The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma

Like millions of others, I read The Body Keeps the Score and felt seen for the first time in my life. It is a masterpiece of artistic and poetic observation—a heartbreakingly accurate description of what it feels like to live with a hijacked nervous system. But when I got to the solutions section, I felt utterly exhausted. Yoga?! Theater?! Chanting?! These are wonderful "soft therapies", but asking a person with severe PTSD to meditate their way out of a panic attack is like asking someone with a broken leg to run a mile in four minutes. I was left with the question: Okay, the body keeps the score... but how do we wipe the scoreboard clean? Dino Garner’s Silent Scars, Bold Remedies is the answer to that question. I looked him up on LinkedIn. Very impressive background in many areas, all of which he brought to bear in his landmark book, Silent Scars, Bold Remedies. I heard a podcast of him telling the audience how he taught medical school and discovered that not a single student who was to become a psychiatrist knew anything about physics, or chemistry or basic mathematics, not much less basic neurochemistry. When I heard that it made sense that Dr. van der Kolk spoke in metaphors and poetry. He truly didn’t know anything about the hard science that Garner brings to bear in Silent Scars, Bold Remedies. If van der Kolk wrote the biography of the ghost in the machine, Dino Garner has written the schematic, checklists and training manuals for the machine itself. His book moves beyond the poetry of suffering and gets straight into the hard engineering of the injury. And Dino Garner also includes MANY beautiful charcoal drawings and first-hand accounts and stories from people of all walks of life. Garner's book is "van der Kolk's book gone nuclear”, you ask this old guy. Here is the forensic difference that blew my mind: The Old Paradigm (van der Kolk): Focuses heavily on the Vagus Nerve (the body's "brake pedal") and tries to strengthen it through breathing and mindfulness. Garner's Paradigm: Recognizes that if the "gas pedal" (the Stellate Ganglion) is physically jammed to the floor, pumping the brakes won't work. You have to pop the hood and fix the stuck accelerator. This was the lightbulb moment for me. Garner dives deep into the molecular and biophysical basis of trauma—specifically chemical things like Nerve Growth Factor and cytokines and neuroinflammation and sympathetic nerve sprouting—concepts that are completely absent in The Body Keeps the Score. Garner was a biophysics researcher for many years and an expert in the hard sciences that psychiatrists lack. Garner explains that PTSI (and he rightly calls it an Injury, not a Disorder) is a hardware failure, not a character flaw as van der Kolk says in so many pages. The sections on the Dual Sympathetic Reset are revolutionary. Garner explains how a precise medical intervention can do in 15 minutes what years of talk therapy failed to achieve. It’s not magic, guys, this is realife biophysics in action. Garner also has around 200 pages of recent references and citations, from books to reviews to scientific papers. Those sections I’ve never seen in any other book on PTSD. Garner also included a SUMMARY for each book and paper. That was worth the price of admission!!!!!! Do not get me wrong—The Body Keeps the Score is a necessary book and beautifully written in such artistic form. It validates the pain. But Dino Garner's Silent Scars, Bold Remedies discovers, researches, analyzes, and validates the actual cure. It is the missing second half of van der Kolk's poetic trauma conversation. If you are tired of "managing" your symptoms and want to understand the mechanics of actually fixing them, skip the yoga mat and read Dino Garner’s book. As if not enough, Garner launched a new series of books, Silent Scars, Bold Remedies - The Emerging Science Series, as ebooks. They're here on amazon. They go deeper into specifics about ketamine therapy, weaning yourself off antidepressants, the vagus nerve, and stellate ganglion block and dual sympathetic reset treatments. For those of us not properly schooled in math, physics and chemistry, Dino Garner has also presented Healing In Plain Sight, a book that is the reduced version of Silent Scars, Bold Remedies. Garner took out almost all the science, medicine, technology stuff and hardcore text that would probably drive people who failed chemistry in high school crazy. Healing In Plain Sight is chock full of all the beautiful charcoals, stories, If-Then and Take The Step guidances, and special stories at the end of each chapter. One again, I loved reading Dr. van der Kolk’s The Body Keeps the Score! I highly recommend it to all. But if you want to heal your biological body and mind, read and study Dino Garner’s Silent Scars, Bold Remedies!!!!!

