Book Review: The Body Keeps the Score

I’ll be honest, I mostly want to get this book out of the way. I know that it’s so widely recommended that no review of books on trauma would be complete without it. Every therapist I’ve worked with seems to think it’s the holy grail, and I know that if you’re in my neck of the woods when it comes to recovery, you’ve run into this thing. The problem is, I fucking hated The Body Keeps the Score, for a host of reasons, and I cannot in good faith pretend that it’s worth reading.

Here’s the compromise I’m willing to make. I will review this book from memory. I no longer have a copy, for reasons that are probably already pretty evident, and I have no desire to acquire one just to talk about how much I want to use it for paper mâché. I am sure I’ll leave out details that are pertinent or misremember certain sections, and I hope that you’ll bear with me as I perform a one man hate fest of probably the most widely recommended book of this type. All of that said, I’m largely doing this so no one can ask me down the line if I’ve read it or where this review is. I’m putting it right at the top so we can move on to greener pastures.

Let’s start with the basics. No therapist writing towards patients actually knows how to organize a book in linear fashion. I don’t know why, but with only the exception of Homecoming by Thema Bryant, the arrangement of chapters in these things is always bad. The Body Keeps the Score is no exception. There’s no meaningful cohesion between chapters, and if I recall correctly, the author frequently references sections that haven’t come up yet. It’s annoying, but it’s also incredibly normal for psychology books geared toward laymen.

I’m going to set aside how many times van der Kolk tells us what an asshole he is for now and talk entirely about the content he thinks he’s presenting. The first half of the book isn’t much more than a laundry list of things that are wrong with you or likely to become wrong with you depending on how much trauma you’ve had, and how much cortisol you have swimming in your system, with some self-aggrandizing stories from the author for spice.

“But Vico!” I hear you saying. “It’s such good information!” Is it? I genuinely do not understand who is helped by reading over a hundred pages of how deeply fucked your body is thanks to trauma. I can appreciate going over the risk factors. I do think that’s important to know as you make decisions for your mind and body. I don’t see the utility of going into every gory detail of how bad trauma is for our bodies and our brains. You can get the same information by taking the Adverse Childhood Experiences test online and looking at the graphs afterward. There is absolutely no need to wade through over a hundred pages of existential despair about it. The information also does nothing to contextualize the way traumatized brains work. For instance, if you read up on polyvagal theory, you’ll get a good sense of why your brain is moving between responses, and that knowledge can help with acceptance and the understanding that those moments will pass. The Body Keeps the Score offers no such useful information. It’s just an info dump of things likely to be wrong with survivors that there’s absolutely no way to control for.

I’m additionally troubled by the fact that van der Kolk goes into so much detail about the neuroscience of trauma without giving equal time to the plasticity of our brains. It seems a disservice to me to go into agonizing detail about how screwed trauma survivors are without also pointing out that this is recoverable and that our brains can bounce back from this with proper treatment. It feels to me that van der Kolk isn’t much more than a common rubbernecker. He seems to enjoy seeing how terribly trauma impacts the lives of survivors but doesn’t have much interest in our recovery.

Which leads me to the back half of the book. Going through a list of treatment options that are largely not available did not do much to assuage me of my feelings that van der Kolk is just a voyeur into the lives of survivors. The only notable exception is EMDR, which is available pretty widely at this point. Aside from that, none of the programs he described as exciting or groundbreaking are accessible for the average person. Given that this book is at least theoretically centered on patients, I cannot fathom the point of going over modalities that damn near no one is using in such loving detail.

But let’s go back to EMDR for a second, and the fact that Bessel van der Kolk is an asshole. He admits in that section that his primary interest in trauma is voyeurism. He says it explicitly when talking about one of the few modalities available that doesn’t require you to talk endlessly about the worst moments of your life. To me, the book itself is pretty good evidence that van der Kolk never moved away from that need for the horrific details of survivor’s trauma. There’s a mountain of research here about how much our past impacts the way our brains and bodies work, and very little effort expended to give people hope or tools for recovery. I’ve honestly never been sold that van der Kolk is interested in our recovery at all so much as soaking up the horror of our pasts.

What’s more, van der Kolk was fired from the trauma center he founded and did his research in for abusing his staff in 2018. The center closed not long after. For someone whose work was centered entirely on understanding trauma and how it impacts people, he didn’t seem to have many qualms about causing it.

What it boils down to is this. No one needs to read The Body Keeps the Score. It’s not going to help anyone recover from their trauma. It’s not designed to. The entire thesis of the book is that if you have significant trauma, your body is fucked, and the fact is, you probably already know that. If you’re like me, and you’re a filthy little completionist who’s gonna read it anyway just for the sake of having read everything on this topic you can get your hands on, do so prepared for it to be a mega bummer that won’t add any tools to your toolbox, and consider buying it used so you’re not giving van der Kolk your money.

My next book review will be CPTSD: From Surviving to Thriving, because I think it’s a good alternative to The Body Keeps the Score, that has more to offer folks with CPTSD and a better understanding of what patients actually need to hear.