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The Body Keeps the Score

·7365 words·35 mins·
book-swap 2023 reading-challenge-2023
Jerry S
Author
Jerry S
Table of Contents

Intro
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A friend recommended a book on trauma. Normally I don’t take any book recommendations but this one went immediately onto the list after reading the summary and I started it right away!

You can buy it on Amazon.

You can read more about it on Goodreads as well.

My Own Quick Summary
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The Body Keeps the Score was a very illuminating text on trauma and the effects that it can have in our bodies. In the book there is a wide range of examples of trauma that are presented and many statistics about the reality of the lives people lead in the USA. This is taken straight from the Good Reads summary:

…one in five Americans has been molested;
one in four grew up with alcoholics;
one in three couples have engaged in physical violence.

Similar to how healthy exercise can shape our bodies and moods for the better, trauma has the same power but in the negative direction. It isn’t obvious, but trauma can alter our bodies and leave life-long effects. Think of it as psychological love handles.

If you eat unhealthily and gain a lot of weight and then slim down, you might end up with flabby skin and high cholesterol and other markers of bad health. Similarly, trauma leaves lasting imprints even if we manage to overcome it and heal.

One thing I’ll point out about the above statements is that gender is never mentioned. As a reader it might be easy to make an assumption about the genders of the victims, but the assumption is never right.

Throughout the book there are many techniques and studies that can help anyone with a trauma to begin dealing with it.

Recommendation
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I would highly recommend this book to anyone that has a trauma that is either recent or not recent and would like to self-discover some techniques that they can look into further to help them on their journey towards healing.

My Main Takeaways & Lessons Learned
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Trauma Changes the Body Physically
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Trauma can quite literally change the body’s physicality and thus change how we interpret the world. It’s a little like having a mis-calibrated compass that is off by a few degrees. The greater the trauma or the longer it occurred, the greater the deviation in our compass and the more distorted our view of the world will be.

Those with trauma that has not been fully processed or incorporated have bodies that are fundamentally different. The differences in these bodies can be various things: producing more stress hormones compared to others and always being anxious; wanting to not be seen by others and acting shy or looking down; having a frontal lobe that isn’t correctly exerting its executive functions which leads to emotional spikes or the inability to focus and concentrate; being unable to attune to others around them to get along.

The Easy Solution Wins
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Treatments for trauma that did not involve medicine were being studied previously, like yoga, neuro-feedback, meditation and EMDR (Eye movement desensitization and reprocessing), but with the advent of medications like Prozac and Lexapro the focus on those “alternative” treatments lessened despite showing promising results, results that were even more promising than the drugs.

Some of these alternative treatments have the advantage of getting patients in tune with their bodies and feeling safe so they can metabolize the traumas and heal more fully. The drugs might make patients feel better while they are taking their dosages but the drugs don’t help with the underlying trauma.

So why don’t we choose to use drugs over the alternatives that have shown to be more effective? That’s easy. The alternative methods require active work and participation from the patient. It’s much easier to swallow a pill and hope the problem goes away.

Favorite Quotes
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This book is really long compared to most books I read but there are so many good tidbits, quotes, and statistics in it. I’ll try to limit it to the philosophical ones the most but I won’t be able to resist including some statistics based ones as well.

Each part has 10 quotes in it.

Part 1
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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.

Interesting. Trauma changes the brain, literally. Would you tell a morbidly obese patient to just run a marathon? No. Why not? It’s a little self explanatory isn’t it? Well, why tell a trauma patient to…just get over it? It’s not the same thing, but the same concept applies.

Their bodies are not made to overcome the trauma easily. They must work up to it, slowly, and painfully. There is no way around it.


…since human beings are experts in wishful thinking and obscuring the truth. I remember him saying:

“The greatest sources of our suffering are the lies we tell ourselves.”

I wrote this poem titled Anti-Wish that is partially related to this. I agree with this, partially. I do think the lies we tell ourselves lead to some of our suffering, but there is always a base level of suffering in life that is inevitable and no amount of greatness or talent can avoid that.


…the job of therapists is to help people “acknowledge, experience, and bear” the reality of life—with all its pleasures and heartbreak.

