The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

A pioneering researcher and one of the world’s foremost experts on traumatic stress offers a bold new paradigm for healing Trauma is a fact of life. Veterans and their families deal with the painful aftermath of combat; one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Such experiences inevitably leave traces on minds, emotions, and even on biology. Sadly, trauma sufferers frequently pass on their stress to their partners and children. Renowned trauma expert Bessel van der Kolk has spent over three decades working with survivors. In The Body Keeps the Score, he transforms our understanding of traumatic stress, revealing how it literally rearranges the brain’s wiring—specifically areas dedicated to pleasure, engagement, control, and trust. He shows how these areas can be reactivated through innovative treatments including neurofeedback, mindfulness techniques, play, yoga, and other therapies. Based on Dr. van der Kolk’s own research and that of other leading specialists, The Body Keeps the Score offers proven alternatives to drugs and talk therapy—and a way to reclaim lives.

"The trauma caused by childhood neglect, sexual or domestic abuse and war wreaks havoc in our bodies, says Bessel van der Kolk in The Body Keeps the Score. . . . Van der Kolk draws on 30 years of experience to argue powerfully that trauma is one of the West's most urgent public health issues. . . . Packed with science and human stories, the book is an intense read. . . . [T]he struggle and resilience of his patients is very moving."
--Shaoni Bhattacharya, New Scientist

"War zones may be nearer than you think, as the 25% of US citizens raised with alcoholic relatives might attest. Psychiatrist Bessel van der Kolk argues, moreover, that severe trauma is 'encoded in the viscera' and demands tailored approaches that enable people to experience deep relief from rage and helplessness. In a narrative packed with decades of findings and case studies, he traces the evolution of treatments from the 'chemical coshes' of the 1970s to neurofeedback, mindfulness and other nuanced techniques."
--Nature

"An astonishing amount of information on almost every aspect of trauma experience, research, interventions, and theories is brought together in this book, which . . . has a distinctly holistic feel to it. The title suggests that what will be explored is how the body retains the imprints of trauma. However, it delivers much more than this, delving into how the brain is impacted by overwhelming traumatic events, and is studded with sections on neuroscience which draw on the author's own numerous studies as well as that of his peers. In addition, it investigates the effects of adverse childhood attachment patterns, child abuse, and chronic and long-term abuse. . . . [T]his book is a veritable goldmine of information."
--European Journal of Psychotraumatology

"Dr. van der Kolk . . . has written a fascinating and empowering book about trauma and its effects. He uses modern neuroscience to demonstrate that trauma physically affects the brain and the body, causing anxiety, rage, and the inability to concentrate. Victims have problems remembering, trusting, and forming relationships. They have lost control. Although news reports and discussions tend to focus on war veterans, abused children, domestic violence victims, and victims of violent crime suffer as well. Using a combination of traditional therapy techniques and alternative treatments such as EMDR, yoga, neurofeedback, and theater, patients can regain control of their bodies and rewire their brains so that they can rebuild their lives. The author uses case histories to demonstrate the process. He includes a resource list, bibliography, and extensive notes. This accessible book offers hope and inspiration to those who suffer from trauma and those who care for them. It is an outstanding addition to all library collections.
--Medical Library Association, Consumer Connections

"[A] wonderful new book that everyone involved with trauma ought to read and have available. . . . [B]eautifully, compellingly and sweepingly written in its grand vision of integrating medical, psychological and mixed or alternative approaches, based on a careful reading of the client and a holistic mind-body view. . . . There are very few practitioners who could not learn from this book and become more effective, as well as inspired, by reading and studying it."
--Henry Strick van Linschoten, European Society For Trauma And Dissociation Newsletter

"Psychological trauma can befall anyone, not just soldiers, refugees, or victims of rape. . . . This important and helpful book makes sense of suffering and offers opportunity for healing."
--Booklist

"[C]omprehensive in scope. This valuable work . . . offers hope for the millions of sufferers and their families seeking meaningful treatment and relief from the ongoing pain of trauma."
--Library Journal (Starred Review)

"Dr. van der Kolk's masterpiece combines the boundless curiosity of the scientist, the erudition of the scholar, and the passion of the truth teller."
--Judith Herman, M.D., clinical professor of psychiatry, Harvard Medical School; author of Trauma and Recovery

