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

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!!!!!

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.

Psychiatrist, professor, world-class researcher, and traumatologist Bessel van der Kolk MD requires no introduction to trauma psychotherapists. My enduring impressions of him over many years is one of relevance, cogency, frankness, and accessibility - served up with a subtle dash of impishness. He tends to be a bit disruptive - something of a provocateur - and everything of his I have ever read has taught me something, confirmed something important, or pushed my thinking in a new direction. When he has something to say, I want to hear it. However, I almost didn't buy this book: I was put off by the title. Familiar with major reviews of PTSD psychotherapy outcomes research, I know that research support for body-oriented approaches to treating psychological trauma psychopathology is thin at best, and such treatment models simply do not have the research validation of either EMDR (Eye Movement Desensitization and Reprocessing) and PE (Prolonged Exposure), neither of which are especially body-focused. J. Interlandi's excellent article anticipating publication of this book - "A Revolutionary Approach to Treating PTSD" (New York Times Magazine, 2014.05.22 - available online) - initially supported my fears that for some inexplicable reason van der Kolk was now promoting some treatment model for which we have little confirming research. "Psychomotor therapy is neither widely practiced nor supported by clinical studies," Interlandi informs us. Provocateur he may be, but I'm strongly biased in favor of paying attention to therapies for which we do have solid empirical validation. Our clients do not deserve to be experimental subjects - maybe not even if they agree to this, as I'm not sure they can ever know enough to make a truly informed consent. Knowledge that PTSD and related disorders are usually highly curable, when using the right treatment protocols, sadly remains the possession of a minority of people, even in the professional psychotherapy world. Yet the account of van der Kolk's therapy work in Interlandi's article is gripping. Becoming completely absorbed in the account, I was convinced. (I've been here before, reading van der Kolk's own accounts of his work.) And so the disruption begins! Deeper into the article, he has me. Van der Kolk's critique of CBT (cognitive behavioral therapy - a general class of therapies) and PE (E. Foa's exposure therapy model) is withering and correct: neither really work. "Trauma has nothing whatsoever to do with cognition...It has to do with your body being reset to interpret the world as a dangerous place....It's not something you can talk yourself out of." Interlandi reports that "That view places him on the fringes of the psychiatric mainstream." But he's right, and I can't stress this enough. Why? Because as a trauma treatment professional I'm well aware of what the trauma treatment outcomes research actually says. The best current summary of this research well may be chapter 2 of Ecker, et al.'s (2012) "Unlocking the emotional brain". (Buy this book, too!) Ecker et al. brilliantly presents a synthetic summary that encompasses 11 existing therapy models which actually DO cure trauma psychopathology, if done right. In this context, what van der Kolk is doing makes perfect sense. Finally, it appears, the trauma psychotherapy field is moving toward a consensus which has strong credibility. Van der Kolk's new book has many virtues. Parts One and Two (102 pp) provide a substantial review of the neuropsychology of trauma's impact on a person. It's fun, interesting, informative reading, for professional and layperson alike. Part Three (64 pp) surveys childhood development, attachment experience, and "the hidden epidemic of developmental trauma". Van der Kolk has for years been a leading champion of the idea that there is a type of PTSD which substantially differs from all the rest. It develops in response to chronic child abuse and/or neglect. I completely share his belief that the diagnosis of Developmental Trauma Disorder (sometimes called C-PTSD, with "C" meaning "Complex") is overdue for formal recognition. I find his review of the struggle to legitimize DTD as gripping and distressing as anything else in the book. It is anguishing to know that a major problem exists, AND that the psychiatric establishment simply