The Body Keeps the Score & Healing Trauma: A First Step

I bought “The Body Keeps the Score” over a month ago, long after I was already doing well enough to comfortably read English again. Yet until just a few days ago, I could barely get past the prologue. Not because it’s a difficult read, but because it is so incredibly relatable and confronting to me. The Prologue is titled ‘Facing Trauma’. The thing I have been asking for help with for decades, and needing help with desperately for the past 5 years.

I’ve decided to read the book and journal what touches and triggers me as I go along. Plus since we’ll be virtually attending the 34th Annual Boston International Trauma Conference, now is a perfect time to read up on the work of one of the conference’s founding initiators.

TRIGGER WARNING – PERSONAL EXPERIENCES INCLUDING SUICIDE AND SEXUAL ABUSE AHEAD

The Trauma I never Faced – Residential Mobility

“But traumatic experiences do leave traces, whether on a large scale (on our histories and cultures) or close to home, on our families, with dark secrets being imperceptibly passed down through generations. They also leave traces on our minds and emotions, on our capacity for joy and intimacy, and even on our biology and immune systems.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

Until 5 years ago I never realized that I had been in denial as to when my complex trauma started. I always assumed it stemmed from sexual abuse during my first years back in The Netherlands when I was between 5 and 7 and as a prepubescent 9 to 10 year old.

During my first EMDR session with a therapist I implicitly trusted, I had to imagine or think back to a place I had felt safe. I did as he asked. I had no idea what would end up happening. As I tried to reach back for the times I had felt safe, a rather disturbing pattern emerged. The times I had felt safe were actually feeling ‘safer,’ because I was trying to find safety for a variety of reasons.

Each safe space had a backstory that began with feeling unsafe. And even the places I had felt the most at home, even if it was for a stolen hour or two, were tinged with that they were moments of relative safety. Not actual safety. And that all those places had one glaring thing in common. I was alone and had retreated. In all of them.

That Moment You Realize Why – The Body Keeps the Score and Reacts

“Trauma, by definition, is unbearable and intolerable. Most rape victims, combat soldiers, and children who have been molested become so upset when they think about what they experienced that they try to push it out of their minds, trying to act as if nothing happened, and move on. It takes tremendous energy to keep functioning while carrying the memory of terror, and the shame of utter weakness and vulnerability.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I panicked. I cried. My mind refused to believe what my body had always known.

One of my first memories as a child is my mother explaining to me that in new situations it was perfectly normal to feel anxious or afraid. That as time passed and I got used to the new situations those feelings would go away. I believed it. And it was repeated to me by various other adults. And they were the experts. I should trust them, right?

But that’s where the trouble started. Due in part to residential mobility I never got a chance to get used to much until I was about 16. That was the first year I walked the hallways of a school I knew. I recognized my teachers, friends and acquaintances. And for the first time in ages people recognized and knew me.

I had my first real panic attack right then and there. I was rooted on the spot; couldn’t move a muscle. My throat closed. No sound escaped me though I was screaming for help. I was frozen in place as others passed by.

I managed to get to a ‘safe’ spot by sheer force of will. But it was like my body had waited for 16 years to finally feel ‘safe’ enough to fall apart. My body had kept the score. That was the beginning of my first foray into total exhaustion, not just on the inside, but outwardly too.

Residential Mobility as Acute, Chronic and Covert Trauma

Moving is stressful. Even if you’re ‘moving on up’. And even if a child doesn’t directly have anything to do with the move, children can be affected by their parents’ mood from as early as 3 months old. According to studies tracking 50,000 children in Ireland, moving during childhood is linked to poor mental health. After five or more moves, children are more than three times as likely to experience mental health problems.

According to studies done in China of 39,531 undergraduates, “residential mobility in childhood is associated with psychopathology in adulthood and this association increases with increasing number of moves. Mobility is also associated with childhood disadvantage and maltreatment but associations with psychopathology are independent of these factors. Multiplicative effects were shown for multiple moves starting at a younger age and if the participant had been a left-behind child.”

In plainer terms: moving in childhood is linked to mental health problems as an adult. You’re more likely to suffer maltreatment such as child abuse or neglect if you move as a child. And the more often you move, and the younger you are when you start moving, the chances of mental health problems are multiplied.

The Difference a Few Decades Make

I don’t know who came up with the idea that moving is not stressful for children if they ‘put down roots’ by the age of 16. But whoever it was, this sentiment was repeated to me over and over again for years. Every few years I’d check if any new studies had been done. Because to me it never rang true. My experience was very different. But there was no room for my experience, because science said…

Most studies I found were too small to be able to draw any real conclusions, and a lot of them couldn’t confirm or reject that premise. I stopped searching for studies about 10 years ago. Tried to accept I was probably wrong. Then proceeded to go downhill faster than a kid on a slip-and-slide on the hottest day of summer.

