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Bessel A. van der Kolk Biography

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“When you have a persistent sense of heartbreak and gutwrench, the physical sensations become intolerable and we will do anything to make those feelings disappear. And that is really the origin of what happens in human pathology. People take drugs to make it disappear, and they cut themselves to make it disappear, and they starve themselves to make it disappear, and they have sex with anyone who comes along to make it disappear and once you have these horrible sensations in your body, you’ll do anything to make it go away.”

CuttingHeartbreakMental IllnessPtsdOverwhelmedEmotional PainAnorexiaEating DisorderSelf HarmTraumatizedRecklessnessSelf InjuryCoping MechanismsSex AddictionStarveCutTraumatic StressSelf Destructive BehaviorAnorexia NervosaEmotional RegulationEmotional ReleaseCutterIntolerableGut WrenchingAffect RegulationEating Disorder CausesEmotionally Numb
Author:Bessel A. van der Kolk
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“BEFRIENDING THE BODY Trauma victims cannot recover until they become familiar with and befriend the sensations in their bodies. Being frightened means that you live in a body that is always on guard. Angry people live in angry bodies. The bodies of child-abuse victims are tense and defensive until they find a way to relax and feel safe. In order to change, people need to become aware of their sensations and the way that their bodies interact with the world around them. Physical self-awareness is the first step in releasing the tyranny of the past. In my practice I begin the process by helping my patients to first notice and then describe the feelings in their bodies—not emotions such as anger or anxiety or fear but the physical sensations beneath the emotions: pressure, heat, muscular tension, tingling, caving in, feeling hollow, and so on. I also work on identifying the sensations associated with relaxation or pleasure. I help them become aware of their breath, their gestures and movements. All too often, however, drugs such as Abilify, Zyprexa, and Seroquel, are prescribed instead of teaching people the skills to deal with such distressing physical reactions. Of course, medications only blunt sensations and do nothing to resolve them or transform them from toxic agents into allies. The mind needs to be reeducated to feel physical sensations, and the body needs to be helped to tolerate and enjoy the comforts of touch. Individuals who lack emotional awareness are able, with practice, to connect their physical sensations to psychological events. Then they can slowly reconnect with themselves.”

MindBodyFearPsychologyAwarenessEmotionsTraumaRecoveryPtsdMind Body SpiritTouchVictimsAngerangerMindfulnessmindfulness
Book:The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
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“If your parents’ faces never lit up when they looked at you, it’s hard to know what it feels like to be loved and cherished. If you come from an incomprehensible world filled with secrecy and fear, it’s almost impossible to find the words to express what you have endured. If you grew up unwanted and ignored, it is a major challenge to develop a visceral sense of agency and self-worth.”

LoveFearSelf EsteemAbuseParentingTraumaNeglectPtsdSecrecyParental Abuse
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“Talking about painful events doesn’t necessarily establish community – often quite the contrary. Families and organizations may reject members who air the dirty laundry; friends and family can lost patience with people who get stuck in their grief or hurt. This is one reason why trauma victims often withdraw and why their stories become rote narratives, edited into a form least likely to provoke rejection.”

PainCommunityGriefSupportTrauma
Book:The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
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“The brain-disease model overlooks four fundamental truths: (1) our capacity to destroy one another is matched by our capacity to heal one another. Restoring relationships and community is central to restoring well-being; (2) language gives us the power to change ourselves and others by communicating our experiences, helping us to define what we know, and finding a common sense of meaning; (3) we have the ability to regulate our own physiology, including some of the so-called involuntary functions of the body and brain, through such basic activities as breathing, moving, and touching; and (4) we can change social conditions to create environments in which children and adults can feel safe and where they can thrive. When we ignore these quintessential dimensions of humanity, we deprive people of ways to heal from trauma and restore their autonomy. Being a patient, rather than a participant in one’s healing process, separates suffering people from their community and alienates them from an inner sense of self.”

CommunityHealingHealthMedicineMental HealthTraumaPtsd
Book:The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
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“As I discussed in the previous chapter, attachment researchers have shown that our earliest caregivers don't only feed us, dress us, and comfort us when we are upset; they shape the way our rapidly growing brain perceives reality. Our interactions with our caregivers convey what is safe and what is dangerous: whom we can count on and who will let us down; what we need to do to get our needs met. This information is embodied in the warp and woof of our brain circuitry and forms the template of how we think of ourselves and the world around us. These inner maps are remarkably stable across time. This doesn‘t mean, however, that our maps can‘t be modified by experience. A deep love relationship, particularly during adolescence, when the brain once again goes through a period of exponential change, truly can transform us. So can the birth of a child, as our babies often teach us how to love. Adults who were abused or neglected as children can still learn the beauty of intimacy and mutual trust or have a deep spiritual experience that opens them to a larger universe. In contrast, previously uncontaminated childhood maps can become so distorted by an adult rape or assault that all roads are rerouted into terror or despair. These responses are not reasonable and therefore cannot be changed simply by reframing irrational beliefs.”

