A father and daughter in a conversation with each other about parenting stuff and about the parent ‘screwing up’ the child… that must be interesting, right? Well, it is, especially because in this case, it is not just a random parent-child-couple, but dr. Gabor Maté and his daughter Hannah. They are the ones who share their wisdom with us in this almost an hour long Instagram Live-session.
Following up on our review of ‘The Wisdom of Trauma’ last week, we are pleased to share with you this father-daughter talk. They pick several of an abundance of questions asked by those present and we see a loving interaction between the two of them. Maté points out that as soon as we start asking questions about how to heal from trauma, we are already on the healing path, or we would not bring up the issue. He encourages everyone to trust that process and continue on that road, not towards perfection, but towards awareness.

These are the questions from the audience that they speak about together:

• Will there be an update of the book ‘When the Body Says NO’?
• Is there any trauma-related research you can share to prove that trauma is actually a thing?
• What is the best thing I can say or do for my daughter who was sexually abused between 2 and 6 years old and is 14 now and  who is seriously suicidal?
• How can mothers/parents forgive themselves and take responsibility for creating change in the environment the child grew up in?
• Can you touch on and explain the difference between trauma and disturbed/non-attachment in infants? Are presentations the same? Are healing processes different?
• How has the pandemic affected addiction and alcoholism?
• Do you have tips for enmeshed families and for healing unconscious relatives in denial?
• Is the main reason for mental illness in the neurotransmitters and their genetic characteristics? Is it correct that trauma is not the main reason?
• Safety is not just absence of threat, but also the presence of connection; how can you learn to be present in connection?
• What are the tools to connect to and feel safe in the present moment?

(A funny moment, where Hannah suddenly understands an explanation and dad is surprised to have actually taught her something!)

Every time, for all questions and cases, the advice seems to be similar in a certain way in the sense that Maté keeps motivating everyone to work on their own trauma, as no one can solve someone else’s issues. The harder you push, even if it’s in the ‘right’ direction and with honest intentions, the more resistance you are likely to meet with. With regard to parents and how they communicate with and are present (or absent…) for their children, it is important to realise that there is always a difference between ‘acts of abandonment’ (by the adult) and ‘experience of abandonment’ (by the child). Most often, the parent does not harm or emotionally abandon the child on purpose, so the child may have the experience of abandonment without the parent consciously abandoning the child and although for the child the result may be the same, this makes a huge difference with regard matters of guilt. It does not mean, however, that the parent should not take responsibility for what happened; acknowledging the child’s pain is actually a crucial thing to do. As Gabor Maté says somewhere in the session about something the parent feels to have done to their child: ‘It happened through you, but you didn’t do it in any conscious sense. You cannot be blamed, but you can take responsibility for it.’ This addresses the ever present issue of shame and blame and guilt. Trauma, he explains, keeps us from being present around the ones nearest and dearest to us, to really see and hear and feel them, and this is the heart of healing from trauma: moving into connection with your authentic self in the present moment and thus healing from the wounds you carry inside up until this very day as a consequence of what happened to you in the past.

We hope you enjoy this father-daughter-session in which they addressed questions from a live audience. We will keep you posted, if we come across another one!

One month has passed approximately after we, at ACE Aware NL, watched ‘The Wisdom of Trauma’ and, after letting it sink in for a while and after discussing the film’s best moments and its strengths, it feels like a good time to write a review about it.

The 1.5 hour film is made by Zaya and Maurizio Benazzo from Science and Nonduality. It was provided on a donation-basis screening that gave you the opportunity to access the film for 7 days, and (with an upgrade) watch discussions by professionals such as Stephen Porges, Fritzi Horstman, Esther Perel, Peter Levine and many more. There is also a very active Facebook group with many interesting discussions and a lot of networking.

Dr. Gabor Maté is probably one of the most outspoken and quoted trauma writers. He has been invited to many events, conferences and festivals around the world. If you perform a Google search, you can find an incredible number of his appearances on screen. In this film, you will encounter most of the themes he addresses in his lectures and that he is well-known for. On top of those, he goes into deeper depths by sharing his ideas from decades of working in the trauma studies field.The way the film is shot and made, draws the viewer into the stories that are being told; with Dr. Maté in the lead and in the voice-over, we are provided with the insights of people from all walks of life who work and live using the principles of his books and lessons.

