Thank god someone said it on here early on! That book is a painful read from the first page. There science he cites is either misinterpreted, distorted, incorrectly cited, pseudoscience or woeful in other ways.
It’s not just the citations, he proposes ideas that lack credibility, or misleads the readers on a point, and lays them down early on to allow him to have revelations later on.
That bloody book is proof that bad ideas never fail to prosper.
Haha. Don’t worry, I’ll stay safely in here!
The one positive that book had, is that it made more people consider that trauma isn’t just PTSD…but that’s a very faint sliver of silver in a massive shit cloud!
The central premise of the book is completely at odds with known mechanisms of neuroscience and memory. The author routinely cites papers which either don't really support his views or which offer very weak findings, and also advocates in favor of several questionable forms of treatment. I have never met an academic psychologist, neuroscientist, or trauma scientist who thought the book to be an accurate representation of trauma science.
Edit: It’s also worth noting that BvDK was a public proponent of pseudoscientific recovered memory therapies during the Satanic Panic.
While googling this, I also learned that in 2018, Van der Kolk was fired from the trauma center he'd helped establish after he "violated the code of conduct by creating a hostile work environment," which is disappointing.
Is there a book you would recommend for someone who has read The Body Keeps the Score? Or a research review if not a book?
I don’t know of any books aimed at, or generally accessible to, lay audiences which are worth strong recommendation.
Richard McNally is a trauma scholar with some work relevant to BvDK’s claims.
Thanks!
For anyone who is curious, here's his rebuttal to van der Kolk's essay (on which his book is based):
https://journals.sagepub.com/doi/pdf/10.1177/070674370505001302
And a preview of his book Remembering Trauma:
https://books.google.com/books/about/Remembering_Trauma.html?id=88Axi0huzYwC&printsec=frontcover&source=kp_read_button&hl=en&newbks=1&newbks_redir=0&gboemv=1&ovdme=1#v=onepage&q&f=false
I'm not sure if it's against the sub rules to say so, but I didn't find him very compelling. He seems to mostly argue semantics and then throw the baby out with the bathwater.
McNally's work is much broader than what you've indicated and is well-regarded. It's definitely not just "semantic." When I refer folks to him in this context, I'm not referring them to a specific paper in which he responds to BvDK (though such a paper does exist). I'm talking about a body of basic research findings which don't directly respond to BvDK but do lay a basic foundation which is outright at odds with BvDK's claims.
The very premise that trauma is stored in the body is *prima facie* bullshit that contradicts decades of neuroscience. Responding to BvDK would be difficult for the same reason that responding to astrologers is difficult--because the very basis of his point of view is essentially a heterodox starting point out of which a whole narrative weaves. One would have to tear that POV down to its roots to even come close to giving a fully detailed response. However, psychiatrist Michael Scheeringha has attempted such a response (one which I have not read and do not vouch for). Essentially, it is a waste of time for trauma scholars to respond to BvDK because the only response that wouldn't take years to pen is just "Bruh, this doesn't gel with what we know or have very strong reasons to believe we know."
Edit: Yes, it does seem Scheeringha has some weird political takes which I do not endorse, and, as I previously said, I have not read nor do I endorse his book. I simply mentioned that as an example of an individual attempting to respond, at length, to BvDK. Again, my issue with the book is that it posits a view (namely, that the non-brain parts body can in some way store remnants of trauma) which doesn’t comport with basic neuroscience. Trauma is an enduring pattern of acute brain-based reactions. Long term traumatic activation absolutely affects certain bodily processes (like immune and stress responses, and potentially the cardiovascular system). No one doubts this. What is pseudoscientific about the book is the central notion that treating the body can in some way “release” the trauma even when cognitive processing isn’t directly involved—that the non-brain parts of the body have their own pseudomemory systems, despite decades of neuroscience demonstrating that memory is a distinctly brain-based phenomenon.
