The Body Keeps The Score

Every so often I buy a book, rather than get it from the library, because it demands underlining. 

Here are some concepts from Bessel Van Der Kolk's The Body Keeps The Score that I found interesting and want to remember:

Our brain stem and limbic system make up the "emotional brain" while the neocortex forms our "rational brain". When we have an experience, sensory information is integrated and filtered in the thalamus before passing to the amygdala, which lies in the emotional brain. The amygdala determines the significance of sensory information in consultation with the hippocampus, which sorts sensations by referencing past experiences. If a threat is identified by the amygdala, it will direct the hippocampus to release stress hormones and recruit the autonomic nervous system (which we can't consciously control and acts as an accelerator or expender of energy) to facilitate a whole-body fight/flight response. 

It takes slightly longer for information from the thalamus to travel to the rational brain. The rational brain contextualizes sensory data from the thalamus. It offers us a "view on high" of our situation and the capacity to objectively and calmly observe, predict, and consciously choose. The rational brain controls the parasympathetic nervous system which acts counter to the autonomic system, as a brake or preserver of energy. Its function is key to our ability to connect with others and care for ourselves outside of emergency situations.

So our emotional brain leads the charge when it comes to hard-wired reactions, while our rational brain (operating at a deficit because it receives information with a delay) facilitates our more thoughtful responses. When the emotional and rational brain work together in a balanced relationship, we feel healthy and like ourselves. When our emotional and rational brains are in conflict, this tension plays itself out viscerally in our bodies. 

Traumatic experiences change the threat-perception system in the brain. The amygdala looses its capacity to differentiate between the past and the present or recognize the possibility of a future. The trauma has a beginning, but no end, and is continuously relived. With each flashback, the imprint of the past trauma is engraved deeper in the mind. The thalamus shuts down and sensory input bombards the brain unfiltered. Dissociation, a physiological response to trauma, causes difficulty focusing and a blunting of engagement in life.

Shame floods in as a person looses their capacity to self-regulate, hijacked by a brain on high alert. Once the emotional brain sounds the body's alarm, no amount of reasoning or insight will silence it. And as long as a person is stuck in survival mode, their ability to imagine, play, learn, love, and nurture are deeply compromised. 

Debilitated when it comes to connection and growth, a traumatized person is vulnerable to feelings of irrelevance and alienation. Yet the body never stops trying to heal. As french psychologist Pierre Janet said, "Every life is a piece of art, put together with all means available."

The critical role of a well-functioning emotional brain is to initiate movement that will restore a person to safety and physical equilibrium. The word emotions comes from Latin and means "to move out". Thus, being able to do something to protect oneself is a key factor in determining if an experience will become traumatic.

Because of this dynamic, babies are particularly vulnerable to trauma. Research shows that infants who are not seen or known by their mothers grow up into adolescents who struggle to know or see others. Traumatic feedback loops are thus easily established between generations. Van Der Kolk believes that the gravest and most costly public health issue in the United States is child abuse.

In breaking cycles of trauma, he quotes Auden saying, "Truth, like love and sleep, resents approaches that are too intense." He relies on phrases such as "Notice that" and "What happens next?" when helping patients ease into and out of sensation. Van Der Kolk explains that terror and safety are incompatible and that people need to feel safe in order to let go of trauma. 

He underlines that people recover from trauma within the context of relationships-- in relationship with their inner experience, in relationship with their body, in relationship with others, and in relationship with their surroundings.

Understanding and applying the Buddhist concept of shenpa, meaning "biting the hook", may help us address the personal risk of being traumatized in our current political context.