Psychiatrist, professor, world-class researcher, and traumatologist Bessel van der Kolk MD requires no introduction to trauma psychotherapists. My enduring impressions of him over many years is one of relevance, cogency, frankness, and accessibility - served up with a subtle dash of impishness. He tends to be a bit disruptive - something of a provocateur - and everything of his I have ever read has taught me something, confirmed something important, or pushed my thinking in a new direction. When he has something to say, I want to hear it. However, I almost didn't buy this book: I was put off by the title. Familiar with major reviews of PTSD psychotherapy outcomes research, I know that research support for body-oriented approaches to treating psychological trauma psychopathology is thin at best, and such treatment models simply do not have the research validation of either EMDR (Eye Movement Desensitization and Reprocessing) and PE (Prolonged Exposure), neither of which are especially body-focused. J. Interlandi's excellent article anticipating publication of this book - "A Revolutionary Approach to Treating PTSD" (New York Times Magazine, 2014.05.22 - available online) - initially supported my fears that for some inexplicable reason van der Kolk was now promoting some treatment model for which we have little confirming research. "Psychomotor therapy is neither widely practiced nor supported by clinical studies," Interlandi informs us. Provocateur he may be, but I'm strongly biased in favor of paying attention to therapies for which we do have solid empirical validation. Our clients do not deserve to be experimental subjects - maybe not even if they agree to this, as I'm not sure they can ever know enough to make a truly informed consent. Knowledge that PTSD and related disorders are usually highly curable, when using the right treatment protocols, sadly remains the possession of a minority of people, even in the professional psychotherapy world. Yet the account of van der Kolk's therapy work in Interlandi's article is gripping. Becoming completely absorbed in the account, I was convinced. (I've been here before, reading van der Kolk's own accounts of his work.) And so the disruption begins! Deeper into the article, he has me. Van der Kolk's critique of CBT (cognitive behavioral therapy - a general class of therapies) and PE (E. Foa's exposure therapy model) is withering and correct: neither really work. "Trauma has nothing whatsoever to do with cognition...It has to do with your body being reset to interpret the world as a dangerous place....It's not something you can talk yourself out of." Interlandi reports that "That view places him on the fringes of the psychiatric mainstream." But he's right, and I can't stress this enough. Why? Because as a trauma treatment professional I'm well aware of what the trauma treatment outcomes research actually says. The best current summary of this research well may be chapter 2 of Ecker, et al.'s (2012) "Unlocking the emotional brain". (Buy this book, too!) Ecker et al. brilliantly presents a synthetic summary that encompasses 11 existing therapy models which actually DO cure trauma psychopathology, if done right. In this context, what van der Kolk is doing makes perfect sense. Finally, it appears, the trauma psychotherapy field is moving toward a consensus which has strong credibility. Van der Kolk's new book has many virtues. Parts One and Two (102 pp) provide a substantial review of the neuropsychology of trauma's impact on a person. It's fun, interesting, informative reading, for professional and layperson alike. Part Three (64 pp) surveys childhood development, attachment experience, and "the hidden epidemic of developmental trauma". Van der Kolk has for years been a leading champion of the idea that there is a type of PTSD which substantially differs from all the rest. It develops in response to chronic child abuse and/or neglect. I completely share his belief that the diagnosis of Developmental Trauma Disorder (sometimes called C-PTSD, with "C" meaning "Complex") is overdue for formal recognition. I find his review of the struggle to legitimize DTD as gripping and distressing as anything else in the book. It is anguishing to know that a major problem exists, AND that the psychiatric establishment simply refuses to acknowledge it. DTD/C-PTSD is no fantasy. We see and treat these people, as children and adults. They exist, and they are nothing like "ordinary" PTSD treatment clients. Part Four (29 pp) focuses on memory. I've long thought that much writing on treating psychological trauma seems to miss the point: trauma memory is what causes the problem. Deal with that and the symptoms vanish. Why is this so hard to understand? Yet, it is not a common understanding at all. Explaining how trauma memory works is invariably enlightening to my clients. And experiencing what happens when we change the nature of trauma memory is revelatory to someone who's lived with it for years, if not decades. As he does throughout the book, van der Kolk offers fine stories about clients who have experienced exactly what I've seen happen in my clients, making excellent use of what cognitive research tells us: people understand things best through narratives. Offer a good narrative and you convince. Psychological trauma therapy is complex, but we are now well prepared to launch into the book's core content - Part Five (154 pp), "Paths to Recovery". He gets right to it: we cannot undo the trauma, but we CAN undo its effect on us, and so get our "self" back. Ch. 13 reviews existing therapies. His approach is to repair "Descartes' Error" (see Damásio's 1994 book of that title) by viewing mind and body as a single coherent functional unit. His topical coverage is complete and his critique of current therapies acute - not to be missed. He then writes of the importance of language (Ch. 14). We construct our narrative mainly in words, and the words we choose are critical. But language is not enough (this anticipates his next two chapters). Our senses encompass a larger world, and it's center is our body, where all our sensory receptors are located. Then he introduces the treatment model he's long advocated: EMDR (Eye Movement Desensitization and Reprocessing). I'm trained in EMDR, and in fact van der Kolk and I had the same instructor for our advanced training: Gerald Puk PhD. Van der Kolk tells an amusing and self-deprecating story about his advanced training experience, in which Puk was able to provide a strong corrective to his approach to clients. This is typical van der Kolk - he's a truth-teller, even when it may put him in a poor light! And,after all, at this point he has nothing to prove to anyone. Finding an EMDR therapist is not hard (see his "Resources" section). Nor is it hard to find a yoga instructor, and yoga is what he advises for helping a trauma victim get back into their body. Yoga is a wise choice, because it is available, already widely known, and adaptable to a wide range of individuals and capabilities. There is much more in Part Five, and the focus is on self-empowerment. "Victim no more!" as they say. Most trauma therapists have a keen interest in seeing their clients leave therapy charged up and ready to fully embrace their life - that certainly is my own emphasis. Van der Kolk's thoughts on self-empowerment for those in recovery from psychological trauma will be invaluable to any trauma psychotherapy client. For psychotherapy professionals, this book will be both delightful and confirming. For everyone else, it will be a readable, gripping, highly educational tour of topics all of which are critical to a successful transition back from the impact of psychological trauma. That he gives prominent though not dominating emphasis to developmental trauma disorders is entirely appropriate. Our society has yet to grasp that child abuse and neglect is a more often chronic than not, and that its impact is largely ignored and poorly treated, if at all. This does not have to be. Get educated (this book will do that), then commit to being an advocate for children as well as for adults impacted by trauma. They all deserve the chance to be healed, and we can now do that. Van der Kolk shows us how. The physical book: Jacket design is pleasant and interesting. Binding is less so: color of spine wrapping is semi-florescent, and of paper, not cloth. The book feels substantial and pleasant to hold and look at. Organization - * 6 pp: prefatory praise by peers and related luminaries (interesting comments from some important people in the field); * 2 pp: Table of Contents; * 356 pp: actual text; * 4 pp: Appendix: Consensus proposed criteria for developmental trauma disorder * 3 pp: Resources * 4 pp: Further reading * 51 pp: Notes * 21 pp: Index