TraumaParentsChild AbuseRapeMind And BodyAbuse SurvivorsSurvivorsWorld ViewHealing InsightsSurvivors Of AbuseComplex PtsdMind Body ConnectionAbusive ParentsEffects Of Child AbuseRape SurvivorsCare Givers
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“Generally the rational brain can override the emotional brain, as long as our fears don’t hijack us. (For example, your fear at being flagged down by the police can turn instantly to gratitude when the cop warns you that there’s an accident ahead.) But the moment we feel trapped, enraged, or rejected, we are vulnerable to activating old maps and to follow their directions. Change begins when we learn to "own" our emotional brains. That means learning to observe and tolerate the heartbreaking and gut-wrenching sensations that register misery and humiliation. Only after learning to bear what is going on inside can we start to befriend, rather than obliterate, the emotions that keep our maps fixed and immutable.”

FeelingsBrainEmotionsMiseryTraumaHumiliationHealing The PastWorld ViewHealing InsightsTraumatizedHealing The Emotional SelfComplex PtsdHealing AbuseComplex TraumaTrauma TherapyGut Wrenching
Book:The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
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“Beneath the surface of the protective parts of trauma survivors there exists an undamaged essence, a Self that is confident, curious, and calm, a Self that has been sheltered from destruction by the various protectors that have emerged in their efforts to ensure survival. Once those protectors trust that it is safe to separate, the Self will spontaneously emerge, and the parts can be enlisted in the healing process”

PsychologyTraumaNeuroscienceComplex PtsdDissociative DisordersComplex Trauma
Book:The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
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“People who suffer from alexithymia tend to feel physically uncomfortable but cannot describe exactly what the problem is. As a result they often have multiple vague and distressing physical complaints that doctors can't diagnose. In addition, they can't figure out for themselves what they're really feeling about any given situation or what makes them feel better or worse. This is the result of numbing, which keeps them from anticipating and responding to the ordinary demands of their bodies in quiet, mindful ways. If you are not aware of what your body needs, you can't take care of it. If you don't feel hunger, you can't nourish yourself. If you mistake anxiety for hunger, you may eat too much. And if you can't feel when you're satiated, you'll keep eating.”

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“When people are unable to integrate their traumatic memories, they seem to lose their capacity to assimilate new experiences as well. It is as if their personality stops at a certain points and cannot enlarge any more by the addition or assimilation of new elements. Unless they become aware of the split off elements and integrate them into a story that had happened in the past but was now over, they would experience a slow decline in their personal and professional functioning.”

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“Imagination is absolutely critical to the quality of our lives. Our imagination enables us to leave our routine everyday existence by fantasizing about travel, food, sex, falling in love, or having the last word—all the things that make life interesting. Imagination gives us the opportunity to envision new possibilities—it is an essential launchpad for making our hopes come true. It fires our creativity, relieves our boredom, alleviates our pain, enhances our pleasure, and enriches our most intimate relationships. When people are compulsively and constantly pulled back into the past, to the last time they felt intense involvement and deep emotions, they suffer from a failure of imagination, a loss of the mental flexibility. Without imagination there is no hope, no chance to envision a better future, no place to go, no goal to reach.”

PsychologyPsychiatry
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“The internal system of an abuse victim differs from the non-abuse system with regard to the consistent absence of the effective leadership, the extreme rules under which the parts function, and the absenve of any consistent balance or harmony. Typically, the parts operate around outdated assumptions and beliefs derived from the childhood abuse, believing, for example, that it is still extremely dangerous to reveal secrets about childhood experiences which were endured.”

PsychologyAbuseTraumaAbuse SurvivorsTrauma RecoveryPsychological Trauma
Book:The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
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“Eighty two percent of the traumatized children seen in the National Child Traumatic Stress Network do not meet diagnostic criteria for PTSD.15 Because they often are shut down, suspicious, or aggressive they now receive pseudoscientific diagnoses such as “oppositional defiant disorder,” meaning “This kid hates my guts and won’t do anything I tell him to do,” or “disruptive mood dysregulation disorder,” meaning he has temper tantrums. Having as many problems as they do, these kids accumulate numerous diagnoses over time. Before they reach their twenties, many patients have been given four, five, six, or more of these impressive but meaningless labels. If they receive treatment at all, they get whatever is being promulgated as the method of management du jour: medications, behavioral modification, or exposure therapy. These rarely work and often cause more damage.”

AggressiveChild AbusePtsdDisruptiveTraumatizedMisdiagnosisChild Abuse SurvivorsComplex TraumaTraumatic StressMental Health BiasTemper TantrumsChild TraumaPsuedoscience
Book:The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
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“Imagination is absolutely critical to the quality of our lives. Our imagination enables us to leave our routine everyday existence by fantasizing about travel, food, sex, falling in love, or having the last word—all the things that make life interesting. Imagination gives us the opportunity to envision new possibilities—it is an essential launchpad for making our hopes come true. It fires our creativity, relieves our boredom, alleviates our pain, enhances our pleasure, and enriches our most intimate relationships.”

