Recovery from Trauma – the Body Keeps the Score

I’m in The Hague for the next few days at the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) conference. There have been lots of interesting papers so far but I was inspired to blog about two sessions today from Bessel Van de Kolk because it’s all about the effects of trauma on the brain and how to recover from it – so exactly what I am interested in.

People’s normal response to a traumatic incident, he used the example of the twin towers attack on 9/11, is to run away and specifically run home. This is because running is a very effective strategy when you are in danger and home is a safe place.

The picture here was drawn by a 5 year old boy who was involved in 9/11. He drew this the day after, when he had escaped to his safe home. It shows the towers, falling people and at the top right a fireball. What touched me is that the black circle in the bottom of the picture is apparently a trampoline to help the people falling. It shows the inherent goodness and optimism of kids in my opinion.

But what happens when you cannot run, because you are prevented from escape? Also what happens if home is not safe? He said that in one study adults were asked if they felt safe with anyone as a child. A large percentage (didn’t write it down but I think it was around 45%) said they did not.

So this is where PTSD and other traumatic responses come in. Without the ability to escape and/or a safe person or place to help the child stays in a panic state into adulthood, which they do not have the ability to process. He describes it as being stuck with a broken alarm system – either overreacting or under reacting to events.

This panic state is either numbed emotionally, expressed explosively or dulled through behaviour that can be harmful long term (drink, drugs etc). Bessel argues that the very first thing a person who has been abused needs to learn is how to calm down in a safe, healthy way.

Apparently he asked Nelson Mandela how he stayed so calm when in prison. Mandela said it was boxing – because it helped him become aware of his body. Bessel van de Kolk recommends yoga, mindfulness, tai chi – anything involving movement and mindfulness.

Bessel has written a book about this ‘The Body Keeps the Score‘ which is very good. I realised that I had misunderstood what PTSD was. I had thought it was like on tv or the movies where a Vietnam vet is still hallucinating being in a war zone despite being at home. Instead complex PTSD can involve avoiding anything that reminds the person of their abuser(s) and can also involve using coping strategies (like drink or drugs) to reduce anxiety. ACT therapy is recommended as a useful treatment. It involves mindfulness and accepting that you will always have strong feelings about being abused and that trying to deny them actually causes problems. It’s an approach that makes sense (to me anyway).

So there’s a number of things you can try here if you are struggling:

1. Get tested for complex PTSD by your GP – The most important one I think!

2. Mindfulness

3. Tai chi

4. Martial arts

5. Yoga

6. Read any books by Russ Harris (who designed ACT therapy). They have stupid titles in my opinion but are useful books.

7. Get ‘The Body Keeps the Score’ by Bessel Van De Kolk.