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What is trauma? The author of "The Body Keeps the Score" explains [video]

92 points by keepamovin 3y ago

deleted 3y ago
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Aurornis 3y ago
Like most popular science/psychology books, this one has attracted a lot of criticism for making exaggerated claims and for peddling reductive concepts to appeal to a wider audience. There’s no denying that massive stress and trauma can have long lasting effects. However, the pop culture definition of trauma and stress have become very diluted. I spent some time working with college students recently and it was remarkable to hear how many of them described common life events as “trauma”: Break ups, failing a class, or even getting yelled at by someone. Something weird happens when they’ve been primed to recognize everything uncomfortable as “trauma” and they’ve been instilled with the belief that it will forever become embedded in their person as baggage.
- ajkjk 3y ago
  In my experience it's kinda the opposite. Realizing that stuff was trauma helped move on from it. Until I had a framework for why a fairly-normal-sounding experience was affecting my personality so much, I just felt like I was going crazy. It helped a lot to realize that ruminating on it was how trauma works: its purpose is to figure out how to avoid a recurrence at all costs, including warping one's behavior in aberrant ways.
  - DANmode 3y ago
    Instinctual, evolutionary response. It makes all sorts of sense.
- armatav 3y ago
  Some people can kill a man, or lose a limb and not suffer traumatic rumination. Some other people lose their favorite toy as an kid and it really does become a deep rumination pattern of traumatic loss for them.
  - Aurornis 3y ago
    > Some other people lose their favorite toy as an kid and it really does become a deep rumination pattern of traumatic loss for them. In this case, the "trauma" is virtually irrelevant, though. The issue is the rumination and pattern of overreaction, which should certainly be addressed. For some, the obsession with "trauma" becomes a way to move the focus to something external, which is therefore out of their control. In your example, too much focus on "trauma" as an explanation for everything could mislead someone into thinking that the loss of the toy is to blame for their situation, whereas they really need to accept that their reaction and pattern of rumination is what needs to be addressed.
- batch12 3y ago
  I agree that words have meanings. Words like trauma and abuse shouldn’t be used casually or we won't have the language to describe horrific things. However-- having experienced some early childhood difficulties, I have had to make an intentional effort not to downgrade people's experiences and fall into a no true Scotsman trap. I try to remind myself that things like trauma and abuse are experiences that filter through people's minds. It's trauma if they think it is. I do also think though that some people have never experienced the same types of trauma as others so they may not really understand it. If and when they do, they may choose to rank the experiences differently. Edit: updated my ramble
  - throwanem 3y ago
    > It's trauma if they think it is and it impacts them as trauma. This sentence gained a clause before I hit 'reply', and I understand why because it addresses the criticism I intended to make, but I'm still not at all sure I agree with you here. Even the edit implies the assumption that no one is responsible for how they choose to respond to the events of their lives, and that is plausible but requires substantiation not evident here. In particular, I do not think it is necessary for anyone to personally experience 'horrific things' to understand that some things are worse than others, and be glad that what they're dealing with isn't worse - which probably sounds cruel to some, but is in fact quite helpful; maintaining a sense of perspective around the mishaps that attend every human life can in itself go a long way toward responding to them in a way that's well calibrated to their actual severity. In the meantime, not treating 'trauma' as suitable to describe every unfortunate happenstance - a college breakup! Really... - also avoids vitiating the concept, which strikes me as a worthwhile kindness to those who really have been through hell - or those who haven't yet, and will find it easier to come out the other side for there still being social space to accommodate the existence of those who have to recover from, or just find a way to live with, long experience of the genuinely atrocious.
    - batch12 3y ago
      Yeah, I've waffled on that because I don't know how to say it how I mean it. I'll try to generalize it but I'm sure I won't get it right. If something has you afraid, it doesnt matter if I think your fear is justified. Me disregarding your emotion doesn't make you lose the fear. I don't disagree with the idea that we are responsible for how we respond to events in our lives. I tell my kids the same thing- nobody can control you unless you let them. You have the power to control how you respond to things. Sometimes it's the only power you have. I don't have to agree that a college breakup is trauma, but it isn't helpful in most cases to point that out when someone thinks it is. Instead, maybe I can just listen the way I would if it were something I thought was more important. Maybe they'll get through it the same way I did given enough time. Edit: >In particular, I do not think it is necessary for anyone to personally experience 'horrific things' to understand that some things are worse than others, Unfortunately I do disagree with you here. I've met too many people that seem incapable of proper empathy or otherwise lack the ability to learn from the mistakes of others. I could agree with swapping anyone with everyone.
- nonrandomstring 3y ago
  Certainly "trauma" has been diluted. Someone I think who does a really good job of distinguishing actual trauma (something that disrupts development) from acquired entitlement etc is Gabor Mate in "The myth of normal". Would definitely recommend.
  - Aurornis 3y ago
    > Someone I think who does a really good job of distinguishing actual trauma (something that disrupts development) from acquired entitlement etc is Gabor Mate Gabor Mate is extremely charismatic, but IMO he's part of the problem. The last time I listened to a podcast where he was a guest, he pushed the idea that being born could qualify as trauma leading to PTSD in adulthood. He told a story about a patient with mental health issues where he was unable to identify overt trauma until despite going through her life in fine detail. Eventually he concluded that it must have been the experience of being born that was her trauma. This is what I was talking about when someone pushes the "trauma explains everything" angle: When all you have is a hammer, everything looks like a nail. Some of these pseudo-experts may be good at treating trauma, but they take it too far and start trying to describe everything big or small as a trauma.
    - nonrandomstring 3y ago
      If true that does indeed sound quite ridiculous.
      - luxpir 3y ago
        I may be misremembering, but my recollection is that he talks about the stresses of the parents being passed on from birth. My other vague recollection is that studies exist which prove this phenomenon to be true. A third vague recollection is that his own mother was persecuted due to religion, giving his theories and his reason to pursue them some level of credibility. My memory is not machine-like in its efficiency. I am open to correction. But I believe GP may not be fully stating the facts for their own reasons.
- dnissley 3y ago
  See "The rise of therapy-speak": https://www.newyorker.com/culture/cultural-comment/the-rise-of-therapy-speak https://www.newyorker.com/culture/cultural-comment/the-rise-...
- flatline 3y ago
  As someone who grew up in the 80s, this type of minimization of personal suffering was the norm. “You don’t know how good you have it” despite real mental and physical health struggles. You either made it to adulthood, cynical and damaged, transformed your suffering into growth on your own, or ended up in some marginalized place like a mental ward. Sometimes a mix of all of the above. I think we can do better. I remember the first time I saw a therapist she thought I may have PTSD. I thought she was nuts and never went back. It took me another decade to realize that my mother was deeply mentally ill and physically and emotionally abusive, it’s just that no one ever talked about or recognized these things as abnormal. My dad was a high functioning alcoholic. I’ve talked to other adults who went through much less than I did and left home and lived on the streets rather than deal with their family situation. But talk to my parents, everything was “fine” and “pretty normal”. I had a “good upbringing” because we were not poor or in trouble with the law. I also had some early sexual encounters that people would jump to classify as child abuse, but they were, from my standpoint, overall positive experiences. I don’t know where to draw the line on what constitutes trauma for someone else. It’s highly subjective. There are always things in life we must just bear. But it’s good to recognize when things are not working and to make what changes we can, and to recognize when things have long lasting impacts, and when they don’t.
  - slibhb 3y ago
