The Body Keeps The Score by Bessel Van Der Kolk

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Summary

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. However, previous traumatic experiences with loved ones in childhood and adolescence make it difficult to let our guard down and feel safe with an intimate partner.

The problem with trauma is that, when it happens, we don’t feel like we have agency over our actions. Traumatic events can lead to actual changes in our brain that will impair our ability to think, imagine, connect with others, assess danger and more.

In order to heal emotional trauma we need to a) trigger uncomfortable feelings to surface b) befriending them c) act deliberately to protect ourselves (what we were unable to do back then). In other words, we need to trigger the emotional intensity of the trauma, give it a new context/meaning and regain agency over it.

Mindfulness and introspection are key to this process.

Book Notes

→ 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.

In order to feel emotionally close to another human being, our defensive system must temporarily shut down. In order to play, mate, and nurture our young, the brain needs to turn off its natural vigilance. This is made difficult by traumatic experiences with our loved ones.

→ Trauma is about carrying the memory of terror and the shame of utter weakness and vulnerability.

Trauma produces actual 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. Trauma results in a fundamental reorganization of the way mind and brain manage perceptions. It changes not only how we think and what we think about, but also our very capacity to think.

→ Trauma almost always makes it difficult to engage in intimate relationships. After you have experienced something so unspeakable, how do you learn to trust yourself or anyone else again?

One of the hardest things for traumatized people is to confront their shame about the way they behaved during a traumatic episode. Many traumatized people are haunted by the shame they feel about what they themselves did or did not do under the circumstances. They despise themselves for how terrified, dependent, excited, or enraged they felt.

→ Traumatized people are stuck in their past and suffer from a failure of imagination, a loss of mental flexibility. Without imagination there is no hope, no chance to envision a better future, no place to go, no goal to reach.

→ The Broca’s area, one of the speech centers of the brain, is cut off when a traumatic experience occurs, which makes it impossible to put our thoughts and feelings into words - in a coherent account.  

→ When a traumatic event happens, the amygdala processes the information it receives from the thalamus faster than the frontal lobes do, it decides whether incoming information is a threat to our survival even before we are consciously aware of the danger. We don’t have agency over our actions.

Trauma increases the risk of misinterpreting whether a particular situation is dangerous or safe. As long as you are not too upset, your frontal lobes can restore your balance by helping you realize that you are responding to a false alarm and abort the stress response. Being able to hover calmly and objectively over our thoughts, feelings, and emotions and then take our time to respond allows the executive brain to inhibit, organize, and modulate the hardwired automatic reactions preprogrammed into the emotional brain.

To process a traumatic event two brain systems are key: those dealing with emotional intensity and context/meaning. Emotional intensity depends on the response of the amygdala and medial prefrontal cortex. Context and meaning depend on the dorsolateral prefrontal cortex (DLPFC) and the hippocampus, which tell us how our present experience relates to the past and how it may affect the future.

→ The two main problems with processing trauma are then a) that we are not able to welcome the unpleasant feeling by escaping them b) that we cannot put the event into context and realize it’s a momentary and finite experience. This means that for healing to take place we need to learn a) how to welcome unpleasant feelings in our body and b) feel safe in the reality of the present.

→ The thalamus functions as a “cook”—a relay station that collects sensations from the ears, eyes, and skin and integrates them into the soup that is our autobiographical memory.

Breakdown of the thalamus explains why trauma is primarily remembered not as a story but as isolated sensory imprints (images, sounds) and intense emotions, usually terror and helplessness.

If you want to manage your emotions better, you can learn to regulate your brain from the top down, with mindfulness meditation and yoga, or from the bottom up, accessing the autonomic nervous system through breath, movement or touch.

→ Our self-experience is the product of the balance between our rational and our emotional brains. When these two systems are in balance, we “feel like ourselves.”

→ Human beings are astoundingly attuned to subtle emotional shifts in the people (and animals) around them. Our mirror neurons register their inner experience, and our own bodies make internal adjustments to whatever we notice.

→ “Agency” is the technical term for the feeling of being in charge of your life: knowing that you have some ability to shape your circumstances. It starts with what scientists call interoception, our awareness of our subtle sensory, body-based feelings: the greater that awareness, the greater our potential to control our lives. If we are aware of the constant changes in our inner and outer environment, we can mobilize to manage them. Being able to move and do something to protect oneself is a critical factor in determining whether or not a horrible experience will leave long-lasting scars.

Agency/self-awareness is increased through mindfulness practice, which strengthens the MPFC (medial prefrontal cortex), which - unlike the rational analyzing part of the brain on the dorsolateral prefrontal cortex - has direct connections with the emotional brain, where most imprints of trauma reside.

→ Trauma shuts down our inner compass and rob us of the imagination we need to create something better. Without flexible, active frontal lobes people become creatures of habit, and their relationships become superficial and routine. Invention and innovation, discovery and wonder—all are lacking.

→ It is one thing to process memories of trauma, but it is an entirely different matter to confront the inner void—the holes in the soul that result from not having been wanted, not having been seen, and not having been allowed to speak the truth. If you grew up unwanted and ignored, it is a major challenge to develop a visceral sense of agency and self-worth.

→ Process to heal trauma:

- Draw out the sensory information that is blocked and frozen by trauma

- Befriend (rather than suppress) the energies released by that inner experience

- Complete the self-preserving physical actions that were thwarted when you were trapped, restrained, or immobilized by terror.

→ When a baby’s needs are not met, the baby perceives that “there is something wrong with him”, so he discounts his inner sensations and tries to adjust to its caregiver’s needs.

→ Infants who live in secure relationships learn to communicate not only their frustrations and distress but also their emerging selves—their interests, preferences, and goals.

→ A deep love relationship, particularly during adolescence, when the brain once again goes through a period of exponential change, truly can transform us.

→ Understanding why you feel a certain way does not change how you feel. Change begins when we learn to “own” our emotional brains. That means learning to observe and tolerate the heartbreaking and gut-wrenching sensations that register misery and humiliation. Only after learning to bear what is going on inside can we start to befriend, rather than obliterate, the emotions that keep our inner maps fixed and immutable.

→ For many children it is safer to hate themselves than to risk their relationship with their caregivers by expressing anger or by running away. As a result, traumatized children are likely to grow up believing that they are fundamentally unlovable; that was the only way their young minds could explain why they were treated so badly.

→ Some tools to heal trauma: EMDR, Yoga, Theta healing, Structure family work, Therapy

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