What if Bessel van der Kolk is right about trauma?

B0000757Bessel van der Kolk (vdK) is probably the world’s most well known trauma theorist. I reviewed his recent book, The Body Keeps the Score, in an earlier post. Since then I’ve read more of his work and listened to him speak for hours (he is all over youtube). The best way I’ve figured out to think seriously about his work is to ask what difference it would make if he were right.

What he says

Asked about how he treats the victims of acute trauma, vdK says

Holding them, rocking them, giving them massages, calming their bodies down is a critical issue. I am probably the minority among my colleagues in that I am much more focused on bodily state than on articulating what’s going on. I think that words are not really the core issue here. It is the state of being, of tenseness, of arousal, and of numbing, and that people need to learn again to be safely in their bodies. (http://www.medscape.com/viewarticle/408691)

Think about this for a minute. One might expect a trauma therapist to say something like “I try to create a safe environment in which my patients can put words to unspeakable experiences. I try to help them remember an experience so they don’t have to constantly relive it.” This makes sense, for trauma is a disorder of time, in which the past is never past but is constantly intruding upon the present.

VdK would have no difficulty with the last sentence, and yet his treatment program (or rather programs) has little to do with the past, and everything to do with the present. Trauma is when the past colonizes the present. Its treatment depends on reappropriating the present, and one does that not through understanding the past, but coming to live in the present, and the best way to do this is to bring the body into the present.

Behind vdK’s approach is his view that PTSD and related traumatic disorders, particularly developmental trauma (childhood abuse and neglect), are disorders of the limbic system, one of the oldest parts of the brain, the one we share with all mammals. In the limbic system, threat is experienced as sensation, and the impulse to fight or flee. Threat turns into trauma when we can neither fight nor flee, when we are trapped, and the stress is turned against the self. Trauma is embedded in the body-mind, a single entity.

The problem is not verbalization but imagination

VdK tells the story of a little boy named Noam whose school was near the twin towers on 9/11. The little boy saw the first plane crash into the tower, and said that he could still feel the heat through the classroom window. That’s trauma, the sensation of heat that persists long after the original experience is over. On the morning of 9/12 Noam made a drawing of what he had witnessed, which included people jumping out of the towers. Toward the bottom of the drawing was an unclear object, and when vdK asked Noam what it was, Noam said that it was a trampoline, so that next time when people have to jump they will be safe (vdK, pp. 51-52).

Noam’s story illustrates a key point. He felt and saw terrible things, but he was quickly reunited with his family, and was able to respond to the awful events with a creative imagination. He was not traumatized. Trauma is about the loss of imagination. One stops learning from experience, one stops imagining alternative futures for oneself and others. The world stops. The goal of trauma treatment is to free us from being trapped in our bodies so that we are free to be in our bodies, and from there imaginatively participate in the larger world.

What about talk therapy? VdK says talk therapy is important when the trauma is part of a secret, especially a secret that involves shame, guilt, and self-blaming. This is often the case in developmental trauma, such as child abuse and neglect. But the trauma of war veterans, for example, also frequently involves shame and guilt at what they have had to do to survive, or just the fact that they survived and others didn’t. Talk therapy opens a door out of a jungle of secrets. But the body has to walk through it.

What talk isn’t about

Talk isn’t about what Cathy Caruth, Shoshana Felman, and Dori Laub say it is about: the inability of the witness to be present at his or her own experience of trauma. The problem is not the inability of the traumatized person to give a coherent narrative account of his or her own experience. The problem is not the need for someone else, the therapist, to hear the traumatized person’s story, and so experience what the traumatized person could not, at least not without the intervention of the therapist.

All these things may occur, but they are not the problem, and talking about the trauma is not going to be particularly helpful. The more the traumatized person talks, the greater the disconnect, as narratives are elaborated that simply don’t connect with an emotional experience that had nothing to do with cognitive or linguistic experience to begin with. Veterans have a name for these stories. “Cover stories,” they call them, the account of the traumatic experience that makes sense to others, and even to themselves, but does nothing to relieve the symptoms of post-traumatic stress (vdK, p. 43).