    > As someone who grew up in the 80s, this type of minimization of personal suffering was the norm. It's a tricky problem. Some people need help. But there are a lot of people for whom "holding it in" and adopting general-purpose stoic principles are enough. For the latter group, the new openness about mental illness and trauma has been a disaster. Like a lot of things, you can think of this issue in terms of "type 1 and type 2 errors". Ideally we try to minimize both but it seems that we often end up minimizing one and totally ignoring the other.
    - bjornsing 3y ago
      > For the latter group, the new openness about mental illness and trauma has been a disaster. Why so?
- lepus 3y ago
  For now it's the term people have adopted to describe a wide range of negative impactful experiences. Usually there's something deeper and older going on in someone when a seemingly minor event causes feelings of "trauma", but sometimes the extreme results of opening that can of worms in someone can be nearly as devastating. The human experience is messy and ultimately hard to keep confined in rigid definitions, but we keep trying.
- shadowbanned4 3y ago
  [dead]
- TaylorAlexander 3y ago
  I can absolutely see why break ups, failing a class, and getting yelled at by someone can be traumatic. I’ve had quite traumatic break ups in my youth due to my own attachment and expectations about the relationship and life. If someone had a lot of pressure about academic success growing up, or a lot of hopes attached to good grades, failure could be traumatic. I would hope that the potential for trauma in getting yelled at would be self evident. Trauma doesn’t mean the experience will be forever embedded as “baggage”. It means it’s something we’re carrying with us right now. Something we’ve not fully processed or healed from. I’ve found that identifying and recognizing trauma is part of the healing process. Failing to identify trauma can mean carrying it with you longer - snapping at others when you get too irritated, because someone did so to you and you haven’t processed the emotional trauma of the situation, for example. Or high anxiety at work carried over from the trauma of failing a class, because you haven’t recognized that even after that failure things worked out okay and you’re still carrying the fear of failure. Trauma like many words has degrees. It is similar to the word injury in that sense. Losing your legs in a motorcycle accident is an injury. A sprained wrist is also an injury. Just remember that with trauma it is hard to see how deep it went. Perhaps someone did experience quite strong trauma from something you would manage easily. That’s due to the different lives you lead, and differences in experience, values, and goals. And remember that situations others might handle well could be things you struggle with. Everyone’s experience is their own.
- mock-possum 3y ago
  > it was remarkable to hear how many of them described common life events as “trauma”: Break ups, failing a class, or even getting yelled at by someone. Isn’t it a bit cruel to dismiss the ups and downs of college life as unworthy of being called ‘traumatic?’ Who are you to make that judgement?
- DANmode 3y ago
  Many people experience severe health problems related to trauma that other people can shake right off. Humans are a wide spectrum, all good and bad at unique things - and you "can't judge a fish on its ability to climb a tree".
- ronald_raygun 3y ago
  > Break ups, failing a class, or even getting yelled at by someone I agree a lot of people overblow trauma. However it is worth mentioning, all the things that you mention can be traumatizing, though. Like imagine breaking up with a partner of a few years because they've been serially cheating on you and lying about it. Imagine failing a class when you've been pressured by your parents your entire life to do well in school, and you know this is going to set them off the edge. Imagine being yelled at for 20 minutes in front of the whole class as a tiny kid. Like the question isn't really "is X bad in an objective way" but more "did X create a bunch of problems for so and so that make their life harder in terms of emotions, psychology, etc."
  - voisin 3y ago
    > Like the question isn't really "is X bad in an objective way" but more "did X create a bunch of problems for so and so that make their life harder in terms of emotions, psychology, etc." From the book itself, trauma is more closely defined as “what causes the sympathetic nervous system (fight or flight) to overreact” which then causes the body to have to deal with the excess cortisol released by the overreaction. This can be the accumulation of micro-stressors or individual major events. OP’s dismissal of things due to being “common life events” is simply ridiculous.
- voisin 3y ago
  I find it ludicrous that you would suggest that the breakup of a close romantic relationship shouldn’t be considered traumatic or qualify as trauma for someone that is of college age, only because of the commonality of occurrence.
- kirse 3y ago
  many of them described common life events as “trauma” We've experienced a massive dilution in language over the past decade or so. I'm not sure if it's because we're churning out more black & white thinkers or incentivizing folks with a victim mindset, but all sorts of words like *-phobic, gaslighting, trauma, etc. have become significantly overused given their traditional symptomatic markers. It's the language equivalent of WebMD - basically implying that a grab bag of cold symptoms are in fact brain cancer. On one hand it's good that the next generation thinks a breakup is "traumatic", because it means people are experiencing less absolute trauma. On the other hand words have meanings so we can accurately describe the world.
- Fire-Dragon-DoL 3y ago
  The severity of pain of a life event changes with the skilld of a person. 2 children playing and one starts crying because the other broke their toy, is that less intense than an adult breakfing up with the lifelong partner? The answer I thought was yes and over time came to realize that it's probably no. Given that, what you perceive as traumatic is not the same for another person
- Tactile6700 3y ago
  The book does distinguish “Big T” & “Little T” trauma. Little T is a helpful concept re the fairly normal life difficulties noted—-validates the pain but keeps it in perspective. Concern about a priming effect is also valid.
- bowsamic 3y ago
  Idk it wasn’t until I went to my therapist that I realised that my mum leaving at the age of 2 was traumatic and that I have a lot of extreme stress and depressive responses now from that even though I didn’t know it. It’s easy to say “divorce is normal and not traumatic” but I think that normal life events can and do cause trauma
bloopernova 3y ago
I'm annoyed at this book and others like it. Despite their helpfulness to many people, one side effect has been that some doctors in the USA now use CPTSD or similar to dismiss people suffering from chronic pain. "If you're in pain, you probably have some (childhood) trauma that you haven't processed correctly. Go see a therapist and come back for a follow-up." (when it takes 6 months or more to get in to a therapist, and the patient is in pain right now) (Yes, this is a huge chip on my shoulder. Like copper thieves have ruined many buildings, doctors handing out opioid prescriptions to everyone has ruined pain management in the USA)
- ronald_raygun 3y ago
  Yeah I mean its not great. Obviously, having CPTSD stresses the body out and can cause chronic issues. So there a big problem of the intersection of (people with chronic pain) and (people with CPTSD), is non-empty. But also a lot of chronic issues seem hard to diagnose, so if you're a doctor, and you're basically moving through the set of common problems/treatments that wont cause more harm, well then a bunch of people that should be down the pipeline will get delays.
- esperent 3y ago
  It's a huge stretch to blame this book for the opioid crisis.
ants_everywhere 3y ago
Isn't "The Body Keeps the Score" regarded as a crackpot book full of long-discredited theories? E.g. https://journals.sagepub.com/doi/pdf/10.1177/070674370505001302 https://journals.sagepub.com/doi/pdf/10.1177/070674370505001... and https://www.washingtonpost.com/books/2023/08/02/body-keeps-score-grieving-brain-bessel-van-der-kolk-neuroscience-self-help/ https://www.washingtonpost.com/books/2023/08/02/body-keeps-s...
- nonrandomstring 3y ago
  No. And some would say that elements of the "medical profession" have spent a lot of money soliciting hit pieces that try to weaken the link between trauma and physiological effects. But that would be a pointless 'argument' to get into since there is mountains of dishonest rubbish on both sides. Instead I think this rather reputable Psychology Today summary on the causal links of trauma and consequent disorders is worth a read [0]; [0] https://www.psychologytoday.com/us/blog/the-addiction-connection/202103/how-trauma-affects-the-body https://www.psychologytoday.com/us/blog/the-addiction-connec...
  - feoren 3y ago
    Can you give a single example of the oddly scare-quoted "medical profession" soliciting a hit piece on anything, ever?
    - mistrial9 3y ago
