Trauma and the Body: The Wisdom of Bessel Van Der Kolk

Bessel Van Der Kolk is the Dutch psychiatrist known for his work on trauma for the past 20-30 years, culminated in one of his most well known works, The Body Keeps The Score. One of the topics he talks frequently about is how trauma can greatly affect brain activity long after the event. He noted that normally when we interact with strangers, our prefrontal cortex (PFC) is actively engaged in being curious and assessing intentions with them, but those with PTSD have very little PFC activity when making this eye contact. Instead, all their activity shifts to their brain stem, where our traumatic responses are stored. Their ability to discern is thrown out the window, and their bodies simply react, so they cannot adaptively socialize with these people without immense anxiety.

Trauma inhibits our ability to learn about our environment. When we experience a significantly scary event, we become accustomed to reacting to certain related stimuli with survival instincts, even when the situation is actually safe. Alternatively, we react towards dangerous situations without discernment which further endangers us. This confusion disrupts our intuition about what is safe and what isn’t.

The past two years for me have been times where I experienced some traumatic grief, and reading these passages again made me connect the dots about potential explanations for my recent struggles in social interactions. In social settings, it is as if I am waiting to be rejected, hurt, abandoned. My ability to connect with other people is completely paralyzed. The fact that this is a relatively new phenomenon, and that it feels as if I am being “possessed” by something, and it points to potential traumatic reminders of an event that is related to the social situations in which these reactions occur. Perhaps this is what Van Der Kolk’s writings belie: my PFC becomes inactive, my brain stem activates. I lose curiosity and discernment. I panic.

So what do we do about it?

What Van Der Kolk recommends to address these reactions is to work diligently to identify the sensations in one’s body as a general practice - not as much emotions as much as metaphors for what is beneath them: caving in, heating up, feeling hollow, falling forever, exploding. Complementing this with therapy to develop and write narratives of the event can help organize the experience into a story, so it is not experienced in your body as a disjointed, disorganized mass of affect (which is, neurobiologically, what is actually occurring). He writes that “Physical self-awareness is the first step in releasing the tyranny of the past”. Becoming more aware of your body with co-regulated other is a way to provide a reparative experience and to encounter the trauma in a way that is not overwhelming.

The goal of my own therapeutic practice with individuals and families is to re-establish one’s relationship with one’s body, which has eerie correlations with how we treat children. A child’s behavior brings out our early relationship patterns when our bodies were most vulnerable, and so the process of parenting, encountering and organizing these experiences can prevent them from becoming repeated with one’s own children.