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The most important predictor of how well his subjects coped with life’s inevitable disappointments was the level of security with their primary caregiver during the first two years of life. Resilience could be predicted by how lovable mothers rated their kids at age two.
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On YouTube you can still watch the documentary Let There Be Light, by the great Hollywood director John Huston, which shows men undergoing hypnosis to treat “war neurosis.
Bessel van der Kolk
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In April 2013, a few weeks before DSM-V was formally released, NIMH director Thomas Insel announced that his agency could no longer support DSM’s “symptom-based diagnosis.”32 Instead the institute would focus its funding on what are called Research Domain Criteria (RDoC)33 to create a framework for studies that would cut across current diagnostic categories.
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One tragic example of this orientation is the rampant prescription of painkillers, which now kill more people each year in the United States than guns or car accidents.
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Trauma, by definition, is unbearable and intolerable. Most rape victims, combat soldiers, and children who have been molested become so upset when they think about what they experienced that they try to push it out of their minds, trying to act as if nothing happened, and move on. It takes tremendous energy to keep functioning while carrying the memory of terror, and the shame of utter weakness and vulnerability.
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I like to believe that once our society truly focuses on the needs of children, all form of social support for families - a policy that remains so controversial in this country - will gradually come to seem not only desirable but also doable. ... if we feel abandoned, worthless, or invisible, nothing seems to matter. Fear destroys curiosity and playfulness. In order to have a healthy society, we must raise children who can safely play and learn. Currently, more than 50 percent of children served by Head Start have had three or more adverse childhood experience like those included in the ACR study: incarcerated family members, depression, violence, abuse, or drug use in the home and periods of homelessness... Trauma is now our most urgent public health issue, and we have the knowledge necessary to respond effectively. The choice is ours to act on what we know.
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We can assume that parents do the best they can, but all parents need help to nurture their kids. Nearly every industrialized nation, with the exception of the United States, recognizes this and provides some form of guaranteed support to families.
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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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We are a hopeful species. Working with trauma is as much about remembering how we survived as it is about what is broken.
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The way a mother holds her child underlies “the ability to feel the body as the place where the psyche lives.
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While we all want to move beyond trauma, the part of our brain that is devoted to ensuring our survival (deep below our rational brain) is not very good at denial. Long after a traumatic experience is over, it may be reactivated at the slightest hint of danger and mobilize disturbed brain circuits and secrete massive amounts of stress hormones.
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Primordial feelings provide a direct experience of one’s own living body, wordless, unadorned, and connected to nothing but sheer existence. These primordial feelings reflect the current state of the body along varied dimensions, . . . along the scale that ranges from pleasure to pain, and they originate at the level of the brain stem rather than the cerebral cortex. All feelings of emotion are complex musical variations on primordial feelings.
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As the ACE study has shown, child abuse and neglect is the single most preventable cause of mental illness, the single most common cause of drug and alcohol abuse, and a significant contributor to leading causes of death such as diabetes, heart disease, cancer, stroke, and suicide.
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It takes enormous trust and courage to allow yourself to remember.
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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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Most human beings simply cannot tolerate being disengaged from others for any length of time. People who cannot connect through work, friendships, or family usually find other ways of bonding, as through illnesses, lawsuits, or family feuds.
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Maltreatment is a chisel that shapes a brain to contend with strife, but at the cost of deep, enduring wounds. Childhood abuse isn’t something you “get over.”
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Acting is an experience of using your body to take your place in life.
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This research confirms what our patients tell us: that the self can be detached from the body and live a phantom existence on its own. Similarly, Lanius and Frewen, as well as a group of researchers at the University of Groningen in the Netherlands,26 did brain scans on people who dissociated their terror and found that the fear centers of the brain simply shut down as they recalled the event.
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If you criticize others, they don't dare to hurt you. If you are perfect, nobody can criticize you.
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Many traumatized individuals are too hypervigilant to enjoy the ordinary pleasures that life has to offer, while other are too numb to absorb new experiences – or to be alert to signs of real danger. When the smoke detectors of the brain malfunction, people no longer run when they should be trying to escape or fight back when they should be defending themselves.
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Securely attached kids learn the difference between situations they can control and situations where they need help. They learn that they can play an active role when faced with difficult situations. In contrast, children with histories of abuse and neglect learn that their terror, pleading, and crying do not register with their caregiver. Nothing they can do or say stops the beating or brings attention and help. In effect they’re being conditioned to give up when they face challenges later in life.
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While trauma keeps us dumbfounded, the path out of it is paved with words, carefully assembled, piece by piece, until the whole story can be revealed.
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Stabilize and calm patients down, help to lay traumatic memories and reenactments to rest, and reconnect patients with their fellow men and women.
Bessel van der Kolk