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The Body Keeps The Score, Brain, Mind and Body in the Healing of Trauma

By: Bessel Van Der Kolk, M.D.

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Some parts of this book were hard for me to read. The reason for that is that it mentions years of research and real cases of people that have been traumatized in so many different ways.

 I wanted to read this book so that I could understand how trauma affects our brain, mind, and body. Ultimately, the major reason I wanted to read this book was because I wanted everyone to have hope that there are ways that their trauma(s) in their life could be put in the past and that they can have a happier and brighter future.

Let’s first look at how trauma affects our brain, mind, and body. Later, we will look at different ways one can overcome trauma.

Trauma doesn’t just affect the brain, mind, and body—it reorganizes them around survival. The system that’s meant to keep you alive during danger doesn’t always turn off afterward, so everything keeps operating as if the threat might return.

1. How trauma affects the brain

 Amygdala — the alarm

• Becomes overactive, constantly scans for threat, Triggers fear, anger, panic, startle responses

Result: You react fast and intensely, often before thinking.

Hippocampus — the timekeeper

• Becomes less effective under extreme stress, struggles to place memories in the past

• Result:
  Flashbacks, time distortion, confusion between past and present.

•  Prefrontal cortex — the regulator

• Goes offline during threat, harder to think clearly, plan, speak, or calm yourself

• Result: “I know better, but I can’t stop.”

 Brainstem — survival reflexes

• Takes control during trauma, Activates fight, flight, freeze, or collapse

• The (ANS) has two branches. The (SNS) Sympathetic Nervous System is responsible for the fight and flight response for escape and avoidance behaviors. It sends more blood to your muscles and triggers the adrenal gland to put off adrenaline which speeds up your heart rate and raises your blood pressure. The (PNS) Parasympathetic Nervous System is for self-preservative functions like digestion and wound healing triggering acetylcholine which slows your heart rate down, relaxing muscles, and slowing your breathing down.

• The DVC controls the freeze or collapse. Your dorsal vagal complex (DVC) is the oldest branch of your PNS, and it represents a more primitive defense mechanism. When your VVC and SNS are overwhelmed or unable to resolve a threat, your DVC takes over, leading to a “freeze,” “faint,” or “collapse” response. This is a state of profound physiological shutdown, akin to “playing dead.” You might experience numbness, depersonalization (feeling detached from your body), derealization (feeling that your surroundings are unreal), or a profound sense of emptiness. This is a key pathway for various forms of dissociation

Result: Automatic reactions without conscious decision-making.

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2. How trauma affects the mind (psychological experience)

The mind adapts to survive—but these adaptations can become painful later.

🔹 Attention & perception

• Hypervigilance (constantly scanning)

• Or dissociation (checking out, numbness)

The mind is either too present or not present at all.

🔹 Memory & identity

• Fragmented memories, Gaps or intrusive images

• Sense of self shaped by what happened (“I’m unsafe,” “I’m broken”)

Trauma can turn an experience into an identity

 How traumatic memory is remembered

Trauma overwhelms the brain’s ability to process experience normally—especially when there’s intense fear, helplessness, or lack of escape.

Instead of becoming a story, trauma is stored as fragments.

Key differences:

a) It’s sensory, not narrative
Traumatic memory is often remembered as: Images, Sounds, Smells, Body sensations, Emotional states

Rather than: A clear storyline

b) It feels like it’s happening now
Because the hippocampus (time-stamping) goes offline under extreme stress:

• The memory isn’t tagged as “past”, Flashbacks feel present, not remembered

This is why people say: “I know I’m safe, but my body doesn’t.”

c) It’s involuntary
Trauma memories:

• Intrude without choice, Are triggered, not recalled, Show up during states of vulnerability (fatigue, stress)

Normal memories are accessed.
Trauma memories hijack.

d) It’s often fragmented or incomplete
People may remember:

• One moment vividly, Large gaps around it, Or only the terror, without images

This isn’t repression, it’s how the brain survives overload.

Adrenaline sharpens memory for anything that helps survival.

So people often remember with extreme clarity:

• The face of the threat

• The weapon or object involved

• The sound of yelling, footsteps, breaking glass

• The exact moment fear peaked

• Physical sensations (heart racing, breath stopping)

• The instant something went wrong

These details can feel crystal-clear and frozen in time.

What adrenaline makes less likely to be remembered

At the same time, adrenaline impairs:

• Sense of time (“It felt like forever” or “It happened too fast”)

• Sequence of events

• Peripheral details (who else was there, what happened before/after)

• Language processing (finding words later

A simple way to think about it

Normal memory: “This happened to me.”

Trauma memory: “This is happening to me.”

🔹 Emotions

• Big emotions with no clear cause, Emotional shutdown or numbing

Emotions become either overwhelming or unreachable.

🔹 Beliefs

Trauma creates implicit beliefs, not logical ones:

• “The world isn’t safe”, “I have no control”, “Something is wrong with me”

These feel true, even when consciously rejected.

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3. How trauma affects the body

The body remembers what the mind tries to forget.