Comparing Apples and Oranges to Passion Fruit and Lychees

I moved countries 8 times before I turned 16. Moved houses 12 times. Changed schools 10 times. Changed social or school language at least 8 times. Learned 6 different languages. Changed social circles, hobbies and cultures more often than I care to count. From the age of 11 having a two parent household was the exception, not the rule.

The large studies done in the past decade? All participants moved within one country. With one language (even though dialects may vary). In one culture. Within fairly homogeneous ethnicity and culture. With similar norms and values.

The Prospect of Further Trauma – The Body Keeps the Score

When I was twelve, I remember being told we would be moving again. Twice in two years. Two different countries. Changing school language again, as well as social language. I had just gotten used to a school I was supposed to graduate from. Gotten used to Dutch again. Learned Spanish and was re-learning Papiamento. Had managed to build a stable social circle, including international kids like me. Had found team sports that made my body feel like my own again at times.

At twelve I had suffered loss and chronic abuse. And a whole cornucopia of covert trauma, sprinkled with a few acute traumas. I had barely stopped living in perpetual fight/flight/freeze mode. I’d started believing that this time we’d really stay. I still hadn’t confided in anyone about how I felt or what had happened to me. But at that time there were people I had started to trust enough to know that at least I could ask for help if anything happened.

Denial Is Not a Long-Term Solution

“While we all want to move beyond trauma, the part of our brain that is devoted to ensuring our survival (deep below our rational brain) is not very good at denial. Long after a traumatic experience is over, it may be reactivated at the slightest hint of danger and mobilize disturbed brain circuits and secrete massive amounts of stress hormones. This precipitates unpleasant emotions intense physical sensations, and impulsive and aggressive actions. These posttraumatic reactions feel incomprehensible and overwhelming. Feeling out of control, survivors of trauma often begin to fear that they are damaged to the core and beyond redemption.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

I distinctly remember the feeling of utter despair as my body slipped back into survival mode. The disassociation. The de-personalization. The numbness that stopped the new, yet unbearably familiar, assault of anger and grief.

A return to auto-pilot. Smiling at the right moments. Accepting sympathy without feeling it. Tolerating jealousy without understanding it. Watching people take distance before I was even gone. Knowing that what I needed to heal had been within reach, and that what I was facing would wound me more. Giving comfort to those who needed it. Without having a clue how to comfort myself.

Seeing a Way Out – The Body Keeps The Score Till the End

I woke up one morning in the dark. I felt at peace. I knew how to escape. I walked into my bathroom. Tested the shower rod if it would hold my weight. Untied the cord from my laundry bag and slid it out. Spent a good while testing knots I had learned at sailing camp a few years prior. Made a noose. Tied the end of the rope. Slipped the noose over my head. And without a moment’s hesitation let myself fall forward.

I felt nothing but relief. It would be over soon. I would never feel that aching numbness again. I could never be hurt more than I already was.

A brief moment of biting pain and endless suspension. The bliss of darkness. A moment of free-fall followed by the shock of cold tiles against my face. With that shock the numbness came back. And didn’t let up much for years after.

To this day the color of those tiles instantly transports me to numbness coupled with nausea. A flash of a jacket in the corner of my eye. The shade of a book cover. A drape fluttering in the wind.

Obviously I’m Still Alive, But That’s Still Not Living

I didn’t get psychological help until I was in my early twenties. After another acute trauma. But by that time I was once again surrounded by people I trusted. And had confided parts of my past to more than a few people. I’d experienced and seen enough healthy coping mechanisms to know I wasn’t coping at all. I was diagnosed with Post-Traumatic Stress Disorder at that time. Got intense therapy for my acute and obvious chronic traumas. But not any of the covert ones.

Towards the end of my therapy I was put in another double bind. Move out of the relative safe space I was in, with people I trusted and supported me. That was the protocol. If I didn’t comply, I wouldn’t get further treatment.

Choices that Really Aren’t Choices

Later it was acknowledged that in my case with my background, strictly adhering to protocol was shortsighted. And for the first time ever someone bothered to ask me, “why didn’t you fight when you knew it was in your best interest to do so?” I had never experience safety. Choosing between relative safety with the slight possibility of actually feeling safe and possible treatment to feel safe at one point in the future, was still an improvement.

Plus I was used to choosing the best of two terrible options. I was used to my feelings being trivialized. I was used to not being heard by those with authority over me.

I’d spent almost 25 years experiencing that standing up for myself when others had power over me led to greater pain and suffering, not understanding and support. How could I suddenly unlearn that? I could and can stand up for others no problem. For myself? Sure, but the outcome has mostly been the opposite of what I need or asked for.

