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The body keeps the score by M.D. Bessel Van Der Kolk – Remarks

Posted by Raul Barral Tamayo en martes, 18 de abril, 2017

Copyright © 2014 by Bessel van der Kolk.

A pioneering researcher transforms our understanding of trauma and offers a bold new paradigm for healing.

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 world’s 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 brain’s natural neuroplasticity. Based on Dr. van der Kolk’s 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.

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, he works and lives in Boston.

Comments extracted from the book, they could be right or wrong, you decide for yourself:

  • One does not have to be a combat soldier, or visit a refugee camp in Syria or t he Congo to encounter trauma. Trauma happens to us, our friends, our families, and our neighbours. One in five Americans was sexually molested as a child.
  • As human beings we belong to an extremely resilient species. Since time immemorial we have rebounded from our relentless wars, countless disasters, and the violence and betrayal in our own lives.
  • But traumatic experiences do leave traces 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.
  • Trauma, by definition is unbearable and intolerable.
  • It takes tremendous energy to keep functioning while carrying the memory of terror, and the shame of utter weakness and vulnerability.
  • 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 hormons.
  • Posttraumatic reactions feel incomprehensible and overwhelming. Feeling out of control, survivors of trauma often being to fear that they are damaged to the core and beyond redemption.
  • Research from these new disciplines has revealed that trauma produces actual pshysiological changes, including a recalibration of the brain’s alarm system, an increase in stress hormone activity, and alterations in the system that filters relevant information from irrelevant.
  • 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.
  • 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 profund changes, depending on the nature of the particular problem and makeup of t he individual person.
  • Posttraumatic stress isn’t “all in one’s head” as some people supposed, but has a physiological basis.
  • Humans beings are experts in wishful thinking and obscuring the truth.
  • Trauma, whether it is the result of something done to you or something you yourself have done, almost always makes it difficult to engage in intimate relationships.
  • One of the hardest things for traumatized people is to confront their shame about the way they behaved during a traumatic episode whether it is objectively warranted or not.
  • Deep down many traumatized people are even more haunted by the shame they feel abotu what they themselves did or did not do under the circumstances. They despise themselves for how terrified, dependent, excited, or enraged they felt.
  • I encountered a similar phenomenon in victims of child abuse. Most of them suffer from agonizing shame about the actions they took to survive and maintain a connection with the person who abused them. This was particularily true if the abuser was someone close to the child, someone the child depended on, as is so often the case.
  • Maybe the worst of Tom’s symptoms was that he felt emotionally numb. He desperately wanted to love his family, but he just couldn’t evoke any deep feelings for them.
  • Sigmund Freud had said about trauma in 1895: “I think this man is suffering from memories”.
  • Unlike tests that require answers to straightforward questions, responses to the Rorschach are almost impossible to fake.
  • The normal human response to ambigous stimuli is to use our imagination to read something into them.
  • Imaginationis absolutely critical to the quality of our lives. When people are compulsively and constantly pulled back into the past, to the last time they felt intense involvement and deep emotions, they suffer from a failure of imagination, a loss of the mental flexibility.
  • The Rorschach tests also taught us that traumatized people look at the world in a fundamentally different way from other people.
  • After trauma the wolrd becomes sharply divided between those who know and those who don’t. People who have not shared the traumatic experience cannot be trusted, because they can’t understand it. Sadly, this often includes spouses, children, and co-workers.
  • Whether the trauma had ocurred ten years in the part of more than forty, my patients could not bridge the gap between their watime experiences and their current lives.
  • They felt fully alive only when they were revisiting their traumatic past.
  • In those early days at the VA, we labeled our veterans with all sorts of diagnoses (alcoholism, substance abuse, depression, mood disorder, even schizphrenia) and we tried every treatment in our textbooks. A turning point arrive in 1980, when a group of Vietname veterans successfully lobbied the American Psychiatric Association to create a new diagnosis: posttraumatic stress disorder (PTSD).
  • For most people the memory of an unpleasant event eventually fades or is transformed into something more bening. But most of our patients were unable to make their past into a story that happened long ago.
  • It is very difficult for growing children to recover when the source of terror and pain is not enemy combatants but their own caretakers.
  • Trauma results in a fundamental reorganization of the way mind and brain manage perceptions. I changes not only how we thing and what we think about, but also our very capacity to think.
