The Body Keeps the Score

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The Body Keeps the Score Page 56

by Bessel van der Kolk MD


  brain waves and, 324

  see also PTSD (posttraumatic stress disorder), of combat veterans

  community, mental health and, 38, 213–14, 244, 331–34, 355

  Community Mental Health Act (1963), 373n

  competence, sense of, 166, 341

  Comprehensive Textbook of Psychiatry (Freedman and Kaplan), 20, 188–89

  conduct disorder, 282, 392n

  conflict:

  as central to theater, 335

  trauma survivors’ fear of, 335

  consciousness, see self

  Cope, Stephen, 123, 230, 263, 272

  cortical networks, local, 417n

  cortisol, 30, 61, 154, 162, 223

  Countway Library of Medicine, 11, 24

  creativity, see imagination

  Cummings, Adam, 155

  cummings, e. e., 122

  Cymbalta, 35, 37

  Dalai Lama, 79

  Damasio, Antonio, 93, 94–95, 382n

  dance:

  in trauma recovery, 242–43, 355

  see also rhythmic movement

  Darwin, Charles, 74–76, 75, 77

  Daubert hearings, 174–75

  Decety, Jean, 222

  default state network (DSN), 90

  Defense Department, U.S., 156, 224, 226–27, 332

  Pharmacoeconomic Center of, 224

  defense mechanisms, suspension of, in intimate relationships, 84–85

  Delbo, Charlotte, 195

  delta waves, 320

  Dementia Praecox (Bleuler), 24–25

  denial, 46, 291

  Denial: A Memoir (Stern), 7

  depersonalization, 71–73, 71, 99–100, 132–33, 286, 386n, 401n

  depression, 136, 150, 162, 225

  chemistry of, 26, 29

  derealization, 401n

  desensitization therapies, 46–47, 73, 220, 222–23

  developmental psychopathology, 2

  developmental trauma disorder (DTS; proposed), 166–68

  APA’s rejection of, 149, 158–59, 166

  criteria for, 158, 359–62

  see also childhood trauma survivors

  Dewey, Kippy, 337

  diagnosis, definition of, 137–38

  diagnosis, psychiatric, childhood trauma as misunderstood in, 136–48

  Diagnostic and Statistical Manual of Mental Disorders (DSM), 29, 137

  arbitrariness of, 323

  childhood trauma survivors ignored by, 143

  DSM-III, 29, 137, 142, 156, 190

  DSM-IV, 143

  DSM-5, 159, 164–66, 329, 393n

  reliability issues in, 164–65

  social causation ignored in, 165

  dialectical behavior therapy (DBT), 262, 270

  Diamond, Adele, 418n

  disruptive mood dysregulation disorder, 157, 393n

  dissociation, 66–68, 95, 179, 180–81, 194, 211, 247, 281, 294, 317–18, 401n

  maternal misattunement and, 121–22, 286

  neurofeedback and, 318

  in sexual abuse survivors, 132–33, 162, 172, 265, 316, 329

  dissociative amnesia, 190

  dissociative identity disorder (DID), 277–78

  Doerries, Bryan, 332

  domestic violence, 1, 11, 23–24

  deaths from, 348

  increased incidence of, in survivors of childhood abuse, 85, 146–47

  repressed memory and, 190

  victims’ loyalty to abusers in, 133

  victims’ submissiveness in, 218

  dopamine, 29, 226

  dorsal vagal complex (DVC), 82, 82, 83

  dorsolateral prefrontal cortex (DLPFC), 68–69, 376n

  dreaming, 260–61, 308, 309–10, 321

  drumming, 86, 208

  Duffy, Frank, 328

  Dunkirk evacuation, repressed memory and, 189–90

  dysfunctional thinking, 246

  ecstasy (MDMA), 223–24

  education system:

  cutting of social engagement programs in, 349

  inattention to emotional brain in, 86

  as resources for childhood trauma recovery, 351–56

  EEGs (electroencephalograms), 309–11, 320, 321

  Effexor, 225

  Ekman, Paul, 74

  Eli Lilly, 34–35

  El Sistema, 355

  EMDR, see eye movement desensitization and reprocessing (EMDR)

