Body Keeps the Score- Warning (Don’t Miss This!)/What it means to “Be There”
The Body Keeps the Score by Bessel Van Der Kolk is the “go to” book on trauma and interventions in treating those who have suffered from horrible events. I thoroughly enjoyed taking the online course Dr. Van Der Kolk provides and learning the interventions and theories he proposes for a practitioner’s clinical use. Dr. Van Der Kolk has expertise in applying medicinal practice to psychology, this takes years of education and practice to learn. Van Der Kolk says of himself: “It took me many years to learn how to effectively treat flashbacks” [1] If we believe we are to “treat” (make therapeutic interventions) people with trauma, I believe we need to reconsider this notion. We must cautiously work with those who have been subject to traumatic events. The author warns, “When we encourage them (those suffering from trauma) to talk about the precise details of a traumatic event, we often inadvertently trigger a full-blown flash back, rather than helping them resolve the issue.”[2] How might we not cause greater harm to those we minister to? In this blog I will highlight what we, as students in our leadership doctoral program, might make use of what we learn from The Body Keeps the Score.
With this opportunity to explore trauma, I was excited to read at the end of the second chapter a closing paragraph of what the author titled Adaptation or Disease? The closing comments of this chapter give a hopeful prospect for those who will not become doctors specializing in psychotropic medicine but who are able practitioners in helping professions. Listed are four different points outlined in this closing paragraph; I will unpack three of these ideas in this blog.
The brain disease model overlooks four fundamental truths: 1) Our capacity to destroy one another is matched by our capacity to heal one another. Restoring relationships and community is central to restoring wellbeing. 2) Language gives us the power to change ourselves and others by communicating our experiences, helping us define what we know, and finding a common sense of meaning. 3) We have the ability to regulate our own physiology, including some of the so-called involuntary functions of the body and brain, through such basic activities as breathing, moving and touching; and 4) We can change social conditions to create environments in which children and adults can feel safe and thrive.[3]
Capacity to Heal/Restore Relationships and Community
There is hope for healing for those suffering trauma. Suffering is meant to be met by a loving touch, a listening ear, a watchful eye, encouraging words, a prayer for healing or intercession and a comforting presence. This healing comes in the shape of a person who is present, listening, and available. “Being validated by feeling heard and seen is a precondition for feeling safe.”[4] How do people come into relationships where this can take place? A relationship with Jesus Christ brings this healing. Listen to the words of Albert Ellis, a leading cognitive behavioral therapist, who does not profess to have faith: “I and some of my REBT colleagues have found that profound faith in God– especially in a kindly, forgiving God– or in other religious and spiritual ideas that I personally disbelieve, can definitely help some clients.” [5] A relationship with God is irrefutable.
As a Marriage and Family Therapist, I am focused on helping set therapeutic goals, similar to Van De Kolk who describes his clients: “physically reexperiencing the past in the present and then reworking it in a safe and supportive “container”(which) can be powerful enough to create new, supplemental memories: simulated experiences of growing up in an attuned, affectionate setting where (they) are protected from harm.”[6] A supportive “container” is only achieved in a relationship where a great amount of trust has been established. With a certain level of trust, clients may be willing to role play, which is practicing real life scenarios. “Role playing is a technique that can be used for a wide variety of purposes….uncover automatic thoughts, develop an adaptive response, and modify intermediate and core beliefs. Role plays are also useful in learning and practicing social skills.”[7] Working with traumatized clients involves providing a safe container where trust is built and interventions like role playing can be practiced.
Language gives us power when we communicate our experiences
It is difficult to conceive that “all trauma is preverbal.”[8] Trauma puts us in a place where we are at a loss for words. We can attempt to paint a picture for others, explaining what has happened, but this falls short of how things were truly experienced. Van De Kolk summarizes trauma well:
“Trauma by nature drives us to the edge of comprehension, cutting us off from language based on common experience or an imaginable past.” People can “come up with what many call their “cover story” that offers some explanation for their symptoms and behavior for public consumption. These stories, however, rarely capture the inner truth of the experience.”[9]
When people have lived through traumatic experiences, they need to have the opportunity to imagine what exceptions may have come to relieve or free them of the traumatic experience. Imagine asking someone who has suffered the worst experience you can imagine these questions: “What would you have wanted to happen to get out of that experience?” “What can you imagine taking place in order to give you a means of escape?” Making this connection for people and listening to them with hopeful attention will provide healing. “Miracles will always be partly based on hopes for the future and partly on experiences from the past.”[10] Reimagining unlocks the ability to heal.
Change Social Conditions to Create Environments to Feel Safe
We can encourage those who have been traumatized by promoting their relationship with God, building a safe relationship with them personally, and hearing their stories. There is power in “being there” for others. “Trauma almost invariably involves not being seen, not being mirrored, and not being taken into account. Treatment needs to reactivate the capacity to safely mirror, and be mirrored, by others.”[11] In addition to mirroring, recognizing people’s strengths and where they are currently finding success can be transformative, even among those who are unwilling to budge. Albert Ellis proposes five directives in helping clients who are resisting change in his book Overcoming Resistance. Most of these directives would not work well with highly traumatized people, but I found one to be inspiring: “Encourage their constructivism and their positive values of reconstructing their lives.” [12] Constructivism is the ability to construct or envisage life differently.
Van De Kolk outlines fundamental truths in working with those who have been traumatized. I believe he says it best in these words:
In order to change, people need to become viscerally familiar with realities that directly contradict the static feelings of the frozen or panicked self of trauma, replacing them with sensations rooted in safety, mastery, delight, and connection. Of course, we can never undo what happened, but we can create new emotional scenarios intense and real enough to defuse and counter some of those old ones.[13]
How might we help people be “welcomed into a world where people delight in them, protect them, meet their needs, and make (them) feel at home?”[14] This is my work. This is your work. I pray God leads us to help many out of their trauma.