refuses to acknowledge it. DTD/C-PTSD is no fantasy. We see and treat these people, as children and adults. They exist, and they are nothing like "ordinary" PTSD treatment clients. Part Four (29 pp) focuses on memory. I've long thought that much writing on treating psychological trauma seems to miss the point: trauma memory is what causes the problem. Deal with that and the symptoms vanish. Why is this so hard to understand? Yet, it is not a common understanding at all. Explaining how trauma memory works is invariably enlightening to my clients. And experiencing what happens when we change the nature of trauma memory is revelatory to someone who's lived with it for years, if not decades. As he does throughout the book, van der Kolk offers fine stories about clients who have experienced exactly what I've seen happen in my clients, making excellent use of what cognitive research tells us: people understand things best through narratives. Offer a good narrative and you convince. Psychological trauma therapy is complex, but we are now well prepared to launch into the book's core content - Part Five (154 pp), "Paths to Recovery". He gets right to it: we cannot undo the trauma, but we CAN undo its effect on us, and so get our "self" back. Ch. 13 reviews existing therapies. His approach is to repair "Descartes' Error" (see Damásio's 1994 book of that title) by viewing mind and body as a single coherent functional unit. His topical coverage is complete and his critique of current therapies acute - not to be missed. He then writes of the importance of language (Ch. 14). We construct our narrative mainly in words, and the words we choose are critical. But language is not enough (this anticipates his next two chapters). Our senses encompass a larger world, and it's center is our body, where all our sensory receptors are located. Then he introduces the treatment model he's long advocated: EMDR (Eye Movement Desensitization and Reprocessing). I'm trained in EMDR, and in fact van der Kolk and I had the same instructor for our advanced training: Gerald Puk PhD. Van der Kolk tells an amusing and self-deprecating story about his advanced training experience, in which Puk was able to provide a strong corrective to his approach to clients. This is typical van der Kolk - he's a truth-teller, even when it may put him in a poor light! And,after all, at this point he has nothing to prove to anyone. Finding an EMDR therapist is not hard (see his "Resources" section). Nor is it hard to find a yoga instructor, and yoga is what he advises for helping a trauma victim get back into their body. Yoga is a wise choice, because it is available, already widely known, and adaptable to a wide range of individuals and capabilities. There is much more in Part Five, and the focus is on self-empowerment. "Victim no more!" as they say. Most trauma therapists have a keen interest in seeing their clients leave therapy charged up and ready to fully embrace their life - that certainly is my own emphasis. Van der Kolk's thoughts on self-empowerment for those in recovery from psychological trauma will be invaluable to any trauma psychotherapy client. For psychotherapy professionals, this book will be both delightful and confirming. For everyone else, it will be a readable, gripping, highly educational tour of topics all of which are critical to a successful transition back from the impact of psychological trauma. That he gives prominent though not dominating emphasis to developmental trauma disorders is entirely appropriate. Our society has yet to grasp that child abuse and neglect is a more often chronic than not, and that its impact is largely ignored and poorly treated, if at all. This does not have to be. Get educated (this book will do that), then commit to being an advocate for children as well as for adults impacted by trauma. They all deserve the chance to be healed, and we can now do that. Van der Kolk shows us how. The physical book: Jacket design is pleasant and interesting. Binding is less so: color of spine wrapping is semi-florescent, and of paper, not cloth. The book feels substantial and pleasant to hold and look at. Organization - * 6 pp: prefatory praise by peers and related luminaries (interesting comments from some important people in the field); * 2 pp: Table of Contents; * 356 pp: actual text; * 4 pp: Appendix: Consensus proposed criteria for developmental trauma disorder * 3 pp: Resources * 4 pp: Further reading * 51 pp: Notes * 21 pp: Index