What helps, says vdK, is yoga, therapeutic massage (including Feldenkrais and craniosacral therapy), neurofeedback, mindfulness training, dance, drama, martial arts, and a host of other activities that involve the mind-body.

But what happens to the traumatic memories?

Talk therapy, of whatever form, works on the idea that an unspeakable experience must be integrated into words, and words into a story, so that a traumatized person can put these alien experiences, so far from normal experience, into narrative form. At this point, these experiences can be reintegrated into normal memory, and forgotten rather than repressed. Or rather, repressed rather than split-off and dissociated.

What if—and I think this is the challenge vdK poses—talk therapy has it wrong from the beginning? The goal isn’t to turn traumatic memories into normal memories. The goal is to help traumatized people live fully in this world now, and this is accomplished primarily through body work in myriad forms, through which people come alive to the present.

From this position, traumatic memories, which were never really memories but sensations, no longer have the power to overwhelm the mind-body now. That is enough. Cognitive control is unnecessary. Unnecessary because it is impossible: cognition and trauma belong to separate worlds, separate brains, limbic and pre-frontal cortex. One can learn how to feel, live, and be in the present, and so participate in the world. That is enough.

What difference does it make to trauma theory if vdK is right?

Trauma theorists, like the traumatized, are captivated by the past. We spend too much time characterizing the way in which trauma destroys narrative, and we idealize narrative as a cure for trauma, as though being able to tell the story of one’s trauma is a sign that one has somehow integrated the traumatic experience. In reality, narrative and trauma have little to do with one another. By the time one is able to narrate the trauma, it is no longer necessary.

VdK’s approach redirects us from an obsession with the experience of trauma, and toward the experience of living fully in one’s body in the world—that is, what a life without trauma, a life fully lived, looks like. He redirects us because his characterization of trauma is inseparable from its cure. Trauma is not a disorder of narrative time, though he would not deny that is the case. Trauma is an inability to inhabit one’s body without being possessed by its defenses. Not just hyperreactivity, but even more so the emotional numbing that shuts down all experience, including pleasure and satisfaction. The cure for trauma is life. Living life is not the result of the cure; living life is the cure.

Is vdK right?

What seems right is vdK’s claim that the body-mind learns to live with traumatic experience by living in the present, and that body-work, in all its forms, is central. Talk is overrated, though perhaps not as overrated as he suggests. Where he is wrong is in his simplistic neuroscience. In one of his talks, responding to a question about one of his beloved colored images of the brain made by a MRI, vdK makes the comment, almost as an aside, that these images are really metaphors whose colors can be manipulated to make a point. I think he could make the same point better with more phenomenology and less neuroscience. But today phenomenology is out and neuroscience is in. If that’s progress, it comes at a cost in human self-understanding.


Cathy Caruth, ed. Trauma: Explorations in Memory. Baltimore: Johns Hopkins University Press, 1995, pp. 3-12, 152-157.

Shoshana Felman and Dori Laub, Testimony: Crises of Witnessing in Literature, Psychoanalysis, and History. New York: Routledge, 1992.

Bessel van der Kolk, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: Viking/Penguin, 2014.


Comments (20)

  1. Michael J Scott

    The primary therapist does not have to provide the “body work.” Many agencies dealing with sexual assault have ancillary therapist who do teach body work and trauma-focused yoga. I think the great Dr. van der Kolk might approve.

    • I need body work (damaged/compromised due to developmental trauma. Do I need rolfing? Reiki? Deep tissue massage? Body work as done by Alexander Lowen? Where do I go?

