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

As van der Kolk builds his case for interconnections between mind and body, he cites lesser-known studies from two famous scientists, Charles Darwin and Ivan Pavlov. Both men developed theories that involve maintaining equilibrium within the body. Darwin’s theory concerns the idea that, “If an organism is stuck in survival mode, its energies are focused on fighting off unseen enemies, which leaves no room for nurture, care, and love” (76). Pavlov “showed that after exposure to extreme stress, animals find a new internal equilibrium different from the previous organization of their internal housekeeping” (77).

Using Darwin and Pavlov’s discoveries as a jumping-off point, van der Kolk explains from an anatomical perspective how the body reacts to stress. Our autonomic nervous system (ANS) controls physiological reactions to stress, with a balance between the sympathetic (accelerator) and parasympathetic (brake). When humans encounter threatening situations, they go through three levels of “safety” during which different parts of the ANS come into play, all triggered by the vagus nerve that runs all the way from the brain to the intestines.

At level one, when a threat first appears, people turn to social engagement for help. If a person cannot obtain help or the danger is immediate, “the organism reverts to a more primitive way to survive: fight or flight” (82). If the person cannot run or fight back, “the organism tries to preserve itself by shutting down” (82), causing freeze or collapse.

Van der Kolk adds that humans work as members of a tribe. We learn how to synchronize with others as babies and a strong network of support is one of the best protections against stress and trauma. Lack of access to support can itself cause trauma or make a bad experience more likely to traumatize. Moreover, traumatized people have more trouble synchronizing with others, which causes feelings of alienation. 

Van der Kolk moves on to how the body reacts to trauma in an anatomical sense. Citing a study of traumatized brains in an idle state, van der Kolk observes that unlike “normal” people, people with trauma do not take stock of their own bodies when their minds are clear. Trauma causes people to lose their sense of self, which is a significant factor in their inability to connect with others.

Van der Kolk notes that some patients with extreme trauma cannot recognize their own reflection in the mirror or identify sensations from entire areas of their bodies: “their sensory perceptions simply weren’t working” (91). As an explanation, van der Kolk theorizes, “In an effort to shut off terrifying sensations, they also deadened their capacity to feel fully alive” (94). Essentially, humans need to register physical sensations of themselves and the world around them in order to feel safe. When those sensations are overwhelmed and/or dulled, the person exists in a constant state of threat, distrusting their own feelings and the feelings of those around them.

In addition to lacking sensation, traumatized people sometimes lack the language to describe feelings, a condition called alexithymia. Van der Kolk explains that a traumatized person’s lack of access to understanding their own body can account for the “well-documented lack of self-protection and high rates of revictimization” (101). His conclusion from his own practice is that trauma treatment must start with helping patients become aware of the sensations of their own bodies, even if the process is frightening and painful. Prescribing medications that numb a person’s uncomfortable feelings further only perpetuates the underlying problem.