      this question seems naive, despite the hyperbole from the parent-post. Western accredited medicine has made huge advances in things like antibiotics or germ-theory, yet have struggled with common definitions of mental health and its complement, mental illness. It was not very long ago, but perhaps two generations ago, that very, very different ideas of diagnosis and prescription for mental health conditions were published as fact with the force of law. There are literally hundreds of modern books written responsibly, but with varying levels of rigor and accredation, on these topics. Since every thinking person also has moods, aging parents, and sometimes ill relatives or personal episodes, the source pool for writing is endless. Last IMHO - yes, the American Medical Association and its accredited members do in fact draw lines, that change over time, but are defended at the time, sometimes aggressively. It is not exactly a "hit piece" but it is in fact, a disagreement with one side trying to settle the matter as an authority. Yet the decisions change over time. etc...
Simon_ORourke 3y ago
My old boy went through a good amount of nasty stuff in Vietnam, but was from the stuff upper lip school of emotion. He suppressed it pretty well, but it stayed with him. The stuff the commenters describe as being labeled trauma, such as being yelled at, doesn't reach the threshold of being problematic trauma by a reasonable person.
- nonrandomstring 3y ago
  Same. My old fella (Korea, Malaya, nuke tests) never once would have asked for help or admitted effects. He's call trauma "silly talk". It's definitely a generational thing.
  - ronald_raygun 3y ago
    "Veterans die by suicide at a higher rate than non-Veterans. In 2020, the age- and sex- adjusted suicide rate among Veterans was 57.3% higher than the age- and sex-adjusted rate among non-Veteran U.S. adults." https://www.mentalhealth.va.gov/suicide_prevention/docs/FSTP-Ways-Veterans-Differ-from-the-General-Population.pdf https://www.mentalhealth.va.gov/suicide_prevention/docs/FSTP...
    - nonrandomstring 3y ago
      When I can I dig in my pocket for this charity [0]. They do a bit of proactive mental-health work over here in UK. [0] https://www.helpforheroes.org.uk/ https://www.helpforheroes.org.uk/
- epylar 3y ago
  If it's a child being yelled at loudly almost every day for many years while growing up, I could see that as trauma.
  - dimal 3y ago
    Having experienced that, I can confirm that it is traumatic. And it does take a toll on your body.
sonofhans 3y ago
This is a reductive video from a content farm about a complex topic. Trauma has been well-studied in reasonably scientific ways for 100 years. We’re still not good at treating it, but the causes and mechanisms are pretty well understood — keep almost any human in a state of fear and helplessness long enough and they will develop trauma. Exactly how long, and how, and why — we know more than we did, and you can look it up. Judith Herman’s 1992 “Trauma and Recovery” is groundwork in the field, and responsible for much of our modern thought about it. Do we know exactly which brain regions and neurotransmitters give rise to specific effects? No. TBKTS does make forays into that, some with confidence and some with speculation. Criticisms of this aspect of the book don’t seem meaningful to me. We do know clearly that trauma appears to be kept in and released from the body, usually against the conscious intent of the victim. That alone is a giant idea, and it would have been world-altering for WW1 veterans accused of cowardice for their “shell shock.” Kids These Days (tm) are using the word “trauma” a lot to discuss things outside the medical definition of it. This happens with words. I’ve heard them talk, and most of it seems lightweight and ironic — “Oh god that English assignment gave me PTSD.” None of this should reflect back on the book, or the ideas within it.
- Modified3019 3y ago
  It should be noted that what is often called “shell shock” is at least two distinct things that get lumped together (though they can absolutely co-occur). The first is what we typically mean by “psychological” trauma, which can have physical secondary effects, but not reliably. Spending months being hunted is going to rewire some things. From what I’ve read, those who consistently imagine themselves “the hunter” rather than “the hunted” seem to fare better. The second is blast-induced neurotrauma, direct brain damage that blast waves physically cause. If a shell lands nearby, even if the head is fully protected, the wave can propagate up the spine into the skull. These force waves can then cause microshearing in the extremely fragile tissue there, resulting in inflammation and oxidation of the highly reactive polyunsaturated fats that make up our brains. The cascade of complex negative effects that follow only finally started getting proper attention due to the large number of IED injuries when the US invaded Iraq/Afganistan. Autopsies of those subjected to blast effects can often show a brain filled with nodules, either tiny like sand or much larger. This is the one that is really the cause of involuntary tremors and seizures that resulted in the brain damaged victim blamed for “cowardice”. The former can kinda-sorta be addressed. The later gets “hopes and prayers”.
viburnum 3y ago
Here’s a good article on the subject https://nymag.com/intelligencer/article/trauma-bessel-van-der-kolk-the-body-keeps-the-score-profile.html https://nymag.com/intelligencer/article/trauma-bessel-van-de...
munch117 3y ago
Question: That part of the brain he likes to call the cockroach brain - what's the standard name for that part of the brain?
- canadiantim 3y ago
  Reptilian brain? See https://en.m.wikipedia.org/wiki/Triune_brain https://en.m.wikipedia.org/wiki/Triune_brain
  - lazide 3y ago
    Amygdala?
    - munch117 3y ago
      Sounds about right, thank you.
gentleman11 3y ago
Question: how is trauma treated in this model? Basically, the concept is that there are hypersensitive neural pathways and your goal is to de-sensitize them? Is that right? Is there any parallel to the behaviouralist concept of behaviour extinction? Because that is really hard to achieve. Sounds similar to Exposure therapy too I don’t really want to talk about why but I’d love to know more about it
- tomek_ycomb 3y ago
  It's not entirely clear from a brief Google what behavior extinction is. However, I don't really think this is particularly parallel let alone same as any sort of prescriptive process for reward/training which the brief search on Google suggested behavior extinction is about. I'm not going to totally deny that there are any parallels between any behavior reinforcement mechanism m, but I'd sooner redirect to reading more about body keeps score before making the parallels to another concept (in this case)
- specialist 3y ago
  My mental model is replacing unwanted habits with preferred new habits. An example might be replacing negative thoughts with something more positive. Terribly over simplifying, but in my case I decided to fake being happy and positive, wrote some scripts for myself, and just kept repeating these new scripts. Imagine my surprise some years later when I actually sincerely meant what I was saying. -- In the case of pain and trauma, there's now a large and growing body of science about pain. In my case, my worst pain was a stabbing sensation in my back. It wasn't related to any of my physical injuries. Looking back, I now liken it to phantom limb pain. I enrolled in Swedish's Pain Services, what I nicknamed "Pain College". Lots of lectures and self-study about the best available science. Like "all pain is real" and the new paradigm of "pain is protection". So the trick is to identify that trigger and neutralize it. (My words. YMMV.) I also learned a bunch of new skills. Tai chi and qi gong; multiple specific forms of breathing, relaxation, and mediation; ideas on how to reorganize my life (and schedule) to better manage pain; and a bunch of other stuff. The most crazy thing I learned was "graded motor imagery". The intent was to reconnect my brain's pain processing with the actual source. So I was shown picture puzzles where I had to identify left vs right shoulder. During this activity, my experience of the stabbing pain (in my right shoulder) greatly diminished. Something that not even pain killers could do. Mind blown. -- So. Any way. Addressing one's trauma shouldn't cause more trauma. I've experienced that, multiple times. "The Body Keeps the Score" is like a primer for addressing some kinds of trauma. It's main contribution is popularizing the new pain and trauma sciences. There's been so much progress since it was first published, no one book could cover it all. -- To address one's pain (trauma), one has to find the right kind of professional, who has the answers you need. For me, that was Swedish's Pain Services. There's similar clinics nationwide. It might be worth getting a consultation. The team that helped me gave me additional resources (referrals) for my problems that were outside of their purview. -- https://www.swedish.org/services/pain-services https://www.swedish.org/services/pain-services
throwanem 3y ago
At time of writing, 'PTSD' occurs in these comments fully an order of magnitude less often than 'trauma' (12 vs 178 instances). Even discounting for the biasing effect of the title, this seems remarkable given what is being discussed. When did this distinction largely disappear from the discourse? It seems like it could have a great deal of clarifying power here. I don't believe I've yet seen anyone from the 'it's trauma if you think it is' school attempt to fit the empirical fact of PTSD into their theoretical model. I would be interested to see that, if anyone's inclined to try it.
- qazxcvbnmlp 3y ago