      • calford@umd.edu

        Dear Saundra, Perhaps there is one best form of therapy, but I’ve not found it. Straightforward massage is often just right. It’s not the technique as much as the touching. So you have to like your masseur or masseuse, or whoever is doing the touching. Hope this helps. Fred

      • This post is a year and a half old, so I hope you have since gotten the help you need. If not, I can speak as a therapist, and a trauma specialist. “Body” or somatic work is included in some of the best therapies for trauma. In my opinion finding someone who is certified in EMDR, Internal Family Systems, Sensorimotor Therapy or Somatic Experiencing your best bets.

  2. Shay

    I’ve read some of your articles and I wanted to share some critical knowledge on trauma, in case you are not aware. In addition to Bessel van der Kolk, there are two pioneering researchers, Peter Levine, and Stephen Porges, who have basically cracked the trauma mystery, which is that traumatic experiences recruit the defense circuits (fight-flight-freeze) in the Vagus nerve, which is the primary nerve of the autonomic nervous system, and that leads to a dysregulation of the autonomic nervous system; and all the symptoms are born of how the dysregulation affects the body. The science that has clarified this is found in Professor Stephen Porges’ Polyvagal Theory, and I’ve attached a YouTube video below where he explains it. Also, Peter Levine discovered this mechanism in his own way, and has developed a therapy system of healing trauma, called Somatic Experiencing. I’ve attached a link to one of his books (audiobook in his own voice), which explains in great detail how our body responds to threat and how it recovers when in safety.

    Basically, trauma is more biological than psychological, and the primary mechanism that gets us into the mental/physical mess is our autonomic nervous system, and explained in Polyvagal Theory. Most of the new therapies are not talk therapies, but body-oriented psychotherapies that focus on felt sensations in our body that we can track and use to guide ourselves out of the sympathetic-Dorsal Vagus threat circuit, and get us into the happy, engaged circuit of the sympathetic-Ventral Vagus. Ultimately, it’s not so much about the story of what happened to us, but the state into which it put our body.

    Polyvagal Theory: https://m.youtube.com/watch?v=ivLEAlhBHPM

    Healing Trauma by Peter Levine

    • Angela

      Thank you for this.

    • While I appreciate your advocacy of Levine and Porges, they have, in my 40 years experience as a psychologist, not ‘cracked the trauma mystery.’ More to the point, certainly from a phenomenological perspective of direct embodied experience, they both reify trauma as biology. Where is the human here? I suggest you read David Michael Levin, e.g. The Body’s Recollection of Being- for an alternative. In the book I am writing, when we allow the person (i.e. the living body) to play itself out, it inevitably moves us closer to a rupture, a breakthrough of the usual patterning. We let this happen, not foreclose the build up of energy- which educes an awakening of not just the trauma-based patterns (usually as evidenced in current life situations), but also reconnects us with the undamaged, primordial life force and energy underneath, and beyond these patterns. This process follows Merleau-Ponty radical phenomenology and Levin’s hermeneutic phenomenology, as well as Gendlin’s Focusing practice- to let the body ‘perform’ the felt sensing- and thus retrieve the natal spirit that trauma had disconnected us from. The tendency to place trauma in the either/or camp of biology/neurology or psychology are both incomplete. So you are correct in the notion of felt sensations as being important- only these sensations are filled with meaning, not biology. Also, gestures, postural stances, movements, facial expressions are all outward signs or traces of the ‘trail’ of trauma as it haunts the spirit-body.

    • Darren Taylor

      Hi Shay
      I am a Craniosacral therapist of more than 20 years qualification, I was trained by Franklyn Sills.
      My trauma work training consisted of the Peter Levine framework/ model and well, I digress…
      I’ve just read note / reply on this web page and I must say that you sum up what can be difficult to explain very well. I don’t think I’ve read any that really spells out the nuts and bolts of what’s happening and how a patient has to here in present time and in resources / body sensation.
      Many thanks

  3. Michael McCarthy

    van der Kolk and his right hand man, Joe Spinazzola, were both fired for psychological and/or sexual abuse of their staff at the Justice Resource Institute earlier this year. van der Kolk has for years been a chief proponent of junk science.

