The Body Keeps the Score PDF Book by Bessel van der Kolk


Click here to Download The Body Keeps the Score PDF Book by Bessel van der Kolk English having PDF Size 9.1 MB and No of Pages 504.

Trauma happens to us, our friends, our families, and our neighbors. Research by the Centers for Disease Control and Prevention has shown that one in five Americans was sexually molested as a child; one in four was beaten by a parent to the point of a mark being left on their body; and one in three couples engages in physical violence.

The Body Keeps the Score PDF Book by Bessel van der Kolk

Name of Book The Body Keeps the Score
Author Bessel van der Kolk
PDF Size 9.1 MB
No of Pages 504
Language  English
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About Book – The Body Keeps the Score PDF Book

A quarter of us grew up with alcoholic relatives, and one out of eight witnessed their mother being beaten or hit.1 As human beings we belong to an extremely resilient species. Since time immemorial we have rebounded from our relentless wars, countless disasters (both natural and man-made), and the violence and betrayal in our own lives.

But traumatic experiences do leave traces, whether on a large scale (on our histories and cultures) or close to home, on our families, with dark secrets being imperceptibly passed down through generations. They also leave traces on our minds and emotions, on our capacity for joy and intimacy, and even on our biology and immune systems.

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Trauma affects not only those who are directly exposed to it, but also those around them. Soldiers returning home from combat may frighten their families with their rages and emotional absence. The wives of men who suffer from PTSD tend to become depressed, and the children of depressed mothers are at risk of growing up insecure and anxious.

Having been exposed to family violence as a child often makes it difficult to establish stable, trusting relationships as an adult. Trauma, by definition, is unbearable and intolerable. Most rape victims, combat soldiers, and children who have been molested become so upset when they think about what they experienced that they try to push it out of their minds, trying to act as if nothing happened, and move on.

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It takes tremendous energy to keep functioning while carrying the memory of terror, and the shame of utter weakness and vulnerability. While we all want to move beyond trauma, the part of our brain that is devoted to ensuring our survival (deep below our rational brain) is not very good at denial. Long after a traumatic experience is over.

It may be reactivated at the slightest hint of danger and mobilize disturbed brain circuits and secrete massive amounts of stress hormones. This precipitates unpleasant emotions intense physical sensations, and impulsive and aggressive actions. These posttraumatic reactions feel incomprehensible and overwhelming.

Feeling out of control, survivors of trauma often begin to fear that they are damaged to the core and beyond redemption. While the majority of the veterans were greatly upset by what they saw, the reactions of the remaining five were even more alarming: They simply went blank. “This is nothing,” one observed, “just a bunch of ink.” The Body Keeps the Score PDF Book

They were right, of course, but the normal human response to ambiguous stimuli is to use our imagination to read something into them. We learned from these Rorschach tests that traumatized people have a tendency to superimpose their trauma on everything around them and have trouble deciphering whatever is going on around them.

There appeared to be little in between. We also learned that trauma affects the imagination. The five men who saw nothing in the blots had lost the capacity to let their minds play. But so, too, had the other sixteen men, for in viewing scenes from the past in those blots they were not displaying the mental flexibility that is the hallmark of imagination.

They simply kept replaying an old reel. Imagination is absolutely critical to the quality of our lives. Our imagination enables us to leave our routine everyday existence by fantasizing about travel, food, sex, falling in love, or having the last word— all the things that make life interesting. Imagination gives us the opportunity to envision new possibilities—it is an essential launchpad for making our hopes come true. The Body Keeps the Score PDF Book

It fires our creativity, relieves our boredom, alleviates our pain, enhances our pleasure, and enriches our most intimate relationships. When people are compulsively and constantly pulled back into the past, to the last time they felt intense involvement and deep emotions, they suffer from a failure of imagination, a loss of the mental flexibility.

Without imagination there is no hope, no chance to envision a better future, no place to go, no goal to reach. The Rorschach tests also taught us that traumatized people look at the world in a fundamentally different way from other people. For most of us a man coming down the street is just someone taking a walk. A rape victim, however, may see a person who is about to molest her and go into a panic.

A stern schoolteacher may be an intimidating presence to an average kid, but for a child whose stepfather beats him up, she may represent a torturer and precipitate a rage attack or a terrified cowering in the corner. I spent many nights and weekends on the unit, which exposed me to things the doctors never saw during their brief visits. The Body Keeps the Score PDF Book

When patients could not sleep, they often wandered in their tightly wrapped bathrobes into the darkened nursing station to talk. The quiet of the night seemed to help them open up, and they told me stories about having been hit, assaulted, or molested, often by their own parents, sometimes by relatives, classmates, or neighbors.

They shared memories of lying in bed at night, helpless and terrified, hearing their mother being beaten by their father or a boyfriend, hearing their parents yell horrible threats at each other, hearing the sounds of furniture breaking. Others told me about fathers who came home drunk —hearing their footsteps on the landing and how they waited for them to come in.

Pull them out of bed, and punish them for some imagined offense. Several of the women recalled lying awake, motionless, waiting for the inevitable—a brother or father coming in to molest them. During morning rounds the young doctors presented their cases to their supervisors, a ritual that the ward attendants were allowed to observe in silence. The Body Keeps the Score PDF Book Download

They rarely mentioned stories like the ones I’d heard. However, many later studies have confirmed the relevance of those midnight confessions: We now know that more than half the people who seek psychiatric care have been assaulted, abandoned, neglected, or even raped as children, or have witnessed violence in their families.