  Trauma -> an experience that threatens your way of being / safety above and beyond what you’re capable of handling at the time. It exists on a spectrum. So there’s large and small traumas and something that is traumatic for one person might not be for another. To the spectrum point: seeing your friend killed in war can be traumatic. But also, if you don’t have the emotional tools to handle rejection, then that can also be an event that overloads your emotional system. (Not making value judgements, both no good) PTSD -> post traumatic stress disorder. A group of symptoms that are believed to be originated from a traumatic event and have certain characteristics. An event can be traumatic but not lead to ptsd. Playing a little bit of devils advocate here. I wouldn’t say I’m in the crowd of “it’s trauma if you think it is”. However it can be useful to look at the processes of how our emotional processing system handles events, even if the systems someone is facing don’t reach the level of full on debilitating PTSD.
- graphe 3y ago
  PTSD is also lumped in with shell shock, a jarring of the braincase after explosions (usually during a war) with physical damage. It's unthinkable to me they lump it in with mental problems. George Carlin skit. https://youtu.be/hSp8IyaKCs0 https://youtu.be/hSp8IyaKCs0
  - throwanem 3y ago
    'Shell shock' is an obsolete term originating in the First World War (1914-1918) and referring indeterminately to either PTSD secondary to war trauma, or the chronic traumatic encephalopathy to which you refer. The term's imprecision is why it was retired. I recall the bit well, and being struck as much by its insistence on direct and meaningful language as by the fierce sort of kindness he made evident in its ending. Carlin was and is a treasure. But if I get treated for PTSD when what I have is CTE or vice versa, I probably won't do so well. In that sense, the more specific modern terms do have value, jargon though they also be.
throwanem 3y ago
Also interesting in this connection is a meta-analysis [1] finding significant effect for propranolol, a beta blocker, in mitigating PTSD symptoms via a protocol of administration followed by trauma memory reactivation (colloquially, 'triggering'). The postulated mechanism is the drug's interference with epinephrine and norepinephrine binding sites, the effect being to reduce the experience of fear and anger associated with revisiting such memories. Certainly this strikes me as entirely plausible, given my own experience of such memories. It does seem likely to further complicate the 'it's trauma if you think it is' model, considering the implicit organic correlate of trauma required for there to exist a mechanism of the demonstrated effect; the action of beta blockers is well understood. [1] https://europepmc.org/article/nbk/nbk562942#rc1254.ref3 https://europepmc.org/article/nbk/nbk562942#rc1254.ref3 (free text)
- bordercases 3y ago
  There being an organic correlate for attention, for memory formation, for emotions and so on – it's likely that the beta-blockers makes certain intents easier to override others, rather than the causality being only one way.
  - throwanem 3y ago
    This comment appears to depend on a model unfamiliar to me, in that I have no idea what you mean by 'intents' or the reference to causality here. Would you mind elaborating? I may not be alone in failing as yet to have taken your point.
- wholinator2 3y ago
  Huh, is it true that "its trauma if you think it is" is a current and respected, if not widespread theory? I'm no neurobiochemiologist but it always felt to me like the difference between painful memory and trauma was the involuntary aspect of reaction to trauma. I can think of a painful memory in the middle of a presentation and not appear troubled, i could not say the same for a trauma. My laymans experience with ptsd is that most experiences are outwardly visible (i don't know anyone diagnosed with severe so please excuse my ignorance)
eszed 3y ago
I didn't watch this video, but am familiar with "The Body Keeps the Score", and want to contribute supporting evidence (that I don't recall being discussed in the book). I've taken and taught voice for theatre, following what's called the 'Natural Voice' method. (Look for a book called "Freeing the Natural Voice", by Kristin Linklater, though other practitioners have augmented that since.) To summarize: bodies have natural resonating chambers, that act like the sound-box of a guitar or violin; tension in the body inhibits sound vibrations; release the tension. It's a completely physical process: exercises are about making sounds and feeling their vibrations in the body, relax, rinse repeat. It's occasionally odd, but not 'woo' in the least. Very pragmatic, and not at all psychological. Nevertheless, people have incredible emotional reactions while doing it. Linklater's theory is that we develop habitual tensions in response to things that hurt us (physically or emotionally), and that releasing tension releases emotions connected with the original incitement. (You can call that trauma, if you want, though I don't think Linklater ever uses that word. I never did when I was teaching, though maybe with "kids these days" I would.) In fact, those responses are kind of non-psychological, in that they're not like a flashback, or anything like that. People don't necessarily (although sometimes they do) have any knowledge or memory of the inciting events, but their bodies do. It's a fascinating process, which I think gets at these ideas from (as it were) the other way around.
keepamovin 3y ago
Interesting comments here. There's no way to put an objective scale on an internal experience, and not all effects are going to be externally measurable with any imposed schema of observations. There's no point disagreeing with people about what trauma is, the point of the video is not to define it in a 'programming language' sense of absolute disambiguation, the point is to raise awareness of what's real. Some of the commentary is confused in the sense that it is arguing over this thing which is subjective and cannot be pinned down, at least not in a way where you can objectively compare one person to another. To deny the reality of that internal emotional experience (which nevertheless can have diverse external manifestations) is to minimize people's pain and emotions, and effectively retraumatize them. It's a position which lacks empathy. Fixating on diagnostic criteria as prescriptive absolutes, rather than the non-exhaustive useful guides that is all they can be in this case, encodes this lack of empathy in a persistent formalism, which is very harmful. It's unlikely that those with an understanding of this would be trying to do that, tho it is possible as noted below. Even if you believed that trauma were completely capturable via external measurements, it would be beneficial for people suffering, and a society as a whole, to move the cutoff for what constitutes trauma toward a more inclusive direction. This would enable and encourage more of the very many people who live with unresolved trauma (either in awareness, ignorance or wilful suppression that that's what ails them), to take steps to heal themselves. In a real sense, these people are disabled in one or more aspects of their lives, because of the trauma. This trauma is harder for them to deal with and heal from to the extent that there is large portion of society who hampers attempts to acknowledge it as real. Pushing the needle in a more restrictive direction, as some of the comments sadly advocate for here, lacks empathy, harms society, is out of touch with the reality of the epidemic of unresolved emotional issues in society that often span generations, and even cultures, and is fundamentally incorrect. In short, people will be reluctant to seek help, and unlikely to receive support, for what they or those around them do not believe is real. Reducing stigma around trauma (and mental illness) in general) , is crucial to developing the fairer, more just, happier and healthier society, and individuals in it, that we all deserve. But why would people want to push the needle in the other direction, insist solely on limited objective measures of subjective experiences that you will not know unless you experience it, and in effect, try to minimize and disrespectfully dismiss other people's suffering? Probably there's a small amount of mimicry commentary that's merely picking a side without thinking it through. Aside from that, the greatest share looks to be people who seek to minimize or deny the reality of trauma to hide from their own. That's because, as they are too afraid to face their own trauma, so therefore they want to pretend it's not real for any, except in the most obvious, and safely distant to them, cases. This is because their own suppressed suffering, and their lack of knowledge of how to deal with it, so frightens them, that they don't even want to acknowledge it. Akin to a young child (or even an adult) keep their eyes tight shut and their ears covered, to avoid facing a traumatic scene in a film. These suffering in silence, likely also do not know how to even begin to deal with what so ails them, and do not like the sense of powerlessness that even thinking about opening that 'can of worms' to face, process and heal their own trauma, seems to them to be. This is very understandable. The last category of deniers or minimizers, while less understandable, are no less expected. These consist of people who seek to minimize other's trauma because they are so afraid that their own actions have hurt people, and do not want to see themselves called out for, or punished for this. Therefore, they think that by trying to minimize, mock, discredit and dismiss the feelings and experience of many traumatized people, they will make themselves safter from the feared punishment for the trauma they believe they caused others.

