What is trauma? The author of “The Body Keeps the Score” explains | Bessel van der Kolk | Big Think

Summary

Dr. Bessel van der Kolk, a renowned psychiatrist, neuroscientist, and author of 'The Body Keeps the Score,' explains the profound difference between stress and trauma. He emphasizes that while everyone experiences stress, trauma is a deeply distressing event that continues to affect the body and mind long after it has occurred. Trauma is not just the event itself but the individual's response, which can lead to a state of constant danger perception, impacting brain function and physical health. Dr. van der Kolk highlights the importance of social support in mitigating trauma's effects and stresses the need for societal changes to address the root causes of trauma, such as poverty, racism, and unemployment. He advocates for a trauma-informed society where individuals can recover and thrive, underlining the significance of community and interpersonal support.

Takeaways

• 🧠 **Understanding Trauma vs. Stress**: Trauma differs from stress as it continues to affect the body even after the event has ended, causing the person to relive the experience.
• 👤 **Author's Background**: Bessel van der Kolk, a psychiatrist and neuroscientist, has extensively studied trauma and its effects on the body and mind.
• 🌟 **Trauma's Prevalence**: Contrary to initial beliefs, trauma is extremely common and not limited to military experiences; it also includes child abuse and domestic violence.
• 🤝 **Social Support's Role**: The presence of supportive individuals during a traumatic event can significantly mitigate the potential for long-term trauma.
• 🧐 **Trauma's Subjectivity**: Trauma is a subjective experience, varying from person to person based on individual personalities and past experiences.
• 🧬 **Biological Impact**: Trauma can alter the brain, particularly affecting the primitive survival parts, leading to a constant state of perceived danger.
• 🛡️ **Survival Responses**: Traumatic events can trigger automatic survival responses like fight, flight, or freeze, which are not based on cognitive assessments but on primitive brain functions.
• 😔 **Emotional Consequences**: Traumatized individuals often struggle with experiencing pleasure and joy due to the ongoing physiological stress on the body.
• 🏥 **Physical Health Impact**: The stress of trauma can lead to immunological and endocrine abnormalities, sometimes resulting in longer-lasting physical health issues than mental ones.
• 🌱 **Community and Recovery**: A sense of community and mutual support is vital for individuals to recover and thrive after experiencing trauma.
• 🌐 **Societal Factors**: Societal issues such as poverty, racism, and unemployment can exacerbate the effects of trauma and highlight the need for societal rearrangements to address these issues.

Q & A

What is the primary difference between trauma and stress as described by Bessel van der Kolk?

Trauma is an event that continues to affect the individual even after it has ended, causing the body to relive it, whereas stress is a response to unpleasant situations that dissipates once the situation is over.

What was Bessel van der Kolk's first encounter with trauma?

Bessel van der Kolk's first encounter with trauma was on his first day working at the Veterans Administration in 1978, where he met Vietnam veterans who were deeply affected by their experiences.

How did the initial definition of PTSD contribute to a narrow understanding of trauma?

The initial definition of PTSD described it as a response to extraordinary events outside of normal human experience, which later was recognized as a narrow view since trauma is actually quite common and can occur in various everyday situations.

What are some common examples of trauma experienced by children in America?

Examples include witnessing physical violence within their parents, being beaten severely by their caregivers, and experiencing unwanted sexual encounters.

How does the presence of supportive individuals during a traumatic event affect the likelihood of becoming traumatized?

Supportive individuals can mitigate the effects of trauma by providing a sense of safety and help, which prevents the foundation of a person's safety from being destroyed.

What is the 'cockroach brain' referred to by Bessel van der Kolk, and what role does it play in trauma?

The 'cockroach brain' is a term for the primitive survival part of the brain that detects danger and safety. After a traumatic event, this part of the brain can become overactive, continuously signaling danger and causing the person to react as if they are still in threat.

Why do traumatized individuals often struggle with experiencing pleasure and joy?

