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How Trauma Lodges In The Body....An Article About Becoming The Change 10/20/2017


Health & Wellness  (tags: trauma, psychiatry, Body Work, Body-Mind-Spirit, AlternativeMed, disease, exercise, health, humans, illness, interesting, medicine, protection, research, science )

Fiona
- 52 days ago - dailygood.org
This article is based on interview between Krista Tippett and Bessel van der Kolk. Psychiatrist Bessel van der Kolk is an innovator in treating the effects of overwhelming experiences on people and society. We call these experiences âEURoetrauma."



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Fiona Ogilvie (597)
Friday October 20, 2017, 7:28 am
Bessel van der Kolk knows how some experiences imprint themselves beyond where language can reach. He explores state-of-the-art therapeutic treatments, including body work like yoga and eye movement therapy.

He’s been a leading researcher of traumatic stress since it first became a diagnosis in the wake of the Vietnam War, and from there, was applied to other populations. A conversation with this psychiatrist is a surprisingly joyful thing. He shares what he and others are learning on this edge of humanity about the complexity of memory, our need for others, and how our brains take care of our bodies.

DR. BESSEL VAN DER KOLK: I think trauma really does confront you with the best and the worst. You see the horrendous things that people do to each other, but you also see resiliency, the power of love, the power of caring, the power of commitment, the power of commitment to oneself, the knowledge that there are things that are larger than our individual survival. And in some ways, I don’t think you can appreciate the glory of life unless you also know the dark side of life.

MS. TIPPETT: I’m Krista Tippett, and this is On Being.

MS. TIPPETT: Bessel van der Kolk is a professor of psychiatry at Boston University Medical School, and he helped found a community-based trauma center in Brookline, Massachusetts. As medical director there, he works with people affected by trauma and adversity to re-establish a sense of safety and predictability in the world, and to reclaim their lives. Bessel van der Kolk was born in the Netherlands. His own father spent time as religious prisoner in a German concentration camp during World War II. I spoke with him in 2013.

MS. TIPPETT: I always start my conversations with this question, whoever I’m speaking with. I’m just wondering, was there a religious or spiritual background to your childhood?

DR. VAN DER KOLK: Yeah, multiplicity. My parents were fundamentalist Christians in some good and some not so good ways. As an adolescent, I spent a fair amount of time in a monastery in France called Taizé.

MS. TIPPETT: Oh, you did? Oh, interesting. So you went to Taizé just…

DR. VAN DER KOLK: Because I loved the music.
 

Fiona Ogilvie (597)
Friday October 20, 2017, 7:29 am
MS. TIPPETT: Yeah. This field you’re in of trauma, traumatic stress, nowadays, this language is everywhere, right? This language of “trauma” and “traumatic stress” has made its way into culture, movie, TV scripts, the news, public policy discussions. I’ve read a few different accounts of how you stumbled into this field. How do you trace the beginnings of your research into traumatic stress?

DR. VAN DER KOLK: Well, it starts in a very pedestrian way. I mean, as characters from a generation that it was generally recommended that people have their own heads examined, which, I think, is sort of a good idea if you try to help other people. So psychoanalysis was the way to do that back then. And the only program that paid for that was the VA. So I went to work for the VA for the same reason that soldiers go to the VA, namely, to get their benefits package.

MS. TIPPETT: This was in the 1970s? Is that right?

DR. VAN DER KOLK: It was in the 1970s, yeah. And like many of my colleagues, I was just there to — as a step in my career. And then the very first person I saw was a Vietnam veteran who had terrible nightmares. I happened to have studied nightmares up to that point and some sleep studies, and I knew a little bit how to treat it, so I gave him some medicines to make the nightmares go away.

Two weeks later, he came back, and I said, “So how did the medicines work?” And he said, “I did not take your medicines because I realized I need to have my nightmares because I need to be a living memorial to my friends who died in Vietnam.” And that statement was the opening of my fascination about how people become living testimonials for things that no longer exist, but they need to hold it in their hearts and minds and bodies and brains. The loyalty to the dead, the loyalty to what was just blew me away.

And the veterans really touched me very deeply both for what they had done, how ashamed they were about what they had done, how they went in idealistically, how they came back broken, how they relied on their comrades. And they reminded me, I think, of the uncles and my father, who I grew up with in the Netherlands after the Second World War. So it resonated with me.

MS. TIPPETT: At that time, I believe there was no formal connection made between military service and problems after discharge, right? This diagnosis hadn’t happened?

DR. VAN DER KOLK: Well, it comes and goes. I became quite interested in history of how Western culture has looked at trauma. And people were very aware of it in the 1880s, and after the Civil War, and during the First World War, and during the Second World War. And then, in between, it gets forgotten. And so, the way – the time that I got into the field, happened to be a time of ignorance again. It was come and go.

MS. TIPPETT: After the Vietnam War.

