our friends, our families, and our neighbors. Research by the Centers for Disease Control and Prevention has shown that one in five Americans was sexually molested as a child; one in four was beaten by a parent to the point of a mark being left on their body; and one in three couples engages in physical violence. A quarter of us grew up with alcoholic relatives, and one out of eight witnessed their mother being beaten or hit.1 As human beings we belong to an extremely resilient species. Since time immemorial we have rebounded from our relentless wars, countless disasters (both natural and man-made), and the violence and betrayal in our own lives. But traumatic experiences do leave traces, whether on a large scale (on our histories and cultures) or close to home, on our families, with dark secrets being imperceptibly passed down through generations. They also leave traces on our minds and emotions, on our capacity for joy and intimacy, and even on our biology and immune systems. Trauma affects not only those who are directly exposed to it, but also those around them. Soldiers returning home from combat may frighten their families with their rages and emotional absence. The wives of men who suffer from PTSD tend to become depressed, and the children of depressed mothers are at risk of growing up insecure and anxious. Having been exposed to family violence as a child often makes it difficult to establish stable, trusting relationships as an adult. Trauma, by definition, is unbearable and intolerable. Most rape victims, combat soldiers, and children who have been molested become so upset when they think about what they experienced that they try to push it out of their minds, trying to act as if nothing happened, and move on. It takes tremendous energy to keep functioning while carrying the memory of terror, and the shame of utter weakness and vulnerability. While we all want to move beyond trauma, the part of our brain that is devoted to ensuring our survival (deep below our rational brain) is not very good at denial. Long after a traumatic experience is over, it may be reactivated at the slightest hint of danger and mobilize disturbed brain circuits and secrete massive amounts of stress hormones. This precipitates unpleasant emotions intense physical sensations, and impulsive and aggressive actions. These posttraumatic reactions feel incomprehensible and overwhelming. Feeling out of control, survivors of trauma often begin to fear that they are damaged to the core and beyond redemption. * * * The first time I remember being drawn to study medicine was at a summer camp when I was about fourteen years old. My cousin Michael kept me up all night explaining the intricacies of how kidneys work, how they secrete the bodys waste materials and then reabsorb the chemicals that keep the system in balance. I was riveted by his account of the miraculous way the body functions. Later, during every stage of my medical training, whether I was studying surgery, cardiology, or pediatrics, it was obvious to me that the key to healing was understanding how the human organism works. When I began my psychiatry rotation, however, I was struck by the contrast between the incredible complexity of the mind and the ways that we human beings are connected and attached to one another, and how little psychiatrists knew about the origins of the problems they were treating. Would it be possible one day to know as much about brains, minds, and love as we do about the other systems that make up our organism? We are obviously still years from attaining that sort of detailed understanding, but the birth of three new branches of science has led to an explosion of knowledge about the effects of psychological trauma, abuse, and neglect. Those new disciplines are neuroscience, the study of how the brain supports mental processes; developmental psychopathology, the study of the impact of adverse experiences on the development of mind and brain; and interpersonal neurobiology, the study of how our behavior influences the emotions, biology, and mind-sets of those around us. Research from these new disciplines has revealed that trauma produces actual physiological changes, including a recalibration of the brains alarm system, an increase in stress hormone activity, and alterations in the system that filters relevant information from irrelevant. We now know that trauma compromises the brain area that communicates the physical, embodied feeling of being alive. These changes explain why traumatized individuals become hypervigilant to threat at the expense of spontaneously engaging in their day-to-day lives. They also help us understand why traumatized people so often keep repeating the same problems and have such trouble learning from experience. We now know that their behaviors are not the result of moral failings or signs of lack of willpower or bad character--they are caused by actual changes in the brain. This vast increase in our knowledge about the basic processes that underlie trauma has also opened up new possibilities to palliate or even reverse the damage. We can now develop methods and experiences that utilize the brains own natural