BODY KEEPS THE SCORE

LESSON FROM VIETNAM VETERANS

I BECAME WHAT I AM TODAY AT THE AGE OF TWELVE, ON A FRIDGE OVERCAST DAY IN WINTERS OF 1975….THAT WAS A LONG TIME AGO, BUT IT’S WRONG WHAT THEY SAY ABOUT THE PAST…… LOOKING BACK NOW, I REALIZED I HAVE BEEN PEEKING INTO THAT DESERTED ALLEY FOR THE LAST TWENTY_SIX YEARS __Khaled Hosseini, The Kite Runner

SOME PEOPLE’S LIVES SEEM TO FLOW IN A NARRATIVE ;MINE HAD MANY STOPS AND STARTED. THAT’S WHAT TRAUMA DOES. IT INTERRUPTS THE PLOT…… IT JUST HAPPENS, AND THEN LIFE GOES ON. NO ONE PREPARES YOU FOR IT. ____________________Jessica Stern, Denial :A Memoir Of Terror

The challenge is :How can people gain control over the residues of past trauma and return to being masters of their own ship?

Talking, understanding, and human connections help and drugs can dampen hyperactive alarm system. But we will also see that imprints from the past can be transformed by having physical experiences that directly contradict the helplessness, rage, and collapse that are part of trauma and thereby regaining self_mastery. I have no preferred treatment that I discuss in this blog. Each one of them can produce profound changes, depending on the nature of the particular problem and the makeup of the individual person.

I wrote this blog to serve as both a guide and an invitation __an invitation to dedicate ourselves to facing the reality of trauma, to explore how best to treat it, and to commit ourselves, as a society, to using every means we have to prevent it.

Our principal mission has always been to take care of the children and adults who have come to us for treatment, but from the very beginning we also have dedicated ourselves to conducting research to explore the effects of traumatic stress on different populations and to determine what treatments work for whom. We have been supported by research grants from the NATIONAL INSTITUTE OF MENTAL HEALTH, THE NATIONAL CENTER FOR COMPLEMENTARY AND ALTERNATIVE MEDICINE, THE CENTER OF DISEASE CONTROL, AND A NUMBER OF private foundations to study the efficacy of many different forms of treatment from medication to talking, yoga, EMDR, theater and neuro_feedback.

This has been my life’s work. In this effort I have been supported by my colleagues and students at the trauma center, I found thirty years ago. Together we are treating thousands of traumatized children and adults :victims of child abuse, natural disaster, wars, accidents,and human trafficking ;people who have suffered assaults by intimates and strangers. We have a long tradition of discussing all our patients in great depth at weekly treatment team meetings and carefully tracking how well different forms of treatment work for particular individuals

The vast increase in our knowledge about the basic process that underlie trauma has also opened up new possibilities to palliate or even reverse the damage. We can now develop methods and experience the utilize the brains own natural neuroplasticity to help survivors feel fully alive in the present and move on with their lives. There are fundamentally three avenues

1__top down, by talking, re_conneting with others, and allowing ourselves to know and understand what is going on with us, while processing the momories of trauma.

2__by taking medicines that shut down inappropriate alarm reactions, or by utilizing other technologies that change the way the brain organizes information.

3__bottom up : by allowing the body to have experiences that deeply and viscerally condradict the helplessness, rage,or collapse that result from trauma

Which one of these is the best for any particular survivor is an empirical question. Most people I have worked with require a combination.

Research from New disciplines has revealed that trauma produces actual physiological changes, including a recalibration of the brains alarm system, an increase in stress harmone activity, and alternation in the system that filters relevant information from irrelevant. We know that trauma compromises the brain area that communicates the physical, embodied feeling of being alive. These changes explain why traumatized individuals become hypervigilant to threat at The expense of spontaneously engaging in their day _to_day lives. They also help us to understand why traumatized people so often keep repeating the same problem and have such trouble learning from experience. We now know that their behaviors are not the result of moral failings or signs of lack of willpower or bad character _they are caused by the actual changes in the brain

We are obviously still years from attaining that sort of detail understanding, but the birth of three new branches of science has led to an explosion of knowledge about the effects of psychological trauma, abuse and neglect. Those new disciplines are neuroscience, the study of how brain support mental processes;developmental psychopathalogy, the study of impact of adverse experiences on the development of mind and brain;and interpersonal neurobiology, the study of how our behavior influences the emotions, biology and mind-set of those around us.

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 sighted of danger and mobilize disturbed brain circuits and secret massive accounts of stress harmonies. This precipitates unpleasant emotions intense physical sensation, and impulsive and aggressive actions. These posttraumatic reactions feel incomprehensible and overwhelming. Feeling out of control, sunrvivers of trauma often begin to fear that they are damaged to the core and beyond redemption.

Trauma, by definition, is unbearable and in tolerable. Most rape victims, combat soldiers, and the children who have been molested become so upset when they think about what they experienced that try to push it out of their minds, trying to act as if nothing happened, and move on. It takes tremendous energy to keep functioning while carrying the memory of terror, and the shame of utter weakness and vulnerability.

One does not have be a combat soldier, or visit a refugee camp in Syria or the Congo to encounter trauma. Trauma happens to us, our friends, our families, and our neighbors. Research by the centers of diseases control and prevention has shown that one in five Americans was sexually molested as a child ; and one in three couples engages in physical violence. A quarter of us grew up with alcoholic relatives, and one out eight witnessed their mother being beaten or hit.

As human beings we belong to an extreme 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, weather 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.

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