Traumatized individuals struggle with pleasure and joy because their bodies are constantly in a state of fight or flight, mobilizing for survival, which disrupts normal emotional experiences.

What are some of the physiological effects of trauma on the body?

The physiological effects of trauma include immunological and endocrine abnormalities, which can lead to long-lasting physical health problems.

How does societal structure and support impact the recovery from trauma?

A society with less income inequality, universal healthcare, and universal childcare is more trauma savvy and better equipped to support individuals in recovering from trauma by addressing the antecedents of certain pathologies.

What is the broader issue that Bessel van der Kolk identifies regarding trauma?

The broader issue is a political one, concerning how society can be rearranged to understand and address trauma, allowing those who grow up under extreme adverse conditions to become full members of society.

Why is the sense of community important in surviving and thriving after trauma?

The sense of community and having people there for each other is critical for survival and thriving post-trauma because it provides the necessary social support and interconnectedness that can aid in the healing process.

How does trauma affect a person's cognitive and emotional functioning?

Trauma can impair a person's ability to engage, learn, understand others' perspectives, and coordinate their feelings with their thinking due to the automatic survival responses triggered by the 'animal brain.'

Outlines

00:00

📚 Understanding Trauma vs. Stress

Dr. Bessel van der Kolk, a psychiatrist and neuroscientist, explains the fundamental difference between trauma and stress. He emphasizes that while life is inherently challenging, stress is temporary and resolves once the stressful situation ends. In contrast, trauma has a lasting impact on the body and mind, causing a person to continuously relive the event. Dr. van der Kolk's interest in trauma was sparked during his time at the Veterans Administration, where he encountered Vietnam veterans who were deeply affected by their experiences. Initially, PTSD was defined as a response to extraordinary events, but it was later recognized that trauma is a common experience that can result from various forms of violence, abuse, or unwanted sexual experiences. Trauma is not just the event itself but the overwhelming response to it, leading to a state of confusion or rage. The presence of supportive individuals during a traumatic event can significantly mitigate the effects of trauma, highlighting the importance of human interdependence in coping with such experiences.

05:01

🛡️ Trauma's Impact on Survival and Health

Dr. van der Kolk delves into the automatic responses that trauma triggers in the brain, particularly the primitive 'survival' part, often referred to as the 'cockroach brain.' This part of the brain is responsible for assessing danger and safety, and when traumatized, it continuously signals danger even after the event has passed. This leads to a state of constant fight or flight, which is not based on cognitive assessment but rather on instinctual survival mechanisms. The consequences of this prolonged state include difficulties in experiencing pleasure and joy, as well as disruptions in hormonal and physiological balance, leading to immunological and endocrine abnormalities that can have long-lasting effects on physical health. Dr. van der Kolk also discusses the role of socioeconomic factors such as poverty, racism, and unemployment in exacerbating the effects of trauma. He points out that societies with less income inequality, universal healthcare, and childcare are more adept at addressing trauma. The overarching issue, as he sees it, is political, calling for a societal rearrangement to better understand and address trauma, particularly for those who experience it under extreme adverse conditions. He underscores the importance of community and mutual support in overcoming trauma and fostering resilience.

Keywords

💡Trauma

Trauma refers to deeply distressing or disturbing experiences that overwhelm an individual's capacity to cope, often resulting in long-lasting psychological effects. In the video, trauma is distinguished from everyday stress and is shown to have profound impacts on the brain and body, causing individuals to continually relive the event even after it has ended.

💡Stress

Stress is the body's response to a challenge or threat and typically resolves once the situation is over. It is contrasted with trauma in the video, where stress is portrayed as a more temporary and less damaging state compared to the lasting effects of trauma.

💡PTSD (Post-Traumatic Stress Disorder)

PTSD is a mental health condition triggered by experiencing or witnessing a terrifying event. In the video, PTSD is mentioned in the context of defining trauma, emphasizing that it involves exposure to extraordinary events that are outside the range of normal human experience.

