When people are compulsively and constantly pulled back into the past, to the last time they felt intense involvement and deep emotions, they suffer from a failure of imagination, a loss of the mental flexibility. Without imagination there is no hope, no chance to envision a better future, no place to go, no goal to reach.
Imagination is the mental ability to create ideas, images, and sensations that are not physically present. In this quote, van der Kolk describes how trauma can distort a person's sense of time, preventing them from imagining a coherent and meaningful future. However, van der Kolk goes on to write that these effects are not always permanent.
I was often surprised by the dispassionate way patients’ symptoms were discussed and by how much time was spent on trying to manage their suicidal thoughts and self-destructive behaviors, rather than on understanding the possible causes of their despair and helplessness. I was also struck by how little attention was paid to their accomplishments and aspirations; whom they cared for, loved, or hated; what motivated and engaged them, what kept them stuck, and what made them feel at peace—the ecology of their lives.
Even before he began his career as a psychiatrist, van der Kolk had an intuitive grasp of how important it is to consider patients holistically. Solely focusing on how to manage a specific illness or symptom neglects the interconnection between the various parts of a person's life. As seen in this quote, van der Kolk believes that doctors and mental health care providers should also consider their patients' physical, mental, emotional, relational, and spiritual well-being.
After trauma the world is experienced with a different nervous system. The survivor’s energy now becomes focused on suppressing inner chaos, at the expense of spontaneous involvement in their life. These attempts to maintain control over unbearable physiological reactions can result in a whole range of physical symptoms, including fibromyalgia, chronic fatigue, and other autoimmune diseases. This explains why it is critical for trauma treatment to engage the entire organism, body, mind, and brain.
This quote reveals how physically and emotionally taxing trauma is. "Spontaneous involvement" in one's life refers to the ability to embrace moments as they unfold without the need for rigid control. The title of the book expresses the argument that trauma is a physiological as well as a psychological experience. These physical reactions include altered brain function, disruptions in the stress response system, and changes in the somatosensory system. Trying to suppress the physical symptoms of trauma can manifest as a whole other range of symptoms or diseases.
...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.
This quote explains how trauma disrupts a person's safety gauge. Specifically, this relates to the ability to recognize internal and external warning cues, capacity to use coping strategies, and willingness to make connections and reach out for support. One devastating impact is the failure to make and maintain connections with others.
Isolating oneself into a narrowly defined victim group promotes a view of others as irrelevant at best and dangerous at worst, which eventually only leads to further alienation. Gangs, extremist political parties, and religious cults may provide solace, but they rarely foster the mental flexibility needed to be fully open to what life has to offer and, as such, cannot liberate their members from their traumas. Well-functioning people are able to accept individual differences and acknowledge the humanity of others.
This quote reveals the dangers of groupthink and extremism that can occur if people over-identify with groups at the expense of their individual differences. This can apply to nontraumatized individuals as well, and in all cases it can potentially isolate people. While van der Kolk writes that community and group affiliation can also be important sources of healing, here he suggests a balanced approach. In doing so, he encourages people to develop a sense of self beyond trauma.
Understanding what is “wrong” with people currently is more a question of the mind-set of the practitioner (and of what insurance companies will pay for) than of verifiable, objective facts.
This quote argues that factors like bias and bureaucracy can impact the care that a traumatized individual receives. In other chapters, van der Kolk discusses the importance of scientific rigor and diagnostic reliability, but here he acknowledges that the mindsets of mental health care practitioners vary. For instance, if a psychiatrist endorses psychopharmacology and talk therapy as the only effective courses of treatment, then that practitioner will disregard options like EMDR and MDMA.
Denial of the consequences of trauma can wreak havoc with the social fabric of society. The refusal to face the damage caused by the war and the intolerance of “weakness” played an important role in the rise of fascism and militarism around the world in the 1930s.
In Chapter 12, van der Kolk provides a historical analysis with a trauma-informed perspective. Humans are social beings, and so it should come as no surprise that collective or large-scale trauma can erode the foundations of society. In particular, German society's intolerance of "weakness" helped propagate the "stab-in-the-back myth," which claimed that the German army was betrayed by civilians on the home front, particularly Jews, socialists, and republicans. This helped set the stage for Nazism to rise.
Traumatized human beings recover in the context of relationships: with families, loved ones, AA meetings, veterans’ organizations, religious communities, or professional therapists. The role of those relationships is to provide physical and emotional safety, including safety from feeling shamed, admonished, or judged, and to bolster the courage to tolerate, face, and process the reality of what has happened.
This quote contests the notion that traumatized individuals should pull themselves up by their bootstraps and resolve their traumas on their own. While radical self-reliance is an important part of recovery, it cannot be the only part. Important relationships include those with family, friends, loved ones, and therapists.
"What you can do is work side by side with them, help them to understand their vision, and realize it with them. By doing that you give them back control. We’re healing trauma without anyone ever mentioning the word."
Paul Griffin, the founder and president of The Possibility Project, uses performing arts to empower teenagers. In this quote, he discusses how theater can promote healing without any explicit mention of trauma. Theater itself cultivates empowerment, interdependence, emotional exploration, role playing, and embodiment.
Child abuse and neglect is the single most preventable cause of mental illness.
Throughout the book, van der Kolk criticizes the symptoms-only therapeutic approach in conventional psychiatry. Addressing root issues is a far more sustainable path toward healing trauma. This quote implies both the individual and society-wide implications of preventing child abuse and neglect.
