To continue growing my understanding of the mind-body connection, I read the book THE BODY KEEPS THE SCORE, Brain, Mind, and Body in the Healing of Trauma, by Bissell van der Kolk, M.D. While it focuses on traumatic trauma, it provided me more insight of the interaction of the mind and the body. The book is a very substantial work of bringing together history, other professionals, and his work, including specific cases/examples he has done. It has about 350 pages of text and some photos/diagrams, 6 pages of RESOURCES, 50 pages of NOTES [references], and 20 pages of INDEX. The following are the points I wanted to have for easy reference; the book contains much more information. Permission to quote received in an email to me dated February 17, 2026. Italics indicates quotes.
Praise for the book by many people include: compelling descriptions of the work of others, his own pioneering trajectory and experience as the field evolved and him along with it, and above all, his discovery of ways to work skillfully with people by bringing mindfulness to the body…. clarity of vision and breadth of wisdom of this unique highly accessible work is remarkable……has spent a career bringing together diverse trauma scientists and clinicians and their ideas, while making his own pivotal contributions, describes for his arguably the most important series of breakthroughs in mental health in the last thirty years. … eloquently articulates how overwhelming experiences affect the development of brain, mind, and body awareness, all of which are clearly intertwined… takes the reader on a captivating journey that is chock-full of riveting stories of patients and their struggles interpreted through history, research and neuroscience made accessible in the words of a gifted storyteller.
Page 39-40
In the early 1990s novel brain-maging techniques opened up undreamed-of capacities to gain a sophisticated understanding about the way the brain process information. Gigantic multimillion-dollar machines based on advanced physics and computer technology rapidly made neuroscience into one of the most popular areas for research. Positive emission tomography (PET) and, later, functional magnetic resolution imaging (fMRI) enables scientists to visualize how different parts of the brain are activated when people are engaged in certain tasks or when they remember events from the past For the first time we could watch the brain as it processed memories, sensations, and emotions and begin to map the circus of mind and consciousness. Earlier technology of measuring brain chemicals like serotonin or norepinephrine had enabled scientists to look at what fueled neural activity.……………………………………….Neuroimaging made it possible to see inside.
Page 59
The Triune (Three-part) Brain. The brain develops from the bottom up. The reptilian brain develops in the womb and organizes basic life sustaining functions. It is highly responsive to threat throughout our entire lifespan. The limbic system is organized mainly through the first six years of life but continues to evolve in a use-dependent manner. Trauma can have a major impact on its functioning throughout life. The prefrontal cortex develops last, and also is affected by trauma exposure, including being unable to filter out irrelevant information. Throughout life it is vulnerable to go offline in response to threat.
Page 77-78
In 1994 Stephen Porges introduced the Polyvagal Theory, which built on Darwin’s observations and added another 140 years of scientific discovery to really insights… The Polyvagal Theory provided us with a more sophisticated understanding of the biology of safety and danger, one based on subtle interplay between the visceral experiences of our own bodies and the voices and faces of people around us. It explain why a kind face or a soothing turn of voice can dramatically alter the way we feel. It clarified by knowing that we are seen and heard by the important people in our lives can make us feel calm and safe, and why being ignored or dismissed can precipitate rage reactions or mental collapse. It helped us understand why focused attunement with another person can shift us out of disorganized and fearful states.
Page 81
The social-engagement system depends on nerves that have their origin in the brain stem regulatory centers, primarily the vegus–also known as the tenth cranial nerve–together with adjoining nerves that activate the muscles of the face, throat, middle ear, and voice box or larynx. When the “ventral vagal complex” (VVC) runs the show, we smile when others smile at us, we nod our heads when we agree, and we frown when friends tell us of their misfortune. When’s the VVC is engaged, it also sends signals down to our heart and lungs, slowing down the heart rate and increasing the depth of breathing.
A drawing of the nerves running from the base of the brain to the colon has the description:
The many-branched vagas. The Vegas nerve (which Darwin called the pneumogastric nerve) registers heartbreak and gut-wrenching feelings. When a person becomes upset the throat gets dry, the voice becomes tense, the heart speeds up, and respiration becomes rapid and shallow.