To acknowledge, experience, and bear. Not to prevent or avoid. Just to bear it and hope to come out the other end. I say that in a sort of patronizing way, but like I said above, there is a base level of suffering that is unavoidable.


It takes enormous trust and courage to allow yourself to remember.

Hah! Yes, yes, it does, because remember trauma that hasn’t been processed is like launching yourself back in time to relive the nightmare.


It’s hard enough to face the suffering that has been inflicted by others, but deep down many traumatized people are even more 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.

Ah yes, the self loathing that comes with looking back at ourselves and realizing we weren’t better at the time and feeling ashamed. Unfortunately, it’s part of the ordeal of life.


Imagination gives us the opportunity to envision new possibilities—it is an essential launchpad for making our hopes come true.

The book is full of great positivity like this.


The greater the doubt, the greater the awakening; the smaller the doubt, the smaller the awakening. No doubt, no awakening.

Oh? I’ve seen this in the context of Zen. It’s interesting to see this here within a book about trauma.


Scared animals return home, regardless of whether home is safe or frightening.

Oh wow. What a curious thing. If I were to imagine my life collapsing I would want to return home…to where my parents are, but they are a safe space for me. How terrible it is to learn that even for those that have been traumatized by an unsafe home that home is where they would return to as well.


On November 4, 2013, Johnson & Johnson agreed to pay more than $2.2 billion in criminal and civil fines to settle accusations that it had improperly promoted the antipsychotic drug Risperdal to older adults, children, and people with developmental disabilities. But nobody is holding the doctors who prescribed them accountable.

Oh wow. I know someone that took Risperdal. I’m angered to have learned this fact. I wish I had known this then…but I doubt it would have changed any outcome significantly.


Children from low-income families are four times as likely as privately insured children to receive antipsychotic medicines.

This is related to the same story above about Risperdal. How angry it makes me to know that there might have been better treatment than Risperdal and that the antipsychotic medicines were being prescribed more often to the low-income demographic.

Part 2
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Trauma by nature drives us to the edge of comprehension, cutting us off from language based on common experience or an imaginable past.

Wow! That’s a powerhouse of a statement. I read it a different way to comprehend it. Pain, real pain, exists in a realm beyond language. Pain is one of the realest things in this world. If there is a god, when he created the world he created pain as a key component to the equation of the universe.


Being traumatized means continuing to organize your life as if the trauma were still going on—unchanged and immutable—as every new encounter or event is contaminated by the past.

This raises the question for me of how to know you’ve healed from a trauma and that it’s no longer affecting your present day.


When the message we receive from another person is “You’re safe with me,” we relax.

Hmm….how many people in my life do I receive that message from?


Numerous studies of disaster response around the globe have shown that social support is the most powerful protection against becoming overwhelmed by stress and trauma.

Social support is not the same as merely being in the presence of others. The critical issue is reciprocity: being truly heard and seen by the people around us, feeling that we are held in someone else’s mind and heart.

Damn. Who’s heart and mind and I being held in? I feel comfort in knowing that family and friends hold space for me. I’m grateful for that, truly.


No doctor can write a prescription for friendship.

You can’t sell human connection!! If someone figures that out…*cha ching*. Until then, here we are.

This makes me think of a song titled “America Latina” that says:

You can’t go out and buy real warmth

You can’t go out and buy my smiles
You can’t go out and buy my hard times


Well-functioning people are able to accept individual differences and acknowledge the humanity of others.

I don’t fully agree here but I can see where this is coming from. I accept people too much sometimes but I suppose by this measure I must be “well-functioning”.


The vagus nerve (which Darwin called the pneumogastric nerve) registers heartbreak and gut-wrenching feelings.

Oh, very interesting. My doctors have told me I have a strong vagus nerve response in general, which can be seen by me becoming light headed at times in the presence of needles. It’s not that I’m afraid, but my body reacts either way. When I’m hit by heartbreak it hits hard, and this fact about the vagus nerve aligns with my bodily experience. Wow.


Be patient toward all that is unsolved in your heart and try to love the questions themselves. . . . Live the questions now.

Yes, some mysteries of the heart solve themselves with time. Not all, but if you try and try and it doesn’t budge, it could be a good sign to leave it be for a spell and come back later.