"This is an absolutely fascinating and clearly written book by one of the nation's most experienced physicians in the field of emotional trauma. The Body Keeps the Score helps us understand how life experiences play out in the function and the malfunction of our bodies, years later."
--Vincent J. Felitti, M.D., chief of preventative medicine, emeritus, Kaiser Permanente San Diego; co-principal investigator, ACE study

"In this inspirational work which seamlessly weaves keen clinical observation, neuroscience, historical analysis, the arts, and personal narrative, Dr. van der Kolk has created an authoritative guide to the effects of trauma, and pathways to recovery. The book is full of wisdom, humanity, compassion and scientific insight, gleaned from a lifetime of clinical service, research and scholarship in the field of traumatic stress. A must read for mental health and other health care professionals, trauma survivors, their loved ones, and those who seek clinical, social, or political solutions to the cycle of trauma and violence in our society."
--Rachel Yehuda, Ph.D., professor of psychiatry and neuroscience; director of the Traumatic Stress Studies Division at the Mount Sinai School of Medicine, New York, NY

"Breathtaking in its scope and breadth, The Body Keeps the Score is a seminal work by one of the preeminent pioneers in trauma research and treatment. This essential book unites the evolving neuroscience of trauma research with an emergent wave of body-oriented therapies and traditional mind/body practices that go beyond symptom relief and connect us with our vital energy and here-and-now presence."
--Peter A. Levine, Ph.D., author of In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness

"In The Body Keeps the Score we share the author's courageous journey into the parallel dissociative worlds of trauma victims and the medical and psychological disciplines that are meant to provide relief. In this compelling book we learn that as our minds desperately try to leave trauma behind, our bodies keep us trapped in the past with wordless emotions and feelings. These inner disconnections cascade into ruptures in social relationships with disastrous effects on marriages, families, and friendships. Van der Kolk offers hope by describing treatments and strategies that have successfully helped his patients reconnect their thoughts with their bodies. We leave this shared journey understanding that only through fostering self-awareness and gaining an inner sense of safety will we, as a species, fully experience the richness of life.
--Stephen W. Porges, Ph.D., professor of psychiatry, University of North Carolina at Chapel Hill; author of The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation

"This exceptional book will be a classic of modern psychiatric thought. The impact of overwhelming experience can only be truly understood when many disparate domains of knowledge, such as neuroscience, developmental psychopathology, and interpersonal neurobiology are integrated, as this work uniquely does. There is no other volume in the field of traumatic stress that has distilled these domains of science with such rich historical and clinical perspectives, and arrived at such innovative treatment approaches. The clarity of vision and breadth of wisdom of this unique but highly accessible work is remarkable. This book is essential reading for anyone interested in understanding and treating traumatic stress and the scope of its impact on society."
--Alexander McFarlane AO, MB BS (Hons) MD FRANZCP, director of the Centre for Traumatic Stress Studies, The University of Adelaide, South Australia.

"This book is a tour de force. Its deeply empathic, insightful, and compassionate perspective promises to further humanize the treatment of trauma victims, dramatically expand their repertoire of self-regulatory healing practices and therapeutic options, and also stimulate greater creative thinking and research on trauma and its effective treatment. The body does keep the score, and van der Kolk's ability to demonstrate this through compelling descriptions of the work of others, his own pioneering trajectory and experience as the field evolved and him along with it, and above all, his discovery of ways to work skillfully with people by bringing mindfulness to the body (as well as to their thoughts and emotions) through yoga, movement, and theater are a wonderful and welcome breath of fresh air and possibility in the therapy world."
--Jon Kabat-Zinn, professor of medicine emeritus, UMass Medical School; author of Full Catastrophe Living.

