The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel van der Kolk

Author:Bessel van der Kolk [van der Kolk MD, Bessel]
Language: eng
Format: epub
Published: 2014-09-25T00:00:00+00:00

CHAPTER 14

LANGUAGE: MIRACLE AND TYRANNY

Give sorrow words; the grief that does not speak knits up the o’er wrought heart and bids it break.

—William Shakespeare, Macbeth

We can hardly bear to look. The shadow may carry the best of the life we have not lived. Go into the basement, the attic, the refuse bin. Find gold there. Find an animal who has not been fed or watered. It is you!! This neglected, exiled animal, hungry for attention, is a part of your self.

—Marion Woodman (as quoted by Stephen Cope in The Great Work of Your Life)

In September 2001 several organizations, including the National Institutes of Health, Pfizer pharmaceuticals, and the New York Times Company Foundation, organized expert panels to recommend the best treatments for people traumatized by the attacks on the World Trade Center. Because many widely used trauma interventions had never been carefully evaluated in random communities (as opposed to patients who seek psychiatric help), I thought that this presented an extraordinary opportunity to compare how well a variety of different approaches would work. My colleagues were more conservative, and after lengthy deliberations the committees recommended only two forms of treatment: psychoanalytically oriented therapy and cognitive behavioral therapy. Why analytic talk therapy? Since Manhattan is one of the last bastions of Freudian psychoanalysis, it would have been bad politics to exclude a substantial proportion of local mental health practitioners. Why CBT? Because behavioral treatment can be broken down into concrete steps and “manualized” into uniform protocols, it is the favorite treatment of academic researchers, another group that could not be ignored. After the recommendations were approved, we sat back and waited for New Yorkers to find their way to therapists’ offices. Almost nobody showed up.

Dr. Spencer Eth, who ran the psychiatry department at the now-defunct St. Vincent’s Hospital in Greenwich Village, was curious where survivors had turned for help, and early in 2002, together with some medical students, he conducted a survey of 225 people who had escaped from the Twin Towers. Asked what had been most helpful in overcoming the effects of their experience, the survivors credited acupuncture, massage, yoga, and EMDR, in that order.1 Among rescue workers, massages were particularly popular. Eth’s survey suggests that the most helpful interventions focused on relieving the physical burdens generated by trauma. The disparity between the survivors’ experience and the experts’ recommendations is intriguing. Of course, we don’t know how many survivors eventually did seek out more traditional therapies. But the apparent lack of interest in talk therapy raises a basic question: What good is it to talk about your trauma?

THE UNSPEAKABLE TRUTH

Therapists have an undying faith in the capacity of talk to resolve trauma. That confidence dates back to 1893, when Freud (and his mentor, Breuer) wrote that trauma “immediately and permanently disappeared when we had succeeded in bringing clearly to light the memory of the event by which it was provoked and in arousing its accompanying affect, and when the patient had described that event in the greatest possible detail and had put the affect into words.

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