Self-regulation depends on having a friendly relationship with your body. Without it you have to rely on external regulation—from medication, drugs like alcohol, constant reassurance, or compulsive compliance with the wishes of others.

Hmmmm…..disagree and agree, but mostly agree. External regulation is unavoidable. Being able to deal with and become comfortable with what happens in your body is good and a great base to stare with, but we don’t exist in a vacuum and being able to self-regulate with no feedback from the outside world should never be someone’s ultimate goal because it is unrealistic and that’s essentially only people cut-off from the external world do.


Psychiatrists call this phenomenon alexithymia—Greek for not having words for feelings.

Alexithymia! I looked this up on my computer’s dictionary and this is what it said:

the inability to recognize or describe one’s own emotions: alexithymia has been linked to depression and suicidal behavior.

I think the second part is not as serious, to be honest. In today’s world where everything is talked out, yes, it is more important, but pre-linguistic humans, and even us before we are able to talk, should at least be able to recognize something going on with our emotions, even if we can’t put it into words.

Learning there is a word for this was one of the highlights of this book.

Part 3
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There was no activation of any part of the brain involved in social engagement. In response to being looked at they simply went into survival mode.

Huh? Hard to believe, but it’s eye-opening to learn that simply looking someone in the eye can cause an internal panic in someone else. This must be the power of medusa, the ability to look at someone and have them turn to stone and freeze.


Children whose parents are reliable sources of comfort and strength have a lifetime advantage—a kind of buffer against the worst that fate can hand them.

Fortunately for me, I tend to consider myself as one of those children that have reliable parents that are sources of strength, shelter, and comfort. Why does that matter though? It means I have a good point of reference for safety and those less fortunate than me might have never gotten gotten a sense of safety while growing up. As a result they don’t have that as a guiding compass.


The need for attachment never lessens. Most human beings simply cannot tolerate being disengaged from others for any length of time. People who cannot connect through work, friendships, or family usually find other ways of bonding, as through illnesses, lawsuits, or family feuds. Anything is preferable to that godforsaken sense of irrelevance and alienation.

Wow. Connection through family feuds. I can definitely see that in some families, including mine.


When children experience intense inner conflict regarding their angry feelings, this is likely because expressing them may be forbidden or even dangerous.

Damn. I’ve felt this even as an adult. If I could talk to my younger self I’d tell him this.


While life events can change the behavior of the gene, they do not alter its fundamental structure. Methylation patterns, however, can be passed on to offspring—a phenomenon known as epigenetics. Once again, the body keeps the score, at the deepest levels of the organism.

This is a nice biology lesson to learn. The organism’s experience can turn genes on or off and that ultimately affects what gets passed onto offspring. Seriously! Some would call this nature (genes) vs nurture (which genes are actually activated). But I don’t like that. I think potential vs reality is better. The genes you carry determine your potential. A gene can potentially express in one, two, or more ways. Reality is what the state of things are, which genes are actually active.


Having a biological system that keeps pumping out stress hormones to deal with real or imagined threats leads to physical problems: sleep disturbances, headaches, unexplained pain, oversensitivity to touch or sound. Being so agitated or shut down keeps them from being able to focus their attention and concentration. To relieve their tension, they engage in chronic masturbation, rocking, or self-harming activities (biting, cutting, burning, and hitting themselves, pulling their hair out, picking at their skin until it bled).

I’ve definitely picked my skin till it bled before but not with the degree and consistency the book highlights. It’s amazing that even with all the stress hormones, the body is still, we are still, somehow trying to self-soothe the tension.


With “good enough” caregivers, children learn that broken connections can be repaired.

“Good enough” is not defined as some high unattainable standard in the book. In fact, the definition of good enough is quite lax in my opinion. Almost anyone with good intentions AND the follow-through on their intentions can be a good caregiver despite lack of funds.


Our relationship maps are implicit, etched into the emotional brain and not reversible simply by understanding how they were created. You may realize that your fear of intimacy has something to do with your mother’s postpartum depression or with the fact that she herself was molested as a child, but that alone is unlikely to open you to happy, trusting engagement with others.