The title refers to two forms of wisdom:

• the mindbody has a lot of wisdom in dealing with adversity; coping strategies and behaviours caused and triggered by trauma usually show the person’s wisest way of surviving under difficult circumstances and are not a sign of them being ‘faulty by design’;
• the wisdom we gain from going through trauma, gaining insight and healing from it can be used to support other people in their healing journey.

In the film, we get to know more about the way he works with his clients, about his approach of respectfully asking for their history (a method called ‘compassionate inquiry’), and his relationship with his wife Rae Maté. They both speak with sincere openness about the turbulence but also about the love and connection they have shared ever since they met in 1967.

The part where we get to know the couple better is quite moving in its candour. We see a man very much oriented towards knowledge who tries to learn to integrate his vulnerability as a strength, and we see a woman who, as an artist, is very much in touch with her intuition and who tries to learn to respond in a balanced way to her partner, integrating her own pain with that of a man affected by intergenerational and personal trauma resulting from the holocaust. They admit having had rough times, but have found ways to, instead of acting out their traumas by arguing or withdrawing from each other, coregulate and heal reciprocally. In a later shot, we see them walking side by side in the park – an elderly, wise, and deeply connected couple.

Outstanding, impressive moments

We like to share with you what, for us, were really impressive moments in the film.

• Early on, we see Fritzi Horstman, founder of the Compassion Prison Project. Prisoners in the jail yard are in a huge circle and are asked to ‘step inside the circle’, everytime they have to answer with a ‘yes’ to the questions Fritzi asks about humiliation, punishment and trauma they experienced as a child. Watching them realize how much they share in terms of early life adversity and childhood trauma and how they need the support of the community around them (represented by the circle) in order to heal, is both chilling and heartwarming.
• Somewhere in the last third of the film there is a really funny scene, where Maté responds to a question with a hilarious answer filled with self-mockery. We’re not going to spoil it; you will notice, for sure!
• Several people tell about their own lived experience; these moments piercingly illustrate the impact of early adversity or neglect. Addressing the issue of losing connection to the self and the ‘meaningfulness’ of the pain it causes, one of them replies to Dr. Maté: “You’re telling me that having that pain showed me deeper inside of myself how I was abandoning myself.”

The film’s strengths

• The lack of commentary lets you hear the people talk about their trauma, while the camera focuses on their hands, their eyes, their personal space and their artsy, symbolic, or day-to-day belongings.
• Seeing compassionate inquiry in action is very revealing. Maté has developed this way of gaining understanding about a person’s life experience of trauma and of their childhood, while leaving them in charge of what and when they want to share and inviting them to look at these elements with compassion and understanding of how it helped them survive. Most addiction behaviours are a solution to a much deeper, underlying problem. Compassionate inquiry shares some similarities with motivational interviewing and non-violent communication. However, it is focused on uncovering trauma and helping the person find the root cause of their struggles, usually in a past, traumatic experience or the person’s upbringing.
• The core message of the film is this widely shared quote from Gabor Maté: “Trauma is not what happens to you; trauma is what happens inside you as a result of what happened to you.” In the trauma-informed approach, professionals ask “what happened to you?” as a starting point to explore a person’s coping mechanisms to stress, behaviours that cause them health problems. In this film, Gabor uncovers another layer to this important question: it’s not the event itself that traumatizes the individual; it’s the impact inside their body as a result of that event.
• The film explicitly addresses the importance of sensitive parenting and for example, the importance of not letting babies and infants cry-it-out without any consolation. It is summarised in this quote: “Children don’t get traumatised because they get hurt; children get traumatised because they are alone with the hurt.”
• The film does not stop at the personal level, but also addresses big issues, like the influence of patriarchy, of capitalism and globalised materialism that often feed competition and prestige and lead to stress that increases the risk of people feeling unworthy and falling short. The link is intriguing: if we lose the connection to our authentic selves (the essence of trauma) and come to experience the world as a dangerous, horrible place, this will inform how we will approach the world around us: aggressively, suspiciously, cunningly. People acting this way, often get rewarded with power, which makes the vicious circle start all over again. Separating the mind from the body and the individual from the environment, still a very dominant approach in medicine, is what we should get rid of in order to heal the world, Maté says.