    • skyking

      Fired on mere accusations. No investigation, no opportunity to defend themselves- another ludicrous poundmetoo lynching of a white man purely because he is a white man. Taking away from him everything he has built over his long and accomplished career. And you people don’t understand why you’re so hated, so revolting to moral people.

  4. calford@umd.edu

    I briefly checked out Michael’s comment in the Boston Globe. See https://www.bostonglobe.com/metro/2018/03/07/allegations-employee-mistreatment-roil-renowned-trauma-center/sWW13agQDY9B9A1rt9eqnK/story.html

    I don’t think that this questions vdK’s research, but it is surely a sad story if true, as it seems to be. Fred

    • Michael McCarthy

      I’ve read his research. As someone trained in engineering, medicine, social work, psychology, marriage and family therapy and professional counseling who has designed research projects, I can tell you van der Kolk is a “junk scientist. I’m not asserting everything he stands for is wrong, yet he was one of the chief proponents of the long since discredited “repressed memories” movement.

      • Keith

        Hi Michael if your still about. I concur on bad science from an auth in psychiatry who enjoys reading the lit. Dr. V. Matossian, FAAP. Of course, VDKolk tapped into a power with his views that are swarming all over the therapeutic landscape. My question is: What theory or intervention do recmd/find most helpful in treating complex PTSD? I find J. Fisher’s work good, but she builds on VDKolk.

    • Michael McCarthy

      BTW, Harvard stopped their association with van der Kolk after he was deposed in a lawsuit and found to be less than honest in his research. He was also declared not credible to be an expert witness in court proceedings. https://archive.org/stream/BesselVanDerKolkScientificDishonestyTheMysteriousDisappearing/VanDerKolk_djvu.txt

      He also plagiarized the work of others without giving the original sources credit. He’s really what Kohut called “tragic man.” http://childmyths.blogspot.com/2014/06/bessel-van-der-kolk-is-old-fashioned-guy.html

  5. Catherine

    I find this fascinating. What I love about Feldenkrais is that it re-organises that short-circuit and the trauma memory has another new way of doing moving in relationship to the rest of the body. As well as trauma yoga indeed. What I got muddled up in for a while, was Internal Family Systems therapy (By Richard Schwartz) beause this sensations are labelled as “Parts” like young parts, exiles from trauma in the past and so on. I think the direct bodily approach is clearer to that old brain pattern, rather then the IFS system that turns these sensations into living parts who need talking to.Any comments comparing Feldenkrais to IFS would be warmly welcome. I like Bessel’s book and like this blog, its good sense!

    • c. fred alford

      Dear Catherine, I just don’t know the literature well enough to locate anything comparing Feldenkrais to IFST. All I know is that a friend of mine had severe problems with his back, nothing else helped, and Feldenkrais helped a lot. He can’t explain it. Nor can I. Thanks for your comment. Fred

      • catherine

        Thanks Fred. I wonder if there is a Polyvagal Theory trauma body worker, who can give zoom lessons on practices for soothing the nervous system down?

  6. Mtthw Matthw

    Where does this leave the “clientele”, the people seeking help to overcome c-ptsd? What therapy and therapist to follow? I found that EFT and “empathic therapists” work so far very good for me… I’ve learned about vDK recently. I also learned and heard of therapy with horses (ie. animals). And I want to heal further with a support group and such and more. For any advice, I am more than happy to discuss… as I’d like to heal and start thriving. I am tired of battling and experiencing triggers, which pull me in the past behaviors. If you are a doctor reading this, snd mail on (pronouncing it): ajs matt at gmejl dot com (the first word describes frozen water 😀 )

    • c. fred alford

      Dear Matthew, I hope some others responded. I’m all for empathy and horses. Really. I have this idea that if people suffering from C-PTSD (and that includes me)could learn to be kinder to themselves and their own suffering that it might help a lot. ps There’s something about the size of a horse that’s comforting. See my entry on Martin Buber on godblog.org. Buber liked horses. Fred

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