Ah! I really enjoyed this paragraph. One phrase comes to mind: “Book smart vs street smart”… another way of saying “integrated knowledge”, “biological knowledge”, “embodied knowledge”. There are some things we learn and read that we know intellectually but can’t embody naturally in our actions. Then there is integrated knowledge that exists in the very way we move.

This is the type of knowledge and learning I strive for. I want to know something, not through words, but through action, the same way that I pump my heart because I know if I don’t I will die.


The “night sea journey” is the journey into the parts of ourselves that are split off, disavowed, unknown, unwanted, cast out, and exiled to the various subterranean worlds of consciousness….

The goal of this journey is to reunite us with ourselves.
Such a homecoming can be surprisingly painful, even brutal.
In order to undertake it, we must first agree to exile nothing.

Love it. This reminds me of my poem Stellar Moose. It recounts a type of night sea journey to self discovery.

Maybe this is why I like camping. It’s a way to make progress on my night sea journey into the exiled parts.


…the combination of vulnerable infants and inflexible caregivers made for clingy, uptight kids. Insensitive, pushy, and intrusive behavior on the part of the parents at six months predicted hyperactivity and attention problems in kindergarten and beyond.

Inflexible caregivers? I’ll have to reread what this meant exactly but interesting to see that this type of caregiver correlates with a hyperactive inattentive child. Interesting, but not surprising.

Part 4
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By far the most important predictor of how well his subjects coped with life’s inevitable disappointments was the level of security established with their primary caregiver during the first two years of life. Sroufe informally told me that he thought that resilience in adulthood could be predicted by how lovable mothers rated their kids at age two.

Haha. Wow, that makes me laugh for some reason. I wonder how lovable I was? Who knows. I doubt most mothers would give a straight honest answer anyway.


The abused, isolated girls with incest histories mature sexually a year and a half earlier than the nonabused girls. Sexual abuse speeds up their biological clocks and the secretion of sex hormones.

That was not something I was expecting at all. So maybe the fact that our food is “pumped full of hormones” is not the only reason young girls mature faster now than they did in the past.


The adrenaline that we secrete to defend against potential threats helps to engrave those incidents into our minds. Even if the content of the remark fades, our dislike for the person who made it usually persists.

Oh wow. Yes, a lot of adrenaline is an effective way to form longer lasting memories and this goes hand in hand with this famous quote

I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.

Maya Angelou

“Unable to integrate their traumatic memories, they seem to lose their capacity to assimilate new experiences as well. It is . . . as if their personality has definitely stopped at a certain point, and cannot enlarge any more by the addition or assimilation of new elements.”19 He predicted that unless they became aware of the split-off elements and integrated them into a story that had happened in the past but was now over, they would experience a slow decline in their personal and professional functioning. This phenomenon has now been well documented in contemporary research.

Whoa! As someone that has definitely felt “stopped” or “frozen” in the past I am NOT surprised at all by this since I feel like I have lived it. I wonder if parts of me are still frozen. I need to go on a “night sea journey” find out.


The lasting legacy of Breuer and Freud’s 1893 paper is what we now call the “talking cure”: “[W]e found, to our great surprise, at first, that each individual hysterical symptom immediately and permanently disappeared when we had succeeded in bringing clearly to light the memory of the event by which it was provoked and in arousing its accompanying affect, and when the patient had described that event in the greatest possible detail and had put the affect into words (all italics in original). Recollection without affect almost invariably produces no result.” …
Even though psychoanalysis is today in eclipse, the “talking cure” has lived on, and psychologists have generally assumed that telling the trauma story in great detail will help people to leave it behind. That is also a basic premise of cognitive behavioral therapy (CBT), which today is taught in graduate psychology courses around the world.

The “talking cure” is a term I had not yet heard for therapy. However, I largely don’t think talking is enough cure. The book later talks about this but the talking must lead to physical action in the real world in order for us to gain a sense of autonomy and control over our own lives.


Perhaps the most important finding in our study was that remembering the trauma with all its associated affects, does not, as Breuer and Freud claimed back in 1893, necessarily resolve it. Our research did not support the idea that language can substitute for action.

Ahah! There it is. Language cannot substitute action. Language can help identify possible action, or determine which action to take. But when it comes time to leap, you must leap. Talking when it comes time to leap will not get you over the hurdle.


Culture shapes the expression of traumatic stress.