Conclusion

The makers kindly provide another donation-based screening of the film on July 28th till August 1st. So… if you want to watch the film… grab your chance! You can find the film’s details for registration and information here: https://thewisdomoftrauma.com/
Below, you can find the trailer from the film.

More than a question turned into more than just a book!

That all-important phrase… ‘What happened to you?’ (as an inviting, compassionate alternative to ‘What is wrong with you?’) is gaining traction as the guiding question with regard to understanding health issues. In this seminal book, authors Bruce Perry and Oprah Winfrey engage in a long and fascinating dialogue, interspersed with illuminating monologues, in which they address the many faces of trauma. On one of the last pages of the book, Oprah refers to a guest from one of her shows: “She said that until you heal the wounds of your past, you will continue to bleed. The wounds will bleed through and stain your life, through alcohol, through drugs, through sex, through overworking.” In a nutshell, this is what lingering trauma is about and why dealing with it appropriately deserves more societal attention. Although there are many definitions, it is important to realise that trauma is much broader than, for example, being raped, witnessing murder, or fighting a war. The book is a treasure trove of real-life lessons of how things can go wrong in any human’s life. Fortunately, Perry and Winfrey also help us gain insight into what can be done towards healing, partly by diving into what is needed for healthy development.

In this review, the aim is not to do full justice to all the wisdom the authors share with the reader; that is too high an aspiration. Instead, we would like to give you an impression of what to expect and what can be gained from the book. We could hardly put our pencils down while indicating beautiful one-liners and catchphrases. Also, there are a myriad of concepts applicable to the work of raising awareness regarding the impact of childhood trauma and we will certainly return to those in due time. We noticed numerous valuable ideas with profound policy implications.

The book is published as a hard cover with a tender summer blue, mixed with soft tones of green. It has 10 main chapters, apart from the introduction and annexes, beautifully built up. Each chapter starts with an illustration, depicting the chapter’s theme in an abstract fashion on the left, followed by its title on the right, a meditative cloudy page on the left and a gripping story on the right again, the authors taking turns. After each introduction, the dialogue continues, with Winfrey’s words and questions in blue, Perry’s stories and answers in black. In total, there are 11 visuals explaining the basics of neurophysiology and stress regulation. Throughout the book, they are being referenced where applicable for the reader to return to and get a good grasp. What would have been helpful is a detailed index so one can easily find back certain concepts and terminology; maybe it can be added in a next print run.

Another merit of the book and something that makes it stand apart, is the fact that it is written in a conversational manner. Not only does that make for an interesting read, it also helps even the uninitiated reader understand how trauma occurs, how it can affect a person’s life even decades later, and what healing from trauma looks like. In the dialogue, after Perry explains a complex neurological concept, Winfrey responds by asking questions that a lay person may have, to which Perry responds with even more depth. Storytelling and sharing the lived experience of trauma is a means that can help readers understand trauma and its impact in an accessible way. The way these two authors handle this approach, gives the material profound and impressive authenticity and depth.

Image of Table of Contents used with permission from www.neurosequential.com

From the many noteworthy topics, we have made a selection of themes that we feel carry a world of insights underneath and are helpful in provoking paradigm shifts. These themes deserve to have those with the lived experience as their audience, as well as those in positions of professional expertise, policy making, and political power. The book aims to address ‘anyone with a mother, father, partner, or child who may have experienced trauma’ (p. 10). Of course, many of us will be in several categories at the same time, which makes this material all the more relevant.