💡Veterans Administration

The Veterans Administration (VA) is a U.S. government agency providing aid to military veterans. In the video, the speaker's interest in trauma began during his first day working at the VA, where he encountered Vietnam veterans who were deeply affected by their experiences.

💡Survival Part of the Brain

The survival part of the brain, often referred to as the 'cockroach brain' in the video, is the primitive area responsible for assessing danger and safety. When trauma occurs, this part of the brain becomes hyperactive, causing the individual to constantly feel in danger even after the traumatic event has passed.

💡Fight-Flight Response

The fight-flight response is a physiological reaction that occurs in the presence of a perceived harmful event or threat to survival. The video explains that traumatized individuals may go into a fight-flight mode or experience a shutdown as a primitive survival mechanism.

💡Hormones

Hormones are chemical messengers in the body that regulate various functions, including responses to stress and trauma. The video discusses how the body's hormonal response to trauma can lead to difficulties in experiencing pleasure and joy, as well as physical health problems.

💡Community

Community refers to a group of people living in the same place or having a particular characteristic in common. In the video, the sense of community and social support is highlighted as a critical factor in helping individuals survive and thrive after experiencing trauma.

💡Poverty

Poverty is the state of having little or no money and few or no material possessions. The video touches on how the impact of poverty, along with other societal issues like racism and unemployment, can exacerbate the effects of trauma on individuals and communities.

💡Income Inequality

Income inequality refers to the uneven distribution of income within a society. The video suggests that societies with less income inequality and more universal access to healthcare and childcare are better equipped to address the antecedents of trauma and support those affected.

💡Trauma Savvy

Being 'trauma savvy' implies having a deep understanding of trauma and its effects, and being able to provide appropriate support and resources. The video contrasts societies that are trauma savvy with those that are not, emphasizing the importance of societal awareness and action to mitigate the impact of trauma.

Highlights

The distinction between trauma and stress is emphasized, with trauma causing the body to continue reliving the event post-occurrence.

Bessel van der Kolk, a psychiatrist, neuroscientist, and author, shares his expertise on trauma.

Trauma's impact on Vietnam veterans was profound, leading to a significant change in their physical and social well-being post-war.

The initial definition of PTSD involved exposure to extraordinary events, reflecting a limited understanding of trauma's prevalence.

Trauma is now recognized as extremely common, affecting various aspects of life beyond military experiences.

Children in America face high rates of witnessing violence and experiencing abuse, highlighting the domestic nature of trauma.

Trauma is not just the event, but the overwhelmed response to it, often leading to a state of confusion or rage.

Social support is a significant factor in mitigating the effects of trauma, as it provides a foundation of safety.

Trauma is a subjective experience, varying in impact based on individual personality and past experiences.

Trauma alters the brain, particularly affecting the primitive survival part, often referred to as the 'cockroach brain'.

Traumatized individuals often have an ongoing sense of danger and a difficulty engaging in normal cognitive functions.

The fight-flight response and the shutdown of the brain are automatic physiological reactions to perceived life threats.

Trauma survivors struggle with experiencing pleasure and joy due to the body's continuous mobilization for survival.

Physical health can be severely impacted by trauma, with immunological and endocrine abnormalities being common.

The long-term effects of trauma can be more pronounced in physical health compared to mental health.

Socioeconomic factors such as poverty, racism, and unemployment significantly impact the experience and outcomes of trauma.

Cultural and societal awareness of trauma is crucial for supporting individuals who have experienced adverse conditions.

The political aspect of addressing trauma involves societal rearrangements to support those affected by extreme conditions.

Community and social support are essential for surviving and thriving post-trauma, emphasizing the importance of interconnectedness.

Transcripts

- The most important thing to know

is that there's a difference between trauma and stress.

As I like to say to people,

life sucks a good amount of the time.

We all have jobs and situations that are really unpleasant.

But the moment that a situation is over, it's over.