This is hands down one of the best trauma books that I have read. I sent this book to a person in prison that has gone through a lot of trauma in her life. If you have been through trauma, this is a must read. I have been to combat twice, the book was very insightful.

The Body Keeps the Score was recommended to me by my therapist, and as someone with a history of childhood trauma I had long avoided facing, this was not an easy book to read. It is heavy, emotional, and at times uncomfortable—but it is also incredibly important. This is the kind of book that meets you where you are, and I truly believe that every time you read it, you will walk away with something new. The book is deeply informational while remaining accessible. Complex ideas about trauma, the brain, and the body are explained in clear, layman’s terms, making it possible to understand what applies to your own life and how healing might begin. Rather than feeling clinical or detached, it offers insight, validation, and practical understanding for people who have lived through trauma, even if they’ve spent years pushing it aside. One of the most powerful aspects of this book is the way it sparks conversation and connection. It even inspired a close friend of mine—someone who hadn’t read a book in years—to start her own book club just to discuss it. Watching that happen made me incredibly proud and reinforced how impactful this book can be. Several quotes stayed with me long after I finished reading. One in particular struck deeply: “It takes enormous trust and courage to allow yourself to remember.” Another equally powerful line was, “The greatest sources of our suffering are the lies we tell ourselves.” These words capture the heart of the book: healing is hard, painful, and courageous—but also possible. Trauma can feel like a lifelong sentence, and any tool that helps make that burden lighter is invaluable. The Body Keeps the Score is not an easy read, but it is a meaningful one. If you’re brave enough to face it, I highly recommend it. Dare to read it—it’s a good one.

A traumatic experience is any event or series of events that overwhelms a person’s ability to cope with the present moment, causes intense physical or emotional stress, and leaves a lasting impact on either mental, emotional, and/or physical well-being. Soldiers returning from war, children abused by their caregivers, and people who have experienced a sudden and shocking death or extreme tragedy are all prime candidates for trauma. It rewires our brain and changes “not only how we think and what we think about, but also our very capacity to think.” Trauma encodes itself in our brains, our minds, and our bodies, and after a traumatic incident, the world is experienced with a different nervous system now focused on suppressing inner chaos at the expense of active involvement in life. It burrows deep, and for some people, traumatic experiences can be very difficult to recover from. This book is filled with both good news and bad news. The good news is that our understanding of trauma and how it affects us mentally, emotionally, and physically has greatly improved, as have the ways in which we treat it. The bad news is that sadly, trauma isn’t as rare as we would like to believe. Research 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.” This, of course, doesn’t include trauma we might experience as an adult like natural disasters, car accidents, or acts of terrorism, and, of course, the most common candidates for trauma: soldiers returning from war. An important question to consider is what all of these disparate events have in common in the way they affect us, and the answer is in how the emotions we experience at the time of the trauma stay with us and become encoded in our brains, minds, and bodies. “Ideally our stress hormone system should provide a lightning-fast response to threat, but then quickly return us to equilibrium,” Van der Kolk writes, “in PTSD patients, however, the stress hormone system fails at this balancing act.” When something traumatic occurs it produces physiological 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,”—it literally changes the way we see and understand the world around us and how we interact with it. Then, when something similar triggers us in the future, our brain and body react as if the traumatic event were happening in the present. We may not even be aware that we are re-experiencing and reenacting the past—all we know is that we feel furious, terrified, enraged, ashamed, or frozen. The continued secretion of stress hormones is expressed as agitation and panic and, in the long term, can wreak havoc with our health. The most common example is the ex-soldier who hears a loud motorcycle and throws himself to the ground for cover because his body reacts as though it’s an enemy tank. It’s also true for the women (and men) who have been sexually assaulted and now can’t stand to be touched by anybody without it feeling like their attacker again. It is likewise true for the adult who was hit by their caregiver as a child and cannot figure out how to connect with others in an intimate way. In each scenario, when the stimulus occurs (a loud motorcycle, someone touching them, or their inability to connect emotionally with others) the brain, mind, and body react as though the original trauma is occurring. So, what can be done to help people rehabilitate their lives after a traumatic experience? Van der Kolk devotes an entire section of his book to healing and makes a point to include strategies that not only attempt to soften the effects of trauma on the brain and the mind, but also on the body. For some people, talking about the traumatic event with a close friend or therapist is enough to get themselves back to a healthy internal state. The trick is to talk to someone who provides a sense of safety, because “being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives.” Van der Kolk suggests activities like yoga or theater to help us reconnect with ourselves in a physical way. Yoga’s central theme is connecting the breath to the body, which can directly target bodily tension left over from traumatic experiences. When it comes to theater, embodying a fictional character as they tell their story and go through a life transition can aid trauma survivors by helping them vicariously tell their own stories and go through their own transitions. “Traumatized people are afraid of conflict” he writes, and “conflict is central to theater—inner conflicts, interpersonal conflicts, family conflicts, social conflicts, and their consequences.” Performing in a play requires us to use our body, and, similar to yoga, being active in our body can help us locate places where we may hold tension from a previous trauma and help to release it. An important first step is diagnosing people correctly. All too often patients with horrible histories of trauma are diagnosed with depression and prescribed a medication from a pharmacy which is the equivalent of putting a band-aid on a bullet hole. While depression may be an accurate description, clinicians need to go deeper and uncover what is at the root of the problem in order to treat it successfully because the emotions associated with the traumatic event are stored separately in the mind, brain, and body. Even with a prescription for medication, the right stimulus will send someone with PTSD right back to the pivotal moment in the past when the event first occurred, maintaining their inability to integrate the experience into their sense of self. “Normal memory integrates the elements of each experience into the continuous flow of self-experience by a complex process of association,”—but the problem with PTSD is that memories are dissociated. So getting a prescription from a doctor may block or numb some of the negative feelings, but it doesn’t heal the patient. Van der Kolk pinpoints childhood as the location of much trauma and describes how “child abuse and neglect is the single most preventable cause of mental illness, the single most common cause of drug and alcohol abuse, and a significant contributor to leading causes of death such as diabetes, heart disease, cancer, stroke, and suicide.” We need caregivers who support and love us in our infancy so that we can develop proper relationships with the other people and experiences we will encounter throughout our lives. This is the same for adults who suffer traumatic experiences—we need people we can trust to support us through the healing process. We need to recognize that trauma imprints itself in our brains, our minds, and our bodies, and that treatment and therapy should target all of these areas so as to best help us heal mentally, emotionally, and physically. It takes the right diagnoses, a proper support network, and the time and perseverance required to do the work. Both individually and collectively, we can heal from trauma, for if all we know is fear, then that’s all we’ll ever know. For those looking for more information about trauma, its symptoms, effects, and how to heal from it, this book is a wonderful place to start.