Some theory

The core of Dr. Bruce Perry’s work is in the concept of neurosequential programming, meaning that the brain and its neurobiology get built from the bottom up, from simple to complex, from the brain stem up to the cortex: we feel before we think (p. 27-29). All those early experiences build our ‘world view’ and create setpoints for our stress regulation, with the first year of life having a disproportionately large impact. If, in that life stage, someone has too many experiences of being unseen and unloved, neglected or abused, their healthy development is at risk. If we experience too much toxic stress (as opposed to healthy stress and tolerable stress with buffering protection from stable adults), we become dysregulated. Our neurobiology gets sensitised and becomes ‘overactive and overly reactive’, which leads to dis-stress, dis-comfort and can result in dis-ease and dis-functioning on many levels. Also, it damages our view of others as safe, predictable and caring. This can have huge implications for how we approach relationships and life’s challenges. We may start seeing the world through a ‘prism of pain’ (p. 97) and develop a deep sense of unworthiness (p. 98). To soothe it, a flight into addictions may seem the solution. Marginalisation, humiliation, shaming, and emotional abuse are all part of ACEs, ‘adverse childhood experiences’ (p. 103). Dr. Perry righteously points out, however, that ACEs are not a diagnosis, not the ‘prolonged exploration required to truly understand [someone’s] personal journey’ (p. 108). They do increase the likelihood of struggle later in life, though, depending on their duration, intensity and timing: ‘Adversity impacts the developing child. Period’ (p. 191).

Importance of nurture and connection

Seeing that buffering protection is crucial to prevent stress from turning into toxic stress and trauma, the importance of nurture and connection becomes obvious, throughout life, but especially in the early years. If a child experiences coregulation and connection, it can build resilience, which is, contrary to the often held belief, not an innate quality. There is ‘neuroplasticity’ (brain malleability), but this can go either way. This means that resilience is a potential that requires healthy relationships. It cannot flourish in ‘relational and emotional starvation’ (p. 266). Therefore, caregiving and parenting quality really matters for the child’s wellbeing and there are a number of great concepts in the book further explaining and illustrating that. We mention three important ones:

• regulate, relate, reason: first downregulate stress, so you can get the relationship right, and only then the cortex becomes accessible for reasoning and learning (p. 142);
• relational poverty: not having enough adults around to take care of children’s needs (p. 201);
• sociocultural evolution: learning from our elders and transmitting abstract (cortical, so very human) things like values, beliefs, skills, hopes and dreams to the next generation not through genetic inheritance, but by example and through intentional instruction, which means we can proactively influence what we hand down (p. 129-131).

Those who can create holding space for us (p. 114) and can apply ‘reflective listening’ (p. 197) and ‘empathic fluency’ (p. 259) help build safe spaces where we can experience a true sense of belonging.

From hurt to healing

If the pain is there, how do we soothe it? It all comes back to loving relationships: ‘Everything matters’ and ‘belonging is biology’ (p. 137): our sensory organs and brains translate experience into biological activity of the body (p. 137). Brain and body are always inextricably connected in these perceptions, so, Perry states, a dualistic approach of health fails to do justice to this connectedness and is dismissive, as it only addresses symptoms. If we understand that ‘the relationship is the superhighway to the cortex’ (p. 144) and that ‘if we don’t feel safe, we become dysregulated’ (p. 148), we know what we can do for ourselves and those around us: be there for one another, because ‘neglect is as toxic as trauma’ (p. 159). If we no longer ask ‘what is wrong with you’, but understand ‘what happened to you’ (and to us, for that matter), we can start learning to look at health in a different way. We can learn to see our own and other people’s behaviours and illnesses in a non-judgmental and compassionate way, as a result of our efforts to survive difficult circumstances. As Perry humbly explains about his own process of becoming more competent in supporting people: ‘[W]e kept listening and learning’ (p. 151), something all of us can do.

Perry does see an issue, however: ‘Science gathers knowledge faster than society gathers wisdom’ (p. 257) and ‘many policy recommendations are made with good intentions but with minimal understanding of the developmental needs of children’ (p. 267). This is an appeal to all those professionals working with young ones (or with the inner children of the older ones!), because ‘many people feel incredibly relieved when they understand how their brain works and why’ (p. 283). If we manage to heal from the trauma we experienced, we can develop ‘post-traumatic wisdom’ (p. 200), wisdom that comes from the hardship we endured and the healing we went through.