Page 82
Any threat to our safety or social connection triggers changes in the areas innervated by the VCC. When something distressing happens, we automatically signal our upset to our facial expressions and tone of voice, changes meant to beckon others to come to our assistance. However, if no one responds or a call for help, the threat increases, and the older limbic brain jumps in. The sympathetic nervous system takes over, mobilizing muscles, heart, lungs for fight or flight. Our voice becomes faster and more strident and our heart starts pumping faster. If a dog is in the room, she will stir and growl, because she can smell the activation of our sweat glands.
Finally if there’s no way out, and there’s nothing we can do to stave off the inevitable, we’ll activate the ultimate emergency system the dorsal vagal complex (DVC). This system reaches down below the diaphragm to the stomach, kidneys, and intestine and drastically reduces metabolism throughout the body. Heart rate plunges (we feel our heart “drop”) we can’t breathe, and our gut stops working or empties (literally “scaring the shit out of us”). This is a point at which we disengage, collapse, and freeze.
p 97
Self-regulation depends on having a friendly relatioship with your body. Without it you have to rely on external regulation–from medication, drugs like alcohol, constant reassurance, or compulsive compliance with the wishes of others…….Suppressing our inner cries for help does not stop our stress hormones from mobilizing the body.
p 100-101
Trauma victims cannot recover until they become familiar with and befriend the sensation in their bodies……..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 of fear but the physical sensations beneath the emotions: pressure, heat, muscular tension, tingling, caving in, feeling hollow, and so on.
.P 160
Beginning in 1975,….Alan Stoufe and his collegues tracked of 180 children and their families… from 3 months before birth for almost 30 years ….Neither the mother’s personality. nor the infants neurological anomalies at birth, nor IQ, not its temperament….. would develop serious behavioral problems in adolescence. The key issue, rather, was the nature of the parent-child relationship.
p 167-168
In the past there have been problems in identifying specific mental health labels. The Developmental Trauma Disorder document helps to establish and focus research and treatment on mental health patients. James Heckman, winner of the 2000 Nobel Prize in Economics, has shown that quality early childhood programs that involve parents and promote basic skills and disadvantaged children more than pay for themselves and improved outcomes. Scandinavian countries put their money in helping parents to help reduce later costs to society. The United States spends 84 billion dollars per year to incarcerate people at approximately $44,000 per prisoner; the northern European countries a fraction of that amount.
P 206
There is a rational brain, and there is a emotional brain. Most of our conscious brain is dedicated to focusing on the outside world: getting along with others and making plans for the future. However, that does not help us manage ourselves. Neuroscience research shows that the only way we can change the way we feel is becoming aware of our inner experience and learning to befriend what is going inside ourselves.
P 239
In 1986, James Penbaker of the University of Texas in Austin turned his introductory psychology class into an experimental laboratory….. He began by asking his (200) students to identify a deeply personal experience that they found very stressful or traumatic. They were divided into three groups: One would write about what was currently going on in their lives; the second would write about the details of the traumatic or stressful event; and the third were recount the effects of the experience, their feelings and emotions about it and what’s impact they thought this event had on their lives. All of the students wrote continuously for fifteen minutes on four consecutive days while sitting alone in a small cubicle in the psychology building.
P 240
The group that had written about both the facts and the emotions related to their trauma clearly benefited the most: They had a 50% drop in doctor visits compared with the other two groups. Writing about their deepest thoughts and feelings about trauma had improved their mood and resulted in a more optimistic attitude and better physical health.