Oh wow. That’s interesting. Yes. After all, I don’t think our ancestors would imagine airing out all their trauma to the entire world via a mechanism like social media…yet, here we are.


As long as a memory is inaccessible, the mind is unable to change it. But as soon as a story starts being told, particularly if it is told repeatedly, it changes—the act of telling itself changes the tale. The mind cannot help but make meaning out of what it knows, and the meaning we make of our lives changes how and what we remember.

Look at the “talking cure” term and comment above, but I can’t help but agree. Telling story, even if just to yourself, over and over again, can lead to the discovery of something…and you can use that something to change your behavior and to change the actions you take.


As we will see, finding words to describe what has happened to you can be transformative, but it does not always abolish flashbacks or improve concentration, stimulate vital involvement in your life or reduce hypersensitivity to disappointments and perceived injuries.

The ability to articulate what has happened with wording as accurate as possible is important, especially if it is the first time. This is what the “cure” part of the “talking cure” term is supposed to be. We should talk until we feel we have accurately described what occurred, but it’s not enough to integrate the experience and lay it to rest.


“If you were not there, it’s difficult to describe and say how it was. How men function under such stress is one thing, and then how you communicate and express that to somebody who never knew that such a degree of brutality exists seems like a fantasy.”

Functioning under stress is “biological knowledge”, not “articulated knowledge”. It is my opinion that articulating that knowledge to others can be perceived almost as an assault by their minds and bodies because they have never experienced that knowledge before and being forced to contend with it, to integrate it, is something that most will resist; avoiding pain is human, even if it comes at the cost of alienating ourselves from one another, even if it comes at the cost of alienating ourselves from our own exiled parts.

Part 5
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The essence of trauma is that it is overwhelming, unbelievable, and unbearable. Each patient demands that we suspend our sense of what is normal and accept that we are dealing with a dual reality: the reality of a relatively secure and predictable present that lives side by side with a ruinous, ever-present past.

And this is why I think the multi-verse exists, in one form or another. Trauma is one of the universes that lives alongside our “common” universe. When you meet someone it can be hard to tell what will send them to the trauma-verse unless you know their triggers.


Shortly after the birth of her third child, Nancy underwent what is usually routine outpatient surgery, a laparoscopic tubal ligation in which the fallopian tubes are cauterized to prevent future pregnancies. However, because she was given insufficient anesthesia, she awakened after the operation began and remained aware nearly to the end, at times falling into what she called “a light sleep” or “dream,” at times experiencing the full horror of her situation. …
“Then suddenly there was an intense searing, burning pain. I tried to escape, but the cautery tip pursued me, relentlessly burning through. There simply are no words to describe the terror of this experience. This pain was not in the same realm as other pain I had known and conquered, like a broken bone or natural childbirth. It begins as extreme pain, then continues relentlessly as it slowly burns through the tube. The pain of being cut with the scalpel pales beside this giant.”


As long as people are either hyperaroused or shut down, they cannot learn from experience.

Hm, yes. It’s in the quiet that I can reflect and foster understanding. When things are moving fast and furious there is not much else to do except react and hope what one knows is enough to get by. I have had to learn to take the time to reflect, otherwise I don’t change and grow.


Even though the trauma is a thing of the past, the emotional brain keeps generating sensations that make the sufferer feel scared and helpless. It’s not surprising that so many trauma survivors are compulsive eaters and drinkers, fear making love, and avoid many social activities: Their sensory world is largely off limits.

Largely off limits!? No wonder trauma survivors can seem as if they’re not fully there. Some part of them is still stuck in that past event.


Study after study shows that having a good support network constitutes the single most powerful protection against becoming traumatized.

I would like to know what counts as “good” here. Primarily I want to know if I need to work on my support network or not. Secondarily I can find out if I can be a better support network for someone else.


Studies conducted during World War II in England showed that children who lived in London during the Blitz and were sent away to the countryside for protection against German bombing raids fared much worse than children who remained with their parents and endured nights in bomb shelters and frightening images of destroyed buildings and dead people. …
The role of those relationships is to provide physical and emotional safety, including safety from feeling shamed, admonished, or judged, and to bolster the courage to tolerate, face, and process the reality of what has happened.