In summary, ‘What Happened to You?’ is an amazing read, a guaranteed page-turner. It is an impressive addition to the field of trauma studies. Published in English just in April of this year, it was already a New York Times best-seller in May and included in Amazon’s best science books for 2021 so far. It is translated in Dutch and published this month by Spectrum.
Our pasts, especially if we have experienced trauma, shape the way we interact with others, form relationships, and live our lives. This book helps trace and piece together all these experiences that formed us, while showing us many ways to healing. Whether you or a loved one have experienced adversity and you are trying to understand more about yourself and others, or whether you work in healthcare, educational, judicial, and other professional settings, this book is a must read. The idea of developing post-traumatic wisdom is a very hopeful and encouraging thought. We wish all readers great strides in that process with the help of this book!

Last week, we dealt with Parts 1, 2, and 3 of the book ‘The Body Keeps the Score’. In these parts of the book, Van der Kolk discusses how science started including trauma in medical diagnoses, how neuroimaging allowed us to see the effects of trauma on the nervous system, and the impact of trauma and attachment styles on the way we develop into adulthood.
This week we will dive in deeper on memory formation after exposure to adversity or trauma  and ways of healing from trauma, especially in relation to Van der Kolk’s subtitle of the book: ‘Mind, Brain and Body in the Transformation of Trauma’.

Part 4
Part 4 is all about remembering the trauma. Here, Van der Kolk provides a detailed illustration of how society perceived narrative versus traumatic memory from the 19th century onwards. He explains the difference between the two forms of memory. On the one hand, people might be telling about the traumatic events they went through (which can be hard, but also allows for reshaping what happened depending on who is listening). On the other hand, people might be reliving the traumatic event (repeatedly and while feeling trapped in that moment or situation). In the traumatic memory, people might dissociate (understood as a process of mentally escaping or detaching from an experience or a memory), or form a second self (understood as losing the connection with your authentic self). In essence, the difference between the two is that the narrative memory gives one a sense of control over the story’s unfolding, whereas the traumatic memory focuses on the embodiment aspects of the experience.
Together with the analysis of these concepts, the author touches upon the problem of misdiagnosis, using as an example the diagnosis for ‘hysteria’ in women during the 19th century. These women were, in hindsight, clearly suffering from trauma-related disorders. He repeatedly mentions the theme of the reluctance of society at large to talk about trauma, and more importantly, to listen to the survivors.

These two topics, memory (narrative and traumatic) and society’s reluctance to talk about trauma, are interconnected. On the one hand, victims strive to forget trauma, because it’s too painful to realise that other people can be so violent or inhumane as to inflict trauma, or that the world can be so chaotic, scary, and cruel. It can make you doubt the foundation under your existence or it could make you create multiple selves or realities in order to cope with this loss of security and Sense of Coherence (SoC). On the other hand, society at large prefers to view trauma as being the exception and the rest of the world being safe and orderly, because acknowledging the trauma is somehow proof of sociocultural practices being problematic. It can mean that something in the status quo has to change, which is uncomfortable, because systems tend to strive for continuity and stability, not so much for change. Both keep one another captured: the individual has a hard time telling their story because society has difficulty hearing it, and society has a hard time acknowledging the trauma because the system has difficulty adjusting to a new approach or a new paradigm altogether. To the end of this part, we find this quote that both summarises how these two are connected and how we can move on to healing, which is dealt with in Part 5 of the book.

“Nobody wants to remember trauma. In that regard society is no different from the victims themselves. We all want to live in a world that is safe, manageable, and predictable, and victims remind us that this is not always the case. In order to understand trauma, we have to overcome our natural reluctance to confront that reality and cultivate the courage to listen to the testimonies of survivors.”

Rembrandt van Rijn: Christ healing the sick. Gestures of comfort are universally recognisable and reflect the healing power of attuned touch.

Part 5
This is one of the most powerful and optimistic parts of the book. In these last eight chapters, Bessel van der Kolk shares decades of research and his experience in working with professionals from all over the world in research settings, community centers and school environments. He describes the mindset shifts, the strategies and the methods he has found useful in treating trauma. He acknowledges the fact that your body, your mind, and your soul store the sensations you experienced during certain events. That means that the past cannot simply be erased, because there is an embodied memory of what happened. That, however, does not mean that no progress in healing can be made; you really can reduce the sense of fear, alertness or fog in order to not constantly remind you of the trauma or make you dissociate. He discusses a few goals one can set on the journey to healing, such as using calming practices and learning to be present in the here and now. Loving, secure, and attuned touch can play an important role in this process, as it helps co-regulate each other’s nervous systems.