DR. VAN DER KOLK: Yeah.
 

Fiona Ogilvie (597)
Friday October 20, 2017, 7:31 am
MS. TIPPETT: And my understanding from your writing that this diagnosis of PTSD, the term we use now, came about because of post-Vietnam War advocacy.

DR. VAN DER KOLK: Yeah, absolutely. And so later on, I became aware of all sorts of colleagues who had been working with abused kids and rape victims. And they had been trying to get a diagnosis in. And that group was too small to have any political clout. And it’s really the Vietnam veterans that brought this in and the power of the large numbers of psychiatrists and patients at the VA. That was strong enough to make it an issue and a diagnosis.

MS. TIPPETT: So I think that language you used a moment ago about that first veteran you spoke with, that he was a living testimonial to his memories and to something that had happened, which no longer was happening but utterly defined him, is a good way in to how you define trauma. So I’d like to spend a moment on that. I mean, start with me. How do you describe what this is, trauma, as you deal with it, as you study it, as you treat it?

DR. VAN DER KOLK: Well, what I think happens is that people have terrible experiences and — we all do. And we are a very resilient species. So if we are around people who love us, trust us, take care of us, nurture us when we are down, most people do pretty well with even very horrendous events. But particularly traumas that occur at the hands of people who are supposed to take care of you, if you’re not allowed to feel what you feel, know what you know, your mind cannot integrate what goes on, and you can get stuck on the situation. So the social context in which it occurs is fantastically important.

MS. TIPPETT: Something that’s very interesting to me in how you talk about trauma, the experience of trauma, what it is, is how the nature of memory is distorted, that memories are never precise recollections, but that in general, as we move through the world, memories become integrated and transformed into stories that help us make sense. But in the case of traumatic memories, they’re not integrated, and they’re not even really remembered as much as they’re relived.

DR. VAN DER KOLK: That’s correct. There’s actually a very old observation, and it was made extensively in the 1890s already by various people, including Freud. That’s really what you see when you see traumatized people. Now, these days, the trauma is a popular subject. People say, “Tell me about your trauma.” But the nature of our trauma is that you actually have no recollection for it as a story in a way.

Many victims, over time, get to tell a story to explain why they are so messed up. But the nature of a traumatic experience is that the brain doesn’t allow a story to be created. And here, you have an interesting paradox that it’s normal to distort your memories. Like, I’m one out of five kids. When we have a family reunion, we all tell stories about our own childhood, and everybody always listens to everybody else’s stories — says, “Did you grow up in the same family as I did?”
 

Fiona Ogilvie (597)
Friday October 20, 2017, 7:32 am
MS. TIPPETT: Right. There are five versions of every story.

DR. VAN DER KOLK: Yeah. There’s all these very, very different versions, and they barely ever overlap. So, people create their own realities in a way. What is so extraordinary about trauma, is that these images or sounds or physical sensations don’t change over time. So people who have been molested as kids continue to see the wallpaper of the room in which they were molested. Or when they examine all these priest-abuse victims, they keep seeing the silhouette of the priest standing in the door of the bathroom and stuff like that. So it’s these images, these sounds that don’t get changed. So it’s normal to change.

My old teacher, George Vaillant, did a study that you may have heard about. It’s called the Grant Study. And from 1939 to 1942, they followed the classes at Harvard every five years, and it’s going on to this day. Most of them went off to war in 1942, and almost all of them came back in 1945, and they were interviewed. And then they have interviews in 1989, 1990, 1991. It turns out that the people who did not develop PTSD, which was the vast majority, tell very different stories, let’s say, in 1990 than back in 1945. So now it was a glorious experience, it was a growth experience, and how good it was, how close they were to people, and how patriotic they felt. And it’s all sort of cleaned up.

MS. TIPPETT: Right. But it’s become a coherent narrative.

DR. VAN DER KOLK: But it’s very coherent, and it’s a nice story, and it’s good to listen to it, and relatives have all heard it a million times, but — because we make happy stories in our mind. People who got traumatized continue to have the same story in 1990 as they told back in 1945, so they cannot transform it. When we treat people, you see the narrative change, and people start introducing new elements.

I compare it very much to what happens when people dream. Maybe dreaming is very central here, actually, in that the natural way in which we deal with difficult stuff is we go to sleep and we dream, and next day we feel better. It’s very striking how we get upset and say, “I’m going to move to Florida, bummer day in Boston in the winter.” And the next morning, you wake up, and you shovel out your car, and everything’s fine.

And so sleep is a very important way in which we restore ourselves. And that process of that restoration that occurs during REM sleep — dream sleep — is probably an important factor in why traumatic memories do not get integrated.

MS. TIPPETT: And also, that gets at the fact that it’s not just cognitive, right? It’s not just a story that you could tell. I mean, it may eventually become a story, but that it’s body memory. It’s a neural net of memory. It’s not just about words that you can formulate.