[1] Bessel Van Der Kolk, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, 2014, p.16
[2] Ibid. p.19
[3] Ibid. p.38
[4] Ibid. p.303
[5] Albert Ellis, Overcoming Resistance: A Rational Emotive Behavior Therapy Integrated Approach, 2002, p.132
[6] Ibid. p.302
[7] Judith S. Beck, Cognitive Behavior Therapy: Basics and Beyond, 2021, p.334
[8] Bessel Van Der Kolk, p.43
[9] Ibid. p.43
[10] Steve DE Shazer, More Than Miracles: The State of the Art Solution-Focused Brief Therapy, 2021, p.41
[11] Bessel Van Der Kolk, p.59
[12] Albert Ellis, p.157
[13] Bessel Van Der Kolk, p.310
[14] Ibid. p.310
About the Author
Kristy Newport
12 responses to “Body Keeps the Score- Warning (Don’t Miss This!)/What it means to “Be There””
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Kristy,
I really appreciated your post. I still get a little nervous with heights after my construction accident. I get a severe pain in my neck and spine. I have also found this same result with intense situations having some same result in my neck and spine.
Do you have any recommendations?
Greg,
I responded to you privately as it was a personal conversation in response to the comments above.
I am looking at this verse today and loving the last line:
Deuteronomy 32:39
See now that I myself am He! There is no God besides me. I put to death and I bring to life, I have wounded and I will heal, and no one can deliver out of my hand.
My prayers will continue for you brother, Greg
God has done amazing things in your life and it is my hope that He will comfort you in your body, when you experience pain.
Kristy, due to your background in therapy, I am not surprised by the level at which you write about Van Der Kolk’s work! Great job! Are you seeing any connections or overlap with your NPO?
David,
I appreciate your question.
This makes me think that I need to look over VanderKolk and see if I might glean some information for my research. I will look into this! I am very interested in finding how Jesus may have helped those who had experienced trauma and what we may learn from His example. I believe we can learn from how Jesus healed people. He invited them to be apart of the process (pick up your mat). He touched people (put stuff on a mans eyes to heal him). He commanded demons to leave (the demons went into the pigs). When the one leper returned he asked where the others were and emphasized the need to be grateful and say thanks. There is so much we can learn from Jesus and how he helped people/healed people from trauma.
I am greatly benefiting from you asking the question you asked. I am eager to see if there are similarities in how Jesus communicated/healed and what treatment Van De Kolk recommends.
(I did not include Scripture references because I do not have time to note them here)
BTW-thanks for praying for me when we met over peer group zoom chat this last week. I need prayer!
Kristy, this is a seriously impressive post. Not surprising considering your passion for this field and your love for Jesus.
How do you spot a “cover story?” Do you see them often in your practice?
Kristy, great post! I confess a slight envy that you had an opportunity to take a class with Dr. Van Der Kolk! What a great opportunity! I am always impressed with your knowledge and attention to details in your posts. This is another fantastic example and I look forward to seeing you in the “hot seat” next week.
One of the most important lessons I learned about trauma was that I am not responsible for my trauma, but I am responsible for my response to trauma. How do you, as a therapist, help others acknowledge their responsibility to their responses and help them grow?
Becca,
I like your question about taking responsibility for one’s response to trauma.
Some of these ideas are not processed in a set order-
1) Acknowledge the loss/grieve the loss- I worked with someone today who was able to put some language to the loss of not being included and valued in her family. I validated the loss and also mirrored how painful this must be.
2) Explore- What action can be taken due to what has been discovered in the loss?
3) Identity- Who are they- apart from how the trauma has effected them? Create (client creates) the identity they would like to have
4) Forgiveness- Attempt to bring context (back story) to the lives of those who were apart of the trauma. How might a person have empathy to those who have been the cause of trauma?
*Note issues processed before forgiveness. Openness to forgiveness will be greater when other aspects are explored first.
I’d love to hear what your thoughts on this might be! Maybe in England :)!
Michael,
Great question on cover stories and how I have experienced these in the counseling office.
Here are some things I look for:
MASKING- People like to hide what really is going on (think of the garden of Eden) They like to hide behind excuses. Sometimes this is more apparent than other times. It depends how long and how skilled a person is at masking what is really going on. It is difficult to face the truth when the truth is painful. More times than not, anger is a mask for sadness. I am often asking myself: Where is the loss? This unmasks the anger, and discloses sadness. It is easier to be angry than sad (this varies with people)
DISMISSING- People can have the tendency to make issues “less of a deal”. This is a coping strategy. If a loved one is an alcoholic and they are enabling, drinking (some to excessive amounts) will be dismissed as “this is just something they do…”
DENIAL- People can deny that something is an issue again, because it is difficult to face the truth.
Clients who cut- often times the cover story is simply wearing long sleaves that cover the cuts/scars. They create a story of how they were hurt in a way other than cutting.
These are my initial thoughts
Thank you for those insights. This is extremely helpful for me. I look forward to more coaching in the future. It has to be so rewarding to help people overcome fears and doubts and find Jesus in all of it. Again, brilliant post. Well done.
Great job with exercising your expertise in the content of your writing. In my experience I have been very fascinated with trauma. How has treating trauma changed your life personally?
I have another question I was going to ask in our cohort session but we ran out of time.
From a business standpoint, where and how does Jesus fit into your practice and therapy? Is it something that is listed on your website and established or does Jesus come into play when the clients give permission? Do you get any resistance?
Kristy, Wow! This post is packed full of wisdom, insights, sensitivity, and care. It’s obvious you put a lot of energy into being present for people and listening carefully to their whole being. This post definitely needs some more conversation down the road! Whew, nice work.