Trauma is considered today one of the world’s most urgent public health issues. As a hypnotherapist I often come across victims of trauma, who are coming to me to regain control over their feelings, emotions and behaviors. Trauma has the power to reshape both the body and the brain, confining us to the past despite any effort of the mind to leave it behind.
“The Body Keeps the Score: Mind, Brain, and Body in the Transformation of Trauma” is an essential read for anyone interested in comprehending and treating traumatic stress.
In The Body Keeps the Score, the author – Van der Kolk – explores innovative treatments that offer new pathways to recovery by utilizing the brain’s natural ability to heal, which is why I am a big fan of this book.
Trauma is universal and occurs more frequently than we tend to think. One doesn’t have to be a war veteran to experience it, trauma happens to our family members, friends, neighbours, it happens to us…
Trauma not only affects those directly exposed to it but those around them. Healthy relationships become extremely challenging to maintain, as people who have experienced trauma have to deal with all sorts of issues in life, ranging from substance abuse to emotional absence.
Van der Kolk asserts that:
The safest way to help traumatized children and people victim of trauma is to provide them with a safe environment, allowing them to connect with others, learn to self-regulate, and develop autonomy around their own lives.
Survivors are often triggered or forced (sometime through therapy!) to endure the powerful memories of the trauma. These flashbacks cause people to relive the trauma’s mental and physical experience.
According to Van der Kolk victims of trauma can learn to regulate their own physiology through movement and breath. Solution Focused Hypnotherapy, Mindfulness meditation, yoga, dance, kinesiology, martial arts such as Thai Chi and Qi Gong, and new therapeutic interventions such as neurofeedback are vital tools for survivors as they discover how to accept, cope with and recover from their life-changing experiences.
Trauma says van der Kolk:
Drives us to the edge of comprehension, cutting us off from language based on common experience. Its effects are profound and lasting when it occurs before we have language to describe it or even hope to get the help we need. Like a splinter that causes an infection, it is the body’s response to the foreign object that becomes the problem more than the object itself.
One of the reactions to trauma is the so-called Numbing State. Numbing may keep us from suffering in the short-term, but long-term is another matter. Though the mind may learn to ignore the messages from the emotional brain, the alarm signals don’t stop. The emotional brain keeps working, and stress hormones keep sending signals to the muscles to tense for action or immobilize in collapse. The physical effects on the organs go on unabated until they demand notice when they are expressed as illness. Medications, drugs, and alcohol can also temporarily dull or obliterate unbearable sensations and feelings. But the body continues to “keep the score.” Through numbing, the survivor’s energy now becomes focused on suppressing inner chaos, at the expense of spontaneous involvement in their life.
Another reaction to trauma is that of being a Stimulus Seeker. Often survivors of trauma don’t feel quite alive if they aren’t in the middle of chaos. Somehow the very event that caused the victim so much pain had also become their sole source of meaning. They felt fully alive only when they were revisiting their traumatic past. That is why so many abused and traumatized people feel fully alive in the face of actual danger, while they go numb in situations that are more complex but objectively safe, like birthday parties or family dinners.
If an organism is stuck in survival mode, its energies are focused on fighting off unseen enemies, which leaves no room for nurture, care, and love. For us humans, it means that if the mind is defending itself against invisible assaults, our closest bonds are threatened, along with our ability to imagine, plan, play, learn, and pay attention to other people’s needs.
Treatment needs to reactivate the capacity to safely mirror, and be mirrored, by others, but also to resist being hijacked by others’ negative emotions.
The great challenge is finding ways to reset the victim’s physiology, so that their survival mechanisms stop working against them. This means helping them to respond appropriately to danger but, even more, to recover the capacity to experience safety, relaxation, and true reciprocity.
Mindfulness, or the ability to hover calmly and objectively over our thoughts, feelings, and emotions, is one of the primary tools. This ability allows the intellectual brain to inhibit, organize, and modulate the hardwired automatic reactions programmed into the emotional brain after the trauma. This capacity is crucial for preserving their relationships with fellow human beings.
Increasing self-awareness, is another important feature of recovery, because traumatized people often have trouble sensing what is going on in their bodies. They either react to stress by becoming ‘spaced out’ or with excessive anger. Whatever their response, they often can’t tell what is upsetting them. This failure to be in touch with their bodies contributes to their well-documented lack of self-protection and high rates of revictimization. And, to their remarkable difficulties feeling pleasure, sensuality, and having a sense of meaning. Noticing and then describing what they are feeling is a process van der Kolk helps his patients learn. He begins the process by helping them talk about what is happening in their bodies, not emotions such as anger or anxiety or fear but the physical sensations beneath the emotions: pressure, heat, muscular tension, tingling, caving in, feeling hollow, and so on. He also works on identifying the sensations associated with relaxation or pleasure…their breath, their gestures and movements. He asks them to pay attention to subtle shifts in their bodies, such as tightness in their chests or gnawing in their bellies, when they talk about negative events that they claim did not bother them.
Victims of trauma need to engage the safety system of the brain before trying to promote new ways of thinking. Ways to engage this part of the brain are:
- Solution Focused Hypnotherapy
- Theatre Programs
- Breath Exercises (Pranayama)
- Martial Arts
- Group Singing
If people are either hyper aroused or shut down, they cannot learn from experience. Even if they manage to stay in control, they become so uptight that they are inflexible, stubborn, and depressed. Recovery from trauma involves the restoration of executive functioning and, with it, self-confidence and the capacity for playfulness and creativity.
In order to recover, mind, body, and brain need to be convinced that it is safe to let go. That happens only when you feel safe at a visceral level and allow yourself to connect that sense of safety with memories of past helplessness. 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.
If we keep secrets and suppress information, you are fundamentally at war with yourself. Hiding core feelings takes an enormous amount of energy, it saps your motivation to pursue worthwhile goals, and it leaves you feeling bored and shut down.
What is great about the book is that in my experience one of the difficulties people have when trying to get over trauma is questioning their response to the trauma or their role within it. Gaining insight from this book in relation to the commonalities of how people respond to trauma helps the reader feel normal.
Van der Kolk, himself a survivor of early relational trauma is the Medical Director of the Trauma Centre in Boston, he is also a Professor of Psychiatry at Boston University Medical School and serves as the Co-Director of the National Centre for Child Traumatic Stress Complex Trauma Network.