  • Helping victims of trauma find the words to describe what has happened to them is profoundly meaningful, but usually it is not enough. For real change to take place, the body needs to learn that the danger has passed and to live in the reality of the present.
  • C.C. Chang, The Practice of Zen: “The greater the doubt, the greater the awakening; the smaller the doubt, the smaller the awakening. No doubt, no awakening”.
  • When patients could not sleep, they often wandered in their tightly wrapped bathrobes into the darkened nursing station to talk. The quiet of the night seemed to help them open up, and they told me stories about having bee hit, assaulted, or molested, often by their own parents, sometimes by relatives, classmates, or neighbores.
  • More than half the people who seek psychiatric care have been assaulted, abandoned, neglected, or even raped as children, or have witnessed violence in their families.
  • Elvin Semrad taught us that most human suffering is related to love and loss. The greatest sources of our suffering are the lies we tell ourselves.
  • Healing depends on experiential knowledge. You can be fully in charge of your life if you can acknowledge the reality of your body, in all its visceral dimensions.
  • Many traumatized people simply give up. Rather than risk experimenting with new options they stay stuck in the fear they know.
  • Traumatized people keep secreting large amounts of stress hormones long after the actual danger has passed.
  • Ideally our stress hormone system should provide a lighting-fast response to threat, but then quickly return us to equilibrium. In PTSD patients, however, the stress hormone system fails at this balancing act.
  • The only way to teach the traumatized dogs to get off the electric grids when the doors were open was to repeatedly drag them our of their cages so they could physically experience how they could get away.
  • Many traumatized people seem to seek out experiences that would repel most of us, and patients oftem complain about a vague sense of emptiness and boredom when they are not angry, under duress, or involved in some dangerous activity. Freud had a term for such traumatic reenactments: “the compulsion to repeat”.
  • Fear and aversion, in some perverse way, can be transformed into pleasure.
  • For many traumatized people, reexposure to stress might provide a similar relief from anxiety.
  • The ability to cope socially was often compromised.
  • Most treatment studies of PTSD find a significant placebo effect. Maybe the reward is only the attention paid to them.
  • Receiving a pension or disability benefits prevents people from getting better.
  • The drug revolution that started out with so much promise may in the end have done as much harm as good. In many places drugs have displaced therapy and enabled patients to suppress their problems without addressing the underlying issues.
  • The brain-disease model overlooks four fundamental truths:
    • Our capacity to destroy one another is matched by our capacity to heal one another. Restoring relationships and community is central to restoring well-being.
    • Language gives us the power to change ourselves and other by communicating sens of meaing.
    • We have the ability to regulate our own physiology, including some of the so-called involuntary functions of the body and brain, through such basic activities as breathing, moving, and touching.
    • We can change social conditions to create environments in which children and adults can feel safe and where they can thrive.
  • All trauma is preverbal. Under extreme conditions people may scream obscenities, call for their mothers, howl in terror, or simply shut down. Traumatized children “lose their tongues” and refuse to speak.
  • Even years later traumatized people often have enourmous difficulty telling other people what has happenned to them. Trauma by nature drives us to the edge of comprehension, cutting us off from language based on common experience or an imaginable past.
  • Images of past trauma activate the right hemisphere of the brain and deactivate the left.
  • People who are very upset sometimes say the are “losing their minds”. In technical terms they are experiencing the loss of executive functioning.
  • When something reminds traumatized people of the past, their right brain reacts as if the traumatic event were happenning in the present.
  • During disasters young children usually take their cues from their parents. As long as their caregivers remain calm and responsive to their needs, they often survive terrible incidents wihout serious psychological scars.
  • Traumatized people become stuck, stopped in their growth because they can’t integrate new experiences into their lives.
  • Attempts to maintain control over unbearable physiological reactions can result in a whole range of physical symptoms, including fibromyalgia, chronic fatigue, and other autoimmune diseases.
  • The most important job of the brain is to ensure our survival, even under the most miserable conditions. Everything else is secondary. In order to do t hat, brain need to:
    • Generate internal signals that register what our bodies need, such as food, rest, protection, sex, and shelter.
    • Create a map of the world to point us where to go to satisfy those needs.
    • Generate the necessary energy and actions to get us there.
    • Warn us of dangers and opportunities along the way.
    • Adjust our actions based on the requirements of the moment.
  • It is amazing how many psychological problems involve difficulties with sleep, appetite, touch, digestion, and arousal. Any effective treatment for trauma has to address these basic housekeeping functions of the body.