Ahah! Amazing. Children that live in chaos with good role models are better off than those who live in peaceful environments with no role models? Is that what that says? If so, it’s no wonder that chaos breeds strong resilient people, if they have adequate guides to show them a way of living resistant to chaos.


As we have seen, much of the wiring of our brain circuits is devoted to being in tune with others. Recovery from trauma involves (re)connecting with our fellow human beings. This is why trauma that has occurred within relationships is generally more difficult to treat than trauma resulting from traffic accidents or natural disasters. In our society the most common traumas in women and children occur at the hands of their parents or intimate partners. Child abuse, molestation, and domestic violence all are inflicted by people who are supposed to love you. That knocks out the most important protection against being traumatized: being sheltered by the people you love.

Makes sense to me. Environments can be crazy and accidents happen. The unfairness of the world and its accidents can be explained away by the randomness of it all, the chaos. But how does one explain a loving relationship being the source of such pain? It’s not just the unfairness of the world at that point. It’s the intent of a loved on, aimed sharply at us. It’s not an accident, not happenstance. It’s on purpose.

Inside, I don’t believe that though. I almost don’t believe we have any free will, which would mean we’re just as cold and lifeless as the world around us.


Some people don’t remember anybody they felt safe with. For them, engaging with horses or dogs may be much safer than dealing with human beings.

Makes sense to me. Is that why more and more people are getting pets nowadays?


Eventually, the activation patterns that were meant to promote coping are turned back against the organism and now keep fueling inappropriate fight/flight and freeze responses.

Hm, interesting. This seems like an auto-immune disease. Auto-immune diseases cause the body to attack its own cells. Traumas can cause the mind to attack its own psychic structures.


INTEGRATING TRAUMATIC MEMORIES People cannot put traumatic events behind until they are able to acknowledge what has happened and start to recognize the invisible demons they’re struggling with.

Acknowledging reality is the first step towards being able to change it.

Part 6
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Research has shown that up to one hundred minutes of flooding (in which anxiety-provoking triggers are presented in an intense, sustained form) are required before decreases in anxiety are reported. Exposure sometimes helps to deal with fear and anxiety, but it has not been proven to help with guilt or other complex emotions. …
The poorest outcome in exposure treatments occurs in patients who suffer from “mental defeat”—those who have given up.

Exposure therapy is interesting to read about here because it helps to a degree with subduing the initial attacks of fear and anxiety that might arise from a stimulus, like seeing a photograph or hearing a sound or purposefully remembering a memory. Destructing the more complex intense emotions and thoughts underneath that, however, is something that must be done within the confines of one’s own mind.


Over the past two decades the prevailing treatment taught to psychology students has been some form of systematic desensitization: helping patients become less reactive to certain emotions and sensations. But is this the correct goal? Maybe the issue is not desensitization but integration: putting the traumatic event into its proper place in the overall arc of one’s life.

Yes, that feels more correct as an approach. Integration therapy, as opposed to exposure therapy, seems more complete. Maybe it isn’t actually a complete treatment, but it provides more that just simple exposure therapy.


This is very different from traditional desensitization techniques, which are about blunting a person’s response to past horrors. This is about association and integration—making a horrendous event that overwhelmed you in the past into a memory of something that happened a long time ago.

Ah, the gift of forgetting. This is what this sounds like. It’s restoring our minds ability to forget the events that have caused us pain. Do Artificial Intelligences forget?


However, drugs cannot “cure” trauma; they can only dampen the expressions of a disturbed physiology. And they do not teach the lasting lessons of self-regulation. They can help to control feelings and behavior, but always at a price—because they work by blocking the chemical systems that regulate engagement, motivation, pain, and pleasure.

I’ve never liked medication but it has its uses. This is one of the reasons. If the medication keeps me from healing at all…is it worth it?


in a study in which we compared Prozac with eye movement desensitization and reprocessing (EMDR) for patients with PTSD, many of whom were also depressed, EMDR proved to be a more effective antidepressant than Prozac.

What? That’s incredible. Why had I heard of Prozac but not EMDR before this book?