DR. VAN DER KOLK: Yeah. It’s amazing to me what a hard time many people I know have with that. This is not about something you think or something you figure out. This is about your body, your organism, having been reset to interpret the world as a terrifying place and yourself as being unsafe. And it has nothing to do with cognition, with — you can say to people, “You shouldn’t feel that way,” or, “You’re not a bad person,” or, “It wasn’t your fault.” And people say, “I know that, but I feel that it is.”

It was very striking in our yoga study because we see yoga as one important thing that helps people who’ve been traumatized because they get back into their bodies. How hard it was for people to even during the most blissful part of the yoga practice called Shavasana, what a hard time traumatized people had at that moment to just feel relaxed and safe and feel totally enveloped with goodness, how the sense of goodness and safety disappears out of your body, basically.

MS. TIPPETT: I want to talk about yoga in a minute. That’s really — I mean, as you said, people were talking about this in the late 19th century. Freud talked about it and I guess his phrase was “hysteria.” But something that you seemed to have noticed early on is that traditional therapy was ignoring this sensate dimension of these experiences in trying to reduce it to talk therapy, which absolutely didn’t fit with the experience.
 

Fiona Ogilvie (597)
Friday October 20, 2017, 7:36 am
DR. VAN DER KOLK: Right, right. There’s a few people here and there in the last 150 years who do it. The great Frenchman Pierre Janet did, Wilhelm Reich, of course, who then went crazy afterwards. Here and there, people noticed the somatic dimension of it, but by and large, I think psychology training really breeds the tensions of body out of people. It’s a medical training. It’s amazing. Psychiatrists just don’t pay much attention to sensate experience at all.

Antonio Damasio, in his books, The Feeling of What Happens, in books like this, really talks about a core experience of ourselves is a somatic experience, and that the function of the brain is to take care of the body. But it’s a minority voice. It’s a small voice.

MS. TIPPETT: But it seems to me that what we’re learning from brain imaging is bearing out these kinds of observations. I mean, what are we learning? Is any of this surprising to you?

DR. VAN DER KOLK: What we see is that the parts of the brain that help people to see clearly and to observe things clearly really get interfered with by trauma and the imprint of trauma is in areas to the brain that really have no access to cognition. So it’s in an area called the periaqueductal gray, which has something to do with the sort of total safety of the body. The amygdala, of course, which is the smoke detector, alarm bell system of the brain — that’s where the trauma lands, and trauma makes that part of the brain hypersensitive or renders it totally insensitive.

MS. TIPPETT: And the Broca’s area?

DR. VAN DER KOLK: Well, in our study and some others, I mean, for me that was really the great finding early on, is that when people are into their trauma, Broca’s area shuts down. That is something that almost everybody has experienced. You get really upset with your partner or your kid, suddenly you take leave of your senses and you say horrible things to that person. And afterwards, you say, “Oh, I didn’t mean to say that.”

The reason why you said it is because Broca’s area, which is sort of the part of your brain that helps you to say reasonable things and to understand things and articulate them, shuts down. So when people really become very upset, that whole capacity to put things into words in an articulate way disappears. And for me, that is a very important finding because it helped me to realize that, if people need to overcome the trauma, we need to also find methods to bypass what they call the tyranny of language.

MS. TIPPETT: Don’t ask to be verbal, to verbalize it.

DR. VAN DER KOLK: Or to be reasonable. [laughs]

MS. TIPPETT: Right. [laughs]

DR. VAN DER KOLK: The trauma is not about being reasonable or to be verbal or to be articulate.

[music: “Third” by Hiatus]

MS. TIPPETT: I’m Krista Tippett, and this is On Being. Today, with psychiatrist Bessel van der Kolk. He’s a leading innovator in the treatment of traumatic stress.

This insightful and meaningful interview continues on site.

As the interview continues, we come to understand this quotation from Bessel van der Kolk:

"Neuroscience research shows that the only way we can change the way we feel is by becoming aware of our inner experience and learning to befriend what is going on inside ourselves."

Please note, comment, and forward.
 

Kalliope M (30)
Friday October 20, 2017, 10:43 am
YOGA, YOGA, YOGA..... :-D Thanks, dear Fiona :-)
 

Patrice Z (16)
Friday October 20, 2017, 11:51 am
Thanks for the great article. This man is doing great work to help treat trauma.
 

Animae C (512)
Friday October 20, 2017, 2:27 pm
Very interesting interview.
i have always done Hatha Yoga but didn't find as much benefit from it as i did with high impact aerobics & resistance training, if executed properly all types of exercise focus on the breath.

TY Fiona
 

ANA MARIJA R (200)
Friday October 20, 2017, 2:45 pm
noted with thanks
 

Colleen L (3)
Friday October 20, 2017, 5:18 pm
Interesting interview. Thanks Fiona
 
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