  • When a circuit fires repeatedly, it can become a default setting, the response most likely to occur. If you feel safe and loved, your brain becomes specialized in exploration, play, and cooperation; if you are frightened and unwanted, it specializes in managing feelings of fear and abandonment.
  • Trauma almost invariably involves not being seen, not being mirrored, and not being taken into account. Treatment needs to reactivate the capacity to safely mirror, and be mirrored, by others, but also to resist being hijacked by others’ negative emotions.
  • Trauma increases the risk of misinterpreting whether a particular situation is dangerous or safe.
  • When that system breaks down we become like conditioned animals. The moment we detect danger we automatically go into fight-or-flight mode.
  • Knowing the difference between top down and bottom up regulation is central for understanding and treating traumatic stress. Top-down regulation involves strengthening the capacity of the watchtower to monitor your body’s sensations. Mindfulness meditation and yoga can help with this. Bottom-up regulation involves recalibrating the autonomic nervous system.
  • Dissociation is the essence of trauma. The overwhelming experience is split off and fragmented, so that the emotions, sounds, images, thoughts, and physical sensations related to the trauma tkae on a life of their own.
  • As long as the trauma is not resolved, the stress hormones that the body secretes to protect itself keep circulating, and the defensive movements and emotional responses keep getting replayed.
  • Flashbacks and reliving are in some ways worse that the trauma itself. A traumatic event has a beginning and an end, at some point is over. But for people with PTSD a flashback can occur at any time, whether they are awake or asleep. There is no way of knowing when it’s going to occur again or how long it will last. People organize their lives around trying to protect against them. Constantly fighting unseen dangers is exhausting and leaves them fatigued, depressed, and weary.
  • Knowing that whatever is happenning is finite and will sooner or later come to an end makes most experiences tolerable. The opposite is also true, situations become intolerable if they feel interminable.
  • Therapy won’t work as long as people keep being pulled back into the past.
  • Trauma is primarily remembered not as a story, a narrative with a beginning, middle, and end, but as isolated sensory imprints: images, sounds, and physical sensations that are accompanied by intense emotions, usually terror and helplessness.
  • People with PTSD have their floodgates wide open. Lacking a filter, they are on constant sensory overload. In order to cope, they try to shut themselves down and develop tunnel vision and hyperfocus.
  • The medical term for Ute’s response is depersonalization. Anyone who deals with traumatized men, women, or children is sooner or later confronted with blank stares and absent minds.
  • A lifeless patient forces you to work much harder to keep the therapy alive, and I often used to pray for the hour to be over quickly.
  • The challenge of trauma treatment is not only dealing with the past but, even more, enhancing the quality of day-to-day experience.
  • Darwin goes on to observe that the fundamental purpose of emotions is to initiate movement that will restore the organism to safety and physical equilibrium.
  • For us humans, as long as 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.
  • We’ll do anything to make these awful visceral sensations go away.
  • Bidirectional communication between body and mind was largely ignored by Western science, even as it had long been central to traditional healing practices in many other parts of the world, notably in India and china.
  • If no one comes to our aid, or we’re in inmmediate danger, the organism reverts to a more primitive way to survive, fight of flight. If this fails, the organism tries to preserve itself by shutting down and expending as little energy as possible. We are then in a state of freeze of collapse.
  • Immobilization es at the root of most trauma.
  • In order to feel emotionally close to another human being, our defensive system must temporarily shut down. In order to play, mate, and nurture our young, the brain needs to turn off its natural vigilance.
  • It is specially challenging for traumatized people to discern when they are actually safe and to be able to activate their defenses when they are in danger. This requires having experiences that can restore the sense of physical safety.
  • Yelling at someone who is already out of control can only lead to further dysregulation.
  • Yoga had proved so successful in helping them calm down and get in touch with their dissociated bodies.
  • People often pretend to joke when they say something serious.
  • In my experience, people who cut themselves are seldom suicidal but are trying to make themselves feel better in the only way they know.
  • The disappearence of medial prefontal activation could explain why so many traumatized people lose their sense of purpose and direction.
  • The lack of self-awareness in victims of chronic childhood trauma is sometimes so profund that they cannot recognize themselves in a mirror.
  • Moshe Feldenkrais, great twentieth-century body therapist: “You can’t do what you want till you know what you are doing”.
