Bessel van der Kolk Quotes
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Many traumatized people seem to seek out experiences that would repel most of us,14 and patients often complain about a vague sense of emptiness and boredom when they are not angry, under duress, or involved in some dangerous activity.
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Many traumatized children and adults simply cannot describe what they are feeling because they cannot identify what their physical sensations mean. They may look furious but deny that they are angry; they may appear terrified but say that they are fine. Not being able to discern what is going on inside their bodies causes them to be out of touch with their needs, and they have trouble taking care of themselves, whether it involves eating the right amount at the right time or getting the sleep they need.
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The single most important issue for traumatized people is to find a sense of safety in their own bodies.
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In the chapters on the biology of trauma we saw how trauma and abandonment disconnect people from their body as a source of pleasure and comfort, or even as a part of themselves that needs care and nurturance. When we cannot rely on our body to signal safety or warning and instead feel chronically overwhelmed by physical stirrings, we lose the capacity to feel at home in our own skin and, by extension, in the world. As long as their map of the world is based on trauma, abuse, and neglect, people are likely to seek shortcuts to oblivion. Anticipating rejection, ridicule, and deprivation, they are reluctant to try out new options, certain that these will lead to failure. This lack of experimentation traps people in a matrix of fear, isolation, and scarcity where it is impossible to welcome the very experiences that might change their basic worldview.
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Now I know people in a different way. It’s not based on memorizing them out of fear. When you’re not afraid of being hurt, you can know people differently.
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In the early 1970s psychologist David Olds was working in a Baltimore day-care center where many of the preschoolers came from homes wracked by poverty, domestic violence, and drug abuse. Aware that only addressing the children’s problems at school was not sufficient to improve their home conditions, he started a home-visitation program in which skilled nurses helped mothers to provide a safe and stimulating environment for their children and, in the process, to imagine a better future for themselves. Twenty years later, the children of the home-visitation mothers.
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That happens only when you feel safe at a visceral level and allow yourself to connect that sense of safety with memories of past helplessness.
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Many of our patients are barely aware of their breath, so learning to focus on the in and out breath, to notice whether the breath was fast or slow, and to count breaths in some poses can be a significant accomplishment.
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What differentiated our patients was the abuse they had suffered within their families. They included a boy who was severely bruised from repeated beatings by his mother; a girl whose father had molested her at the age of four; two boys who had been repeatedly tied to a chair and whipped; and a girl who, at the age of five, had seen her mother (a prostitute) raped, dismembered, burned, and put into the trunk of a car. The mother’s pimp was suspected of sexually abusing the girl.
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Games like Simon Says lead to lots of sniggering and giggling—signs of safety and relaxation. When teenagers balk at these “stupid games,” we nod understandingly and enlist their cooperation by asking them to demonstrate games to the little kids, who “need their help.
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Thalamus also acts as a filter or gatekeeper. This makes it a central component of attention, concentration, and new learning—all of which are compromised by trauma. As you sit here reading.
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Tendency to superimpose their trauma on everything around them and have trouble deciphering whatever is going on around them. There appeared to be little in between.
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Psychological problems occur when our internal signals don’t work, when our maps don’t lead us where we need to go, when we are too paralyzed to move.
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Spilled out stories about painful marriages, difficult children, and guilt over abortions. As they spoke, they visibly brightened and often thanked me effusively for listening to them.
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Treatment needs to reactivate the capacity to safely mirror, and be mirrored, by others, but also to resist being hijacked by others’ negative emotions.
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Being able to feel safe with other people is probably the most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives. Numerous studies of disaster response around the globe have shown that social support is the most powerful protection against becoming overwhelmed by stress and trauma. Social support is not the same as merely being in the presence of others. The critical issue is reciprocity: being truly heard and seek by the people around us, feeling that we are held in someone else's mind and heart.
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Trauma increases the risk of misinterpreting whether a particular situation is dangerous or safe. You can get along with other people only if you can accurately gauge whether their intentions are benign or dangerous. Even a slight misreading can lead to painful misunderstandings in relationships at home and at work. Functioning effectively in a complex work environment or a household filled with rambunctious kids requires the ability to quickly assess how people are feeling and continuously adjusting your behavior accordingly. Faulty alarm systems lead to blowups or shutdowns in response to innocuous comments or facial expressions.
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Since then, however, scientific methods have confirmed that changing the way one breathes can improve problems with anger, depression, and anxiety and that yoga can positively affect such wide-ranging medical problems as high blood pressure, elevated stress hormone secretion, asthma, and low-back pain.
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If you do something to a patient that you would not do to your friends or children, consider whether you are unwittingly replicating a trauma from the patient’s past.
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The number of people under the age of twenty receiving Medicaid-funded prescriptions for antipsychotic drugs tripled between 1999 and 2008.
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Erratic caregiving produced kids who were chronically physiologically aroused. The children of unpredictable parents often clamored for attention and became intensely frustrated in the face of small challenges. Their persistent arousal made them chronically anxious. Constantly looking for reassurance got in the way of playing and exploration, and, as a result, they grew up chronically nervous and nonadventurous.
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Traumatized people have a tendency to superimpose their trauma on everything around them and have trouble deciphering whatever is going on around them.
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People can learn to control and change their behavior, but only if they feel safe enough to experiment with new solutions. The body keeps the score: If trauma is encoded in heartbreaking and gut-wrenching sensations, then our first priority is to help people move out of fight-or-flight states, reorganize their perception of danger, and manage relationships. Where traumatized children are concerned, the last things we should be cutting from school schedules are the activities that can do precisely that: chorus, physical education, recess, and anything else that involves movement, play, and other forms of joyful engagement.
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One thing is certain: Yelling at someone who is already out of control can only lead to further dysregulation. Just as your dog cowers if you shout and wags his tail when you speak in a high singsong, we humans respond to harsh voices with fear, anger, or shutdown and to playful tones by opening up and relaxing. We simply cannot help but respond to these indicators of safety or danger.