The object of writing is to write to yourself, to let yourself see what you have been trying to avoid. It increases self-understanding. A subsequent study…half of a group of seventy-two-students to talk into a tape recorder about the most traumatic experience of their lives, the other half discussed their plans for the rest of the day. This studying had similar results: those who allowed themselves to feel their emotions showed significant physiological changes, both immediate and long-term. During their confessions blood pressure, heart rate and other autonomic functions increase, but afterwards there arousal fell to levels below where they had been at the start of the study. The drop in blood pressure could still be measured 6 weeks after the experiment ended…Those who wrote about personal traumas had fewer visits to the student health center, and their improved health correlated with improved health function, as measured by the action of T lymphocytes (natural killer cells) and other immune markers in the blood.
p 247
Almost every brain imaging study of trauma patients finds abnormal activation of the insula. This part of the brain integrates and interprets the input from the internal organs–including our muscles, joints, and balance (proprioceptive) system–to generate the sense of being embodied. The insula can transmit signals to amygdala that trigger flight fight responses……This does not require any cognitive input or any conscious recognition something has gone awry–you just feel on edge and unable to focus on or, at worst, have a sense of imminent doom. These powerful feelings are generated deep inside the brain and cannot be eliminated by reason or understanding.
EMDR or eye movement desensitization and reprocessing.
p 251
One day in 1987, psychologist Francine Shapiro was walking through a park preoccupied with some painful memories when she noticed that rapid eye movement produced a traumatic relief from her distress.
p 253
Bissell Van der Kolk, M.D., relates that is necessary to know the difference between the therapist desire to hear stories and the therapist patient’s internal process of healing.
I left my EMDR training preoccupied with three issues that fascinate me to this day:
EMDR loosens up something in the mind/brain that gives people rapid access to loosely associated memories and images from their past. This seems to help them put the traumatic experience into a larger context or perspective.
People may be able to heal from trauma without talking about it. EMDR enables them to observe their experience in a new way, without verbal give-and-take with another person.
EMDR can help even if the patient and the therapist do not have a trusting relationship. This was particularly intriguing because trauma, understandably, rarely leaves people in an open, trusting heart.
P 254
Studies have shown EMDR to be more effective than medicines, such as Prozac.
P 255
As of 2014 our EMDR study had the most positive outcome of any published study of people who developed their PTSD in reaction to a traumatic event as an adult.
Some psychologists have hypothesized that EMDR actually desensitizes people to the traumatic material and thus is this related to exposure therapy. A more accurate description would be that it integrates the traumatic material. Research showed, after EMDR people thought of the trauma as a coherent event in the past, instead of experiencing sensations and images divorced from any context.
p 259
An example of utilizing EMDR revealed the ability to integrate the memories of her trauma and call on her imagination to help her to lay them to rest, arriving at a sense of completion and control. She did so with minimal input from me and without any discussion of the particulars of . The process freed something in her mind/brain to activate new images, feelings, and thoughts; it was as if their life force emerged to create new possibilities for her future.….traumatic memories persist as split-off, unmodified images, sensations, and feelings…..the most remarkable feature of EMDR is its apparent a capacity to activate a series of unsought and seemingly unrelated sensations, emotions, images, and thoughts and connection with the original memory. This way of reassembling old information into new packages maybe just the way we integrate ordinary, non-traumatic day-to-day experiences.
p 261
Research assistant, Robert Stickgold, noted similarities between dreams and EMDR. He suggests a clear link between EMDR and memory processing and dreams: “If the bilateral stimulation of EMDR can alter brain states in the manner similar to that seen during REM sleep then there is now good evidence that EMDR should be able to take advantage of sleep-dependent processes, which may have blocked or ineffective in PTSD suffers, to allow effective memory processing and trauma resolution”
p 261-262
Unlike conventional exposure treatment, EMDR spends very little time revisiting the original trauma. The trauma itself is certainly the starting point, but the focus on the stimulating and opening up the associative processes. As our Prozac/EMDR study showed, drugs can plant the images and sensations of terror, but they remain embedded in the mind and body. In contrast with the subjects who improved on Prozac–whose memories were merely blunted, not integrated as an event that happened in the past, and still cause considerable anxiety–those who received EMDR no longer experience the distinct imprints of the trauma. It became a story of a terrible event that had happened a long time ago. As one of the patients said, making a dismissive hand gesture: “it’s over.”
p 264-265
In early therapy sessions, to help calm a patient, the therapist used emphasis on breathing with a focus on the out breath, which activates the relaxing parasympathetic nervous system. I also taught her to use her fingers to tap a sequence of acupressure points on various parts of their body, a practice often taught under the name EFT (emotional freedom technique) which has been shown to help patients stay within the window of tolerance and also positive effects on PTSD symptoms.