  • To people who are reliving a trauma, nothing makes sense; they are trapped in a life-or-death situation, a state of paralyzing fear or blind rage. Mind and body are constantly aroused, as if t hey are in immediate danger.
  • Trauma victims cannot recover until they become familiar with and befriend the sensations in their bodies. Physical self-awareness is the first step in releasing the tyranny of the past.
  • Drugs such as Ability, Zyprexa and Seroquel, are prescribed instead of teaching people the skills to deal with such distressing physical reactions.
  • Medications only blunt sensations and do nothing to resolve them or transform them from toxic agents into allies.
  • The most natural way for human beings to calm themselves when they are upset is by clinging to another person.
  • Manu patients who come to my office are unable to make eye contact.
  • Mind and brain are indistinguishable, what happens in one is registered in the other.
  • Diana Fosha: “The roots of resilience … are to be found in the sense of being understood by and existing in the mind and heart of a loving, attuned, and self-possesed other”.
  • For abused children, the whole world is filled with triggers. As long as they can imagine only disastrous outcomes to relatively benign situations.
  • Kids will go to almost any length to feel seen and connected.
  • If you have no internal sense of security, it is difficult to distinguish between safety and danger.
  • The phenomenon of dissociation, which is manifested in feeling lost, overwhelmed, abandoned, and disconnected from the world and in seeing oneself as unloved, empty, helpless, trapped, and weighed down.
  • If your caregiver ignore your needs, or resent your very existence, you learn to anticipate rejection and withdrawal.
  • Bowlby: “What cannot be communicated to the [m]other cannot be communicated to the self”.
  • Later abuse or other traumas did not account for dissociative symptons in young adults. Abuse and trauma accounted for many other problems, but not for chronic dissociation or aggresion against self.
  • Therapy often starts with some inexplicable behaviour.
  • W.H. Auden, poet: “Truth, like love and sleep, resents approaches that are too intense”.
  • I’ve learned that it’s not important for me to know every detail of a patient’s trauma. What it is critical is that the patients themselves learn to tolerate feeling what they feel and knowing what they know. This may take weeks or even years.
  • The rational brain can override the emotional brain, as long as our fears don’t hijack us.
  • Change begins when we learn to “own” our emotional brains. That means learning to observe and tolerate the heartbreaking and gut-wrenching sensations that register misery and humilliation. Only after learning to bear what is going on inside can we start to befriend, rather than obliterate, the emotions that keep our maps fixed and immutable.
  • Children are also programmed to be fundamentally loyal to their caretakers, even if they are abused by them. Terror increases the need for attachment, even if the source of comfort isalso the source of terror.
  • Erasing awareness and cultivating denial are often essential to survival, but the price is that you lose track of who you are, of what you are feeling, and of what and whom you can trust.
  • Trauma is not stored as a narrative with an orderly beginning, middle, and end.
  • Our patients did not have the option to run away or escape; they had nobody to turn to and no place to hide. Yet they somehow had to manage their terror and despair.
  • When children experience intense inner conflict regarding their angry feelings, this is likely because expressing them may be forbidden or even dangerous.
  • If you carry a memory of having felt safe with somebody long ago, the traces of that earlier affection can be reactivated in attuned relationships when you are an adult, whether these occur in daily life or in good therapy. However, if you lack a deep memory of feeling loved and safe, the receptors in the brain that respond to human kindness may simply fail to develop.
  • The more isolated and unprotected a person feels, the more death will feel like the only escape.
  • Martin Teicher: “Childhood abuse isn’t something you “get over” It is an evil that we must acknowledge and confront if we aim to do anything about the unchecked cycle of violence in this country”.
  • The challenge is to find ways to help them lead productive lives and, in doing so, save hundreds of millions of dollars of taxpayers’ money.
  • The body keeps the score, at the deepest levels of the organism.
  • At least in monkeys, early experience has at least as much impact on biology as heredity does.
  • Mental illness is not at all like cancer: Humans are social animals, and mental problems involve not being able to get along with other people, not fitting in, not belonging, and in general not being able to get on the same wavelength.
  • We all know who fickle memory is our stories change and are constantly revised and updated. Wether we remember a particular event at all, and how accurate our memories of it are, largely depends on how personally meaningful it was and how emotional we felt about it at the time.
  • Jean-Martin Charcot, Pierre Janet, and Sigmund Freud are associated with the discovery that tauma is at the root of hysteria, particularly the trauma of childhood sexual abuse.