  Emerson, David, 269

  emotional brain, 54, 57, 62, 63, 176, 226, 265

  balance between rational brain and, 64–65, 129–30, 205, 310

  befriending of, 206–19, 206, 273, 274–75

  education system’s inattention to, 86

  inner world map encoded in, 129

  medial prefrontal cortex and, 206, 206, 236, 353

  physical manifestations of trauma in, 204–5

  Emotional Freedom Technique (EFT), 264–65

  emotional intelligence, 354

  emotions:

  articulation of, 232–34

  calming effect of physical activity on, 88

  fear of, in trauma survivors, 335

  physical expression of, 74–76, 75, 78

  regulation of, see self-regulation

  in therapeutic theater, 335, 344–45

  vagus nerve and, 76, 78, 80–82, 81

  writing and, 238–42

  empathy, 58–60, 111–12, 161

  endocrine system, 56

  endorphins, 32

  epigenetics, 152

  epilepsy, 310, 315

  equine therapy, 150–51, 213

  Erichsen, John Eric, 189

  Erickson, Milton, 254

  Esalen Institute, 300

  Estonia, “Singing Revolution” in, 334

  Eth, Spencer, 231

  executive function, 62, 323

  exiles (in IFS therapy), 281–82, 289–90, 291–95

  exposure therapy, 194

  EMDR vs., 255–56

  PTSD and, 256

  Expression of the Emotions in Man and Animals, The (Darwin), 74–76

  eye contact, direct vs. averted, 102

  eye movement desensitization and reprocessing (EMDR), 47, 220, 225, 228, 231, 246, 248–62, 290, 308, 321

  author’s training in, 251–53

  clinical study of, 254–55

  exposure therapy vs., 255–56

  medication vs., 254, 261

  origin of, 251

  PTSD and, 248–49, 253–54, 260

  sleep disorders and, 259–61

  eyewitness testimony, unreliability of, 192

  Fairbairn, Ronald, 109

  false memories, 189, 190, 191–92

  Father-Daughter Incest (Herman), 138

  “Faulty Circuits” (Insel), 328

  Feeling of What Happens, The (Damasio), 93

  Feldenkrais, Moshe, 92

  Felitti, Vincent, 143–47, 156

  feminist movement, 189

  fight/flight response, 30, 42, 45–47, 54, 57, 60–61, 64, 77, 78, 80, 82, 85, 96, 97, 209, 217, 218, 247, 265, 329, 408n

  firefighters, in IFS therapy, 282, 288–89, 291–92

  Fisher, Sebern, 312–14, 316–18, 325

  Fish-Murray, Nina, 105–7

  Fisler, Rita, 40

  flashbacks, 8, 13, 16, 20, 40, 42, 44, 45, 66–67, 68, 68, 70, 72, 101, 135, 172, 173, 176, 193–94, 196–98, 219, 227

  fluoxetine, see Prozac (fluoxetine)

  Foa, Edna, 233

  focus:

  in trauma recovery, 203, 347–48, 355

  trauma survivors’ difficulties with, 158, 166, 245–46, 311–12, 328


  Fortunoff Video Archive, 195

  Fosha, Diana, 105

  foster-care youth, Possibility Project theater program for, 340–42

  free writing, 238–39

  freeze response (immobilization), 54, 54, 82–83, 82, 85, 95, 217, 218, 265

  of Ute Lawrence, 65–66, 68, 71–72, 80, 82, 99–100, 219–20

  see also numbing

  Freud, Sigmund, 15, 27, 177, 181–82, 183, 184, 194, 219, 220, 231, 246–47

  Frewen, Paul, 99

  Friedman, Matthew, 159

  frontal cortex, 314

  frontal lobes, 57–58, 62, 176

  ADHD and, 310, 320

  empathy and, 58–60

  imagination and, 58

  PTSD and, 320

  see also medial prefrontal cortex (MPFC)

  frontal midline theta rhythm, 417n

  functional magnetic resonance imaging (fMRI), 39, 66

  Fussell, Paul, 243–44

  Galen, 77

  Gazzaniga, Michael, 280–81

  gene expression:

  attachment and, 154–55

  stress and, 152, 347

  genetics:

  mental illness and, 151–52

  of rhesus monkeys, 153–54

  Germany, treatment of shell-shock victims in, 185, 186–87

  Glenhaven Academy, Van der Kolk Center at, 213, 401n

  Gottman, John, 113

  Grant Study of Adult Development, 175

  Gray, Jeffrey, 33

  Great Depression, 186

  Great War in Modern Memory, The (Fussell), 243–44

  Great Work of Your Life, The (Cope), 230

  Greenberg, Mark, 31, 32, 33

  Greenberg, Ramon, 409n

  Greer, Germaine, 187

  Griffin, Paul, 335, 340–42

  Gross, Steve, 85

  group therapy, limits of, 18

  Gruzelier, John, 322

  gun control, 348

  Guntrip, Harry, 109

  gut feelings, 96–97

  Haig, Douglas, 185

  Haley, Sarah, 13

  Hamlin, Ed, 323

  handwriting, switching in, 241–42

  Harris, Bill, 155

  Hartmann, Ernest, 309–10

  Harvard Medical School, 40

  Countway Library of Medicine at, 11, 24

  Laboratory of Human Development at, 112

  see also Massachusetts Mental Health Center

  Hawthorne, Nathaniel, 309

  Head Start, 350

  heart disease, 267

  HeartMath, 413n

  heart rate, 46, 61, 66, 72, 116

  heart rate variability (HRV), 77, 266–69, 268, 271, 355, 413n

  Heckman, James, 167, 347

  Hedges, Chris, 31

  helplessness, of trauma survivors, 131, 133–34, 211, 265, 289–90, 341

  Herman, Judith, 138–41, 189, 296

  hippocampus, 60, 69, 176

  Hobson, Allan, 26, 259–60, 261

  Holocaust, 43

  Holocaust survivors, 99, 195, 223, 372n

  children of, 118–19, 293–95

  Holocaust Testimonies: The Ruins of Memory (Langer), 195, 372n

  Hölzel, Britta, 209–10, 275

  homeostasis, 56

  Hopper, Jim, 266

  Hosseini, Khaled, 7

  human connectome, 329

  humans, as social animals, 110, 166, 349

  Hurt Locker, The (film), 312

  Huston, John, 187, 220

  hypnagogic (trance) states, 117, 187, 238, 302, 305, 326

  hypnosis, 187, 220

  hypothalamus, 56, 60

  hysteria, 177–78, 178

  Freud and Breuer on, 181–82, 194

  hysterical blindness, 126

  imagination:

  dreams and, 261

  frontal lobes as seat of, 58

  loss of, 17, 350

  pathological, 25

  psychomotor therapy and, 305

  recovery of, 205

  imitation, 112

  immobilization, see freeze response (immobilization)

  immune system, 56

  stress and, 240

  of trauma survivors, 126–27, 291

  impulsivity, 120, 164

  incest survivors:

  cognitive defects in, 162

  depression in, 162

  dissociation in, 132–33, 162

  distorted perception of safety in, 164

  father-daughter, 20, 188–89, 250, 265

  high-risk behavior in, 164

  hypersensitivity to threat in, 163

  immune systems of, 126–27

  longitudinal study of, 161–64

  misguided views of, 20, 188–89

  numbing in, 162–63

  obesity in, 144, 162

  self-harming in, 162

  self-hatred in, 163

  troubled sexual development in, 162, 163

  trust as difficult for, 163

  India, traditional medicine in, 207

  inescapable shock, 29–31

  infants, 83–84

  arousal in, 84, 113, 121, 161

  attunement of caregivers and, 111–13, 117, 118

  caregivers’ bonds with, 109–11, 113, 128–29

  internal locus of control in, 113

  sense of self in, 113

  sensory experiences of, 93–94

  VVC development in, 83–84

  inferior medial prefrontal cortex, 376n

  Insel, Thomas, 328

  Institute of the Pennsylvania Hospital, 251

  insula, 91, 91, 247, 274, 274, 382

  integration, of traumatic memories, 181, 219–20, 222, 228, 237, 279, 308

  interdependence, 340–41

  intermittent explosive disorder, 151

  internal family systems (IFS) therapy, 223–24, 262, 281–95, 418n

  exiles in, 281–82, 289–90, 291–95

  firefighters in, 282, 288–89, 291–92

  managers in, 282, 286–88, 291–92, 293

  mindfulness in, 283

  rheumatoid arthritis and, 291–92

  Self in, 224, 283–85, 288, 289, 305

  unburdening in, 295

  interoception, 95–96, 413n

  yoga and, 272–74

  see also sensory self-awareness

  interpersonal neurobiology, 2, 58–60

  intimacy:

