Wordy Wednesday: The Body Keeps the Score by Bessel van der Kolk
[tw: this post briefly mentions suicidal ideation.]
When my daily migraines had persisted for eighteen months, I felt nearly suicidal. To me, the despair of not knowing when or how the pain would be relieved, or whether I could regain even a semi-normal life was its own kind of anguish.
My husband Mark expressed additional concern for my anxiety about the migraines. I didn’t understand. What anxiety? I was constantly on the lookout for a prospective migraine so that I could take medication to stop one as soon as it appeared, otherwise the medicine wouldn’t work. I analyzed my behavior and my surroundings in hopes to identify patterns that might either trigger or subdue the migraines. To anyone observing me I probably looked like a basket case. To be anxious means to be excessively vigilant. But I didn’t see my worry as excessive. I felt it was only appropriate.
I sought and received effective care for both my depression and my anxiety. However, I expect that had I never been plagued with chronic migraines, I wouldn’t have required mental health care. If I had no migraines, then I wouldn’t have had cause to feel anxious or hopeless.
Still the migraines do return, although they are less frequent and better managed than before. That’s the thing with trauma (and yes, I do consider my chronic condition to be a trauma): if we could just make it stop, then everything would be okay, and we wouldn’t feel traumatized. An experience is traumatic due to its power to shake us and our inability to escape it. And even when the event is over, it doesn’t feel over.
In The Body Keeps the Score, author Bessel van der Kolk, MD explains that the manifestations of trauma that are diagnosed as psychological disorders are not primary disorders—occurring from aberrantly functioning brains without external cause—but are secondary to the trauma. Symptoms develop “honestly” in a person’s attempt to cope with their pain and protect from further harm. Treating those symptoms alone neglects to address the cause, the trauma that started it all.
So how do we address the cause? Talking or writing about trauma, especially if it encourages you to identify your emotions and integrate them into your story, certainly helps. To avoid confronting the trauma entirely is antithetical to healing: “people can never get better without knowing what they know and feeling what they feel” (27).
Yet sometimes the pain is too overwhelming to face head-on. Van der Kolk explains that when a person recalls trauma, the brain engages with it in a way that makes the sensations and emotions feel as if the event is in the present, not the past. The individual needs ways to process the trauma so that it can be put in the past, and the body no longer fires up the alarm system when the trauma is recalled.
Individuals with a trauma history tend to cut off themselves from their physical sensations in an attempt to barricade themselves from the pain and panic of their trauma. They lose body awareness, a symptom termed alexithymia.
Treatment for trauma must involve engaging in body self-awareness combined with retraining the emotional brain to stave off panic so that the memories of trauma can be processed as memories rather than present danger.
Van der Kolk presents interventions for accomplishing this that include a talk therapy technique called Internal Family Systems, neurofeedback technology, Eye Movement Desensitization and Reprocessing (EMDR), yoga, and theater.
Right from the beginning I found the author’s word choice intriguing. He wrote of “residues” and “imprints” of past trauma. In addition to teaching readers about psychiatric terms such as alexithymia, van der Kolk used a handful of adjectives that I chose to define and adopt for my own use.
Below are those five adjectives with the original sentence in which I found them, their Oxford definitions, and a sentence of my own using the word. Feel free to try them out and share your own sentences in the comments below!
“Piaget based his theories of child development on meticulous, direct observation of children themselves, starting with his own infants, and Nina brought this spirit to the incipient Trauma Center at MMHC” (107).
adjective: in an initial stage; beginning to happen or develop.
(of a person) developing into a specified type or role.
My chiropractic office, the incipient haven for women with chronic health conditions, is where I will provide gentle and thorough care to patients in search of a better quality of life.
“he could not tolerate living with Julian’s emotionally labile mother” (175).
adjective: liable to change, easily altered.
Politicians have a reputation for labile aims and broken promises.
“Preoccupied with so many lingering questions about traumatic stress, I became intrigued with the idea that the nascent field of neuroscience could provide some answers” (29).
adjective: (especially of a process or organization) just coming into existence and beginning to display signs of future potential.
EMDR, a nascent therapy that involves coupling eye movements with recall of trauma and related memories, is gaining traction in mental health care due to its seemingly miraculous results.
“These theater programs are not for aspiring actors but for angry, frightened, and obstreperous teenagers or withdrawn, alcoholic, burned-out veterans” (338).
adjective: noisy and difficult to control.
The first time I had an MRI was to image my wrist, requiring me to lie on my side for two hours, right arm overhead, while the obstreperous machinery went to work.
“Helen’s story reminds me of the abused, recalcitrant, uncommunicative kids we see in our residential treatment programs” (237).
adjective: having an obstinately uncooperative attitude toward authority or discipline.
Recalcitrant, Kayla met her brother’s gaze and replied, “Nope, not gonna happen,” and crossed her arms over her chest.
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