  • Traumatized people simultaneously remember too little and too much.
  • When one element of a traumatic experience is triggered, other elements are likely to automatically follow.
  • Reenactments are frozen in time, unchanging, and they are always lonely, humiliating, and alienating experiences.
  • People with PTSD are unable to put the actual event, the source of those memories, behind them. Dissociation prevents the trauma from becoming integrated within the conglomerated, ever-shifting stories of autobiographical memory, in essence creating a dual memory system.
  • Freud reaffirmed the lack of verbal memory is central intrauma and that, if a person does not remember, he is likely to act out.
  • The lasting legacy of Breuer and Freud’s 1893 paper is what we now call the “talking cure”.
  • Katie Cannon: “Our bodies are the texts that carry the memories and therefore remembering is no less than reincarnation”.
  • As long as memory is inaccessible, the mind is unable to change it. But as soon as a story starts being told, particularly if it is told repeatedly, it changes.
  • Academic researchers have shown that is relatively easy to implant memories of events that never took place.
  • Nobody wants to remember trauma. In that regard society is no different from the victims themselves. In order to understand trauma, we have to overcome our natural relunctante to confront that reality and cultivate the courage to listen to the testimonies of survivors.
  • Some degree of “anesthesia awareness” is now estimated to occur in approximately thirty thousand surgical patients in the United States every year.
  • Nobody can “treat” a war, or abuse, rape, molestation, or any other horrendous event, for that matter; what has happened cannot be undone. What can be dealt with are the imprints of t he trauma on body, mind and soul.
  • Trauma robs you of the feeling that you are in charge of yourself, of what I will call self-leadership in the chapters to come.
  • Trauma is much more than a story about something that happened long ago. The emotions and physical sensations that were imprinted during the trauma are experienced not as memories but as disruptive physical reactions in the present.
  • In order to regain control over your self, you need to revisit the trauma: sooner or later you need to confront what has happened to you, but only after you feel safe and will not be retraumatized by it.
  • The engines of postraumatic reactions are located in the emotional brain. In contrast with the rational brain, which expresses itself in thoughts, the emotional brain manifests itself in physical reactions.
  • The fundamental issue in resolving traumatic stress is to restore the proper balance between the rational and emotional brains, so that you can feel in charge of how you respond and how you conduct your life.
  • As long as people are either hyperaroused or shut down, they cannot learn from experience.
  • If we want to change posttraumatic reactions, we have to access the emotional brain and do “limbic system therapy”: repairing faulty alarms systems and restoring the emotional brain to its ordinary job of being a quiet background presence that takes care of the housekeeping of the body, ensuring that you eat, sleep, connect with intimate partners, protect your children, and defend against danger.
  • Neuroscience research shows that the only way we feel is by becoming aware of our inner experience and learning to befriend what is going on inside ourselves.
  • Over the past decades mainstream pshychiatry has focused on using drugs to change the way we feel, and this has become the accepted way to deal with hyper- and hypoarousal.
  • We can directly train our arousal system by the way we breathe, chant, and mnove, a principle that has been utilized since time immemorial in places like China and India.
  • Ten weeks of yoga practice markedly reduced the PTSD symptoms of patients who had failed to respond to any medication or to any other treatment.
  • Mainstream Western pshychiatric and pshychological healing traditions have paid scant attention to self-management. In contrast to the Western reliance on drugs and verbal therapies.
  • At the core of recovery is self-awareness.
  • Traumatized people are often afraid of feeling.
  • In order to change you need to open yourself to your inner experience.
  • Practicing mindfulness calms down the sympathetic nervous system, so that you are less likely to be thrown into fight-or-flight.
  • Mindfulness has been shown to have a positive effect on numerous psychiatric, pshychosomatic, and stress-related symptoms, including depression and chronic pain.
  • Study after study shows than having a good support network constitutes the single most powerful protection against becoming traumatized.
  • Safety and terror are incompatible.
  • Children who are separated from their parents after a traumatic event are likely to suffer serious negative long-term effects.
  • Recovery from trauma involves (re)connecting with our fellow human beings. This is why trauma that has occurred within relationships is generally more difficult to treat than trauma resulting from traffic accidents or natural disasters.
  • If the people whom you naturally turn to for care and protection terrify or reject you, you learn to shut down and to ignore what you feel. When your caregivers turn on you, you have to find alternative ways to deal with feeling scared, angry, or frustrated.
