The Body Keeps the Score - Book Summary by a Therapist w/o the Triggering Bits

I think a lot of people are intimidated by  The Body Keeps The Score and to be honest I was too. It's pretty long it has a lot of  triggering examples of real-life trauma but it's also a great book for understanding how  trauma affects the brain and body and that's probably why it's been on the New York Times  bestseller list for like 5 years. It's also probably because trauma affects all of us  and the author, Dr Bessel van der Kolk has written the modern users's guide to understanding  trauma.

There's so much to talk about with trauma and PTSD and the book is over 350 pages long.  So, I'm going to summarize the essentials without the triggering bits and you can  download the free PDF summary linked In the description. Okay so I'm excited to tell you what  Dr van der Kolk has learned about trauma treatments that are surprisingly effective but first let's  talk about the broad impacts that trauma has on the brain the body and relationships and to do  that we've got to start with a basic question: How would you define trauma?

Now, most of us think of it  as an event that is deeply disturbing but really trauma is about how different people might respond  to the same event with either an adaptive response or a traumatic response that gets the brain and  body stuck reliving the trauma and that's one of the defining parts of trauma that it continues  to affect a person in damaging ways. Van der Kolk says, "Trauma is not just an event that took place  sometime in the past. It's also the imprint left by that experience on mind, brain, and body.

This  imprint has ongoing consequences for how the human organism manages to survive in the present. " So while trauma may start with an event the brain and body's reaction can keep a person stuck as  time moves on. Rather than live in the present, survivors focus their energy on suppressing the  inner chaos that arises when a trigger makes them remember and re-experience their past and that  affects their relationships with people all around them.

I saw this several years ago with one of my  neighbors. We have a neighborhood Facebook group where people ask to borrow stuff or post about  lost pets, basically anything a neighbor can help with and one year around the 4th of July, a war  veteran, a neighbor posted a request. He planned to escape to the quiet of the mountains for the  4th of July to avoid the fireworks that night but he asked if we could all please just not set off  any fireworks for the days around the holiday and he said that each time these unexpected fireworks  went off he would hit the floor and he would see desert palm trees.

He'd feel like he was back  in Iraq, hoping not to get hit by a mortar. He was stuck in a survival response. He said it  was a very difficult week for him and I truly feel for him but can you also see how his trauma  had him stuck?

He was asking his family to miss the holiday and asking our entire neighborhood to cut  our celebrations to accommodate his trauma. Now, I get where he's coming from. I'm not judging.

I'm  just saying this was impacting him. Trauma is not just a mental or emotional problem, it affects  the whole person. So, let's look at three places that trauma lives on in its survivors, trauma  in the brain, trauma in the body, and trauma in relationships.

Okay so to understand what happens  in traumatized brains it's helpful to know that the brain has to simplify three sections that  respond to trauma differently, the brain stem which some people think of as the reptilian brain. It's in charge of survival functions and reflexes. The limbic system, it manages emotions and social  behavior.

This is where the fight, flight, freeze response is triggered and then number three is  the prefrontal cortex. It takes care of rational thinking and decision-making. This is the part  of the brain that we would normally consider as the thinking part of the brain and it helps us  manage our lives.

But when danger is present the prefrontal cortex shuts down and the reptilian  brain springs to action kicking us into fight, flight, or freeze. Now when fight, flight, or freeze  has worked and we have escaped that danger we can go back to our normal brain function. The  body's part in a dangerous situation is to run, to scream, to fight back, or to take some other  action against the threat and then the brain knows that that threat has been handled but  when we can't fight back or escape the body's last attempt to create safety is to shut down and  this can happen in a war zone, a car accident, or assault when running away isn't possible.

As van der   Kolk says, immobilization is at the root of most traumas. Being unable to do anything about what  is happening is what makes the event traumatic. With the freeze and the shutdown response the  parasympathetic nervous system takes over which causes a slower heart rate, shallow breathing, a  loss of muscle tone.

You might feel numb, detached, or some people faint. More frequently people  dissociate, they find themselves separating from their feelings or watching the abuse as an event  or an observer like it's happening to someone else. So as part of the shutdown response to trauma,  some people experience depersonalization, which is when a person loses their sense of self.

They  feel like they are separated from their body. Researchers in the Netherlands scanned the  brands of trauma survivors and saw that fear centers in the brain simply shut down when they  recall their traumatic event. Now shut down is one of the ways the brain protects itself but you can't selectively numb.