So good, I read it twice. This book changed my life. It helped me understand myself on a deeper level. I have recommended this to several people and each one loved it!

Useful cards that deal with insecurities and ideas on body wellness. I have my own insecurities as it is. So these cards are helpful to me. I am more secure about my health. I also talked about my issue at an appt. I was at a psychologist appt. and she showed me both sets of cards. I ordered mine right away and I use both sets. I also write about my feelings. With her help and me using the cards have been helpful. As with anything it takes time. For me it has become doable.

If you struggle with anxiety, panic attacks, or find yourself constantly ruminating and self-sabotaging, this is the most important book you will read. For anyone who has navigated emotional neglect, a chaotic childhood, or trauma—and perhaps uses addiction to cope—this book offers a completely new perspective. The Body Keeps the Score connects your biology with your biography. It explains how your past experiences physically rewire your brain and nervous system, making sense of the confusing emotions and reactions that can keep you stuck. It validates that these struggles aren't character flaws; they are physiological responses. What truly surprised me was Dr. Bessel van der Kolk’s empathy. It is rare to find a scientific text that feels so deeply human. You can tell he genuinely cares about his patients and understands the pain of trauma survivors. It bridges the gap between hard science and human compassion in a way that just clicks. I am incredibly grateful for this work. It provides clarity, hope, and a roadmap for understanding yourself. A masterpiece for anyone looking to heal. As for the physical book, the print is slightly on the smaller side and the paper quality is okay but I was too captured by the words to care about the physical quality and you shouldn't care either.

One of the rare books that remains in New York best sellers list for years. Still reading it but the book is crucial in psychology and contains heartbreaking stories with a real life hard experience stories some ending with successful relief and just surviving for others.

Very nice product, truly recommend it!

Beautiful book.... insightful, caring, bringing science and somatic experience together. Absolutely loved it.

Es un libro que puedes leer sin saber nada de psiquiatría o psicología, trae incluso varios esquemas que explican todo muy bien. Me encanta que no es un libro tipo "superación personal" (que igual no tiene nada de malo), sino uno que relata con fundamento, casos reales y evidencia científica los procesos de trauma y recuperación. Personalmente, el proceso de lectura también sirve mucho para validar tus sentimientos, es muy bello❤️‍🩹