  • Managing your terror all by yourself gives rise to another set of problems: dissociation, despair, addictions, a chronic sense of panic, and relationships that are marked by alienation, disconnection, and explosions. Patients with these histories rarely make the connection between what happened to them long ago and how they currently feel and behave. Everything just seems unmanageable.
  • Unresolved trauma can take a terrible toll on relationships. In fact, you may unwittingly try to hurt them before they have a chance to hurt you.
  • You have to find someone you can trust enough to accompany you, someone who can safely hold your feelings and help you listen to the painful messages from your emotional brain.
  • Patients get better only if they develop deep positive feelings for their therapists.
  • Patients who have been brutalized by their caregivers as children often do not feel safe with anyone.
  • Different patients have told me how much choral singing, aikido, tango dancing, and kickboxing have helped them, and I am delighted to pass their recommendations on to other people I treat.
  • When we play together, we feel physically attuned and experience a sense of connection and joy.
  • The most natural way that we humans calm down our distress is by being touched, hugged, and rocked.
  • The first place I might touch is their hand and foreadm, because that’s the safest place to touch anybody, the place where they can touch you back.
  • People who actively do something to deal with a disaster utilize their stress hormones for their proper purpose and therefore are at much lower risk of becoming traumatized. Helplessness and immobilization keep people from utilizing their stress hormones to defend themselves.
  • Hypnosis can induce a state of relative calm from which patients can observe their traumatic experiences without being overwhelmed by them.
  • Patients are gradually desensitized from their irrational fears by bringing to mind what they are most afraid of.
  • As with Prozac and other psychotropic aents, we don’t know exactly how MDMA works, but it is known to increase concentrations of a number of important hormones including oxytocin, vasopressin, cortisol, and prolactin. Most relevant for trauma treatment, it increases people’s awareness of themselves.
  • Drugs cannot “cure” trauma; they can only dampen the expresions of a disturbed physiology. And they do not teach the lasting lesson of self-regulation. They can help to control feelings and behaviour, but always at a price, because they work by blocking the chemical systems that regulate engagement, motivation, pain, and pleasure.
  • Therapists have an undying faith in the capacity of talk to resolve trauma. Unfortunately, it’s not so simple: Traumatic events are almost impossible to put into words.
  • Silence about trauma leads to death, the death of the soul. Silence reinforces the godforsaken isolation of trauma.
  • Only when I could talk about how that little boy felt, only when I could forgive him for having been as scared and submissive as he was, did I start to enjoy the pleasure of my own company.
  • Determined to stay in control, you are likely to avoid anybody or anything that reminds you even vaguely of your trauma.
  • As long as you keep secrets and suppress information, you are fundamentally at war with yourself. Hiding your 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.
  • Being able to share your deepest pain and deepest feelings with another human being. This is one of the most profound experiences we can have, and such resonance, in which hitherto unspoken words can be discovered, uttered, and received, is fundamental to healing the isolation of trauma.
  • Communicating fully is the opposite of being traumatized.
  • Neuroscience research has shown that we possess two distinct forms of self-awareness: one that keeps track of the self across time and one that registers the self in the present moment.
  • When you activate your gut feelings and listen to your heartbreak, when you follow the interoceptive pathways to your innermost recesses, things being to change.
  • There are other ways to access your inner world of feelings. One of the most effective is through writing.
  • There are thousands of art, music, and dance therapists who do beautiful work with abused children, soldiers suffering from PTSD, incest victims, refugees, and torture survivors, and numerous accounts attest to the effectiveness of expressive therapies.
  • Therapists need to have done their own intensive therapy, so they can take care of themselves and remain emotionally available to their patients, even when their patients’ stories arouse feelings of rage or revulsion.
  • Confusion and mutism are routine in therapy offices.
  • Numerous studies have found that people with PTSD have more general problems with focused attention and with learning new information.
  • Like many scientific advances, EMDR originated with a chance observation.
  • As far as we know, simply exposing someone to the old trauma does not integrate the memory into the overall context of their lives, and it rarely restores them to the level of joyful engagement with people and pursuits they had prior to the trauma.
  • At least half of all traumatized people try to dull their intolerable inner world with drugs or alcohol.
  • When people are chronically angry or scared, constant muscle tension ultimately leads to spasms, back pain, migraine headaches, fibromyalgia, and other forms of chronic pain.