Internal Family System
p 281-282
I met Richard Schwartz, the developer of internal family systems therapy (IFS) parentheses. It was through his work that Minsky’s “family” metaphor truly came to life for me and offered a systematic way to look at the split-off parts that result from trauma. At the core of IFS is the notion that the mind of each of us is like a family in which the members have different levels of maturity, excitability, wisdom, and pain. The parts form a network or system in which change in any one part will affect all the others.
The IFS model helped me realize that dissociation occurs on a continuum. In trauma the self system breaks down, and parts of the self become polarized and go to war with one another. Self-loathing coexist (and fights) with grandiosity; loving care with hatred; numbing and passivity with rage and aggression. These extreme parts bear the burden of the trauma.
In IFS a part is considered not just a passing emotional state or customary thought pattern but a distinct metal system with its own history, abilities, needs and worldview. Trauma injects parts with beliefs and emotions that hijack them out of their natural valuable state. For example, we all have parts that are childlike and fun. When we are abused, these are the parts that are hurt the most, and they become frozen, carrying the pain, terror, and betrayal of abuse. This burden makes them toxic–parts of ourselves that we need to deny at all costs. Because they are locked away inside, IFS calls them the exiles.
At this point other parts organized to protect the internal family from the exiles. These protectors keep the toxic parts away, but in so doing they take on some of the energy of the abuser. Critical and perfectionistic managers can make sure we never get close to anyone or drive us to be relentlessly productive. Another group of protectors, which IFS calls firefighters, are emergency responders, acting impulsively whenever an experience triggers and exiled emotion.
Each split off part holds different memories, beliefs, and physical sensations; some hold the shame, other the rage, some of the pleasure and excitement, another that intense loneliness or the abject compliance. These are all aspects of the abuse experience. The critical insight is that all these parts have a function: to protect the self from feeling the full terror of annihilation.
Parts that are “out” may be entirely unaware of the other parts of the system.
Patients may also dislike the parts that are out: the parts that are angry, destructive, or critical. But ifs offers a framework for understanding them and, also important, talking about them in the nonpathologizing way. Recognizing each part is stuck with burdens from the past and respecting its function in the overall system makes it less threatening or overwhelming.
p 283-284
As Richard Schwartz explains:
The internal system of abuse victim differs from the non-abuse system with regards to the consistent absence of effective leadership, the extreme rules under which the parts function, and the absence of any consistent balance or harmony. Typically, the parts operate around outdated assumptions and beliefs the right from the childhood of abuse, believing, for example, that is still extremely dangerous to reveal secrets about childhood experiences which were endured.
Schwartz makes two assertions that extend the concept of mindfulness into the realm of active leadership. The first is that the Self does not need to be cultivated or developed. Beneath the surface of the protective parts of trauma survivors there exists and 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 effort to endure survival. Once these protectors trust that it is safe to separate, the Self will spontaneously emerge, and the parts can be enlisted in the healing process.
The second assumption is that, rather than being passive observer, this mindful Self can help reorganize the inner system and communicate with the parts in ways that help those parts trust that there is someone inside who can handle things. …Mindfulness increased activation of the medial prefrontal cortex and decreases activation of structures like the amygdala that trigger our emotional responses. This increases our control over the emotional brain.
p 296 – 308 Chapter 18
“The greatest discovery of my generation is the human being can alter their lives by altering their attitude of mind”. William James
“It not that something different is seen, but that one sees differently. It is as though the spatial act of seeing were changed by a new dimension”. Carl Jung
PBSP psychomotor therapy “recreates” earlier events using other people or objects as stand-ins
Protagonist: client describes situation…what is troubling?
Witness: leads, invites and reflects “microtracking”