92 points by keepamovin 3y ago

deleted 3y ago

[deleted]

Like most popular science/psychology books, this one has attracted a lot of criticism for making exaggerated claims and for peddling reductive concepts to appeal to a wider audience. There’s no denying that massive stress and trauma can have long lasting effects. However, the pop culture definition of trauma and stress have become very diluted. I spent some time working with college students recently and it was remarkable to hear how many of them described common life events as “trauma”: Break ups, failing a class, or even getting yelled at by someone. Something weird happens when they’ve been primed to recognize everything uncomfortable as “trauma” and they’ve been instilled with the belief that it will forever become embedded in their person as baggage.

ajkjk 3y ago
In my experience it's kinda the opposite. Realizing that stuff was trauma helped move on from it. Until I had a framework for why a fairly-normal-sounding experience was affecting my personality so much, I just felt like I was going crazy. It helped a lot to realize that ruminating on it was how trauma works: its purpose is to figure out how to avoid a recurrence at all costs, including warping one's behavior in aberrant ways.
- DANmode 3y ago
  Instinctual, evolutionary response. It makes all sorts of sense.
armatav 3y ago
Some people can kill a man, or lose a limb and not suffer traumatic rumination. Some other people lose their favorite toy as an kid and it really does become a deep rumination pattern of traumatic loss for them.
- Aurornis 3y ago
  > Some other people lose their favorite toy as an kid and it really does become a deep rumination pattern of traumatic loss for them. In this case, the "trauma" is virtually irrelevant, though. The issue is the rumination and pattern of overreaction, which should certainly be addressed. For some, the obsession with "trauma" becomes a way to move the focus to something external, which is therefore out of their control. In your example, too much focus on "trauma" as an explanation for everything could mislead someone into thinking that the loss of the toy is to blame for their situation, whereas they really need to accept that their reaction and pattern of rumination is what needs to be addressed.
batch12 3y ago
I agree that words have meanings. Words like trauma and abuse shouldn’t be used casually or we won't have the language to describe horrific things. However-- having experienced some early childhood difficulties, I have had to make an intentional effort not to downgrade people's experiences and fall into a no true Scotsman trap. I try to remind myself that things like trauma and abuse are experiences that filter through people's minds. It's trauma if they think it is. I do also think though that some people have never experienced the same types of trauma as others so they may not really understand it. If and when they do, they may choose to rank the experiences differently. Edit: updated my ramble
- throwanem 3y ago
  > It's trauma if they think it is and it impacts them as trauma. This sentence gained a clause before I hit 'reply', and I understand why because it addresses the criticism I intended to make, but I'm still not at all sure I agree with you here. Even the edit implies the assumption that no one is responsible for how they choose to respond to the events of their lives, and that is plausible but requires substantiation not evident here. In particular, I do not think it is necessary for anyone to personally experience 'horrific things' to understand that some things are worse than others, and be glad that what they're dealing with isn't worse - which probably sounds cruel to some, but is in fact quite helpful; maintaining a sense of perspective around the mishaps that attend every human life can in itself go a long way toward responding to them in a way that's well calibrated to their actual severity. In the meantime, not treating 'trauma' as suitable to describe every unfortunate happenstance - a college breakup! Really... - also avoids vitiating the concept, which strikes me as a worthwhile kindness to those who really have been through hell - or those who haven't yet, and will find it easier to come out the other side for there still being social space to accommodate the existence of those who have to recover from, or just find a way to live with, long experience of the genuinely atrocious.
  - batch12 3y ago
    Yeah, I've waffled on that because I don't know how to say it how I mean it. I'll try to generalize it but I'm sure I won't get it right. If something has you afraid, it doesnt matter if I think your fear is justified. Me disregarding your emotion doesn't make you lose the fear. I don't disagree with the idea that we are responsible for how we respond to events in our lives. I tell my kids the same thing- nobody can control you unless you let them. You have the power to control how you respond to things. Sometimes it's the only power you have. I don't have to agree that a college breakup is trauma, but it isn't helpful in most cases to point that out when someone thinks it is. Instead, maybe I can just listen the way I would if it were something I thought was more important. Maybe they'll get through it the same way I did given enough time. Edit: >In particular, I do not think it is necessary for anyone to personally experience 'horrific things' to understand that some things are worse than others, Unfortunately I do disagree with you here. I've met too many people that seem incapable of proper empathy or otherwise lack the ability to learn from the mistakes of others. I could agree with swapping anyone with everyone.
nonrandomstring 3y ago
Certainly "trauma" has been diluted. Someone I think who does a really good job of distinguishing actual trauma (something that disrupts development) from acquired entitlement etc is Gabor Mate in "The myth of normal". Would definitely recommend.
- Aurornis 3y ago
  > Someone I think who does a really good job of distinguishing actual trauma (something that disrupts development) from acquired entitlement etc is Gabor Mate Gabor Mate is extremely charismatic, but IMO he's part of the problem. The last time I listened to a podcast where he was a guest, he pushed the idea that being born could qualify as trauma leading to PTSD in adulthood. He told a story about a patient with mental health issues where he was unable to identify overt trauma until despite going through her life in fine detail. Eventually he concluded that it must have been the experience of being born that was her trauma. This is what I was talking about when someone pushes the "trauma explains everything" angle: When all you have is a hammer, everything looks like a nail. Some of these pseudo-experts may be good at treating trauma, but they take it too far and start trying to describe everything big or small as a trauma.
  - nonrandomstring 3y ago
    If true that does indeed sound quite ridiculous.
    - luxpir 3y ago
      I may be misremembering, but my recollection is that he talks about the stresses of the parents being passed on from birth. My other vague recollection is that studies exist which prove this phenomenon to be true. A third vague recollection is that his own mother was persecuted due to religion, giving his theories and his reason to pursue them some level of credibility. My memory is not machine-like in its efficiency. I am open to correction. But I believe GP may not be fully stating the facts for their own reasons.
dnissley 3y ago
See "The rise of therapy-speak": https://www.newyorker.com/culture/cultural-comment/the-rise-of-therapy-speak https://www.newyorker.com/culture/cultural-comment/the-rise-...
flatline 3y ago
As someone who grew up in the 80s, this type of minimization of personal suffering was the norm. “You don’t know how good you have it” despite real mental and physical health struggles. You either made it to adulthood, cynical and damaged, transformed your suffering into growth on your own, or ended up in some marginalized place like a mental ward. Sometimes a mix of all of the above. I think we can do better. I remember the first time I saw a therapist she thought I may have PTSD. I thought she was nuts and never went back. It took me another decade to realize that my mother was deeply mentally ill and physically and emotionally abusive, it’s just that no one ever talked about or recognized these things as abnormal. My dad was a high functioning alcoholic. I’ve talked to other adults who went through much less than I did and left home and lived on the streets rather than deal with their family situation. But talk to my parents, everything was “fine” and “pretty normal”. I had a “good upbringing” because we were not poor or in trouble with the law. I also had some early sexual encounters that people would jump to classify as child abuse, but they were, from my standpoint, overall positive experiences. I don’t know where to draw the line on what constitutes trauma for someone else. It’s highly subjective. There are always things in life we must just bear. But it’s good to recognize when things are not working and to make what changes we can, and to recognize when things have long lasting impacts, and when they don’t.
- slibhb 3y ago
  > As someone who grew up in the 80s, this type of minimization of personal suffering was the norm. It's a tricky problem. Some people need help. But there are a lot of people for whom "holding it in" and adopting general-purpose stoic principles are enough. For the latter group, the new openness about mental illness and trauma has been a disaster. Like a lot of things, you can think of this issue in terms of "type 1 and type 2 errors". Ideally we try to minimize both but it seems that we often end up minimizing one and totally ignoring the other.
  - bjornsing 3y ago
    > For the latter group, the new openness about mental illness and trauma has been a disaster. Why so?
lepus 3y ago
For now it's the term people have adopted to describe a wide range of negative impactful experiences. Usually there's something deeper and older going on in someone when a seemingly minor event causes feelings of "trauma", but sometimes the extreme results of opening that can of worms in someone can be nearly as devastating. The human experience is messy and ultimately hard to keep confined in rigid definitions, but we keep trying.
shadowbanned4 3y ago
[dead]
TaylorAlexander 3y ago
I can absolutely see why break ups, failing a class, and getting yelled at by someone can be traumatic. I’ve had quite traumatic break ups in my youth due to my own attachment and expectations about the relationship and life. If someone had a lot of pressure about academic success growing up, or a lot of hopes attached to good grades, failure could be traumatic. I would hope that the potential for trauma in getting yelled at would be self evident. Trauma doesn’t mean the experience will be forever embedded as “baggage”. It means it’s something we’re carrying with us right now. Something we’ve not fully processed or healed from. I’ve found that identifying and recognizing trauma is part of the healing process. Failing to identify trauma can mean carrying it with you longer - snapping at others when you get too irritated, because someone did so to you and you haven’t processed the emotional trauma of the situation, for example. Or high anxiety at work carried over from the trauma of failing a class, because you haven’t recognized that even after that failure things worked out okay and you’re still carrying the fear of failure. Trauma like many words has degrees. It is similar to the word injury in that sense. Losing your legs in a motorcycle accident is an injury. A sprained wrist is also an injury. Just remember that with trauma it is hard to see how deep it went. Perhaps someone did experience quite strong trauma from something you would manage easily. That’s due to the different lives you lead, and differences in experience, values, and goals. And remember that situations others might handle well could be things you struggle with. Everyone’s experience is their own.
mock-possum 3y ago
> it was remarkable to hear how many of them described common life events as “trauma”: Break ups, failing a class, or even getting yelled at by someone. Isn’t it a bit cruel to dismiss the ups and downs of college life as unworthy of being called ‘traumatic?’ Who are you to make that judgement?
DANmode 3y ago
Many people experience severe health problems related to trauma that other people can shake right off. Humans are a wide spectrum, all good and bad at unique things - and you "can't judge a fish on its ability to climb a tree".
ronald_raygun 3y ago
> Break ups, failing a class, or even getting yelled at by someone I agree a lot of people overblow trauma. However it is worth mentioning, all the things that you mention can be traumatizing, though. Like imagine breaking up with a partner of a few years because they've been serially cheating on you and lying about it. Imagine failing a class when you've been pressured by your parents your entire life to do well in school, and you know this is going to set them off the edge. Imagine being yelled at for 20 minutes in front of the whole class as a tiny kid. Like the question isn't really "is X bad in an objective way" but more "did X create a bunch of problems for so and so that make their life harder in terms of emotions, psychology, etc."
- voisin 3y ago
  > Like the question isn't really "is X bad in an objective way" but more "did X create a bunch of problems for so and so that make their life harder in terms of emotions, psychology, etc." From the book itself, trauma is more closely defined as “what causes the sympathetic nervous system (fight or flight) to overreact” which then causes the body to have to deal with the excess cortisol released by the overreaction. This can be the accumulation of micro-stressors or individual major events. OP’s dismissal of things due to being “common life events” is simply ridiculous.
voisin 3y ago
I find it ludicrous that you would suggest that the breakup of a close romantic relationship shouldn’t be considered traumatic or qualify as trauma for someone that is of college age, only because of the commonality of occurrence.
kirse 3y ago
many of them described common life events as “trauma” We've experienced a massive dilution in language over the past decade or so. I'm not sure if it's because we're churning out more black & white thinkers or incentivizing folks with a victim mindset, but all sorts of words like *-phobic, gaslighting, trauma, etc. have become significantly overused given their traditional symptomatic markers. It's the language equivalent of WebMD - basically implying that a grab bag of cold symptoms are in fact brain cancer. On one hand it's good that the next generation thinks a breakup is "traumatic", because it means people are experiencing less absolute trauma. On the other hand words have meanings so we can accurately describe the world.
Fire-Dragon-DoL 3y ago
The severity of pain of a life event changes with the skilld of a person. 2 children playing and one starts crying because the other broke their toy, is that less intense than an adult breakfing up with the lifelong partner? The answer I thought was yes and over time came to realize that it's probably no. Given that, what you perceive as traumatic is not the same for another person
Tactile6700 3y ago
The book does distinguish “Big T” & “Little T” trauma. Little T is a helpful concept re the fairly normal life difficulties noted—-validates the pain but keeps it in perspective. Concern about a priming effect is also valid.
bowsamic 3y ago
Idk it wasn’t until I went to my therapist that I realised that my mum leaving at the age of 2 was traumatic and that I have a lot of extreme stress and depressive responses now from that even though I didn’t know it. It’s easy to say “divorce is normal and not traumatic” but I think that normal life events can and do cause trauma