So getting stuck in a chronic freeze or shutdown state leaves people  feeling numb or detached in many areas of their lives. This might look like burnout at work or  disconnected relationships or just a general loss as part of your healing process can help victims  restore their sense of wholeness. Okay so that's how that fight flight freeze response can get  stuck.

Sometimes people get stuck in shutdown response. Sometimes people get stuck in that fight or flight response. They maybe really angry or really scared all the time and that's the  nervous system reaction to trauma.

So that's one of the ways trauma gets stored in the nervous  system which includes the brain. Okay trauma also impacts the victim's ability to store and retrieve  memories. Some memories get stuck as vibrant and as real as the day they happen and other memories can  be repressed for years or decades and memory loss is a really common symptom of trauma.

When trauma  is unresolved after the event is over the lower brain doesn't know that it can stop telling the  body to escape a threat that is now gone. So it's going to continue to secrete stress hormones  especially when something triggers the memory of that traumatic event and it could be years or  decades after the trauma happened and the amygdala will still jump into overreaction mode. That is  PTSD.

Now, military veterans deal with this. Their their rational brain knows when they're home, the war is over. But any trigger can jump start that lower brain that survival brain and this all  happens beneath the reasoning of the more evolved part of the brain and this is not a failing of  willpower.

Their amygdala is stuck on constant high alert and harmless situations can trigger their  survival brain to fight, flee, or freeze; sometimes all at once as the thinking brain tries to stay  in control. And this can result in panic, rage attack, or terrified cowering. People with PTSD  frequently experience flashbacks, nightmares, severe anxiety, and emotional numbing and these symptoms  just get in the way of maintaining relationships and holding jobs and living normal lives.

Van der Kolk says, "Trauma results in a fundamental reorganization of the way mind and brain manage  perceptions it changes not only how we think and what we think about but also our very capacity to  think. " Now, the author likes the Rorschach Test as a way of seeing how is patients think differently  than non-traumatized people. You've probably heard of these inkblots before.

Because this  test is all about what a person draws from the inkblot the test can't be faked, the patient is  asked what meaning he sees in each ink block. So for example most people say this looks like a bat  or a butterfly or a moth but a traumatized person might see something that is broken or ruined or  some sort of aggressive act or they might not be able to imagine anything at all. Van der Kolk says that  traumatized people have a tendency to superimpose their trauma on everything around them.

So an  innocuous comment might feel like an attack or an article of clothing might elicit intense  shame or the smell of food might trigger an intense fear response. Louis Zamperini from the book, Unbroken, describes how a waiter once brought him white rice and he flew into a rage because it  triggered memories of his time in a Japanese prisoner of war camp. So PTSD disintegrates your  sense of safety.

Most people don't think of trauma as being anything beyond a mental health issue  which is probably why the book's title is a good wakeup call because this is a whole body response.   The amygdala is going to keep triggering a survival response even when it's not needed. The body keeps  sending out these stress hormones long after the traumatic danger has passed.

So over time being  in a near constant state of stress affects memory, attention, sleep, mood, and physiological health. Physical symptoms of unresolved trauma include obesity or rapid weight gain or weight loss,  anorexia, chronic back and neck pain, migraines, some types of asthma, digestive problems, spastic colon/IBS, chronic fatigue, fibromyalgia, and other autoimmune diseases plus a bunch of other conditions like  cardiovascular conditions and other autoimmune diseases. Being under constant stress from past  or present trauma also makes a person vulnerable to depression, heart disease, and cancer.

Many  trauma survivors become addicted to numbing behaviors including overeating, anorexia, addiction  to exercise or work drugs or alcohol and then some do the opposite and seek sensations that will  overpower those anxious feelings in their body. So these people might try high-risk activities  like risky sex, gambling, bungee jumping, bullet biking things like that. Now for some people trauma  has the opposite effect.

As a defense mechanism, the brain will stop registering terrifying sensations  but it can selectively numb so it's going to compromise all bodily sensations and this is  called a depersonalization. The sensory perceptions are just on. So these patients stop being able  to feel whole parts of their bodies.

Imagine that someone blindfolded you and handed you an object  to identify. Most people would be able to identify a car key or a quarter or a can opener with their  eyes closed but people with PTSD often can't put together the sensations of the object's weight, shape, and texture. Their brain can't integrate the senses coming from their body and they can't guess  what object they're holding.

