Introduction
The Body Keeps the Score by Dr. Bessel van der Kolk is one of the most widely discussed books on trauma, offering powerful insights into how deeply emotional wounds can shape both the mind and body. While the book has been praised for its compelling narratives and advocacy for holistic healing, it has also faced criticism for some of its claims about neuroscience. This article explores key concepts from the book and compares them with current scientific evidence to separate established facts from overstated claims.

Book’s Claim: Van der Kolk emphasizes that trauma causes dysregulation in three major brain regions:

• Amygdala (the brain’s alarm system) becomes hyperactive, leading to heightened fear responses.
• Hippocampus (responsible for memory) weakens, making it difficult to differentiate between past and present experiences.
• Prefrontal Cortex (responsible for rational thought and emotional control) is impaired, reducing one’s ability to regulate emotions.

Current Research:
✅ Studies in PTSD patients confirm these patterns: amygdala hyperactivity, hippocampal volume reduction, and prefrontal cortex dysfunction are well-documented. However:

• Not all trauma survivors display the same neurobiological changes. The degree of alteration depends on factors like age, resilience, and social support.
• Van der Kolk’s descriptions sometimes oversimplify these complex brain mechanisms. Neuroscience recognizes these regions interact dynamically rather than playing rigidly defined roles.

🔍 Reference: Bremner JD (2006). “Trauma and the brain: understanding the neurobiology of PTSD.”

Book’s Claim: Van der Kolk suggests that trauma is “stored” in the body, particularly in muscle tension, posture, and chronic pain. He argues that unresolved trauma manifests as physical symptoms.

Current Research:
✅ Trauma can impact the autonomic nervous system, resulting in chronic stress responses (e.g., hypervigilance, muscle tension, gastrointestinal issues).
❗ However, the literal interpretation of trauma being “stored” in tissues is debated. The prevailing view is that trauma leaves imprints on neural pathways rather than being physically embedded in the body’s tissues.

🔍 Reference: Porges SW (2011). The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-Regulation.

Book’s Claim: Van der Kolk strongly endorses EMDR as a breakthrough therapy for trauma, describing it as uniquely powerful for reprocessing distressing memories.

Current Research:
✅ EMDR is a validated and effective treatment for PTSD. Meta-analyses show EMDR is comparable to traditional exposure therapies.
❗ Critics argue that the “eye movement” aspect may be less critical than Van der Kolk implies. Studies suggest that exposure-based techniques combined with bilateral stimulation may achieve similar outcomes.

🔍 Reference: Shapiro F (2001). Eye Movement Desensitization and Reprocessing (EMDR): Basic Principles, Protocols, and Procedures.

Book’s Claim: Van der Kolk advocates yoga, mindfulness, and somatic practices as crucial interventions to regulate the nervous system and heal trauma.

Current Research:
✅ Studies have shown that yoga, mindfulness, and body-based therapies can improve emotion regulation, reduce stress hormones, and enhance well-being.
❗ However, these interventions should be seen as adjunctive therapies, complementing but not replacing evidence-based treatments like CBT or medication.

🔍 Reference: van der Kolk B. et al. (2014). “Yoga as an Adjunctive Treatment for PTSD: A Randomized Controlled Trial.”

Book’s Claim: Van der Kolk critiques mainstream psychiatry’s reliance on medications, arguing that addressing trauma through body-centered therapies is more effective.

Current Research:
✅ Over-reliance on medications alone is indeed a concern, and trauma-focused therapies are essential in PTSD care.
❗ However, medications like SSRIs, SNRIs, and prazosin are still vital components of PTSD treatment, particularly for severe symptoms or co-occurring conditions like depression.

🔍 Reference: Yehuda R et al. (2015). “Biological factors associated with resilience to psychological trauma.”

Van der Kolk’s The Body Keeps the Score has been instrumental in highlighting the complexities of trauma and pushing the field toward integrative treatments. While some claims—particularly around neuroscience—may be oversimplified, the book’s core message about the body-mind connection remains valuable.

For clinicians, combining van der Kolk’s insights with robust evidence-based approaches can create a comprehensive treatment model that respects both the emotional and physiological dimensions of trauma.

Key Takeaway: Trauma healing is multifaceted — combining neuroscience, psychotherapy, and body-based practices offers the most comprehensive path toward recovery.