Traumatized patients tend to like tranquilizing drugs, benzodiazepines like Klonopin, Valium, Xanax, and Ativan. In many ways, they work like alcohol, in that they make people feel calm and keep them from worrying. (Casino owners love customers on benzodiazepines; they don’t get upset when they lose and keep gambling.)

I don’t like tranquilizers at all. I’ve not had them often, but the few times I did, I was not myself. I was not even another…I was just not.


Antipsychotic medications such as Risperdal, Abilify, or Seroquel can significantly dampen the emotional brain and thus make patients less skittish or enraged, but they also may interfere with being able to appreciate subtle signals of pleasure, danger, or satisfaction.

I wish I had known that. No, I did know that. I read it on the warning labels. I just didn’t do anything about it.


While trauma keeps us dumbfounded, the path out of it is paved with words, carefully assembled, piece by piece, until the whole story can be revealed.

This reminds me a lot of this poem: Constructing the Novel

It’s funny that wrote that before reading the book, but the idea is so simple.

One word at a time to explore dreams and ideas

What’s left after the words have long been said?
Understanding.


Feeling listened to and understood changes our physiology; being able to articulate a complex feeling, and having our feelings recognized, lights up our limbic brain and creates an “aha moment.” In contrast, being met by silence and incomprehension kills the spirit. Or, as John Bowlby so memorably put it: “What can not be spoken to the other cannot be told to the self.”

Oh! This is gold.

What can not be spoken to the other cannot be told to the self.

This all circles back to the “talking cure” in m mind. What you can’t express remains a mystery, even to oneself. Thus I finally discovered some form of outside proof that talking to oneself has benefits.


Trauma stories lessen the isolation of trauma, and they provide an explanation for why people suffer the way they do.

In my own “woke” words (lol): Telling your story to yourself is important, and having others hear it inspires compassion.

Part 7
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Blaming is a universal human trait that helps people feel good while feeling bad, or, as my old teacher Elvin Semrad used to say: “Hate makes the world go round.” But stories also obscure a more important issue, namely, that trauma radically changes people: that in fact they no longer are “themselves.”

Can one ever go back to being oneself? No, but you can also move away from being the trauma victim and be another version of you free from the trauma. Not the same, yet not another.


Most of us have poured out our hearts in angry, accusatory, plaintive, or sad letters after people have betrayed or abandoned us. Doing so almost always makes us feel better, even if we never send them.

One or two of those letters I have sent, but a vast majority goes unsent.

Writing them certainly helped though.


Writing experiments from around the world, with grade school students, nursing home residents, medical students, maximum-security prisoners, arthritis sufferers, new mothers, and rape victims, consistently show that writing about upsetting events improves physical and mental health.

Writing, another form of the “talking cure”. It forces the victim to slow down, formulate words, check-in with themselves about what’s deep on the inside.


Another aspect of Pennebaker’s studies caught my attention: When his subjects talked about intimate or difficult issues, they often changed their tone of voice and speaking style. The differences were so striking that Pennebaker wondered if he had mixed up his tapes. For example, one woman described her plans for the day in a childlike, high-pitched voice, but a few minutes later, when she described stealing one hundred dollars from an open cash register, both the volume and pitch of her voice became so much lower that she sounded like an entirely different person. Alterations in emotional states were also reflected in the subjects’ handwriting. As participants changed topics, they might move from cursive to block letters and back to cursive; there were also variations in the slant of the letters and in the pressure of their pens. Such changes are called “switching” in clinical practice, and we see them often in individuals with trauma histories. Patients activate distinctly different emotional and physiological states as they move from one topic to another.

I’ve studied personality and people and this doesn’t surprise me one bit.


However, we still do not know whether this conclusion—that language is essential to healing—is, in fact, always true.

Ah, interesting question. Is language necessary for healing? I’d venture to guess that it isn’t. I would say that “understanding” is necessary, but I don’t entirely agree with that. I don’t have a word for it yet.


The real reason [that soldiers fall silent] is that soldiers have discovered that no one is very interested in the bad news they have to report. What listener wants to be torn and shaken when he doesn’t have to be? We have made unspeakable mean indescribable: it really means nasty.

Hahahaha. Yes. Isn’t that so ironic. We ask our armies to defend us and then when they come to us broken we barely want to hear them out. Why? Out of fear of being infected by their trauma. We might not want to express it like this but when we say “how horrible, how unspeakable”, what we really mean is “shut up and spare me having to listen to your story that I wouldn’t possibly be able to process and understand without causing my own self pain”.