So what do you think happens when the brain and body aren't able to  connect and integrate? You can't feel fully alive. You don't feel physical sensations like pleasure  or pain and this leads to losing your sense of purpose and direction even your sense of self and  in severe cases traumatized patients can't even recognize themselves in a mirror.

Whether a trauma  survivor experiences chronic pain and illness or numbness they aren't able to feel anything it's  important for doctors and therapists to be able to see that trauma might be at the root of what's  going on. In that case these physical problems won't heal unless a person faces their traumatic  past in a way that lets their body heal along with their mind and and I promise we're going to get  to many of the options for healing but first i'm just going to quickly summarize what the book  said about trauma and relationships. It makes sense that trauma almost always gets in the way  of intimate relationships.

After all if you were a soldier causing violence in a war or a victim  receiving violence through abuse the trauma makes it very hard to trust oneself or someone else. But a lack of trust is not the only issue at play here. The book shares some of the research   done by Dr Ruth Lainus and she researched how brains react to social situations and she found  something really amazing.

For someone who has not experienced trauma, when someone attempts to  make eye contact with them and the prefrontal cortex is activated, they become curious about the  other person their mirror neurons pick up on the person's intentions and the thinking part of the  brain works through whether this person is safe or not but for people with PTSD the prefrontal  cortex does not get activated with eye contact. Instead a part of their emotional brain  called the Periaqueductal Gray area lights up and it generates these self-protective behaviors. In survival mode when meeting strangers, a PTSD patient will often break eye contact and feel  intense shame.

They maybe believe that they're broken because they feel afraid around other  people and and when we look at people who had childhood trauma more than half of them also  had learning or behavioral problems in school and they didn't outgrow the problems and instead  they just learned to hide them with secrecy or shame. So in adulthood this shame leads to missing  work frequently and financial problems which gets in the way of your ability to succeed you know at  work and build up good personal relationships. Okay, so basically trauma messes with your relationships. 

Now, we're going to move into the part about how to treat trauma how to heal from trauma but before  we do that it's super important to say that the majority of trauma can be prevented. Van der Kolk  says, "Child abuse and neglect is the single most preventable cause of mental illness. The single  most common cause of drug and alcohol abuse and a significant contributor to leading causes of  death like diabetes, heart disease, cancer, stroke, and suicide.

Now, I made another video about the  ACES study but I'm just going to summarize it real quick because it's so important. ACE is short for  adverse childhood experiences and this includes observing or experiencing abuse, neglect, domestic  violence, or losing a parent death or divorce or in incarceration. The groundbreaking ACES study  found two things.

Number one, a massive percentage 64% of people experience at least one ACE in their  life and 16% that's one in six people experience four or more ACES and secondly these ACES have a  massive impact on physical and mental health for the rest of your life. Kids who experience four  to six traumatic events are up to five times as likely to have chronic depression. Suicide attempts  are 5,000 times more likely.

Alcoholism is seven times more likely. IV drug use is 4,600% greater. Adult  rape of child-abuse victims is six times as likely.

Basically the list of additional traumas  and high-risk behaviors and health impacts just goes on and on and ACES drastically increase your  risk of physical disease like heart disease, cancer stroke, obesity, diabetes, autoimmune conditions. I  could go on and on. I'm not going to.

Long story short, childhood trauma, abuse, neglect impact your  physical health for the rest of your life. Maybe you know what it's like to be one of these kids, to live in a world that's filled with triggers, to live with multiple physical symptoms that are  showing up in your adult life and these symptoms have their roots in childhood trauma. Maybe your  doctor is treating your physical symptoms and while those might be less bothersome maybe they  never go away.

Maybe you're taking a medication that helps a little but it isn't getting to the  root of the problem. Much of our country's trauma could be prevented and it might not be be popular  to talk about but child abuse in all its forms is way too prevalent. Eliminating child abuse through  training and support for parents would prevent most trauma and would solve a multitude of health  conditions and societal and economic problems.

Now if you're watching this video, you're already  taking the first step to preventing childhood trauma. We can all make the world a better place  by being trauma informed and working to raise kids in supportive safe families. So, thank you  for being here.

Now, we're going to move on to healing. Okay so because trauma gets stuck in the  body, the body must be treated along with the mind so it can release the emotions it is held on to  in the form of disease, bad habits, or reactive behaviors, two things so as we get ready to talk  about healing trauma it's helpful to understand what that looks like. There are basically two  ways to know when trauma has been healed.

