Trauma, trust and triumph: psychiatrist Bessel van der Kolk on how to recover from our deepest pain

"European and American psychiatry have an obsession with analysis and pharmaceuticals, which is partly – especially in the US – about monetisation, with research grants flowing to the most profitable and established fields. Van der Kolk is keenly aware of inequality as a factor in untreated PTSD, and no great fan of capitalism generally. “I’m not sure that the fall of the Berlin Wall was the best thing that ever happened to us,” he says, gnomically, but I get the drift. Part of the commercial imperative in psychiatry has been the drive to find one thing that works for everyone: a Fordist factory-line approach to the brain that has seen millions spent on figuring out, for instance, what works best between pharmaceuticals and talking therapies, or between one therapy and another.
Van der Kolk’s insistence that no single treatment is likely to work alone, and no combination will be exactly the same for every patient, is iconoclastic enough on its own. Yet it is his engagement with what you could loosely classify as “hippy stuff” – eye-movement desensitisation and reprocessing, yoga, bodywork (Feldenkrais, craniosacral therapy) and touch – that shows how unperturbed he is in going beyond the realm of classic psychiatry. His thinking on the body is so succinct and simple: if the body is storing trauma in its musculature, in its hormonal pathways, then it is the body that needs “experiences that deeply and viscerally contradict the helplessness, rage or collapse that result from trauma”, as he writes in his book.
This is not to say he is totally against pharmaceuticals, which can play a useful role in shutting down inappropriate alarm reactions. But he is much more interested in psychedelics, which are gaining widespread interest in the treatment of PTSD and depression, as well as the fear of death. Van der Kolk has yet to nail down how MDMA differs from ketamine, psychiatrically speaking, but he has tried both a number of times.


Collective trauma is complicated. Taboo is a core component of PTSD. The brain buries feelings only if they can’t be spoken about, because of the risk of alienation, from a family (this is particularly relevant to abused children) or from society (this is what silences veterans). Large, shared events which are not suppressed, which in fact bring those affected together, do not leave the same scars.

This is an excerpt of an article in The Guardian by Zoe Williams – if you are a little like me, and want to have the whole picture, you will find10 minutes to read the entire article. Or Dr Bessel van der Kolk’s book, The Body Keeps the Score. These are Dr Kolk’s views on how to recover from our deepest pain.

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