bloopernova 3y ago

I'm annoyed at this book and others like it. Despite their helpfulness to many people, one side effect has been that some doctors in the USA now use CPTSD or similar to dismiss people suffering from chronic pain. "If you're in pain, you probably have some (childhood) trauma that you haven't processed correctly. Go see a therapist and come back for a follow-up." (when it takes 6 months or more to get in to a therapist, and the patient is in pain right now) (Yes, this is a huge chip on my shoulder. Like copper thieves have ruined many buildings, doctors handing out opioid prescriptions to everyone has ruined pain management in the USA)

ronald_raygun 3y ago
Yeah I mean its not great. Obviously, having CPTSD stresses the body out and can cause chronic issues. So there a big problem of the intersection of (people with chronic pain) and (people with CPTSD), is non-empty. But also a lot of chronic issues seem hard to diagnose, so if you're a doctor, and you're basically moving through the set of common problems/treatments that wont cause more harm, well then a bunch of people that should be down the pipeline will get delays.
esperent 3y ago
It's a huge stretch to blame this book for the opioid crisis.

ants_everywhere 3y ago

Isn't "The Body Keeps the Score" regarded as a crackpot book full of long-discredited theories? E.g. https://journals.sagepub.com/doi/pdf/10.1177/070674370505001302 https://journals.sagepub.com/doi/pdf/10.1177/070674370505001... and https://www.washingtonpost.com/books/2023/08/02/body-keeps-score-grieving-brain-bessel-van-der-kolk-neuroscience-self-help/ https://www.washingtonpost.com/books/2023/08/02/body-keeps-s...

nonrandomstring 3y ago
No. And some would say that elements of the "medical profession" have spent a lot of money soliciting hit pieces that try to weaken the link between trauma and physiological effects. But that would be a pointless 'argument' to get into since there is mountains of dishonest rubbish on both sides. Instead I think this rather reputable Psychology Today summary on the causal links of trauma and consequent disorders is worth a read [0]; [0] https://www.psychologytoday.com/us/blog/the-addiction-connection/202103/how-trauma-affects-the-body https://www.psychologytoday.com/us/blog/the-addiction-connec...
- feoren 3y ago
  Can you give a single example of the oddly scare-quoted "medical profession" soliciting a hit piece on anything, ever?
  - mistrial9 3y ago
    this question seems naive, despite the hyperbole from the parent-post. Western accredited medicine has made huge advances in things like antibiotics or germ-theory, yet have struggled with common definitions of mental health and its complement, mental illness. It was not very long ago, but perhaps two generations ago, that very, very different ideas of diagnosis and prescription for mental health conditions were published as fact with the force of law. There are literally hundreds of modern books written responsibly, but with varying levels of rigor and accredation, on these topics. Since every thinking person also has moods, aging parents, and sometimes ill relatives or personal episodes, the source pool for writing is endless. Last IMHO - yes, the American Medical Association and its accredited members do in fact draw lines, that change over time, but are defended at the time, sometimes aggressively. It is not exactly a "hit piece" but it is in fact, a disagreement with one side trying to settle the matter as an authority. Yet the decisions change over time. etc...

