The book The Body Keeps the Score by Bessel van der Kolk has had a big impact on the way people look at harmful experiences. The idea that traumatic or adverse experiences are in some sense stored in the body has helped many people make sense of what they feel in their own bodies and given them a reason to try somatic (body) treatments to help heal from these experiences.

So, when a journal article came out in April of this year entitled The Body Does Not Keep the Score, it caught my interest. If trauma isn’t stored in the body, why do so many people feel like it is? And more importantly, does this mean that therapies that include body work are ineffective?

The short answers to these questions:

It feels like the body keeps the score because it participates in the trauma response
No! The debate isn’t really about whether somatic therapies work, but rather how they work

Now let me tell you the slightly longer answers.

The Body as Player and the Brain as a Coach:

The article was written by three neuroscientists and a writer, and the argument they make is based on a neuroscience theory called predictive processing. The article argues that trauma is technically not stored in your body proper, but that there are feedback loops that originate from the brain and your nervous system that are felt in the body. According to the writers, the “score” the body might seem to be keeping is actually part of a feedback loop: your brain predicts danger, senses arousal in your body (arousal that began because your brain was predicting danger), and then the brain takes that arousal as proof that danger persists. The body is a player in the game, and the brain coaches it based on what it thinks should be the next move.

From this viewpoint, symptoms that you feel in your body can better be understood as a faulty feedback loop between what your brain predicts will happen, the actions you take, and the sensations that arise; rather than something in the past that is stuck in your muscle or fascia. This means that in order to reduce trauma symptoms we need to adjust your brain’s predictions, to break its habit of expecting danger around the corner.

What can help you adjust these predictions of danger to stop this cycle from repeating itself? Trauma therapy.

How Does Trauma Therapy Help

Therapy that helps to increase your psychological flexibility and reduce the danger predictions your brain is making is like teaching the coach that it’s over-using its defense. There are a lot of evidence-based therapies that help to achieve this: Eye-Movement Desensitization and Reprocessing (EMDR), Trauma-Focused Cognitive Behavioural Therapy (TF-CBT), Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), and Narrative Exposure Therapy (NET) are some of the most popular.

Let’s use EMDR as an example: EMDR is designed to help the brain reprocess traumatic memories so that it stops sending danger signals to the rest of the body when a person is actually safe. To do this effectively, the therapist works to help you identify some of the thoughts that feed the predictions of danger, recognize where the body plays out the responses to those danger predictions, and then helps you process the two together while maintaining a sense of safety in the room. The sense of safety is a key aspect of the therapy that helps interrupt the ongoing feedback loop: the brain recognizes that it has made a predictive error and that there is in fact no danger present. In turn, the brain starts to adjust its predictions. This is also why a good EMDR therapist will make sure that you have the tools, resources, and relationship with them to be able to feel safe in the therapy session before trying to reprocess traumatic experiences.

Is including the body in trauma therapy helpful?:

The article is actually not arguing that somatic based interventions are ineffective, it is trying to clear up where trauma responses come from. The second half of the article goes into discussion on how flow states could be therapeutic because in a flow state people experience a balance of fear, challenge, and confidence that would also help to correct predictive errors in the brain: there is a heightened arousal in these states but you are not in danger and so little by little your brain and body can start to adjust its predictions. This is part of what makes EMDR so effective in treating trauma: it helps you be fully embodied in your physical distress, while also being aware you are in a safe space.

If the brain is a coach and the body is a player, then therapy that includes body work is a boot camp where the whole team is learning a new play and practicing it together.

Finding What Works for You

This post is all about understanding the experience of trauma in our bodies and approaches that can support that experience. All of our team at Inward Bound are trained in working with traumatic experiences, including this post’s author Katy Haver. If you’d like to learn more about therapies that can support working through trauma we’d love to hear from you.

You can reach out with questions or for help determining next steps for you. Contact us using the form below, or visit our Therapists and Booking page.