The Body Keeps The Score

“We are obviously still years from attaining that sort of detailed understanding, but the birth of three new branches of science has led to an explosion of knowledge about the effects of psychological trauma, abuse, and neglect. Those new disciplines are neuroscience, the study of how the brain supports mental processes; developmental psychopathology, the study of the impact of adverse experiences on the development of mind and brain; and interpersonal neurobiology, the study of how our behavior influences the emotions, biology, and mind-sets of those around us.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

After our initial attempt at EMDR, and my crushing reaction to trying to find a safe memory to work from, my therapist suspected I had been misdiagnosed. That’s the first time I had heard of cPTSD.

I don’t remember getting home. I do remember not being able to regress back into denial. I could barely step foot outside my bedroom door. If I made it to the front door, it was a personal victory.

Initially I thought it was just constant panic attacks. That I’d suppressed my anxiety and inability to create safety within myself too long. That I’d be able to get back enough balance to function again once I faced my trauma and felt those feelings of pure panic and anxiety long enough.

I was wrong. By the time I asked for help getting my agoraphobia under control, my therapist was gone. Apparently no one else was aware that he suspected cPTSD. Even though I could barely read or retain information, I started gathering information about complex trauma and cPTSD.

Then followed long periods of no therapists. Punctuated with therapists whose administrations made my symptoms worse. The same double bind as before. Relative safety or no therapy at all.

Authority figures who refused to listen to what I was saying.

Every time I tried to explain I needed to listen to my body, my gut, I was told that would follow after we had fixed what was wrong with my thoughts and behavior. My questions about cPTSD were ignored. Or seen as a sign of other disorders. Things like parentification were used to explain that my misgivings about treatment were a symptom of what was wrong with me, not a possible trauma.

The Body Keeps The Score – The Present

“Research from these new disciplines has revealed that 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. We now know that trauma compromises the brain area that communicates the physical, embodied feeling of being alive. These changes explain why traumatized individuals become hypervigilant to threat at the expense of spontaneously engaging in their day-to-day lives. They also help us understand why traumatized people so often keep repeating the same problems and have such trouble learning from experience. We now know that their behaviors are not the result of moral failings or signs of lack of willpower or bad character—they are caused by actual changes in the brain.

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma”

Slowly but surely I started absorbing the articles and research I had gathered. Gradually a horrible and equally reassuring realization dawned. This was the first time ever that what I was reading matched what I had been experiencing since childhood.

That other survivors of complex trauma had similar reactions to therapies dictated by protocol.

That things I had done to make myself feel better instinctively, regarding self-actualization and somatic therapy, also worked for others where cognitive and behavioral therapies had worked adversely.

That putting the protection of self first, if you’ve never experienced it, is not a luxury, but a necessity. Not something that will simply be there one day once you’ve ‘unlearned’ all your aberrant thinking and behaviors.

That by constantly ignoring what my body was telling me all along, I had done more harm to myself than anyone else had. My mind might not like it. But ignoring my body and suppressing my initial emotional reactions had been detrimental to me.

The Body Keeps the Score – The Future

“The challenge is: How can people gain control over the residues of past trauma and return to being masters of their own ship? Talking, understanding, and human connections help, and drugs can dampen hyperactive alarm systems. But we will also see that the imprints from the past can be transformed by having physical experiences that directly contradict the helplessness, rage, and collapse that are part of trauma, and thereby regaining self-mastery. I have no preferred treatment modality, as no single approach fits everybody, but I practice all the forms of treatment that I discuss in this book. Each one of them can produce profound changes, depending on the nature of the particular problem and the makeup of the individual person.”

“The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma” by Bessel van der Kolk

“No single approach fits everybody.” That. Those five words. They’ve touched an overwhelming grief in me.

I feel like I have been saying that for over 25 years. And that, until very recently, hardly anyone I have been assigned as a therapist or mental health professional, with a few exceptional cases, has acknowledged.

“Protocol says. The DSM says. Text-book cases say. According to our norms and values, you should…You have a personality disorder. An eating disorder. You’re on the spectrum. You need to fix yourself.”

All the while my body was keeping the score. And desperately trying to stop me from repeating the same mistakes.

“Regaining self-mastery” also strikes a chord and resonates. I still have no idea how to get there. I do know I’ve been trying to get there in my own bumbling way since early childhood. And experienced it in tiny increments. I just haven’t figured out yet how to re-experience those glimmers often enough to mindfully reproduce them consistently.

But I hope that one day I will. And maybe Bessel van der Kolk’s book “The Body Keeps the Score” will give me a few footholds in that journey into a brighter future.

Part 2: Chapter 1: Lessons from Vietnam Vets