  • I urge all my patients who, for one reason or another, cannot practica yoga, martial arts, or qigong to train themselves at home.
  • One of the clearest lessons from contemporary neuroscience is that our sense of ourselves is anchored in a vital connection with our bodies.
  • If you are not aware of what your body needs, you can’t take of it.
  • Once you start approaching your body with curiosity rather than with fear, everything shifts.
  • A good yoga teacher will encourage you to just notice any tension while timing what you feel with the flow of your breath: “We’ll be holding this position for ten breaths”. This helps you anticipate the end of discomfort and strengthens your capacity to deal with physical and emotional distress.
  • People who feel safe in their bodies can being to translate the memories that previously overwhelmed them into language.
  • If we notice our breath we are in the present because we can’t breathe in the future or the past.
  • Rumi: “This being human is a guest house. Every morning is a new arrival. A joy, a depression, a meanness, some momentary awareness comes as an unexpected visitor… Welcome and entertain them all. Treat each guest honorably. The dark thought, the shame, the malice, meet them at the door laughing, and invite them in. Be grateful for whoever comes, because each has been sent as a guide from beyond”.
  • Many behaviours that are classified as pshychiatric problems, including some obsessions, compulsions, and panic attacks, as well as most self-destructive behaviours, started out as strategies for self-protection. These adaptions to trauma can so interfere with the capacity to function that health-care providers and patients themselves often believe that full recovery is beyond reach.
  • A central task for recovery from trauma is to learn to live with the memories of the past without being overwhelmed by them in the present.
  • It is one thing to process memories of trauma, but it is an entirely different matter to confront the inner void, the holes in the soul that result from not having been wanted, not having been seen, and not having been allowed to speak the truth.
  • A child who has been ignored or chronically humilliated is likely to lack self-respect.
  • Trauma causes people to remain stuck in interpreting the present in light of aun unchanging past.
  • These brain-wave patterns could explain why so many traumatized people have trouble learning from experience and fully engaging in their daily lives. Their brains are not organized to pay careful attention to what is going on in the present moment.
  • Like many severly traumatized people, Lisa could not recognize herself in a mirror.
  • Neurofeedback training can improve creativity, athletic control, and inner awareness, even in people who already are highly accomplished.
  • Tina Packer: “Acting is not about putting on a character but discovering the character within you: you are the character, you just have to find it withing yourself, albeit a very expanded version of yourself”.
  • Since time immemorial human beings have used communal rituals to cope with their most powerful and terrifying feelings.
  • Traumatized people are terrified to feel deeply. They are afraid to experience their emotions, because emotions lead to loss of control.
  • Abandonment makes it impossible to trust, and kids who have gone through foster care understand abandonment. You can have no impact until they trust you.
  • Learning to experience and tolerate deep emotions is essential for recovery from trauma.
  • Advances in neuroscience have given us a better understanding of how trauma changes brain development, self-regulation, and the capacity to stay focused and in tune with others.
  • Poverty, unemployment, inferior schools, social isolation, widespread availability of guns, and substandard housing all are breeding grounds for trauma.
  • Trauma breeds further trauma; hurt people hurt other people.
  • Our increasing use of drugs to treat these conditions doesn’t address the real issues: What are these patients trying to cope with? What are their internal or external resources? How do they calm themselves down? Do they have caring relationships with their bodies, and what do they do to cultivate a physical sense of power, vitality, and relaxation? Do they have dynamic interactions with other people? Who really knows them, loves them, and cares about them? Whom can they count on when they’re scared, when their babies are ill, or when they are sick themselves? Are they members of a community, and do they play vital roles in the lives of the people around them?
  • I like to believe that once our society truly focuses on the needs of children, all forms of social support for families will gradually come to seem not only desirable but also doable.
  • As long as we feel safely held in the hearts and minds of the people who love us, we will climb mountains and cross deserts and stay up all night to finish projects. Children and adults will do anything for people they trust and whose opinion they value. But if we feel abandoned, worthless, or invisible, nothing seems to matter. Fear destroys curiosity and playfulness.
  • There can be no growth without curiosity and no adaptability without being able to explore, through trial and error, who you are and what matters to you.
  • Most bullies have themselves been bullied, and they despise kids who remind them of their own vulnerability.
  • Trauma is now our most urgent public health issue, and we have the knowledge necessary to respond effectively. The choice is ours to act on what we know.

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