The Body Keeps the Score Literary Elements

Nonfiction, Popular Science, Psychology, Mental Health, and Self-Help

Though van der Kolk cites international studies and narratives (including his own), he writes primarily about trauma in an American context. That being said, the book still resonates with readers from around the world.

Van der Kolk writes using the first-person perspective as a psychiatrist, researcher, and clinician. He summarizes scientific research, provides clinical anecdotes, summarizes his career, and reflects on the various avenues toward treating trauma.

The overall authoritative tone demonstrates van der Kolk's expertise in the fields of psychiatry and trauma treatment. Throughout the book, he also fluctuates between an empathetic and a critical tone depending on the subject matter. The gravity of the stories that van der Kolk shares about his patients' trauma conveys a sober yet validating mood.

In one sense, the protagonist is van der Kolk himself as he guides the reader through the science and stories shared in the book. In another sense, the human bodies and minds of trauma survivors are framed as protagonists in the book. The book's antagonistic forces include trauma itself, institutional failures, and cultural stigma.

The major conflict in the book involves the question of how to treat individuals living with the harmful effects of trauma.

The turning point occurs in the final section when van der Kolk shifts from discussing the devastating impacts of trauma to offering possibilities for healing.

In Chapter 2, van der Kolk critiques psychopharmacology for not addressing the root causes of trauma. This foreshadows a need for other therapeutic approaches, which van der Kolk writes about in later sections of the book.

Society often understates the harmful extent to which trauma impacts people's lives.

Van der Kolk alludes to various research studies, concepts, and literature related to psychology and popular culture. For instance, he repeatedly references Vietnam War veterans when discussing PTSD research. This helps frame trauma as a cultural and embodied experience.

Though van der Kolk acknowledges that he used to possess an unconscious voyeuristic need to hear about his patients' traumas, he eventually learned that his primary purpose as a psychiatrist is to help his patients heal. That said, in this book, he shares enough detailed clinical anecdotes for readers to imagine the often brutal events that contribute to trauma.

Martin Seligman and Steven Maier's learned helplessness research fundamentally changed how psychologists understand depression, motivation, and responses to uncontrollable stress (Chapter 2). However, this research was not without sacrifice and would not pass ethical standards today. To learn about the impacts of feeling powerless, the researchers inflicted suffering on dogs. In other words, studying and pushing the limits of knowledge came at a cost. Van der Kolk himself understood this when he and his colleagues conducted research on how trauma impacts the brain. Participants listened to scripted recordings that re-created their traumas while having their brains scanned. One participant, a woman named Marsha whose daughter and unborn child were killed in a car accident, experienced such suffering that van der Kolk wondered if whatever his team discovered would be worth the price of her distress (Chapter 3).

-The child psychologist and professor Nina Fish-Murray was fascinated by van der Kolk's stories about working with combat veterans because their behavior paralleled that of the troubled children she worked with in the Boston public schools (Chapter 7).
- As a young ward attendant at the Massachusetts Mental Health Center, van der Kolk was surprised that he never heard doctors discuss their patients' traumatic pasts. Similarly, while working with abused and neglected children at the Boston Children's Clinic, van der Kolk noticed that staff discussions on the unit rarely mentioned the horrific past experiences of the children (Chapter 7).