The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma

As a Behavioral Health Pharmacist, I work with many patients dealing with PTSD and other trauma-related mental health issues. I wanted to read The Body Keeps the Score to better understand how trauma affects the brain and body, and to be able to explain to my patients why sticking with their prescribed medications can be an important part of their healing process. This book is packed with information. Dr. van der Kolk does a wonderful job of explaining how trauma changes brain chemistry, often leaving people stuck in a cycle of stress and emotional distress. I found the discussions on fight, flight, or freeze especially interesting, as they really helped connect the dots between mental health symptoms and physical reactions. The book also explores different treatment approaches, including traditional therapies and alternative methods like yoga, drama, and neurofeedback, which I found useful. That said, this book isn’t the easiest to read. It’s dense, and at times, I felt like it could have been more concise. Some of the detailed trauma accounts were difficult to get through and might be triggering for some readers. I also think it could have done a better job acknowledging resilience—many people do recover from trauma without extensive therapy, and that wasn’t really addressed. Overall, I’m glad I read it. It gave me valuable insights that will help me guide my patients and explain why managing trauma often requires a combination of medication, therapy, and lifestyle changes. While it may not be for everyone, it’s a powerful book for those wanting a deep dive into the science of trauma and recovery.

This book is unbelievable and has changed my life. It is so well-written for the average laymen and explains the deep topic of trauma and how it affects the body and brain and emotional soul. It thoroughly examines how we carry around physical and emotional, behaviorial ailments in our body and how they are initiated due to our past traumas. It is a fascinating read.

After being struck by trauma – combat, auto accident, assault, abuse – why do the dreams come and come and come? From where does the anxiety, distractedness, or outburst originate? Are there reasons for the gut balling up into a knot and the chest squeezing tight and feeling like it will implode when unwanted memories of the distress invade? Why does the recall come in pieces, chunks, or flashes? And then there’s the inability to communicate, the mental shut-down, the emotional-frigidity; what is that all about? Is there any way to move from the trauma and its aftermath to some sense of genuine wellbeing? All of these subjects, and more, are covered by Bessel van der Kolk, founder and medical director of the Trauma Center in Brookline, Massachusetts, professor of psychiatry at Boston University School of Medicine, and director of the National Complex Trauma Treatment Network, in his 464 page paperback, “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma”. This volume is written for both the helping-professions technician and therapist, as well as for the traumatized and their families. With thousands of book reviews already posted and published, I’ll make this review brief. “The Body Keeps the Score” unpacks the way trauma affects us, mind, brain, and body. The author looks at multiple forms of therapy, showing their strengths and limits. He recognizes that there are “fundamentally three avenues [of therapy]: 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 results from trauma” (3). Van der Kolk addresses each of these approaches while explaining in detail what harrowing ordeals do to people. The author’s proposition through the pages is that the anguish of assault and abuse “changes brain development, self-regulation, and the capacity to stay focused and in tune with others…experiences change the structure and function of the brain – and even affect the genes we pass on to our children…devastates the social-engagement system and interferes with cooperation, nurturing, and the ability to function as a productive member of the clan” (349, 351). One of the aspects that surprised me was how the “ventral vagal complex” – the vagus nerve that interfaces with other nervous systems – takes what my brain is experiencing (even re-experiencing through PTSD, etc.) and mobilizes muscles, heart, lungs and other body parts, so that I feel the alarm – or helplessness – or grief in my brain all the way down into my chest and stomach! Which means my body begins to take on muscle-memory (as we put it in martial arts)! Therefore, if “the memory of trauma is encoded in the viscera, in heartbreaking and gut-wrenching emotions, in autoimmune disorders and skeletal/muscular problems, and if mind/brain/visceral communication is the royal road to emotion regulation, this demands a radical shift in our therapeutic assumptions (88). It’s this “radical shift in therapeutic assumptions” that dominates the authors final eight chapters, where he methodically explains different “paths to recovery”. This is truly a captivating read! Van der Kolk weaves into the technical aspects of the book biographical and autobiographical tales that help the reader to see what has gone on, and not gone on, in the world of psychiatry and psychology regarding trauma. The stories also help to cement into the imagination and comprehension what he is trying to communicate. The book is reasonably technical with neuroscience, brain studies, physiology, professional acronyms and so forth. But the author is careful to not leave anyone in the dark. It is a fascinating read that treats the audience as mature enough to handle the subject and grasp the material. I disagreed with the evolutionary explanations of how the brain develops and found the little political rant in the epilogue disappointing. But beyond these, I was almost mesmerized by the book! “The Body Keeps the Score” is a whole textbook on physiology, brain studies and neuroscience, as well as therapeutic theories. It is not a self-help book, but readers who are looking for help will likely find it beneficial. Helping professionals may also find it advantageous as the author has a plethora of notes on various studies and articles. But I think that the biggest value will be for those who have family members, friends, and parishioners that have been through violent experiences. It gives a bigger and better perspective on what s going on, and they will be able to draw from the various paths to recovery approaches they can take as they seek to be part of the remedy and not the trauma. I highly recommend the book.