If you struggle with anxiety, panic attacks, or find yourself constantly ruminating and self-sabotaging, this is the most important book you will read. For anyone who has navigated emotional neglect, a chaotic childhood, or trauma—and perhaps uses addiction to cope—this book offers a completely new perspective. The Body Keeps the Score connects your biology with your biography. It explains how your past experiences physically rewire your brain and nervous system, making sense of the confusing emotions and reactions that can keep you stuck. It validates that these struggles aren't character flaws; they are physiological responses. What truly surprised me was Dr. Bessel van der Kolk’s empathy. It is rare to find a scientific text that feels so deeply human. You can tell he genuinely cares about his patients and understands the pain of trauma survivors. It bridges the gap between hard science and human compassion in a way that just clicks. I am incredibly grateful for this work. It provides clarity, hope, and a roadmap for understanding yourself. A masterpiece for anyone looking to heal. As for the physical book, the print is slightly on the smaller side and the paper quality is okay but I was too captured by the words to care about the physical quality and you shouldn't care either.

One of the rare books that remains in New York best sellers list for years. Still reading it but the book is crucial in psychology and contains heartbreaking stories with a real life hard experience stories some ending with successful relief and just surviving for others.

Very nice product, truly recommend it!

Beautiful book.... insightful, caring, bringing science and somatic experience together. Absolutely loved it.

Es un libro que puedes leer sin saber nada de psiquiatría o psicología, trae incluso varios esquemas que explican todo muy bien. Me encanta que no es un libro tipo "superación personal" (que igual no tiene nada de malo), sino uno que relata con fundamento, casos reales y evidencia científica los procesos de trauma y recuperación. Personalmente, el proceso de lectura también sirve mucho para validar tus sentimientos, es muy bello❤️‍🩹