Simon_ORourke 3y ago

My old boy went through a good amount of nasty stuff in Vietnam, but was from the stuff upper lip school of emotion. He suppressed it pretty well, but it stayed with him. The stuff the commenters describe as being labeled trauma, such as being yelled at, doesn't reach the threshold of being problematic trauma by a reasonable person.

nonrandomstring 3y ago
Same. My old fella (Korea, Malaya, nuke tests) never once would have asked for help or admitted effects. He's call trauma "silly talk". It's definitely a generational thing.
- ronald_raygun 3y ago
  "Veterans die by suicide at a higher rate than non-Veterans. In 2020, the age- and sex- adjusted suicide rate among Veterans was 57.3% higher than the age- and sex-adjusted rate among non-Veteran U.S. adults." https://www.mentalhealth.va.gov/suicide_prevention/docs/FSTP-Ways-Veterans-Differ-from-the-General-Population.pdf https://www.mentalhealth.va.gov/suicide_prevention/docs/FSTP...
  - nonrandomstring 3y ago
    When I can I dig in my pocket for this charity [0]. They do a bit of proactive mental-health work over here in UK. [0] https://www.helpforheroes.org.uk/ https://www.helpforheroes.org.uk/
epylar 3y ago
If it's a child being yelled at loudly almost every day for many years while growing up, I could see that as trauma.
- dimal 3y ago
  Having experienced that, I can confirm that it is traumatic. And it does take a toll on your body.

sonofhans 3y ago

This is a reductive video from a content farm about a complex topic. Trauma has been well-studied in reasonably scientific ways for 100 years. We’re still not good at treating it, but the causes and mechanisms are pretty well understood — keep almost any human in a state of fear and helplessness long enough and they will develop trauma. Exactly how long, and how, and why — we know more than we did, and you can look it up. Judith Herman’s 1992 “Trauma and Recovery” is groundwork in the field, and responsible for much of our modern thought about it. Do we know exactly which brain regions and neurotransmitters give rise to specific effects? No. TBKTS does make forays into that, some with confidence and some with speculation. Criticisms of this aspect of the book don’t seem meaningful to me. We do know clearly that trauma appears to be kept in and released from the body, usually against the conscious intent of the victim. That alone is a giant idea, and it would have been world-altering for WW1 veterans accused of cowardice for their “shell shock.” Kids These Days (tm) are using the word “trauma” a lot to discuss things outside the medical definition of it. This happens with words. I’ve heard them talk, and most of it seems lightweight and ironic — “Oh god that English assignment gave me PTSD.” None of this should reflect back on the book, or the ideas within it.

Modified3019 3y ago
It should be noted that what is often called “shell shock” is at least two distinct things that get lumped together (though they can absolutely co-occur). The first is what we typically mean by “psychological” trauma, which can have physical secondary effects, but not reliably. Spending months being hunted is going to rewire some things. From what I’ve read, those who consistently imagine themselves “the hunter” rather than “the hunted” seem to fare better. The second is blast-induced neurotrauma, direct brain damage that blast waves physically cause. If a shell lands nearby, even if the head is fully protected, the wave can propagate up the spine into the skull. These force waves can then cause microshearing in the extremely fragile tissue there, resulting in inflammation and oxidation of the highly reactive polyunsaturated fats that make up our brains. The cascade of complex negative effects that follow only finally started getting proper attention due to the large number of IED injuries when the US invaded Iraq/Afganistan. Autopsies of those subjected to blast effects can often show a brain filled with nodules, either tiny like sand or much larger. This is the one that is really the cause of involuntary tremors and seizures that resulted in the brain damaged victim blamed for “cowardice”. The former can kinda-sorta be addressed. The later gets “hopes and prayers”.

viburnum 3y ago

Here’s a good article on the subject https://nymag.com/intelligencer/article/trauma-bessel-van-der-kolk-the-body-keeps-the-score-profile.html https://nymag.com/intelligencer/article/trauma-bessel-van-de...

munch117 3y ago

Question: That part of the brain he likes to call the cockroach brain - what's the standard name for that part of the brain?

canadiantim 3y ago
Reptilian brain? See https://en.m.wikipedia.org/wiki/Triune_brain https://en.m.wikipedia.org/wiki/Triune_brain
- lazide 3y ago
  Amygdala?
  - munch117 3y ago
    Sounds about right, thank you.

gentleman11 3y ago

Question: how is trauma treated in this model? Basically, the concept is that there are hypersensitive neural pathways and your goal is to de-sensitize them? Is that right? Is there any parallel to the behaviouralist concept of behaviour extinction? Because that is really hard to achieve. Sounds similar to Exposure therapy too I don’t really want to talk about why but I’d love to know more about it

tomek_ycomb 3y ago
It's not entirely clear from a brief Google what behavior extinction is. However, I don't really think this is particularly parallel let alone same as any sort of prescriptive process for reward/training which the brief search on Google suggested behavior extinction is about. I'm not going to totally deny that there are any parallels between any behavior reinforcement mechanism m, but I'd sooner redirect to reading more about body keeps score before making the parallels to another concept (in this case)
specialist 3y ago
My mental model is replacing unwanted habits with preferred new habits. An example might be replacing negative thoughts with something more positive. Terribly over simplifying, but in my case I decided to fake being happy and positive, wrote some scripts for myself, and just kept repeating these new scripts. Imagine my surprise some years later when I actually sincerely meant what I was saying. -- In the case of pain and trauma, there's now a large and growing body of science about pain. In my case, my worst pain was a stabbing sensation in my back. It wasn't related to any of my physical injuries. Looking back, I now liken it to phantom limb pain. I enrolled in Swedish's Pain Services, what I nicknamed "Pain College". Lots of lectures and self-study about the best available science. Like "all pain is real" and the new paradigm of "pain is protection". So the trick is to identify that trigger and neutralize it. (My words. YMMV.) I also learned a bunch of new skills. Tai chi and qi gong; multiple specific forms of breathing, relaxation, and mediation; ideas on how to reorganize my life (and schedule) to better manage pain; and a bunch of other stuff. The most crazy thing I learned was "graded motor imagery". The intent was to reconnect my brain's pain processing with the actual source. So I was shown picture puzzles where I had to identify left vs right shoulder. During this activity, my experience of the stabbing pain (in my right shoulder) greatly diminished. Something that not even pain killers could do. Mind blown. -- So. Any way. Addressing one's trauma shouldn't cause more trauma. I've experienced that, multiple times. "The Body Keeps the Score" is like a primer for addressing some kinds of trauma. It's main contribution is popularizing the new pain and trauma sciences. There's been so much progress since it was first published, no one book could cover it all. -- To address one's pain (trauma), one has to find the right kind of professional, who has the answers you need. For me, that was Swedish's Pain Services. There's similar clinics nationwide. It might be worth getting a consultation. The team that helped me gave me additional resources (referrals) for my problems that were outside of their purview. -- https://www.swedish.org/services/pain-services https://www.swedish.org/services/pain-services

throwanem 3y ago

At time of writing, 'PTSD' occurs in these comments fully an order of magnitude less often than 'trauma' (12 vs 178 instances). Even discounting for the biasing effect of the title, this seems remarkable given what is being discussed. When did this distinction largely disappear from the discourse? It seems like it could have a great deal of clarifying power here. I don't believe I've yet seen anyone from the 'it's trauma if you think it is' school attempt to fit the empirical fact of PTSD into their theoretical model. I would be interested to see that, if anyone's inclined to try it.