This is unquestionably the finest and most useful book ever written on the subject of trauma. Bessel van der Kolk M.D. has the incredible gift of being able to write a book on the subject of PTSD, and doing so in a way that is useful for clinicians, as well as for the general population. He does so in a matter of fact way, and makes the reader feel as if he/she is sitting by his side listening to him telling a story. He has the extremely rare ability to get through to the masses, and to do so without any pretense whatsoever. He seems like the kind of guy you could become friends with after meeting for just 5 minutes. The author speaks unequivocally about the dangers of trauma, and the lifelong suffering of individuals. He provides concrete solutions and a plethora of resources to help those who've been suffering for years, decades or even lifetimes. His ability to simplify the complex, is the cornerstone of this watershed book. Without doubt, the material presented by the author will be life changing, in that it provides brilliantly written examples of patients who've suffered from PTSD, and having been cured by using his methodologies. This book is living proof that it's possible to present vital information in a format that provides for easy assimilation by a person suffering from PTSD, and enabling them to adapt to a new environment of freedom from harrowing nightmares and flashbacks. A seemingly impossible or at least improbable resolution to the above issues is made a whole lot easier by following the guidelines of the author. The writing style of Bessel van der Kolk M.D., is one of empathy and compassion throughout. There are no condescending remarks, nor anything other than some of the most useful and accessible information that I've ever come across. This is not just a brilliant book, it's a once in a lifetime read, that in my opinion will be the go to resource on the subject of trauma and PTSD for generations to come. The author goes out of his way to provide easy to understand and follow explanations that will be universally helpful to both patients and mental health professionals. This is hands down, the most readable and accessible book about PTSD ever made available to the general population. Having a background in psychology, I was in total awe at the material presented in this book. It's a must read for all clinicians in the field, and is written in such an accessible style that patients suffering from PTSD will find it the most valuable resource they've ever been presented with. It's simplicity and usability leaves material listed in lesser books in the dust. It takes an exceptional talent to be able to write a book that is equally valuable for both clinicians and their patients. This is a book for the ages. Not just providing case histories and methodologies for conquering the devastating effects of PTSD, this book also provides invaluable resources for both clinicians and patients. Bessel van der Kolk M.D. has written the most informative, and highly readable book on PTSD ever published, period. Look no further, this is as good as it gets, a truly impressive and exceptionally well written book.

I'm not all the way through this yet (it is so full of information and data it is not a fast read), but so far I am really liking it. It has a lot of information from both studies that have been done (and pictures from brain imaging), and from the author's own observations in his interactions with people from the beginning of his career in about the 1950s. You really see the tragedy in how LONG it took to prove how much things like PTSD, abuse, and other trauma actually affects the functionality of the brain long-term. The only thing I don't like so far is how the book is organized. It seems like he's doing it chronologically, but that does mean he is repeating some information, and he is "putting off" in some cases telling you all the information--for example he'll say something like we used ___ therapy, which I talk about in Chapter 9. But this is a fantastic read if you or someone you are close to has experienced something very difficult and has struggled to find the right treatment to help with recovery and to help you not just "cope" but return to living a full and enjoyable life feeling like "yourself" again.

I never find myself engaging in reading normally. I am only a third of the way through this book so far and I can't put it down. I've honestly teared up a few times. It has brought so much to light for me in regards to how our brains and bodies respond to trauma and how connected they are. I've always been interested in psychology but this enters a new level for me. Truly a fantastic and educational read.

"The Body Keeps the Score" by Bessel van der Kolk is not just a book; it's a guiding light through the labyrinth of trauma, offering profound insights and practical tools for healing. As someone who has experienced trauma firsthand, this book has been nothing short of life-changing in my journey towards understanding and processing my experiences. Comprehensive Understanding: One of the most remarkable aspects of this book is its comprehensive exploration of trauma and its effects on the brain, mind, and body. Van der Kolk draws upon decades of research and clinical experience to provide a deep understanding of how trauma manifests physically, emotionally, and psychologically. His insights shed light on the complex interplay between trauma and various mental health conditions, offering clarity and validation to those who have struggled to make sense of their experiences. Holistic Approach: "The Body Keeps the Score" emphasizes the importance of taking a holistic approach to trauma healing, addressing not only the psychological aspects but also the physiological and relational dimensions of trauma. Van der Kolk explores a range of therapeutic modalities, from traditional talk therapy to innovative approaches such as EMDR and neurofeedback, demonstrating how each can play a vital role in the healing process. This holistic perspective resonated deeply with me, providing a roadmap for integrating mind, body, and spirit in my own healing journey. Practical Tools: What sets "The Body Keeps the Score" apart is its emphasis on practical tools and techniques for healing. Van der Kolk offers a wealth of exercises and strategies that readers can incorporate into their daily lives to regulate their nervous systems, cultivate self-awareness, and foster resilience in the face of trauma. From mindfulness practices to yoga and creative expression, these tools empower readers to take an active role in their healing journey, offering hope and agency amidst the darkness of trauma. Validation and Empowerment: Perhaps the most profound impact of "The Body Keeps the Score" is its validation of the trauma survivor's experience and its message of empowerment. Van der Kolk emphasizes that healing is possible, that survivors are not defined by their trauma, and that they have the capacity to reclaim agency and meaning in their lives. This message of hope and empowerment is a beacon of light for anyone who has felt lost or hopeless in the aftermath of trauma. In conclusion, "The Body Keeps the Score" is a masterpiece of trauma literature that offers profound insights, practical guidance, and unwavering hope to trauma survivors and professionals alike. It has helped me navigate the darkest corners of my psyche, find solace in the embrace of community, and reclaim a sense of agency and purpose in my life. If you have experienced trauma or work with trauma survivors, I cannot recommend this book highly enough. It has the power to transform lives and ignite a path towards healing, one page at a time.