But such experiences seemed to be off the table during rounds. I was often surprised by the dispassionate way patients’ symptoms were discussed and by how much time was spent on trying to manage their suicidal thoughts and selfdestructive behaviors, rather than on understanding the possible causes of their despair and helplessness.

I was also struck by how little attention was paid to their accomplishments and aspirations; whom they cared for, loved, or hated; what motivated and engaged them, what kept them stuck, and what made them feel at peace—the ecology of their lives. A few years later, as a young doctor, I was confronted with an especially stark example of the medical model in action. The Body Keeps the Score PDF Book Download

I was then moonlighting at a Catholic hospital, doing physical examinations on women who’d been admitted to receive electroshock treatment for depression. Being my curious immigrant self, I’d look up from their charts to ask them about their lives. Many of them spilled out stories about painful marriages, difficult children, and guilt over abortions.

As they spoke, they visibly brightened and often thanked me effusively for listening to them. Some of them wondered if they really still needed electroshock after having gotten so much off their chests. After my year on the research ward I resumed medical school and then, as a newly minted MD, returned to MMHC to be trained as a psychiatrist, a program to which I was thrilled to be accepted.

Many famous psychiatrists had trained there, including Eric Kandel, who later won the Nobel Prize in Physiology and Medicine. Allan Hobson discovered the brain cells responsible for the generation of dreams in a lab in the hospital basement while I trained there, and the first studies on the chemical underpinnings of depression were also conducted at MMHC. The Body Keeps the Score PDF Book Download

But for many of us residents, the greatest draw was the patients. We spent six hours each day with them and then met as a group with senior psychiatrists to share our observations, pose our questions, and compete to make the wittiest remarks. Our great teacher, Elvin Semrad, actively discouraged us from reading psychiatry textbooks during our first year.

This intellectual starvation diet may account for the fact that most of us later became voracious readers and prolific writers.) Semrad did not want our perceptions of reality to become obscured by the pseudocertainties of psychiatric diagnoses. I remember asking him once: “What would you call this patient—schizophrenic or schizoaffective?”

He paused and stroked his chin, apparently in deep thought. “I think I’d call him Michael McIntyre,” he replied. Semrad taught us that most human suffering is related to love and loss and that the job of therapists is to help people “acknowledge, experience, and bear” the reality of life—with all its pleasures and heartbreak. The Body Keeps the Score PDF Book Free

“The greatest sources of our suffering are the lies we tell ourselves,” he’d say, urging us to be honest with ourselves about every facet of our experience. He often said that people can never get better without knowing what they know and feeling what they feel. I remember being surprised to hear this distinguished old Harvard professor confess how comforted.

He was to feel his wife’s bum against him as he fell asleep at night. By disclosing such simple human needs in himself he helped us recognize how basic they were to our lives. Failure to attend to them results in a stunted existence, no matter how lofty our thoughts and worldly accomplishments.

Healing, he told us, depends on experiential knowledge: You can be fully in charge of your life only if you can acknowledge the reality of your body, in all its visceral dimensions. Our profession, however, was moving in a different direction. As we organized our findings, we discovered a consistent profile. The Body Keeps the Score PDF Book Free

(1) a pervasive pattern of dysregulation, (2) problems with attention and concentration, and (3) difficulties getting along with themselves and others. These children’s moods and feelings rapidly shifted from one extreme to another—from temper tantrums and panic to detachment, flatness, and dissociation.

When they got upset (which was much of the time), they could neither calm themselves down nor describe what they were feeling. Having a biological system that keeps pumping out stress hormones to deal with real or imagined threats leads to physical problems: sleep disturbances, headaches, unexplained pain, oversensitivity to touch or sound.

Being so agitated or shut down keeps them from being able to focus their attention and concentration. To relieve their tension, they engage in chronic masturbation, rocking, or self-harming activities (biting, cutting, burning, and hitting themselves, pulling their hair out, picking at their skin until it bled). It also leads to difficulties with language processing and finemotor coordination. The Body Keeps the Score PDF Book Free

Spending all their energy on staying in control, they usually have trouble paying attention to things, like schoolwork, that are not directly relevant to survival, and their hyperarousal makes them easily distracted. Having been frequently ignored or abandoned leaves them clinging and needy, even with the people who have abused them.

Having been chronically beaten, molested, and otherwise mistreated, they can not help but define themselves as defective and worthless. They come by their selfloathing, sense of defectiveness, and worthlessness honestly. Was it any surprise that they didn’t trust anyone? Finally, the combination of feeling fundamentally despicable and overreacting to slight frustrations makes it difficult for them to make friends.

Over the past few decades mainstream psychiatry has focused on using drugs to change the way we feel, and this has become the accepted way to deal with hyper- and hypoarousal. I will discuss drugs later in this chapter, but first I need to stress the fact that we have a host of inbuilt skills to keep us on an even keel. The Body Keeps the Score PDF Book Free

In chapter 5 we saw how emotions are registered in the body. Some 80 percent of the fibers of the vagus nerve (which connects the brain with many internal organs) are afferent; that is, they run from the body into the brain.6 This means that we can directly train our arousal system by the way we breathe, chant, and move.

A principle that has been utilized since time immemorial in places like China and India, and in every religious practice that I know of, but that is suspiciously eyed as “alternative” in mainstream culture. In research supported by the National Institutes of Health, my colleagues and I have shown that ten weeks of yoga practice.

Markedly reduced the PTSD symptoms of patients who had failed to respond to any medication or to any other treatment.7 (I will discuss yoga in chapter 16.) Neurofeedback, the topic of chapter 19, also can be particularly effective for children and adults who are so hyperaroused or shut down that they have trouble focusing and prioritizing. The Body Keeps the Score PDF Book Free