 Nervous system

• Stuck in sympathetic (fight/flight) or dorsal vagal (freeze/collapse)

Signs: Tension, pain, jaw clenching, Digestive issues, Fatigue or insomnia

Breathing & heart

• Shallow breathing, Irregular heart rate, Sensitivity to stress or exertion

 Hormones & immune system

• Chronic cortisol dysregulation, Increased inflammation, Greater risk for autoimmune and stress-related illness

Trauma isn’t “just psychological”—it’s physiological.

 Posture & movement

• Collapsed posture (shutdown), Rigid posture (defensive readiness), Restricted movement or restlessness

The body holds protective shapes.

. Trauma is a biological event, not just a psychological one

During trauma, the body releases:

• Adrenaline

• Cortisol

• Inflammatory chemicals

These are lifesaving in the short term.
But when the nervous system stays stuck in survival mode, those same chemicals become toxic over time and eventually wear the body down and can cause or increase chances of illness.

When trauma is addressed:

• Nervous system regulation improves, Inflammation decreases, Muscle tension releases, and Immune function stabilizes

4. How it all locks together (the loop)

Here’s the feedback loop trauma creates:

• Body senses threat →

• Brain triggers survival response →

• Mind interprets danger →

• Body reacts again

Much of this is non-conscious, and what your system has learned.

There is hope!

Because trauma changes the brain, mind, and body through experience…
it can be changed back through experience too.

Recovery focuses on:

• Calming the nervous system (body)

• Updating threat responses (brain)

• Restoring meaning and agency (mind)

Not forcing yourself to “move on,” but teaching your system: The danger is over.

 

Here are some different pathways from Bessel Van Der Kolk, M.D. to overcome and recover from trauma.

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1. Restoring a Sense of Safety in the Body

Trauma hijacks the nervous system. Before insight or meaning can help, the body has to learn it’s no longer in danger.

Key ideas:

• Learning to notice bodily sensations without being overwhelmed

• Regulating breathing, tension, heart rate

• Rebuilding the ability to feel calm, grounded, and present

Examples:

• Yoga (trauma-sensitive yoga in particular)

• Breathwork

• Mindfulness practices focused on sensation, not just thoughts

“Trauma is not just remembered—it’s relived.”
So recovery starts by teaching the body now is different from then.

Signs this step is working:

• You can calm down some of the time

• Emotional spikes don’t last as long

• You feel safer inside your body than before. This step answers the body’s question: “Is the danger over?”

 

2. Bottom-Up Therapies (Body → Mind)

Van der Kolk emphasizes that talk alone often isn’t enough, because trauma is stored in nonverbal brain areas.

Bottom-up approaches include:

• EMDR (Eye Movement Desensitization and Reprocessing)

• Somatic experiencing

• Neurofeedback

• Movement-based therapies

These help the brain reprocess trauma without forcing detailed verbal recall.

 

3. Top-Down Therapies (Mind → Body)

These help people make sense of what happened, build narrative, and reduce shame—after some regulation is in place.

Examples:

• Traditional talk therapy

• Parts-based approaches (like working with inner “parts” shaped by trauma)

• Cognitive approaches (used carefully, not to override the body)

Van der Kolk warns that insight without safety can retraumatize—timing matters.

Step 3: Processing — “That happened, and it’s over”

Goal: Re-file traumatic memories into the past.

This is where trauma is transformed—not just talked about.

What this looks like:

• Revisiting memories in a controlled, supported way

• Allowing the body to complete interrupted survival responses

• Updating the memory with new information: I survived

Common tools:

• EMDR

• Somatic therapies

• Parts work / inner child work

• Carefully paced trauma-focused therapy

Signs this step is working:

• Memories lose emotional charge

• Flashbacks become thoughts, not reliving

• The body responds less intensely

This step answers: “Is it still happening?”

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4. Reconnecting with Other People

Trauma is often relational—and healing is too.

Recovery requires:

• Safe, attuned relationships

• Learning to trust without losing autonomy

• Feeling seen, heard, and believed

This can happen through:

• Therapy, Support groups, Healthy friendships, Community and shared purpose

• Isolation reinforces trauma; connection rewires it.

 

5. Reclaiming Agency and Choice

A core wound of trauma is loss of control. Healing means rebuilding the sense: “I have options now.”

This includes:

• Choosing how and when to engage with memories, learning to say no, feeling ownership over one’s body and boundaries

 

6. Expressive & Creative Practices

Some experiences can’t be spoken—but they can be expressed.

Van der Kolk highlights:

• Theater and role play, Art and music, Writing, Movement and dance

These allow trauma to be processed symbolically, not just cognitively.

 

7. Careful Use of Medication (Supportive, Not Curative)

Medications may:

• Reduce hyperarousal, Help sleep, Lower anxiety or depression

But van der Kolk is clear: meds don’t resolve trauma itself. They can create space for other healing work—but aren’t the path on their own.

 

8. Finding Meaning and Integration

The goal isn’t to erase the past, but to:

• Integrate it into one’s life story, Reduce its power over the present, Move from “this defines me” to “this happened to me”

Healing is measured by greater presence, flexibility, connection, and aliveness—not by forgetting.

 

The Big Takeaway:

Trauma recovery is about retraining the nervous system, reconnecting with others, and restoring choice and agency—using both body-based and mind-based approaches.