The Body is Keeping Score and It Is Losing

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PSYCHIATRIC VIEWS ON THE DAILY NEWS

As usual, yesterday my wife and I watched CBS Sunday Morning. What caught my attention was a very brief pop-up of the best-selling nonfiction books. I noticed that the book by the psychiatrist Bessel van der Kolk, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma,¹ was #4. As usual, I could not let a seeming serendipity like that go by.

Psychiatrists writing bestsellers are a distinct rarity, but this book has significant staying power, staying on such lists for years now, sometimes at #1, and translated into many languages. It describes his research on how trauma effects both the mind and body. Rather unique at the time was his conclusion that whether the traumatized realized it or not, their body was hurt as well as their mind—keeping score, if you will.

The body can express trauma in a sense of unease, in an inaccurate assessment of danger, in unexpected muscular-skeleton tension, and more. One patient I had years before the book came out conveyed a sense of dread when hearing a particular song on the radio. As it turned out, that song was played during sexual abuse by her father. Consequently, some of the recommended treatments included the body, such as eye movement desensitization and reprocessing (EMDR), yoga, martial arts, sports, deep tissue rolling, and even hula dancing.

Sunday’s reminder got me wondering: why such popularity? What nerve was it hitting for the public beyond us professionals? Surely, it was something more than the combined science and stories, and the recommendations to help such a difficult-to-treat condition. Moreover, the writing is not breezing and easy. The book and the author also did not escape criticism. Most likely, it had something to do with making something hidden about our often-unconscious bodily memories better understood. Looking back now, was it prophetic as well as timely?

Since its publication, our society has been dealing with several major traumatic developments. Two of them were connected back on October 10, 2021, in a New York Times article by Jennifer Finney Boylan: “Abortion Rights and Trans Rights are Two Sides of the Same Coin.”² Both anti-abortion and anti-trans legislation restrict women and children’s bodily autonomy, even to reclassify transgender care for minors as child abuse. I had personally worked with pregnant women before Roe v Wade and transgender individuals in the decades around the new millennia, and in suffering my own secondary trauma in the process, found that it was the opposite—that it was the societal restrictions that were abusive. We clinicians are also exposed to more micro traumas in our work nowadays, which contributes to our epidemic rate of burnout.

Besides many other traumas, most recently the big ones spun off by the pandemic, I would add the ever-rising numbers of mass shootings and other gun violence rippling out to the public, stalemated by political conflict and gridlock. I saw both the perpetrators and victims when I worked part-time in a state medium-security prison that, by appearance at least, reminded me of the Theresienstadt concentration camp when I first saw it.

Today is the beginning of the All-Star game break for Major League Baseball. Baseball players sometimes develop inexplicable body problems too, such as the sudden inability to throw the ball accurately, nicknamed the yips. Perhaps Dr van der Kolk has been one of our field’s All Stars and his book a playbook of how to try to defeat trauma in our traumatized nation.

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric Times.

References

1. van der Kolk B. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books; 2015.

2. Boylan JF. Abortion rights and trans rights are two sides of the same coin. The New York Times. October 10, 2021. Accessed July 10, 2023. https://www.nytimes.com/2021/10/10/opinion/trans-abortion-rights.html