Number one you don't rely on trauma related coping  strategies anymore. You feel safe enough that these self-protective behaviors or compulsions  or panic attacks or rage attacks or substance abuse or numbing behaviors or self-destructive  behaviors and passivity you feel safe enough that you're not doing these behaviors anymore. Okay the  second thing that shows that you're healed from or healing on the right path to healing from  trauma is that you're able to integrate both your memories and your body's sensations.

You can  have memories come up in your mind or sensations in your body and you make space for them and you  can calm yourself you can remember the past while staying here in your body in the present. Okay  there are three main ways to address and reverse the damage of trauma. Number one taking medication  to dial down some PTSD symptoms so that you can work through them and then number two working top  down through talk therapy, reasoning, and connecting with others and then number three working bottom  up by calming the body's physical sensations and letting it have those visceral experiences and  the safe visceral experiences that contradict the emotions of trauma.

We experience emotions in  the physical heart, in our torso, in our gut, in our muscles. So instead of accessing those stuck  emotions through the brain's cognition treatment needs to address emotions like anger and fear  and resolve them through the body. Most people need a combination of these options some of the  bottomup options are well known but others might surprise you and it's worth noting that van der  Kolk doesn't have a favorite treatment method.

He practices all of the treatments discussed in this  book depending on the specifics of the trauma and the person processing it. I like to think of it  as like a tool belt, you don't want just one tool you want to have a lot of types of tools that  can manage a lot of different situations. Okay, so let's talk about medications.

Medication can  be a powerful tool to help patients stay calm enough to revisit their traumatic experiences so  that the rational brain can integrate them. Some medications like SSRI, ketamine, and psychedelics  might even help the brain improve neuroplasticity, this is the ability to adapt and learn and grow. It's important to acknowledge that medication doesn't heal the trauma.

It's a tool that helps dial  down the intensity of our emotions so that we can do the work little by little and process through  the trauma. The point is to eventually get the body grounded in the calm and safe present so that the  brain can revisit the past and work through it and then integrate it by letting the body take those  fight or flight actions that it couldn't take during the event that caused them and then that'll  take you through that whole nervous system cycle to return to a sense of calm. So when the author  starts working with a patient, he helps them to first recognize the sensations in their body.

He  wants them to recognize and name what anger or fear physically feel like. So for example you might  feel tingling or tense muscles you might feel your gut is churning or you might feel hollow inside. He also helps them recognize and name like happy or relaxing or pleasurable sensations like oh my  muscles feel sleepy or my chest feels open.

Right? And this is this is a type of mindfulness exercise  and this helps strengthen in the medial prefrontal cortex. So sensing naming and identifying what's  going on inside the body is the first step to connecting the trauma in the mind and body  to integrating it.

Okay so let's let's explore this body centric trauma healing by going back  to New York City in September of 2001. Knowing that people would need trauma therapy the experts  recommended that therapists primarily use analytic talk therapy or cognitive behavioral therapy these  were the gold standard treatments. But guess what almost no one showed up for sessions.

Dr Spencer  Eth, who ran the Psychiatry department at one of New York's hospitals was curious what survivors  had done instead to get help. So he surveyed 225 people who had escaped from the Twin Towers and  here's a list, in order, of what survivors found to be the most helpful in overcoming the trauma  they'd experienced: acupuncture, massage, yoga, EMDR. For rescue workers, massage was at the top of the  list.

Would you have guessed that acupuncture or massage could treat trauma? At the time, almost no one did. Some other modalities that were helpful included freewriting, art, music, and dance.

And these might  all be really surprising to those of us in the Western world where the emphasis is on science  and intellect. But in many other parts of the world therapy includes physical movement, breathing, and meditation. So for example Tai Chi and Chi Gong in China or rhythmic drumming in Africa or martial  arts in Brazil and Japan and Korea and yoga in India.

So let's talk about yoga for a minute we  know that healing happens when we integrate our current state of safety with our past bodily  memories. Better breathing improves problems with anger depression and anxiety. Yogis have a  connection to their bodies in which they feel wholly alive and safe.

But as van der Kolk learned  with his patients, yoga's poses can at first feel really Intense or scary for trauma survivors.   So when using yoga therapy he recommends that you just start really slowly and gently with an  instructor who's trained in trauma-informed care. So we know that healing happens when we integrate  our current state of safety like look around you the room you're in most likely safe.

