Bessel van der Kolk - The Body Keeps the Score

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Today I speak with Bessel van der Kolk, author of The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma, about his trailblazing work educating a generation of doctors and therapists about how to heal from trauma. His book has been on the NYT paperback nonfiction bestseller list for 141 weeks, 24 of them in the #1 spot.

A paperback nonfiction NYT bestseller for 141 weeks (24 of them at #1), van der Kolk's book explores: 1) Neuroscience, which deals with how mental processes function within the brain. 2) Developmental psychopathology concerned with how painful experiences impact the development of mind and brain; and 3) Interpersonal neurobiology, which examines how our own behavior affects the emotional and neurobiological states of those close to us.

We talk about what trauma really is, and whether it’s possible that the term has become a bit inflated in popular culture.

Van der Kolk tells the story of playing a part in the creation of the Post Traumatic Stress diagnosis and how it originally focused only on combat stress, and completely missed the far more prevalent and more destructive trauma that takes place in families.

I ask him to offer alternatives to the widespread but woefully imprecise and unhelpful diagnostic terms like narcissism, borderline personality disorder, or anti-social personality disorder and discuss our mutual distaste for the DSM—the diagnostic manual used by psychiatrists and licensed professionals.

Even though Bessel contributed to the development of the DSM versions III and IV, he rails against how using labels interferes with genuine observation and connection to the suffering of each person.

We discuss his proposal of a more precise replacement for the PTSD diagnosis called Developmental Trauma Disorder. And we dive into breakthrough treatments like psychedelics and neurofeedback—using a person’s own brain waves to control a video game that trains the brain to correct nervous system dysregulation that occurs as a result of abuse, neglect, or unprocessed trauma. Finally, I ask Bessel about his last conversation with the late Rich Simon, who’s suicide in November of 2020 rocked many of us in the mental health professions.

This illustration on page 53 shows the whole-body response to threat.

"A trauma is something that changes you. It overwhelms you and leaves you speechless, horrified, paralyzed, enraged, out of it, collapsed. 'Oh my God!' There’s nothing you can do."

                          
– Dr. Bessel van der Kolk, bestselling author of The Body Keeps the Score
Dr. Bessel van der Kolk says child abuse and neglect is the #1 public heath issue facing us today and has dedicated his career to making trauma treatment widespread, available, and effective.

Dr. Bessel van der Kolk is a professor of Psychiatry at Boston University School of Medicine and president of the Trauma Research Foundation in Brookline, Massachusetts. Since the 1970s his research has been in the area of post-traumatic stress.

In 1984, he set up one of the first clinical/research centers in the US dedicated to study and treatment of traumatic stress in civilian populations and he did the first studies on the effects of SSRIs on PTSD; was a member of the first neuroimaging team to investigate how trauma

changes brain processes, and did the first research linking BPD and deliberate self-injury to trauma and neglect in early childhood.

He’s perhaps best known for the legacy of his work establishing the National Child Traumatic Stress Network (NCTSN), a Congressionally mandated initiative that now funds approximately 150 centers specializing in developing effective treatment interventions and helping establish the Trauma Center (now the Trauma Research Foundation) in Boston that is a world-renown center for trauma research and brain science.

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