The chapters in Part 5 are full of ideas for a person to face or help face their trauma, help express it in words, integrate their body in all the mental work they might be doing to resolve the trauma, and ultimately to rise stronger and more resilient.

Bessel van der Kolk

More detailed analysis
One of the biggest strengths of this book is that it manages to describe the path to healing without sounding cheesy or being full of cliches. Bessel van der Kolk’s writing is full of compassion, yet fresh with insights from his research and experience, that are brought to life by the real-life stories and speech fragments from his patients. This makes the material relatable, shocking at the layers of trauma a person can face; it is both humbling and empowering.
Another strength surfaces in Chapter 17 where Van der Kolk explains that the mind is the sum of the experiences and sensations the person feels. If one wants to heal their trauma, or help other people heal theirs, one has to be able to see the mind as a puzzle, with many layers of complex trauma. He has a fascinating story of Jane, who would have uncontrolled temper tantrums and feel guilty for her affairs with other people. Page after page after page, he documents their sessions using internal family systems therapy (IFS). By doing so, there are two things that we feel are perfectly illustrated. One, he shows how healing needs to happen in the context of a system and not just in people on their own (which would be a reductionist approach); and two, he indicates the complex face of trauma which involves shame and guilt, criticism and self doubt. This goes against the often still held perception that trauma is a one-time event leading to a single, defined personal issue that needs to be solved by the person alone, a sort of ‘you have to deal with it’ narrative. It is not always known how pervasive the effects of trauma are on the person as a whole, on behaviours and practices, on worldviews and social functioning. Such a multifaceted issue therefore requires  a multidisciplinary and open-minded attitude.

To sum it all up, The Body Keeps the Score is one of the most influential books in trauma studies and psychology, and rightly so. Van der Kolk explains the neuroendocrinology of trauma from different perspectives and the effects of trauma not only on the individual, but on society as a whole. He takes a critical view of the research and common medical practices and sheds light on the misdiagnosis or the lack of trauma diagnosis that exists (to this day) in different aspects of trauma. In line with discussing the role of society in trauma, he provides strategies and therapies to prevent and to heal trauma when and if it happens.
What he makes a plea for is really something we see advocated by many experts on the topic: for humans, being wired for connection, secure relationships with others are key in order to come to a healing process. It takes courage and compassionate curiosity on the side of both the one who lived through the experience and the one who creates holding space to truly heal as a community. This book greatly contributes to that goal.

In this blog, we will review a book by Bessel van der Kolk, a (Dutch-born) psychiatrist, researcher and author of the book, among others, ‘The Body Keeps the Score’. Since having been published in 2014, the book has become a best-seller and is one of the most prominent books about the effects of trauma on the biopsychosocial level, both for the person and for the society as a whole. He is also the founder of the National Child Traumatic Stress Network (NCTSN), which is a network of organisations and professionals in many different sectors of society that specialise in treating traumatised children and their families all over the US.
Although the introduction of his book feels like a curriculum vitae, it is very relevant to understand Van der Kolk’s work and the way he chose to present his ideas and arguments. He uses many real-life examples (fully anonymously of course to protect the identities of the families). He advocates multidisciplinary cooperation within communities, the same way he works with different professionals from around the world and at the NCTSN.
Per part of the book, we will give an overview of the main aspects dealt with.