If you're  watching this video you're pretty safe right now with we integrate that current safety with our  past bodily memories of trauma because our sense of self is anchored to our bodies we have to be  in tune with our bodies not dissociated or numbing. Yoga therapy helps patients get curious about what  the body is telling them rather than resisting and fearing its sensations. Practitioners focus on both  their breath and bodily sensations while leaning into physical stress and discomfort and then  once they can breathe calmly and stay physically relaxed, survivors have the ability to add in talk  therapy to process in their horrifying memories without freezing up.

I'm going to include three  websites down in the notes and also in that PDF download if you want that the author recommends  for yoga and mindfulness. Okay on to the next section of what helps trauma. So I've explained  what the book says about dissociation.

The author says that treatment for dissociation needs to  include attunment and mirroring to help the patient find his voice. So that's going to bring us  to two treatment options that might not sound like therapy but they are surprisingly effective. So  the first is what van der Kolk calls Communal Rhythms.

Basically this is music in a group setting and  it's great for teaching attunement. Attunement is the ability to notice what's going on with other  people and to connect with them. Rhythmic activity like drumming dancing and singing can help  synchronize brain waves regulate the nervous system and just promote this sense of unity and  safety.

Anyone who's been in a marching band or dance troop understands the unity that happens  when everyone attunes to the beat to create a great performance. Okay dramatic theater is another  wonderful place to find one's voice. Van der Kolk describes how participating in theater can help  trauma survivors work through their emotion with scripts.

It allows them to feel deeply but like  in a controlled setting so it doesn't get out of control. It's like because they're playing a role  through someone else there's a buffer to help tone down the intensity while still allowing them to  process their trauma. I think this is why a lot of us like to watch movies or read books that make  us feel something because it helps us process our own emotions too.

While more research is needed  to understand how theater can help with trauma healing, van der Kolk says it's a pretty effective  tool for trauma recovery and at the very least he really strongly recommends that schools not  cut programs like drama, chorus, art, and PE that help kids who are dealing with trauma stay  connected to their bodies and their group of sick people. Okay on to the next treatment. You  might have heard of EMDR which is short for eye movement desensitization and reprocessing.

EMDR  helps survivors process traumatic memories to make them less distressing. The researchers believe that  EMDR reproduces what happens in deep sleep. During deep sleep there's a stage called REM, Rapid  Eye Movement and while you're sleeping your eyes literally move side to side, like this.

During this sleep stage the brain is processing memories and information from the day but without  intense emotions. So it's basically integrating those memories and filing them away. more time  in REM sleep reduces depression and helps people work through tough emotions but unfortunately  for people with PTSD those memories of trauma are often so intense that when their brain, when  they're sleeping, when their brain is trying to process those memories and file them away, the  memories instead come up as intense nightmares with strong emotions and then that wakes the person up  interrupts their sleep and interrupts the emotion processing.

It's like when you clean your room  sometimes it gets messier before it gets cleaner. Having PTSD makes it so you get interrupted in  the middle of cleaning your room every time and that mess just stays there and gets worse. So this  is often what makes PTSD memories and flashbacks worse.

The creator of EMDR, Francine Shapiro, found  that when she processed painful memories during the day, while also moving her eyes side to side,  those memories weren't as painful anymore. So she created a systematic treatment approach that helps  PTSD patients use bilateral movement to help them process through the memories and now EMDR is one  of the most effective evidence-based treatments for PTSD. So this is not just woo woo.

They've  run a ton of studies on EMDR. They found it to be pretty darn effective. Okay.

Oh and the way it works  is in therapy, the patient recalls distressing events sometimes or brings up distressing memories  they don't necessarily have to talk about it but they're doing some kind of bilateral move movement  like watching a moving light on a bar or tacking their hands on their legs. The patient doesn't have  to talk about the details of the traumatic memory but the patient might report what feelings  or reactions come up with the memory and interestingly EMDR can help even if the patient  doesn't fully trust the therapist. One example in The Body Keeps the Score was of a woman who was in  a car accident and her young daughter was killed and despite trying talk therapy she just was  experiencing debilitating symptoms but after a few sessions of EMDR like she no longer had PTSD.

So  research shows that EMDR significantly decreases PTSD scores and it performs more effectively than  a placebo or Prozac. It cured 60% of patients and it decreased depression scores but adults with  a history of childhood trauma or people who experienced repeated trauma instead of a single  instance do not respond as well to treatment. Okay so that's EMDR.