The problem with trauma is that when it's over,

your body continues to relive it.

My name is Bessel van der Kolk.

I'm a psychiatrist, neuroscientist,

and author of the book, "The Body Keeps the Score."

(upbeat music)

I got interested in trauma

on my first day working at the Veterans Administration.

1978 was the year,

and the Vietnam war was over by about six or seven years.

The very first day that I met Vietnam veterans,

I was just blown away.

These were guys who were my age,

who were clearly smart and competent and athletic.

And they clearly were just a shadow of their former self.

But their bodies were clearly affected by trauma

and they had very hard time connecting with new people

after the war.

Around that time,

a group of us started to define what trauma is.

And in the definition of PTSD, we write,

these people have been exposed to extraordinary events

that's outside of normal human experience.

Now, in retrospect,

that shows us how ignorant and narrow-minded we were,

because it turned out

that this is not our usual experience at all.

People usually think about the military

when they talk about trauma.

But at least one out of eight kids in America

witness physical violence within their parents.

A larger number of kids gets beaten very hard

by their own caregivers.

A very large number of people in general,

but women in particular,

have sexual experiences that were clearly unwanted

and that left them confused and enraged.

So, unlike what we first thought,

trauma is actually extremely common.

There's a lot debates of what the trauma is to this day.

But basically, trauma is something that happens to you

that makes you so upset that it overwhelms you.

And there is nothing you can do to stave off the inevitable.

You basically collapse in a state of confusion, maybe rage,

because you are unable to function

in the face of this particular threat.

But the trauma is not the event that happens,

the trauma is how you respond to it.

One of the largest mitigating factors

against getting traumatized

is who is there for you at that particular time.

When, as a kid, you get bitten by a dog,

it's really very scary and very nasty.

But if your parents pick you up and say,

oh, I see that you're really in bad shape,

let me help you.

The dog bite doesn't become a big issue

because the foundation of your safety

has not been destroyed.

We are profoundly interdependent people,

as long as our relationships are intact,

by and large, we're pretty good with trauma.

It's a subjective experience

and what maybe traumatic for you

may not be traumatic for me,

depending on our personality and our prior experiences.

The problem with trauma

is that it starts off with something that happens to us,

but that's not where it stops,

because it changes your brain.

Much of the imprint of trauma

is the very primitive survival part of your brain

that I like to call the cockroach brain.

As a part of you that just picks up

what's dangerous and what's safe.

And when you're traumatized, that little part of your brain,

which is usually very quiet,

continues to just send messages.

I'm in danger.

I'm not safe.

That event itself is over,

but you continue to react to things as if you're in danger.

We are talking about survival.

We are talking about staying alive.

I say, some people go into fight-flight.

Or on a more primitive level,

people's brain shuts down and they collapse.

Yet, these automatic responses,

they are not a product of your cognitive assessments,

they're products of your animal brain

trying to stay alive in the face of something

that that part of your brain interprets as a life threat.

And the problem then becomes

that you are not able to engage,

or to learn, or to see other people's point of view,

or to coordinate your feelings with your thinking.

Traumatized people have a tremendous problem

experiencing pleasure and joy.

But the core issue is our hormones

and our physiological impulses

that have to do with survival.

Your body keeps mobilizing itself to fight.

You have all kind of immunological abnormalities.

Endocrine abnormalities.

And that really devastates your physical health also.

Oftentimes, the physical problems are longer lasting

than the mental problems.

And the other thing that is terribly important

is the impact of poverty,

or the impact of racism,

or the impact of unemployment.

There is other societies

that are much more trauma savvy than we are.

Where there is not an enormous amount of income inequality,

healthcare is universal,

childcare is universal.

A culture like that really looks at what are the antecedents

for certain forms of pathology.

So, the big issue is a political issue.

How do we rearrange our society to really know about trauma

so that people who grow up under extreme adverse conditions

can become full-fledged members of society?

The sense of community and people being there for each other

is a critical part of surviving and thriving.