Monthly Archives: November 2020

Treating Traumatized Patients

Bessel van der Kolk : A Brief Synopsis

 Bessel van der Kolk (BVDK) is a psychiatrist, researcher, professor, and author who is best known for his work with neurological studies of posttraumatic stress, since the 1970s. This one hour and forty-minute video that I reviewed encompass the research behind BVDK’s The Body Keeps the Score: brain, mind, and body in the healing of trauma. 

Candice Lake, WNY

 BVDK is an outspoken researcher on how neural networks need to be changed to treat patients who have been traumatized; and that our current systems of treating trauma are based on an “insane diagnostic system that ignores the reality of peoples’ lives.” “The DSM ignores the fact that we are a part of a larger universe, part of a social world, and that how we behave affects others around us.” BVDK explained that most mental illness is “of the individual and the environment being at odds with each other. More people will kill themselves after going to war (military persons) than are killed during the war.”

 BVDK points out that trauma can prevent individuals from having loving and intimate relationships. People who have experienced trauma are more likely to become alcoholics and drug addicts. BVDK emphasized that “love” is the antecedent to trauma. He claims that

“trauma is a fear reaction, but what we leave out is that we are a connected species. We are interconnected and love is the glue that keeps us together and life without love has no meaning. Love gets very messed up in traumatic stress. We love people who do terrible things to us and then get numbed out to things that are pleasurable. These things get messed up and left out of our over-simplistic diagnostic system.”

 As a researcher, BVDK did the very first neuroimaging studies on traumatized patients and they found that when people remember their trauma, their whole frontal lobe goes offline. What this means is that executive thinking and knowing right from wrong stops working. Furthermore, traumatic experiences shut off the Broca’s area of the brain, which leaves the person speechless during the traumatic event. So, when the therapist gets to the very core of someone’s trauma, the patient will become speechless. The patient does not remember everything that has happened because their brain was “dumbfounded” from the absence of functioning frontal lobes and Broca’s area.

 In this video, BVDK showed several videos of trauma treatment. Two treatments he shared were vipassana yoga research and eye movement desensitization and reprocessing (EMDR) treatment. In the first video BVDK explained his study on yoga and meditation on traumatized patients. He had maximum security prisoners not speak for seven days along with a daily practice of vipassana yoga. This exercise was designed to have participants “meet one’s internal demons.” The outcomes were “highly significant” and showed better results than drug treatment. The point of this study was that there are other ways of calming both the body and mind down (mindfully) which will change what is most necessary, the structure and wiring of the brain.

 BVDK stated that trauma’s biggest effect is on the body. From each traumatic event, the body becomes frightened, uptight, and tense. The trauma lives in the body and the goal of therapy is to help patients feel safe inside their bodies. He stated the act of telling one’s story is helpful but is not enough. For real change to take place, the body needs to learn that the danger has passed and we need to live in the reality of the present.

 “When you have been traumatized, you keep going back there and that is upsetting to other people, embarrasses you, and keeps you out of tune with your surroundings.” All of these experiences reinforce that there is something wrong with you, so you experience alienation and are usually out-of-sync with other people. As a result of this alienation, people become more shameful, lonely, frightened, and cut off from the human race. “This is how suicide happens.” “There is a loss of love with the human race.”

 Next, BVDK showed a tape of EMDR in a session with a patient that was raped by her father and then blamed herself for the event. He said that it is important to notice how the patient’s body is reacting before the trauma is discussed. The way that you hold your body determines how you feel; therefore, it is important to assume better body positions with an open chest, supported back, and a strong sternocleidomastoid (neck) muscle. This position is incompatible with feeling defeated. He explained that the EMDR technique helps to distinguish relevant information of the present moment changes the part of the brain that helps you focus on what is relevant, and not on what is not relevant (mindfulness). EMDR techniques proved to be a highly effective tool for treating acute traumatic events but not so much for chronic experiences of trauma where mindfulness of the internal world was more effective.

 BVDK concludes, that regardless of the tool you use such as EMDR, the most important thing is for the patient to feel safe and to bring mindful awareness of an intimate connection into treatment. “Find out how people feel safe and what do they do that gives them a sense of power” What works is anything that helps a person feel a sense of safety including the relationship with the therapist. “This helps you rewire the emotional brain. This is resetting the limbic system.”

“This is why we do neurological research to change the processing of the brain rather than using “bullshit” diagnostic systems.” “CBT doesn’t work because the rational brain is not in touch with the emotional brain. This makes no sense from the brain or a trauma perspective.” People need to feel themselves and feel their bodies and without this interior work, one cannot heal. So, “don’t treat the disorder because this is not the cause or the location of the problem.”

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