Let's talk about neuro feedback, it's another therapy that needs better research to know how to apply it but it's used for treating  trauma. It's pretty promising. In a neuro feedback session, a patient wears a cap or another device  with electrodes and those electrodes measure your brain waves and then it works with the computer so  that you can get a little bit of feedback which is like a little dopamine reward.

So when your brain  waves are calmer or healthier, like something good happens on the screen, whether that's one of the  ones I used it was like an arrow shot into the target when you were there like you were aiming  an arrow. Other times it just it gives you other types of like feedback like good job you're doing  it, you know, you're there. You're in this brain wave pattern and so basically what this does  is it trains the brain to relax and get good at making like the healthier brain wave pattern. 

For patients with PTSD their brain repeatedly fires circuits that keep them stuck in fear, shame, and rage but if the patient's brain can be trained to relax they're mentally more resilient and  they can work on integrating all the ways that trauma is recorded. The book shares the story of a  woman named Lisa for whom neuro feedback was the key for her to heal from trauma. But Lisa had been  abandoned by her father and physically tortured by her mother.

As a teenager, she spent time in mental  hospital shelters, foster families group homes, and living on the street to escape her mother. As  an adult she was stuck in a dissociative state and talk therapy did nothing but put her into a  panic. When she started neuro feedback therapy Dr Seburn Fisher started by rewarding the healthy brain  waves in the fear center of Lisa's brain and after a few weeks Lisa noticed that some of her constant  fears dropped away and she was more relaxed around people and then after 6 months of treatment she  stopped dissociating and she started gaining her sense of self and I really love the way that she  describes it.

Let me show you. "I can now actually talk about the things like my childhood. For the  first time I started being able to do therapy.

Up till then, I couldn't calm down enough. If you're  still in it, it's hard to talk about it and I wasn't able to attach in the way that you need  to attach and open up in the way that you need to in order to have any type of relationship with  therapist. " When explaining what life is like for her after neurofeedback she said, "I'm not held  hostage by my feelings.

I'm not in fight or flight all the time. Neurofeedback freed me to  live my life the way I want to. " And Lisa went on to graduate from nursing school and as of the  publication date of this book she worked as a nurse at a hospital.

Okay, the next type of therapy  for PTSD is internal family systems therapy or IFS. In the future, I'm really hoping to make a video  on this topic but here's a quick summary. IFS works with the idea that we all have different  parts inside of us.

You might have a playful or adventurous part of you, a short temper part of you,  and a friendly and relaxed part of you. You might have a protector, you might have a devious part of  you, and basically IFS is similar and that it calls the different parts of a person's personality  their internal family. Now if this sounds familiar that might be because the movie Inside Out was  based on this type of therapy.

So for trauma survivors, their internal family parts all work to  hide or to manage the part that is hurt by trauma. In IFS therapy, the mindful self learns to take  charge. The mindful self is the calm, undamaged essence who can lead the other parts to healing  by taking care of them.

The other parts can come to trust that the self will handle things well and  this creates self-compassion within the person. So the way the book puts it, "the self is like an  orchestra conductor who helps all the parts to function harmoniously as a symphony rather than a  cacophony. " And there's plenty of research showing that IFS is an effective treatment for PTSD.

Okay  here's another thing I think is really important. When it comes to trauma treatment, people need to  actively participate in their healing and not just be a passive patient accepting medicine. Van der Kolk says, "Being a patient rather than a participant in one's healing process separates suffering  people from their community and alienates them from an inner sense of self.

" Healing from trauma  is a process not an event and you'll probably have to keep trying new things, learning and  growing through your experience rather than simply be healed by a single intervention. This is  why I think it's important to educate yourself by watching videos by professionals or reading good  books like The Body Keeps the Score. Also you just can't do it alone.

Community is for a person to  heal. For children, the presence of attuned and responsive caregivers is crucial and adults  also benefit from healing in the context of relationships. I think that's why groups like AA  or veterans groups or religious communities and of course, your family and friends can all provide  the physical and emotional safety needed for a person to process their trauma.

Research shows that  one of the first things people do when facing a severe threat is to look around for someone to  help them. When we're enveloped in the love of a parent a spouse or another protector, their body  can return to a sense of safety. Loving, attuned relationships can even prevent a traumatic  event from becoming trauma for that person but when it's the caregivers who create the  trauma, patients rely on their relationship to their therapist.

