“The Body Keeps The Score” - Separating Fact From Sensation

The book was an instant bestseller, creating a stir within the field of trauma therapy and expanding views relating to 'body-oriented' healing in the public realm. Many were fascinated by its disruptive nature, claiming that healing from trauma may involve not just the mind, but yoga mats, bodywork, and even martial arts. Blending science and such unconventional approaches both captivated and polarised its many readers.

A decade on from its first release, we explore the true impact that this book has had: the good, the bad, and the perhaps still unresolved. The Body Keeps the Score, published by renowned trauma research doctor, Bessel van der Kolk in 2014.

Mind and body united

“Breathtaking in its scope and breadth, The Body Keeps the Score is a seminal work by one of the preeminent pioneers in trauma research and treatment. This essential book unites the evolving neuroscience of trauma research with an emergent wave of body-oriented therapies and traditional mind/body practices. These approaches go beyond symptom relief, connecting us with our vital energy and here-and-now presence.” — Peter A. Levine, PhD, Author, In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness

Whether or not you’re well-versed in wellbeing literature, you have probably come across this book. Many flocked to Bessel van der Kolk’s groundbreaking accounts as a leading voice in his field. Acclaimed for his research on post-traumatic stress since the 1970s, his focus on PTSD patients has directed van der Kolk along a path of intriguing findings and proven hypotheses.

In essence, the book describes healing from trauma as a process involving revisiting all its physical symptoms. Trauma-centred therapy is based on the understanding that trauma is stored in both the body and mind, a concept that is well documented outside of van der Kolk’s text.

The Body Keeps the Score focuses on the impact of trauma, which begins moments after a traumatic event. At this point, the brain commonly suppresses the event through mechanisms like forgetting or shifting blame to avoid social ostracism. However, van der Kolk argues it is the body that keeps the memory and subsequently undergoes physiological changes. A fundamental passage describes it as "a recalibration of the brain’s alarm system, an increase in stress hormones, and an alteration in the system that filters relevant information from the irrelevant". In this instance, he believes tension settles in the muscles and other body tissues and will not diffuse until released.

Physical therapies are then discussed as methods to recover the body from trauma. Several practices are detailed, such as yoga and Eye Movement Desensitisation and Reprocessing (EMDR), among other body-oriented approaches. These bodily interventions are said to be imperative in dealing with physiological effects of trauma, further supporting van der Kolk’s belief that resolution cannot be achieved through cognitive approaches alone.

Unresolved trauma and chronic disease: An integral link

Unresolved trauma is also discussed in relation to the development of physical symptoms and a plethora of long-term health issues. At the core of this hypothesis, van der Kolk argues that trauma can disrupt the body's stress response system and contribute to chronic conditions such as autoimmune disorders, heart disease, and chronic pain. Overwhelming evidence in research external to that of Bessel van der Kolk also points towards chronic stress as a significant factor in the development of chronic disease.

Chapter 6, which is entitled "Losing Your Body, Losing Yourself," expresses how trauma can create a sense of disengagement from the body, giving way to a myriad of somatic complaints including numbness. Van der Kolk reveals some patients whom he treated on a cognitive level had an understanding of what had happened to them but remained physically disconnected from their senses, often presenting with physical numbness and an inability to tune into their bodies. Once again, the book focuses on body-oriented psychotherapies, such as yoga and deep massage to help trauma survivors ‘get back into their bodies’ as a way to heal the whole self, relieve the numbness and re-establish identity.

How trauma ‘lives’ in the body

In The Body Keeps the Score, van der Kolk explains how trauma can be stored in different parts of the body; he also covers the role of physical practices in eliminating these effects. 

The body-mind connection in ‘small t’ trauma

Terms such as ‘Micro-trauma’ or ‘small t’ refer to events that are generally not violent or disastrous in nature but are known to create considerable suffering. In most cases, The Body Keeps the Score deals with severe trauma, such as abuse, war, and other ‘Large traumatic events’. Nonetheless, the questions he raises, particularly around the interrelations between body and mind, are equally relevant to less severe forms of emotional distress, such as financial losses or the end of a relationship. While van der Kolk does not go into detail about ‘small t’ specifically, he alludes to the notion that all forms of emotional upset have the potential to create devastating stress within the body, resulting in somatic symptoms. 

Much of his work falls under the heading of holistic practices, such as yoga and meditation, which propagate healing from the effects of the trauma, irrespective of trauma severity.

The Body Keeps The Score: Truth or overreach?

The esteemed title of #1 New York Times bestseller reflects the book’s immense power, widespread popularity and largely appreciative reception. Yet, despite appearing to be well-grounded in evidence, it has its critics.

We evaluate some of the criticisms the book has faced aside from its praise.

Overgeneralisation of trauma’s effects: Some critics argue that van der Kolk overgeneralises trauma’s effects, suggesting that it is responsible for a very wide range of physical and psychological problems. 

“The brain receives information from the body and world around us... everything is felt in your brain” — Lisa Feldman Barrett

Lisa Feldman Barrett, a neuroscientist featured on the Speaking of Psychology podcast from the American Psychological Association, challenges the idea that the body alone 'keeps the score' of trauma. Barrett emphasises that while the body undergoes physiological changes, it is the brain that interprets and constructs our emotional experiences, suggesting that trauma is processed through the brain's predictive and interpretative functions rather than being stored solely in the body: "Everything is felt in your brain... and the past is re-implemented by the brain as we explore the present moment."

Efficacy of somatic therapies: There is some controversy within the scientific community regarding the evidence supporting somatic therapies like yoga and EMDR. Although they have been found effective in some studies, they are not universally accepted as primary treatments for trauma — and more research needs to be done in order to establish their efficacy across different populations.

Dr. Arielle Schwartz, a licensed clinical psychologist, emphasises this point, stating that “Certain modalities risk re-traumatizing the client. These include intense and even invasive approaches like deep pressure massage, primal screams, and stressful physical positions held over time." She prefers somatic interventions such as tracking sensations, deepening awareness, and self-regulation to complement and increase the efficacy of therapies like EMDR. 

Accounting for the book’s popularity

Despite spending nearly 300 weeks on the New York Times bestseller list, some might argue that The Body Keeps the Score seems an unlikely candidate for such fame. Fans favour this book for being entertaining, and despite the heavily scientific nature of the subject matter “it is not merely a textbook.”

Looking at it through a wider lens, the enormous popularity of this book might not be so strange after all. At its core, psychiatry often mirrors society, acting as the medical enforcer of norms and the denier of realities that may cause suppression of a person’s trauma. 

“An estimated 3.9% of the world population has had post-traumatic stress disorder (PTSD) at some stage in their lives.” — World Health Organisation

Van der Kolk argues that trauma is more prevalent in our society than we could ever imagine. And while his career has focused on treating severely traumatised patients, his role as an author is to serve as a messenger from the world of PTSD, challenging his profession, and the societal systems that shaped it — to confront the true nature of trauma in all its forms.

When the body speaks, listen.

Few books have reshaped our understanding of trauma like Bessel van der Kolk’s The Body Keeps the Score. The innovative concepts explored within it challenge us all to rethink healing—mind, body, and soul.

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