  suspension of defense mechanisms in, 84–85

  trauma survivors’ difficulty with, 99, 143

  Iraq War:

  deaths in, 348

  veterans of, 220, 221, 222–23, 229, 312, 332

  irritability, 10

  isolation, of childhood sexual abuse survivors, 131

  James, William, 89–90, 93, 184, 277, 280, 296, 309

  Janet, Pierre, 54, 177, 178–79, 181, 182, 184, 194, 218, 220, 312, 396n

  Jouvet, Michel, 259–60

  Jung, Carl, 27, 280, 296

  Justice Resource Institute, 339, 401n

  Kabat-Zinn, Jon, 209

  Kagan, Jerome, 79, 237–38

  Kaiser Permanente, 144

  Kamiya, Joe, 315

  Kandel, Eric, 26

  Kardiner, Abram, 11, 187, 189, 371n

  Katrina, Hurricane, 54

  Keats, John, 248

  Keegan, John, 185

  Keeping Together in Time (McNeill), 333

  Keller, Helen, 234–35

  Kennedy, John F., 373n

  Kinneburgh, Kristine, 401n

  Kite Runner, The (Hosseini), 7

 
Klonopin, 225

  Kluft, Richard, 251, 281

  Koch, Robert, 164

  Kradin, Richard, 126

  Krantz, Anne, 243

  Krystal, Henry, 99

  Krystal, John, 30

  Kulkosky, Paul, 326, 327

  Lancet, 189

  Langer, Lawrence, 195, 372n

  language:

  failure of, in trauma survivors, 43–44, 243–45, 352–53

  limitations of, 235–37, 243–45

  mental health and, 38

  self-discovery and, 234–35

  in trauma recovery, 230–47, 275–76

  Lanius, Ruth, 66, 90, 92, 99, 102

  Laub, Dori, 372n

  Lawrence, T. E., 232

  Lazar, Sara, 209–10, 275

  learning disabilities, neurofeedback and, 325

  LeDoux, Joseph, 60, 206

  legal cases:

  admissibility of evidence in, 174–75

  involving pedophile priests, 183, 190, 191

  Lejune, Camp, 270

  Letters to a Young Poet (Rilke), 87

  Let There Be Light (film), 187, 220

  Levine, Peter, 26, 96, 217–18, 245, 408n

  Lifton, Robert J., 19

  limbic system, 42, 42, 56–57, 59, 60, 64

  development of, 56–57

  therapy for, 205–6

  in trauma survivors, 59, 95, 176, 265

  see also emotional brain

  lithium, 27–28, 136, 225

  loss, as basic human experience, 26–27

  love, as basic human experience, 26–27

  LSD, 223

  L-tryptophan, 34

  lupus erythematosus, 126

  Lyons-Ruth, Karlen, 119–22

  MacArthur, Douglas, 186

  Macbeth (Shakespeare), 43, 230

  McFarlane, Alexander, 89, 245–46, 311–12, 324–25

  McGaugh, James, 176

  MacLean, Paul, 64

  McNeill, William H., 333

  Maier, Steven, 29–30

  Main, Mary, 115–17, 381n

  Mamet, David, 331

  managers, in IFS therapy, 282, 286–88, 291–92, 293

  Mandela, Nelson, 356

  map of the world, internal:

  in childhood trauma survivors, 127–30

  of children, 109, 127, 129

  March of the Penguins (film), 96

  Marlantes, Karl, 233–34

  martial arts, 86, 208, 355

  Massachusetts Department of Mental Health, 253

  Massachusetts General Hospital, 192, 251

  Neuroimaging Laboratory of, 40

  Massachusetts Mental Health Center, 19–20, 22, 26, 28, 36, 142, 259–60

  see also Children’s Clinic (MMHC); Trauma Clinic

  massage therapy, 89, 92

  Matthew, Elizabeth, 253–54

  Maurice, Prince of Orange, 333–34

  MDMA (ecstasy), 223–24

  meaning-making, as human trait, 16–17

  medial prefrontal cortex (MPFC), 62, 63, 69, 91, 92, 96, 274, 274

 

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