LifeHopeImaginationPleasureFantasyBoredomQuality Of Life
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“The scientific study of suffering inevitably raises questions of causation, and with these, issues of blame and responsibility. Historically, doctors have highlighted predisposing vulnerability factors for developing PTSD, at the expense of recognizing the reality of their patients' experiences… This search for predisposing factors probably had its origins in the need to deny that all people can be stressed beyond endurance, rather than in solid scientific data; until recently such data were simply not available… When the issue of causation becomes a legitimate area of investigation, one is inevitably confronted with issues of man's inhumanity to man, with carelessness and callousness, with abrogation of responsibility, with manipulation and with failures to protect.”

TruthScienceSufferingHumanityResponsibilityPsychologyBlameTraumaPtsdPsychology QuotesAvoidanceInhumanitySociety DenialInhumanePosttraumatic Stress DisorderMinimization
Book:Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society
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“My colleague Rachel Yehuda studied rates of PTSD in adult New Yorkers who had been assaulted or rapes. Those whose mothers were Holocaust survivors with PTSD had a significantly higher rate of developing serious psychological problems after these traumatic experiences. The most reasonable explanation is that their upbringing had left them with a vulnerable physiology, making it difficult for them to regain their equilibrium after being violated. Yehuda found a similar vulnerability in the children of pregnant women who were in the World Trade Center that fatal day in 2001. Similarly, the reactions of children to painful events are largely determined by how calm or stressed their parents are.”

TraumaEpigenetics
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“When you're sick, who does the shopping or takes you to the doctor? Who do you talk to when you are upset?" In other words, who provides you with emotional and practical support? Some patients gave us surprising answers: "my dog" or "my therapist" – or "nobody".”

DepressionPsychotherapyEmotional Support
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“Mary was my first encounter with dissociative identity disorder (DID), which at that time was called multiple personality disorder. As dramatic as its symptoms are, the internal splitting and emergence of distinct identities experienced in DID represent only the extreme end of the spectrum of mental life.”

Mental HealthDissociative Identity DisorderDissociationMultiple Personality DisorderMental Life
Book:The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
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“Because drugs have become so profitable, major medical journals rarely publish studies on nondrug treatments of mental health problems.31 Practitioners who explore treatments are typically marginalized as “alternative.” Studies of nondrug treatments are rarely funded unless they involve so-called manualized protocols, where patients and therapists go through narrowly prescribed sequences that allow little fine-tuning to individual patients’ needs. Mainstream medicine is firmly committed to a better life through chemistry, and the fact that we can actually change our own physiology and inner equilibrium by means other than drugs is rarely considered.”

Mental HealthMental IllnessEffectivenessPsychotherapyMental Health BiasAlternative TherapyPsychiatric DrugsAlternative TreatmentsClinical LiteratureClinical TrialLack Of ResearchMedical Journals
Book:The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
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“It was early in my career, and I had been seeing Mary, a shy, lonely, and physically collapsed young woman, for about three months in weekly psychotherapy, dealing with the ravages of her terrible history of early abuse. One day I opened the door to my waiting room and saw her standing there provocatively, dressed in a miniskirt, her hair dyed flaming red, with a cup of coffee in one hand and a snarl on her face. “You must be Dr. van der Kolk,” she said. “My name is Jane, and I came to warn you not to believe any the lies that Mary has been telling you. Can I come in and tell you about her?” I was stunned but fortunately kept myself from confronting “Jane” and instead heard her out. Over the course of our session I met not only Jane but also a hurt little girl and an angry male adolescent. That was the beginning of a long and productive treatment.”

LyingDenialDissociative Identity DisorderSurvivorsMultiple Personality DisorderLiarMultiple PersonalitiesDissociativeAbuse SurvivorRecantRetractPyschotherapy
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“Traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from their selves.” (p.97)”

FeelingsBodyTraumaAvoidanceNumbNumbnessTraumatizedTraumaticSense Of Safety
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“Children and adults alike need to experience how rewarding it is to work at the edge of their abilities. Resilience is the product of agency: knowing that what you do can make a difference. Many of us remember what playing team sports, singing in the school choir, or playing in the marching band meant to us, especially if we had coaches or directors who believed in us, pushed us to excel, and taught us we could be better than we thought was possible. The children we reach need this experience. Athletics, playing music, dancing, and theatrical performances all promote agency and community.”

SportsMusicPsychologyDramaDanceTraumaResilienceTheatreAgencyMusic Therapy
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“The disappearance of medial prefrontal activation could explain why so many traumatized people lose their sense of purpose and direction. I used to be surprised by how often my patients asked me for advice about the most ordinary things, and then by how rarely they followed it. Now I understood that their relationship with their own inner reality was impaired. How could they make decisions, or put any plan into action, if they couldn't define what they wanted or, to be more precise, what the sensations in their bodies, the basis of all emotions, were trying to tell them?”

PsychologyDepressionTraumaApathyPtsdNeuroscience
Book:The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma
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