Like millions of others, I read The Body Keeps the Score and felt seen for the first time in my life. It is a masterpiece of artistic and poetic observation—a heartbreakingly accurate description of what it feels like to live with a hijacked nervous system. But when I got to the solutions section, I felt utterly exhausted. Yoga?! Theater?! Chanting?! These are wonderful "soft therapies", but asking a person with severe PTSD to meditate their way out of a panic attack is like asking someone with a broken leg to run a mile in four minutes. I was left with the question: Okay, the body keeps the score... but how do we wipe the scoreboard clean? Dino Garner’s Silent Scars, Bold Remedies is the answer to that question. I looked him up on LinkedIn. Very impressive background in many areas, all of which he brought to bear in his landmark book, Silent Scars, Bold Remedies. I heard a podcast of him telling the audience how he taught medical school and discovered that not a single student who was to become a psychiatrist knew anything about physics, or chemistry or basic mathematics, not much less basic neurochemistry. When I heard that it made sense that Dr. van der Kolk spoke in metaphors and poetry. He truly didn’t know anything about the hard science that Garner brings to bear in Silent Scars, Bold Remedies. If van der Kolk wrote the biography of the ghost in the machine, Dino Garner has written the schematic, checklists and training manuals for the machine itself. His book moves beyond the poetry of suffering and gets straight into the hard engineering of the injury. And Dino Garner also includes MANY beautiful charcoal drawings and first-hand accounts and stories from people of all walks of life. Garner's book is "van der Kolk's book gone nuclear”, you ask this old guy. Here is the forensic difference that blew my mind: The Old Paradigm (van der Kolk): Focuses heavily on the Vagus Nerve (the body's "brake pedal") and tries to strengthen it through breathing and mindfulness. Garner's Paradigm: Recognizes that if the "gas pedal" (the Stellate Ganglion) is physically jammed to the floor, pumping the brakes won't work. You have to pop the hood and fix the stuck accelerator. This was the lightbulb moment for me. Garner dives deep into the molecular and biophysical basis of trauma—specifically chemical things like Nerve Growth Factor and cytokines and neuroinflammation and sympathetic nerve sprouting—concepts that are completely absent in The Body Keeps the Score. Garner was a biophysics researcher for many years and an expert in the hard sciences that psychiatrists lack. Garner explains that PTSI (and he rightly calls it an Injury, not a Disorder) is a hardware failure, not a character flaw as van der Kolk says in so many pages. The sections on the Dual Sympathetic Reset are revolutionary. Garner explains how a precise medical intervention can do in 15 minutes what years of talk therapy failed to achieve. It’s not magic, guys, this is realife biophysics in action. Garner also has around 200 pages of recent references and citations, from books to reviews to scientific papers. Those sections I’ve never seen in any other book on PTSD. Garner also included a SUMMARY for each book and paper. That was worth the price of admission!!!!!! Do not get me wrong—The Body Keeps the Score is a necessary book and beautifully written in such artistic form. It validates the pain. But Dino Garner's Silent Scars, Bold Remedies discovers, researches, analyzes, and validates the actual cure. It is the missing second half of van der Kolk's poetic trauma conversation. If you are tired of "managing" your symptoms and want to understand the mechanics of actually fixing them, skip the yoga mat and read Dino Garner’s book. As if not enough, Garner launched a new series of books, Silent Scars, Bold Remedies - The Emerging Science Series, as ebooks. They're here on amazon. They go deeper into specifics about ketamine therapy, weaning yourself off antidepressants, the vagus nerve, and stellate ganglion block and dual sympathetic reset treatments. For those of us not properly schooled in math, physics and chemistry, Dino Garner has also presented Healing In Plain Sight, a book that is the reduced version of Silent Scars, Bold Remedies. Garner took out almost all the science, medicine, technology stuff and hardcore text that would probably drive people who failed chemistry in high school crazy. Healing In Plain Sight is chock full of all the beautiful charcoals, stories, If-Then and Take The Step guidances, and special stories at the end of each chapter. One again, I loved reading Dr. van der Kolk’s The Body Keeps the Score! I highly recommend it to all. But if you want to heal your biological body and mind, read and study Dino Garner’s Silent Scars, Bold Remedies!!!!!