Part 1
Part 1 is an account of how Bessel van der Kolk started researching traumas and it is almost an account of how the field of trauma studies and trauma research evolved to what it is today. He started his career working with Vietnam war veterans who experienced symptoms of PTSD. However, in the 1970s in America, PTSD was not yet an official diagnosis. Van der Kolk observed many veterans walking into the clinic with complaints about nightmares, panic attacks, rage, aggression, urge to drink or use substances and finding little support because of the lack of resources. As a way to offer them a form of support, he organised an informal group meeting where the veterans who felt unable to talk about their experiences (because of numbing or loss of words) started to share their stories within this social group. People felt supported, came back for a next session and continued coming to the meeting for weeks.
In 1980, he started working with another group of patients: child abuse survivors. He noticed that this area of study was just as understudied as the PTSD in veterans, and that there were similarities with regard to the symptoms that the war veterans were exhibiting. In the 1990s, brain-imaging technology helped scientists to see the effects of trauma in the brain and brought about a new understanding of trauma. Van der Kolk describes this as:
“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. We have discovered that helping victims of trauma find the words to describe what has happened to them is profoundly meaningful, but usually it is not enough. The act of telling the story doesn’t necessarily alter the automatic physical and hormonal responses of bodies that remain hypervigilant, prepared to be assaulted or violated at any time. For real change to take place, the body needs to learn that the danger has passed and to live in the reality of the present.” 

Part 2
Part 2 delves even deeper into neuroscience and the ways the brain and the body respond to toxic stress and trauma and how people do or do not make sense of their traumatic experiences. Two pictures and their accompanying stories are showing this quite strikingly, as explained below.

First, little Noam witnessed the World Trade Center attack on 9/11. He witnessed the first airplane crushing on the Twin Towers and the people falling to their death. The following day he made this drawing of what he had witnessed; in his drawing, however, the people weren’t falling to their death but on a trampoline (the black circle just to the right of the door). Van der Kolk explains that Noah was growing up in a loving family; his caregivers were calm and responsive. Probably, while the initial event created a flight response in Noam, in the safety and security of his home, he was able to make sense of the whole incident he had witnessed.

Second, Stan and Ute, a couple, had a horrible accident in 1999. Three months later, they were both suffering from flashbacks; they were tense, hypersensitive and irritable. They asked Van der Kolk’s team to have a brain scan. Stan’s brain showed that he was reliving the trauma over and over again, causing him to sweat, tremble and feel his heart racing. Ute’s scan was different; it showed that she froze everytime she was reminded of the event, which led Van der Kolk to believe that this came from some unresolved previous trauma that had conditioned her to dissociate.
Van der Kolk explains that traumatised people’s brains have a difficult time processing internal and external stimuli and tend to interpret some signals as threatening although the danger has already passed.

In order to point out the connection between mind and body, Van der Kolk mentions two famous scientists: Charles Darwin and, our contemporary, Stephen Porges.
Darwin documented the responses many animals have in the face of threat and he observed that when an organism is stuck in survival mode, they have no room for nurture or love. He explains this beautifully in this quote:
“If an organism is stuck in survival mode, its energies are focused on fighting off unseen enemies, which leaves no room for nurture, care, and love. For us humans, it means that as long as the mind is defending itself against invisible assaults, our closest bonds are threatened, along with our ability to imagine, plan, play, learn, and pay attention to other people’s needs.”
He then goes on to outline Stephen Porges’ polyvagal theory, as a theory that unifies the body with the mind and that can explain the body’s response to toxic stress and trauma.

Part 3
In Part 3, Van der Kolk closely examines early life experiences and the importance for children to form secure attachments with caregivers. If they do not succeed in doing so, a form of insecure attachment may develop. Generally, three types of insecure attachment are distinguished:

• avoidant attachment: when parents/caregivers are largely emotionally unavailable or unresponsive most of the time and the child feels emotionally distant and distrusting;
• anxious attachment: when the parents/caregivers are overconcerned, inconsistent, or unpredictable and the child can have strong mood swings;
• disorganized attachment: when parents/caregivers are a source of both comfort and fear and the child has a lack of confidence in self and others and feels very confused.

In the rest of Part 3, Van der Kolk discusses the Diagnostic and Statistical Manual of Mental Disorders (DSM) used to diagnose disorders by mental health professionals. He points out the problems with giving people a diagnosis of trauma (sometimes resulting in PTSD), without paying attention to the root causes of their health issues. He also mentions the slow progress the medical community has been making in recognising issues as a sign or symptom of trauma and then translating them into trauma-related diagnoses. He also discusses the results of the ACEs studies and how these are proof of a larger, hidden epidemic of developmental trauma, which, despite its prevalence, remains unclassified as a health risk, and has no formal treatments.

Next week, we will look at Part 4 and 5 and provide a short analysis of the book as a whole.