Why Attacking The Body Keeps the Score Isn't Helpful
And actually mimics an old pattern of silencing survivors
The satirical and dogmatic hosts of the podcast If Books Could Kill put out a new episode recently, on the breakthrough trauma book The Body Keeps the Score. I have occasionally listened to this show — whose tagline is “The airport bestsellers that captured our hearts and ruined our minds” and whose implication is that the books it covers are problematic to the degree of being fatally dangerous — but I heard about this episode first from a patient who came to me in distress.
“Have I been wrong all this time?” they asked, in tears. Not about any of the content of the episode. Rather, they came to me questioning whether they could trust their own experience. And I suspect that many others, still working to reclaim their voices after protracted periods of being silenced and overwhelmed, might feel the same.
Yes, I agree that there are things that need critiqued and developed beyond van der Kolk’s book. I’m not here to defend him, or anything for that matter, as perfect. But constructive critique examines its own reasons and moves the conversation forward. It is in large part due to the immense success of The Body Keeps the Score that we have seen just that: a radical acceptance of the incidence of trauma, and the landscape of research and trade books on the topic expanding to include other perspectives. (As van der Kolk wrote in his first chapter, psychiatry’s position as recently as 1974 was that “incest was extremely rare in the U.S., occurring about once in every million women.” Many others have written about the mental health profession’s amnesia for trauma too. We clearly needed someone to get us back on track). If you want to read other books on trauma, I’d recommend for starters Judith Herman’s Trauma and Recovery and Truth and Repair, Stephanie Foo’s What My Bones Know, Emotional Inheritance by Galit Atlas, The Tell by Amy Griffin, and Resma Menakem’s My Grandmother’s Hands. These books bring a needed breadth to trauma studies including awareness of racialized and transgenerational dimensions of trauma, feminist perspectives, and accessing dissociated memory through psychedelics. These, too, will have critiques and evolution, as it should be.
However, some critiques are meant to sharpen and expand, and others are meant to silence. As I listened to my patient’s distress and then the episode itself, I wondered, “What is the spirit of this critique? What is it the hosts want to accomplish, and is that actually likely to happen as a result of this episode?” I suspect they may have just thought their episode would be sensational. Both Hobbes and Shamshiri admitted that neither of them have experience with trauma, and furthermore that a review of its treatments was far outside the scope of their expertise. They laughed at (accurate) descriptions of patients presenting with dissociative disorders. Needless to say, I didn’t get any sense that they were out to help actual trauma survivors. What I suspect they didn’t know is that they were playing into a decades-old authoritarian and oppressive tendency to silence survivors through unilateral narratives.
The hosts rightly recognize that three things are interwoven in van der Kolk’s explication of trauma: 1) disorganized memory, 2) the Recovered Memory Movement, and 3) a new understanding of PTSD to include Complex-PTSD and Developmental Trauma.
Talking about the Recovered Memory Movement is not an aside but directly to the point. In the 1980’s and 1990’s, growing out of the Women’s Movement and public recognition of PTSD, large numbers of people began to access and disclose dissociated memories of prior trauma. However, there was extreme backlash to the disclosures, driven in large part by a group called the False Memory Syndrome Foundation (FMSF). The founders and a large constituent of that group were — surprise, surprise — themselves accused of committing abuse. What happened then was a conjuration of rhetoric and power.
The FMSF was composed of people who had power (as parents first, and also institutionally and financially). They raised money and used their connections to make sure their stories were told in the media. It’s not hard to imagine that survivors lacked the funds and cohesive institutional power to do the same. In 1991, 80% of media stories addressing memory and abuse considered the perspective of survivors; only three years later in 1994, 80% of stories on the topic questioned the veracity of memory and inclined readers toward denial. The way narratives were framed by the media shaped where we put our attention publicly, and the recent episode of If Books Could Kill is designed to do the same. Van der Kolk quoted internationally renowned neuroscientist Antonio Damasio with an observation that seems apt here: “Sometimes we use our minds not to discover facts, but to hide them.”
Let’s come back to the other two points of van der Kolk’s explication of trauma. He wrote about Developmental Trauma as distinct from PTSD that originates in adulthood, perhaps after a foundation of secure attachment. This is an incredibly meaningful distinction. The context in which potentially traumatic events occur affects what impact those events will have on a person. If, after experiencing something horrific as an adult, you come home to a partner who says “that is horrific! Let’s do everything we can to help you,” you will almost certainly have a very different experience than if you are a young child, the horrific event happens in your own home, other people watch and say its normal or otherwise seem powerless to change it, and then it keeps happening.
The World Health Organization’s International Classification of Diseases recognizes Complex-PTSD as a unique form of trauma. This is in some ways a proxy to Developmental Trauma, as it observes different cognitive impacts depending on age of onset of trauma(s), and recognizes the compounding effect of multiple adverse experiences. Complex Trauma is different from Developmental Trauma, however, because it can begin in adulthood such as in the case of experiencing a genocide campaign.
A related side note: the If Books Could Kill hosts repeated a popular but false notion that traumatic memories are unforgettable, stating that “If it was happening you would notice.” We don’t need any additional research to see the falsity of this claim, when a live-streamed genocide continues to take place before our eyes, people become overwhelmed even as bystanders, and yes, no longer take notice.
The last leg of this trauma frame then is disorganized memory. What happens when people surrounding a traumatized person don’t take notice? When the depended on ones are the source of harm, betrayal, or silence themselves? Experiences can’t be made sense of and are instead overwhelming. Dissociation happens most often in relation to overwhelm. That can look like memory that doesn’t have a clear timeline, fragmented identities, or a mind that tries to get as far away from embodied experience as possible. Most of this falls into the category of what we call dissociation.
People who identify with any of what I’ve written here often carry a sense of something being wrong, but don’t know how to understand it. They need authoritative voices that don’t betray them but listen. Sometimes, coming armed with The Body Keeps the Score is validating enough to help a person hold on to their own truth. What’s at stake is not which external experts are allowed to tell people what is real, but something much more pervasive and personal. Can all people, especially those who have experienced harm and whose experiences have been silenced from an early age, be supported to look deeply into their own psyches, to honor the truth of their experiences in a less fragmented way, and to listen to their own inner wisdom?
If I were being generous, I could imagine that one of the hosts’s aims is to make treaters and patients more aware of best practices for addressing trauma. And yet, it is a bizarre thing to say that clinicians are not aware of accurate research and are misguided in treating trauma. The people who actually have a relationship with traumatized individuals coming in distress might, over the course of time and treatment, know a thing or two about what is working. Most of all, it is those with lived experience who can tell us. If The Body Keeps the Score was on the New York Times bestseller list for 328 weeks, it may not be killing us. It might be part of our survival.