"This is an amazing accomplishment from the neuroscientist most responsible for the contemporary revolution in mental health toward the recognition that so many mental problems are the product of trauma. With the compelling writing of a good novelist, van der Kolk revisits his fascinating journey of discovery that has challenged established wisdom in psychiatry. Interspersed with that narrative are clear and understandable: descriptions of the neurobiology of trauma; explanations of the ineffectiveness of traditional approaches to treating trauma; and introductions to the approaches that take patients beneath their cognitive minds to heal the parts of them that remained frozen in the past. All this is illustrated vividly with dramatic case histories and substantiated with convincing research. This is a watershed book that will be remembered as tipping the scales within psychiatry and the culture at large toward the recognition of the toll traumatic events and our attempts to deny their impact take on us all."
--Richard Schwartz, originator, Internal Family Systems Therapy

"The Body Keeps the Score is clear, fascinating, hard to put down, and filled with powerful case histories. Van der Kolk, the eminent impresario of trauma treatment, who has spent a career bringing together diverse trauma scientists and clinicians and their ideas, while making his own pivotal contributions, describes what is arguably the most important series of breakthroughs in mental health in the last thirty years. We've known that psychological trauma fragments the mind. Here we see not only how psychological trauma also breaks connections within the brain, but also between mind and body, and learn about the exciting new approaches that allow people with the severest forms of trauma to put all the parts back together again."
--Norman Doidge, author of The Brain That Changes Itself

"Every once in a while, a book comes along that fundamentally changes the way we look at the world. Bessel van der Kolk has written such a book. The arc of van der Kolk's story is vast and comprehensive, but he is such a skillful storyteller that he keeps us riveted to the page. I could not put this book down. It is, simply put, a great work."
--Stephen Cope, founder and director, Kripalu Institute for Extraordinary Living; author of Yoga and the Quest for the True Self

"Bessel van der Kolk is unequaled in his ability to synthesize the stunning developments in the field of psychological trauma over the past few decades. Thanks in part to his work, psychological trauma--ranging from chronic child abuse and neglect, to war trauma and natural disasters--is now generally recognized as a major cause of individual, social and cultural breakdown. In this masterfully lucid and engaging tour de force, van der Kolk takes us --both specialists and the general public-- on his personal journey and shows what he has learned from his research, from his colleagues and students, and, most importantly, from his patients. The Body Keeps the Score is, simply put, brilliant."
--Onno van der Hart, Ph.D., Utrecht University, The Netherlands; senior author, The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization

"The Body Keeps the Score articulates new and better therapies for toxic stress based on a deep understanding of the effects of trauma on brain development and attachment systems. This volume provides a moving summary of what is currently known about the effects of trauma on individuals and societies, and introduces the healing potential of both age old and novel approaches to help traumatized children and adults to fully engage in the present."
--Jessica Stern, policy consultant on terrorism; author of Denial: A Memoir of Terror

"A book about understanding the impact of trauma by one of the true pioneers in the field. It is a rare book that integrates cutting edge neuroscience with wisdom and understanding about the experience and meaning of trauma, for people who have suffered from it. Like its author, this book is wise and compassionate, occasionally quite provocative, and always interesting."
--Glenn N. Saxe, M.D., Arnold Simon Professor and chairman, Department of Child and Adolescent Psychiatry; director, NYU Child Study Center, New York University School of Medicine

"A fascinating exploration of a wide range of therapeutic treatments shows readers how to take charge of the healing process, gain a sense of safety, and find their way out of the morass of suffering."
--Francine Shapiro, Ph.D., originator of EMDR therapy, senior research fellow, Emeritus Mental Research Institute, author of Getting Past Your Past

"As an attachment researcher I know that infants are psychobiological beings. They are as much the body as they are of the brain. Without language or symbols infants use every one of their biological systems to make meaning of their self in relation to the world of things and people. Van der Kolk shows that those very same systems continue to operate at every age, and that traumatic experiences, especially chronic toxic experience during early development, produce psychic devastation. With this understanding he provides insight and guidance for survivors, researchers and clinicians alike. Bessel van der Kolk may focus on the body and trauma, but what a mind he must have to have written this book."
--Ed Tronick, distinguished professor, University of Massachusetts, Boston, author of Neurobehavior and Social Emotional Development of Infants and Young Children

"The Body Keeps the Score eloquently articulates how overwhelming experiences affect the development of brain, mind, and body awareness, all of which are closely intertwined. The resulting derailments have a profound impact on the capacity for love and work. This rich integration of clinical case examples with ground breaking scientific studies provides us with a new understanding of trauma, which inevitably leads to the exploration of novel therapeutic approaches that "rewire" the brain, and help traumatized people to (re)...