4 Things The Body Keeps the Score Teaches About the Effects of Trauma

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To be trauma-informed, the first step is to gain an understanding of trauma and its effects. 

The Body Keeps the Score by Bessel van der Kolk was the book that first taught me about the effects of trauma and helped me become interested in this topic. It is a great resource, so I recommend picking up a copy to learn more. You can grab a copy here.

The Body Keeps the Score was written by Bessel van der Kolk, a Dutch psychiatrist who has had a long career researching and treating the effects of trauma. 

This book summarizes van der Kolk’s many years of trauma research, much of which was groundbreaking and has helped drive the direction of current research. Below are four things that stuck out to me from this book that can be helpful takeaways for those working in ministry.

Van der Kolk says there are three ways to help people to heal from trauma.

The first method, top-down, involves talking to and connecting with others and processing the trauma. Some methods of doing this are writing and journaling, therapy, and ways to express yourself, such as art, music, or dance. You can visit the healing resources page for some Catholic top-down methods. 

A second way is through working with a medical professional to find a medication that can help regulate how the body is reacting to the trauma. 

Finally, the third method is a bottom-up method, which involves working with the body to learn how to cope with overwhelming sensations and emotions that trauma can cause and working to reverse how the body may be feeling helpless, have strong emotions, or collapse as a result of the trauma. 

Methods that can help with this regulation include mindfulness (I recommend The Mindful Catholic by Dr. Greg Bottaro for a faith-based perspective), deep breathing, music, relationships with others, and even massages. Van der Kolk also describes some new methods of therapy that can be helpful with this. 

Through his many years of working with trauma survivors, van der Kolk has found that typically, some combination of these three methods can work best, although some people may only need one. 

A quick note: Some of the methods of healing mentioned in the book are a bit New Agey, so read that section with a critical eye.

Van der Kolk mentions that one of the hardest things for trauma survivors to cope with is shame over things they may have done either to survive the trauma or to cope with its effects. These things may include staying in touch with the source of the trauma, lashing out, and addictions. He mentions that therapists should keep this in mind when working with trauma survivors.

Even if you’re not a therapist and are working in ministry, this idea can be helpful to keep in mind because, as Catholics, things people may do in response to trauma may be sinful behavior. We should work to be sensitive to the idea that sin may result from trauma and work to help people heal their sin at its roots instead of shaming people when we likely do not know the story behind their behavior. After all, look at how Christ interacted with sinners. He did not shame them; he instead helped them to find healing.

A lot of van der Kolk’s research has revolved around explaining some of the symptoms of PTSD, or post-traumatic stress disorder. While not everyone who experiences trauma develops PTSD, even those who don’t fully develop the diagnosis can experience some of these symptoms. 

Symptoms of PTSD can include the following:

• Intrusion: Re-experiencing the traumatic event through flashbacks and dreams
• Avoidance: Avoiding things that can trigger that re-experiencing
• Negative alterations of thoughts and mood, such as anger, shame, and fear
• Increased arousal and reactivity, such as irritability or having trouble sleeping.

When humans experience danger, we tend to do one of three things to survive. We may fight, flee the threat, or freeze. A lot of the symptoms of PTSD are because the body remains stuck in these survival mechanisms even after the trauma has passed. 

First, much of the arousal and reactivity involved in PTSD can be due to the brain continuing to release hormones to signal the fight, flight, or freeze response, even after the danger has passed. This release of hormones leads to a constant state of reactivity to potential threats. It can cause agitation and quick reactions to sensory information that we sometimes see in those with PTSD and can even cause physical health problems by increasing inflammation in the body. 

Another part of PTSD is having flashbacks to the trauma. Van der Kolk has found that in those with PTSD, facing images, sounds, and thoughts that remind a survivor of the trauma they faced can impact the fear center of the brain to send them into fight or flight or freeze, just like they did when they faced the original trauma. Flashbacks can cause things such as sending the brain’s speech center offline and the parts of the brain involved in decision-making, which can lead to impulsive behavior. 

Finally, another reason van der Kolk has found for these symptoms is that PTSD can disrupt the parts of the brain that filter out irrelevant sensory information. For example, as I write this, I can hear other people in my home talking and a fan running, but my brain is filtering that out so I can focus on this work. In someone with PTSD, the brain may not filter out that information, causing sensory overload. Those with PTSD then may numb their senses with drugs or alcohol, hyperfocus on an irrelevant stimulus, or feel not like themself.

Why is this important to know for those in ministry? Part of the importance of being trauma-informed is to realize that sometimes, behavior that could be seen as disruptive or negative may be because their brain is trying to cope with trauma, and so we should be patient and understanding. Additionally, by being trauma-informed, we strive to create environments that do not set off a trauma reaction.

To learn more about being trauma-informed, you can visit this page.

Another area of research van der Kolk has focused on has been the trauma of children. Three things stuck out to me in this area. 

First, van der Kolk talks about how those who face abuse or neglect from their parents struggle to develop a secure attachment to their parents. When parents respond to the needs of their children consistently, children can see their parents as a secure base to come back to if they become scared, and they become so in touch with their parents that their parents can help them regulate their emotions. If this happens in the first couple years of life, a child can develop important emotion regulation and relationship skills.

When children face abuse and neglect, they can’t develop this secure attachment, which can lead to difficulties later in life, such as becoming disengaged, having physical health problems, struggling with self-regulation, ADHD, and mental health problems. 

Van der Kolk also briefly mentions the Adverse Childhood Experiences (ACE) study, a groundbreaking study on the effects of trauma in childhood. You can visit this page to learn more. 

Finally, van der Kolk describes children’s trauma as a hidden epidemic causing huge medical and economic costs that are largely preventable. He also talks about how a lack of awareness of children’s trauma can lead to the misdiagnosis of children with ADHD and other mental health disorders who are simply trying to cope with their trauma. 

To help combat this misdiagnosis and get children the help they need, he proposes a new diagnosis called developmental trauma disorder, which involves:

• Dysregulation
• Attention and concentration problems
• Difficulties getting along with themselves or others

He argues that if we can add this diagnosis to the medical and psychological literature, we can help children get the help they need instead of misdiagnosing them, which ultimately could help break the cycle of trauma. 

Unfortunately, it still has not been accepted in the medical and psychological world, but he still advocates for it.

What does all of this have to do with ministry?

First, just like with PTSD, there may be more to the story if a child you’re working with is acting out, so patience is important.

Second, it is important to report any suspected abuse or neglect so a child can get the help they need.

Finally, we as a Church have the ability to promote healthy parenting, so we should strive to do so. 

These four things are just some helpful information about the effects of trauma found in this book. This article would be too long if I covered everything I highlighted while reading it. So, I highly recommend purchasing a copy for yourself to learn more about the effects of trauma so you can apply it to your ministry. You can grab your copy here.