qazxcvbnmlp 3y ago
Trauma -> an experience that threatens your way of being / safety above and beyond what you’re capable of handling at the time. It exists on a spectrum. So there’s large and small traumas and something that is traumatic for one person might not be for another. To the spectrum point: seeing your friend killed in war can be traumatic. But also, if you don’t have the emotional tools to handle rejection, then that can also be an event that overloads your emotional system. (Not making value judgements, both no good) PTSD -> post traumatic stress disorder. A group of symptoms that are believed to be originated from a traumatic event and have certain characteristics. An event can be traumatic but not lead to ptsd. Playing a little bit of devils advocate here. I wouldn’t say I’m in the crowd of “it’s trauma if you think it is”. However it can be useful to look at the processes of how our emotional processing system handles events, even if the systems someone is facing don’t reach the level of full on debilitating PTSD.
graphe 3y ago
PTSD is also lumped in with shell shock, a jarring of the braincase after explosions (usually during a war) with physical damage. It's unthinkable to me they lump it in with mental problems. George Carlin skit. https://youtu.be/hSp8IyaKCs0 https://youtu.be/hSp8IyaKCs0
- throwanem 3y ago
  'Shell shock' is an obsolete term originating in the First World War (1914-1918) and referring indeterminately to either PTSD secondary to war trauma, or the chronic traumatic encephalopathy to which you refer. The term's imprecision is why it was retired. I recall the bit well, and being struck as much by its insistence on direct and meaningful language as by the fierce sort of kindness he made evident in its ending. Carlin was and is a treasure. But if I get treated for PTSD when what I have is CTE or vice versa, I probably won't do so well. In that sense, the more specific modern terms do have value, jargon though they also be.

throwanem 3y ago

Also interesting in this connection is a meta-analysis [1] finding significant effect for propranolol, a beta blocker, in mitigating PTSD symptoms via a protocol of administration followed by trauma memory reactivation (colloquially, 'triggering'). The postulated mechanism is the drug's interference with epinephrine and norepinephrine binding sites, the effect being to reduce the experience of fear and anger associated with revisiting such memories. Certainly this strikes me as entirely plausible, given my own experience of such memories. It does seem likely to further complicate the 'it's trauma if you think it is' model, considering the implicit organic correlate of trauma required for there to exist a mechanism of the demonstrated effect; the action of beta blockers is well understood. [1] https://europepmc.org/article/nbk/nbk562942#rc1254.ref3 https://europepmc.org/article/nbk/nbk562942#rc1254.ref3 (free text)

bordercases 3y ago
There being an organic correlate for attention, for memory formation, for emotions and so on – it's likely that the beta-blockers makes certain intents easier to override others, rather than the causality being only one way.
- throwanem 3y ago
  This comment appears to depend on a model unfamiliar to me, in that I have no idea what you mean by 'intents' or the reference to causality here. Would you mind elaborating? I may not be alone in failing as yet to have taken your point.
wholinator2 3y ago
Huh, is it true that "its trauma if you think it is" is a current and respected, if not widespread theory? I'm no neurobiochemiologist but it always felt to me like the difference between painful memory and trauma was the involuntary aspect of reaction to trauma. I can think of a painful memory in the middle of a presentation and not appear troubled, i could not say the same for a trauma. My laymans experience with ptsd is that most experiences are outwardly visible (i don't know anyone diagnosed with severe so please excuse my ignorance)

eszed 3y ago

I didn't watch this video, but am familiar with "The Body Keeps the Score", and want to contribute supporting evidence (that I don't recall being discussed in the book). I've taken and taught voice for theatre, following what's called the 'Natural Voice' method. (Look for a book called "Freeing the Natural Voice", by Kristin Linklater, though other practitioners have augmented that since.) To summarize: bodies have natural resonating chambers, that act like the sound-box of a guitar or violin; tension in the body inhibits sound vibrations; release the tension. It's a completely physical process: exercises are about making sounds and feeling their vibrations in the body, relax, rinse repeat. It's occasionally odd, but not 'woo' in the least. Very pragmatic, and not at all psychological. Nevertheless, people have incredible emotional reactions while doing it. Linklater's theory is that we develop habitual tensions in response to things that hurt us (physically or emotionally), and that releasing tension releases emotions connected with the original incitement. (You can call that trauma, if you want, though I don't think Linklater ever uses that word. I never did when I was teaching, though maybe with "kids these days" I would.) In fact, those responses are kind of non-psychological, in that they're not like a flashback, or anything like that. People don't necessarily (although sometimes they do) have any knowledge or memory of the inciting events, but their bodies do. It's a fascinating process, which I think gets at these ideas from (as it were) the other way around.

keepamovin 3y ago

Interesting comments here. There's no way to put an objective scale on an internal experience, and not all effects are going to be externally measurable with any imposed schema of observations. There's no point disagreeing with people about what trauma is, the point of the video is not to define it in a 'programming language' sense of absolute disambiguation, the point is to raise awareness of what's real. Some of the commentary is confused in the sense that it is arguing over this thing which is subjective and cannot be pinned down, at least not in a way where you can objectively compare one person to another. To deny the reality of that internal emotional experience (which nevertheless can have diverse external manifestations) is to minimize people's pain and emotions, and effectively retraumatize them. It's a position which lacks empathy. Fixating on diagnostic criteria as prescriptive absolutes, rather than the non-exhaustive useful guides that is all they can be in this case, encodes this lack of empathy in a persistent formalism, which is very harmful. It's unlikely that those with an understanding of this would be trying to do that, tho it is possible as noted below. Even if you believed that trauma were completely capturable via external measurements, it would be beneficial for people suffering, and a society as a whole, to move the cutoff for what constitutes trauma toward a more inclusive direction. This would enable and encourage more of the very many people who live with unresolved trauma (either in awareness, ignorance or wilful suppression that that's what ails them), to take steps to heal themselves. In a real sense, these people are disabled in one or more aspects of their lives, because of the trauma. This trauma is harder for them to deal with and heal from to the extent that there is large portion of society who hampers attempts to acknowledge it as real. Pushing the needle in a more restrictive direction, as some of the comments sadly advocate for here, lacks empathy, harms society, is out of touch with the reality of the epidemic of unresolved emotional issues in society that often span generations, and even cultures, and is fundamentally incorrect. In short, people will be reluctant to seek help, and unlikely to receive support, for what they or those around them do not believe is real. Reducing stigma around trauma (and mental illness) in general) , is crucial to developing the fairer, more just, happier and healthier society, and individuals in it, that we all deserve. But why would people want to push the needle in the other direction, insist solely on limited objective measures of subjective experiences that you will not know unless you experience it, and in effect, try to minimize and disrespectfully dismiss other people's suffering? Probably there's a small amount of mimicry commentary that's merely picking a side without thinking it through. Aside from that, the greatest share looks to be people who seek to minimize or deny the reality of trauma to hide from their own. That's because, as they are too afraid to face their own trauma, so therefore they want to pretend it's not real for any, except in the most obvious, and safely distant to them, cases. This is because their own suppressed suffering, and their lack of knowledge of how to deal with it, so frightens them, that they don't even want to acknowledge it. Akin to a young child (or even an adult) keep their eyes tight shut and their ears covered, to avoid facing a traumatic scene in a film. These suffering in silence, likely also do not know how to even begin to deal with what so ails them, and do not like the sense of powerlessness that even thinking about opening that 'can of worms' to face, process and heal their own trauma, seems to them to be. This is very understandable. The last category of deniers or minimizers, while less understandable, are no less expected. These consist of people who seek to minimize other's trauma because they are so afraid that their own actions have hurt people, and do not want to see themselves called out for, or punished for this. Therefore, they think that by trying to minimize, mock, discredit and dismiss the feelings and experience of many traumatized people, they will make themselves safter from the feared punishment for the trauma they believe they caused others.