So they need to know that their  therapist cares about them as a person. One of van der Kolk's teachers taught the job of a therapist  is to help people acknowledge experience and bear the reality of life. I also hope that all of you  can develop strong relationships with a support group, a faith community friends and family but  a therapist just might be the first person in your tribe.

Okay so there's a bunch of ways that we  can treat trauma. Okay now, let's talk about my big three takeaways from The Body Keeps the Score. First, it's helpful to remember that a mental illness cannot be defined as precisely as most  physical illnesses.

Therapists, doctors, teachers really everyone needs to recognize that a bunch  of behavioral problems probably have trauma at their root. For example, a patient diagnosed with  bipolar disorder because of her mood swings or depression because of her despair or ADHD because  of her lack of attention, this person could be medicated to treat the symptoms for all of those  things. But a good therapist is going to look at the whole picture and evaluate whether there's  an underlying trauma that needs to be healed.

I'm not saying that all those conditions  are caused by trauma. I'm saying sometimes the behaviors that look like those conditions  are actually rooted in trauma. Okay number two, there are a lot of ways to heal trauma and most  survivors need a combination of those methods.

Van der Kolk groups them into six categories: dealing with  hyperarousal, medication, yoga and rhythms help here, mindfulness, slowing down to bring self-awareness  to how the body is doing when the brain thinks about past trauma will help process the trauma, relationships, connecting with others who provide physical and emotion safety to process the trauma, sensory integration like communal rhythms and playing together in groups help restore attunement  to others and self. Physical touch and body work so methods like therapeutic massage, cranio-sacral therapy, these help release emotional tension and help a dissociated person wake up to the parts of  the body being touched let the body take action. Survivors who are forced to submit or be still  when abused or attacked need to be able to act on the physical impulses that they couldn't take  in the middle of trauma.

They need to, in a safe and healthy way, be able to hit, push, or run away  which takes me to my third takeaway. There really is so much we can do to heal from trauma. One  of my favorite anecdotes from the book is about a woman whose childhood was filled with abuse.

She enrolled in what's called a model mugging program, which teaches women to recondition their  freeze response and turn fear into fighting energy. So shortly after finishing this program this  college student was walking alone when three male attackers jumped out of some and demanded  money. Her new response was to take a karate stance and yell back at them, "Okay guys!

I've been  looking forward to this moment who wants to take me on first? " And all three attackers run away. So  I love this.

It's a wonderful example of how a person can be empowered through their trauma. We  can process trauma in such a way that the brain stays online. We can stay connected to language  and story and the body can stay calm all at the same time.

If this video feels overwhelming to  you like maybe you're feeling overwhelmed by all of the impacts of trauma on the brain brain  and body or maybe you're feeling overwhelmed by all the work that that might need to be done to  heal from trauma, I would just say take a breath. You're okay. Let's just do one thing at a time.

So if one thing from this video stood out to you, like write that down and think how can I  do a little research on this topic? How could I learn about this? Maybe I could watch a video on  this or who could I reach out to on this and just work on that one little step.

Okay? And I really  believe if we do tiny steps one at a time, little by little, we'll get a little more energy. We'll get  a little healthier.

We'll get feeling a little more secure in our own bodies and that's going to give  us more energy to take step number two. Okay I really believe trauma can be can be treated effectively.  Okay, so what did you think of this book?

I really liked it. When it was published back in 2014, van der  Kolk said that "we are on the verge of becoming a trauma conscious society. " And I think this book  has contributed to our society talking about what was once taboo and ignored and I think that's  a really good thing.

I still wouldn't recommend this book to everyone because there are a lot of  triggering stories but I would recommend it to school teachers and other caregivers or those who have  friends or loved ones who are dealing with PTSD. You'll come away with a good understanding of  how deeply trauma affects the whole person and if you do know a trauma survivor who could  benefit from therapy, maybe consider sharing this video with them so that they can see that  there are a lot of options for healing trauma. Hopefully at least one of the treatment methods  that I've mentioned will click for them.

I also have a PDF download with a list of the different  therapy methods from the book so you can print that off and talk with your therapist about  it and other options that are available for you in your area. Okay lastly if you'd like to learn  how to regulate your nervous system I've got a free online course, Grounding Skills for Stress, Anxiety, and PTSD. You'll learn to work through that fight flight freeze response and return to a state  of calm and again the link is in the description.

Okay if you're living with the effects of trauma I hope  this video helps you know what your next step toward healing could be because healing really  is possible. Thank you for watching and take care.