Below is a useful excerpt from a New Scientist article on the foundational book about trauma and its impact on our physical selves: The Body Keeps The Score. I should note here that I found this book by Bessel van der Kolk — a Boston area psychiatrist and researcher — to be revelatory and eye opening, so it was a major disappointment to discover that van der Kolk had been fired from his own institute in 2018 over charges of hostile work environment and bullying. His contributions to the field of trauma research and treatment have been significant, but that impact should be taken with knowledge that the field is split on its relationship to his legacy.
What has killed more Americans since 2001 than the Afghanistan and Iraq wars? And which serious health issue is twice as likely to affect US women as breast cancer? The answer, claims psychiatrist Bessel van der Kolk, lies in what we now understand about trauma and its effects. In his disturbing book, The Body Keeps the Score, he explains how trauma and its resulting stress harms us through physiological changes to body and brain, and that those harms can persist throughout life. Excess stress can predispose us to everything from diabetes to heart disease, maybe even cancer. […]
Van der Kolk draws on 30 years of experience to argue powerfully that trauma is one of the West’s most urgent public health issues. The list of its effects is long: on mental and physical health, employment, education, crime, relationships, domestic or family abuse, alcoholism, drug addiction. “We all want to live in a world that is safe, manageable… predictable, and victims remind us that this is not always the case,” says van der Kolk. When no one wants to hear about a person’s trauma, it finds a way to manifest in their body.
And it is not only extreme experiences that linger. Family disturbance or generalised neglect can wire children to be on high alert, their stressed bodies tuned to fight or flight. Or they may be so “numbed out” by keeping demons at bay they can’t engage with life’s pleasures or protect themselves from future trauma. Even parents who don’t attune with their children can do untold damage, van der Kolk argues.
Maria Popova, on her exquisite website Brain Pickings, also delves into The Body Keeps the Score:
Trauma, Van der Kolk notes, affects not only those who have suffered it but also those who surround them and, especially, those who love them. He writes: “One does not have be a combat soldier, or visit a refugee camp in Syria or the Congo to encounter trauma. Trauma happens to us, our friends, our families, and our neighbors. […] It takes tremendous energy to keep functioning while carrying the memory of terror, and the shame of utter weakness and vulnerability.”
In trauma survivors, Van der Kolk notes, the parts of the brain that have evolved to monitor for danger remain overactivated and even the slightest sign of danger, real or misperceived, can trigger an acute stress response accompanied by intense unpleasant emotions and overwhelming sensations. Such posttraumatic reactions make it difficult for survivors to connect with other people, since closeness often triggers the sense of danger. And yet the very thing we come to most dread after experiencing trauma — close contact with other people — is also the thing we most need in order to regain psychoemotional solidity and begin healing. Van der Kolk writes: “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.”
This, he points out, is why we’ve evolved a refined mechanism for detecting danger — we’re incredibly attuned to even the subtlest emotional shifts in those around us and, even if we don’t always heed these intuitive readings, we can read another person’s friendliness or hostility on the basis of such imperceptible cues as brow tension, lip curvature, and body angles. But one of the most pernicious effects of trauma is that it disrupts this ability to accurately read others, rendering the trauma survivor either less able to detect danger or more likely to misperceive danger where there is none. Paradoxically, what normalizes and repairs our ability to read danger and safety correctly is human connection. Van der Kolk writes: “Social support is not the same as merely being in the presence of others. The critical issue is reciprocity: being truly heard and seen by the people around us, feeling that we are held in someone else’s mind and heart. For our physiology to calm down, heal, and grow we need a visceral feeling of safety. No doctor can write a prescription for friendship and love: These are complex and hard-earned capacities. You don’t need a history of trauma to feel self-conscious and even panicked at a party with strangers — but trauma can turn the whole world into a gathering of aliens.”
On the subject of dissociation, and other ways traumatized people navigate the world, Popova writes [note: emphasis below is mine]:
Drawing on his work with patients who have survived a variety of traumatic experiences — from plane crashes to rape to torture — Van der Kolk considers the great challenge of those of us living with trauma: “When our senses become muffled, we no longer feel fully alive. […] In response to the trauma itself, and in coping with the dread that persisted long afterward, these patients had learned to shut down the brain areas that transmit the visceral feelings and emotions that accompany and define terror. Yet in everyday life, those same brain areas are responsible for registering the entire range of emotions and sensations that form the foundation of our self-awareness, our sense of who we are. What we witnessed here was a tragic adaptation: In an effort to shut off terrifying sensations, they also deadened their capacity to feel fully alive.”
While this dissociation from the body is an adaptive response to trauma, the troublesome day-to-day anguish comes from the retriggering of this remembered response by stimuli that don’t remotely warrant it. Van der Kolk examines the interior machinery at play:
“The elementary self system in the brain stem and limbic system is massively activated when people are faced with the threat of annihilation, which results in an overwhelming sense of fear and terror accompanied by intense physiological arousal. 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 they are in imminent danger. They startle in response to the slightest noises and are frustrated by small irritations. Their sleep is chronically disturbed, and food often loses its sensual pleasures. This in turn can trigger desperate attempts to shut those feelings down by freezing and dissociation.”
Which leads us of course to Wolf Play‘s Jeenu/Wolf, and to all the characters in this drama, who are navigating their own personal traumas (oppression, abandonment, kinship units that break apart, professional setbacks, etc), as they try to connect and fight for family.
Bessel van der Kolk writes in The Body Keeps the Score [note: emphasis below is mine]:
If you have a comfortable connection with your inner sensations — if you can trust them to give you accurate information — you will feel in charge of your body, your feelings, and your self.
However, traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from their selves.
The more people try to push away and ignore internal warning signs, the more likely they are to take over and leave them bewildered, confused, and ashamed. People who cannot comfortably notice what is going on inside become vulnerable to respond to any sensory shift either by shutting down or by going into a panic — they develop a fear of fear itself.
Maria Popova continues her summation of the book, this time tackling the role of trauma in childhood — an experience that can often result in complex post traumatic stress disorder, or C-PTSD.
How we respond to trauma, Van der Kolk asserts, is to a large extent conditioned by our formative relationships with our caretakers, whose task is to help us establish a secure base. Essential to this is the notion of attunement between parent and child, mediated by the body — those subtlest of physical interactions in which the caretaker mirrors and meets the baby’s needs, making the infant feel attended to and understood. Attunement is the foundation of secure attachment, which is in turn the scaffolding of psychoemotional health later in life. Van der Kolk writes:
“A secure attachment combined with the cultivation of competency builds an internal locus of control, the key factor in healthy coping throughout life. Securely attached children learn what makes them feel good; they discover what makes them (and others) feel bad, and they acquire a sense of agency: that their actions can change how they feel and how others respond. Securely attached kids learn the difference between situations they can control and situations where they need help. They learn that they can play an active role when faced with difficult situations. In contrast, children with histories of abuse and neglect learn that their terror, pleading, and crying do not register with their caregiver. Nothing they can do or say stops the beating or brings attention and help. In effect they’re being conditioned to give up when they face challenges later in life.”
“All of us, but especially children, need … confidence that others will know, affirm, and cherish us. Without that we can’t develop a sense of agency that will enable us to assert: “This is what I believe in; this is what I stand for; this is what I will devote myself to.” 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. In order to have a healthy society we must raise children who can safely play and learn. 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.”