Talking about painful events doesn’t necessarily establish community—often quite the contrary. Families and organizations may reject members who air the dirty laundry; friends and family can lose patience with people who get stuck in their grief or hurt. This is one reason why trauma victims often withdraw and why their stories become rote narratives, edited into a form least likely to provoke rejection.

Amazing! Isn’t that incredible. I’ve seen people actively try to edit their stories as they tell them to others to make them more palatable for consumption. Can you imagine that? Trauma should be polite, less abrasive. The victims know this based on the reactions of others. So they self-censor.


EMDR can help even if the patient and the therapist do not have a trusting relationship. This was particularly intriguing because trauma, understandably, rarely leaves people with an open, trusting heart.

Excellent. A way to heal without needing to trust your doctor. Seems like a good approach. EMDR appears to be really effective if that’s the case.


A man has as many social selves as there are individuals who recognize him.

I suppose so, though I try to keep all my social selves as similar to one another as I can. How am I doing?


As a result, abused 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.

Such a pity, both to be one of those children and to be witness to one.

I don’t claim to be one, but I have seen at least one child who behaved as if they were not worthy of love.

Part 8
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If you were abused as a child, you are likely to have a childlike part living inside you that is frozen in time, still holding fast to this kind of self-loathing and denial.

A child within, an adult on the outside. A soft filling with a hard shell.


Just as we need to revisit traumatic memories in order to integrate them, we need to revisit the parts of ourselves that developed the defensive habits that helped us to survive.

We must learn to lower our defenses and revisit why we built them in the first place. How did we ever become so defensive?


“If one accepts the basic idea that people have an innate drive toward nurturing their own health, this implies that, when people have chronic problems, something gets in the way of accessing inner resources. Recognizing this, the role of therapists is to collaborate rather than to teach, confront, or fill holes in your psyche.”

Yes! Real therapy is for the therapist to say “dig, dig, dig” and watch you toil away at problems that a 5 year old could solve. They give you the tools but you must use them yourself and you must figure out how to use them effectively for yourself. The therapist cannot do that for you anymore than they can eat to make you feel full.


I did not try to explain to her why she felt so angry, guilty, or shut down—she already thought of herself as damaged goods.

Well, that’s sad, but everything starts somewhere or else it would have nowhere to go.


If you come from an incomprehensible world filled with secrecy and fear, it’s almost impossible to find the words to express what you have endured. If you grew up unwanted and ignored, it is a major challenge to develop a visceral sense of agency and self-worth.

Impossible to find the words? Depending on where you grew up, your environment might be incapable of providing any words at all. If so, how would one find words that don’t exist?


Anticipating rejection, ridicule, and deprivation, they are reluctant to try out new options, certain that these will lead to failure. This lack of experimentation traps people in a matrix of fear, isolation, and scarcity where it is impossible to welcome the very experiences that might change their basic worldview.

I’m afraid of that happening to me; I’m afraid of trapping myself. As a result, I try to venture out.


In order to change, people need to become viscerally familiar with realities that directly contradict the static feelings of the frozen or panicked self of trauma, replacing them with sensations rooted in safety, mastery, delight, and connection.

I don’t quite understand. In my own words: In order to actually change, one must live through experiences that rewire one’s mind to recognize safety and autonomy. Am I wrong with my interpretation?


“The idea that we’re asking our young people to go out in the world completely alone and call themselves independent is crazy. We need to teach them how to be interdependent, which means teaching them how to have relationships.”

Ah! Yes!!!! “We must teach them how to be interdependent”

Finally, someone sees that the modern buffoonery of being a completely independent individual is a bunch of crock.


Resilience is the product of agency: knowing that what you do can make a difference.

Makes good sense. If what I did made no difference I would certainly feel helpless. But I know what I do makes a difference and so I don’t.

In the words of an cartoon show that I really love: “I’m the one that decides the risks I’m going to take! This is my gamble!!”


Trauma is now our most urgent public health issue, and we have the knowledge necessary to respond effectively. The choice is ours to act on what we know.

The choice is yours.