neuroplasticity to help survivors feel fully alive in the present and move on with their lives. There are fundamentally three avenues: 1) top down, by talking, (re-) connecting with others, and allowing ourselves to know and understand what is going on with us, while processing the memories of the trauma; 2) by taking medicines that shut down inappropriate alarm reactions, or by utilizing other technologies that change the way the brain organizes information, and 3) bottom up: by allowing the body to have experiences that deeply and viscerally contradict the helplessness, rage, or collapse that result from trauma. Which one of these is best for any particular survivor is an empirical question. Most people I have worked with require a combination. This has been my lifes work. In this effort I have been supported by my colleagues and students at the Trauma Center, which I founded thirty years ago. Together we have treated thousands of traumatized children and adults: victims of child abuse, natural disasters, wars, accidents, and human trafficking; people who have suffered assaults by intimates and strangers. We have a long tradition of discussing all our patients in great depth at weekly treatment team meetings and carefully tracking how well different forms of treatment work for particular individuals. Our principal mission has always been to take care of the children and adults who have come to us for treatment, but from the very beginning we also have dedicated ourselves to conducting research to explore the effects of traumatic stress on different populations and to determine what treatments work for whom. We have been supported by research grants from the National Institute of Mental Health, the National Center for Complementary and Alternative Medicine, the Centers for Disease Control, and a number of private foundations to study the efficacy of many different forms of treatment, from medications to talking, yoga, EMDR, theater, and neurofeedback. The challenge is: How can people gain control over the residues of past trauma and return to being masters of their own ship? Talking, understanding, and human connections help, and drugs can dampen hyperactive alarm systems. But we will also see that the imprints from the past can be transformed by having physical experiences that directly contradict the helplessness, rage, and collapse that are part of trauma, and thereby regaining self-mastery. I have no preferred treatment modality, as no single approach fits everybody, but I practice all the forms of treatment that I discuss in this book. Each one of them can produce profound changes, depending on the nature of the particular problem and the makeup of the individual person. I wrote this book to serve as both a guide and an invitation--an invitation to dedicate ourselves to facing the reality of trauma, to explore how best to treat it, and to commit ourselves, as a society, to using every means we have to prevent it. PART ONE THE REDISCOVERY OF TRAUMA CHAPTER 1 LESSONS FROM VIETNAM VETERANS I became what I am today at the age of twelve, on a frigid overcast day in the winter of 1975. . . . That was a long time ago, but its wrong what they say about the past. . . . Looking back now, I realize I have been peeking into that deserted alley for the last twenty-six years. --Khaled Hosseini, The Kite Runner Some peoples lives seem to flow in a narrative; mine had many stops and starts. Thats what trauma does. It interrupts the plot. . . . It just happens, and then life goes on. No one prepares you for it. --Jessica Stern, Denial: A Memoir of Terror The Tuesday after the Fourth of July weekend, 1978, was my first day as a staff psychiatrist at the Boston Veterans Administration Clinic. As I was hanging a reproduction of my favorite Breughel painting, "The Blind Leading the Blind," on the wall of my new office, I heard a commotion in the reception area down the hall. A moment later a large, disheveled man in a stained three-piece suit, carrying a copy of Soldier of Fortune magazine under his arm, burst through my door. He was so agitated and so clearly hungover that I wondered how I could possibly help this hulking man. I asked him to take a seat, and tell me what I could do for him. His name was Tom. Ten years earlier he had been in the Marines, doing his ser Details ISBN0143127748 Short Title BODY KEEPS THE SCORE Pages 464 Language English ISBN-10 0143127748 ISBN-13 9780143127741 Media Book Format Paperback Year 2015 Subtitle Brain, Mind, and Body in the Healing of Trauma Place of Publication New York, NY Country of Publication United States Illustrations Illustrations, unspecified AU Release Date 2015-09-08 NZ Release Date 2015-09-08 US Release Date 2015-09-08 UK Release Date 1900-01-01 Publisher Penguin Putnam Inc Publication Date 2015-09-08 Imprint Penguin USA DEWEY 616.8521 Audience General Author Bessel van der Kolk We've got this At The Nile, if you're looking for it, we've got it. With fast shipping, low prices, friendly service and well over a million items - you're bound to find what you want, at a price you'll love! TheNile_Item_ID:95131285;

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