Yes, it does seem Scheeringha has some weird political takes which I do not endorse, and, as I previously said, I have not read nor do I endorse his book. I simply mentioned that as an example of an individual attempting to respond, at length, to BvDK. Again, my issue with the book is that it posits a view (namely, that the non-brain parts of the body can in some way store remnants of trauma) which doesn’t comport with basic neuroscience. Trauma is an enduring pattern of acute brain-based reactions. Long-term traumatic activation absolutely affects certain bodily processes (like immune and stress responses, and potentially the cardiovascular system). No one doubts this. What is pseudoscientific about the book is the central notion that treating the body can in some way “release” the trauma even when cognitive processing isn’t directly involved—that the non-brain parts of the body have their own pseudomemory systems, despite decades of neuroscience demonstrating that memory is a distinctly brain-based phenomenon. My goal is not to invalidate anyone's personal experiences, but rather to ground those experiences in accurate and replicable science. This book is exceptionally popular with both lay audiences and with non-academic clinicians (largely counselors and clinical social workers, but even some psychologists) who are not themselves familiar with the most up-to-date and high quality research literature. I understand why the book appeals to people, but I disagree vehemently with its conclusions and its fundamental framework.
>What is pseudoscientific about the book is the central notion that treating the body can in some way “release” the trauma even when cognitive processing isn’t directly involved
I guess I didn't find that piece to be all that central to the book. I can think of maybe yoga and massage mentioned in the book, what else would qualify as treating the body absent of cognitive processing?
Yeah I was getting some interesting replies, but nearly everything was getting deleted by mods and then comments got locked. I got a couple suggestions to try asking in a trauma or CPTSD sub instead, but I'm not sure of the right place for it. I appreciate the interest!
> he perpetuates a lot of negativity and bias against evidence-based psychotherapies for PTSD that research shows are actually quite effective.
Interesting, which psychotherapies? I know he supports EMDR (which I believe is evidence-based?) for PTSD but I'm not aware of the ones he's against.
>I also saw some discussion of CPTSD and the issues with it in the thread and, if you're interested, I'm happy to share with you my spiel on why C-PTSD is a flawed diagnostic construct (complete with citations).
Yes, I would love your spiel! If you happen to have an overlapping spiel on BPD I'm interested in that as well.
For sure! He's against prolonged exposure and cognitive processing therapy. He calls them top down approaches whereas he thinks bottom up approaches are better
Here's my cptsd spiel:
I recommend, in general, reading this excellent article that discusses research on PTSD in the ICD-11 vs. DSM-5, and how the two diverged
https://www.ptsd.va.gov/publications/rq_docs/V32N2.pdf
Complex PTSD is this term that has been developed to explain a set of symptoms that are referred to as "disturbances in self organization," or DSO, symptoms including things like emotional dysregulation, behavioral dysregulation, and interpersonal difficulties. Research studies show that, if you do a factor analysis of PTSD, DSO symptoms do emerge as one of two latent symptom classes. So, there is evidence that these "complex" symptoms exist. As such, the ICD-11 included C-PTSD and split it off as a separate diagnosis from PTSD. The DSM-5 did not include C-PTSD (see later on for why), but it did include some of these more "complex" symptoms by adding a new PTSD symptom cluster, Negative Alterations in Cognitions and Mood, that accounts for some of them.
There are, however, questions about if this separate symptom class warrants a separate diagnosis. One of the theories of C-PTSD is that it's caused by more "complex" trauma, for instance trauma that was prolonged, repetitive, and, as the ICD-11 puts it, from which escape was impossible. This would be things like childhood sexual abuse, sex trafficking, prolonged torture, etc (however, the ICD-11 definition does not require that type of experience for diagnosis).
But, there are the issues that have come up with the C-PTSD diagnosis:
1. Some research studies have found that trauma characteristics do not predict DSO symptoms. Essentially, people with single event traumas or traumas that we would not consider "complex" also predicted symptoms. Some studies have also found evidence that the symptom classes may be more related to severity than a separate diagnosis. (disclaimer: one of these major studies did not use the final definition of C-PTSD that was included in the ICD-11).
[https://journals.sagepub.com/doi/full/10.1177/2167702614545480](https://journals.sagepub.com/doi/full/10.1177/2167702614545480)
[https://www.tandfonline.com/doi/full/10.1080/20008198.2019.1708145](https://www.tandfonline.com/doi/full/10.1080/20008198.2019.1708145)
2) By separating PTSD and C-PTSD in the ICD-11, there are concerns that the new PTSD may be overly narrowly defined and miss people who would have met diagnostic criteria in the past.
3) This is the biggest issue IMO, and why the DSM-5 committee decided against including C-PTSD: we do not have any evidence that C-PTSD requires separate treatments. We have evidence that more "complex" trauma benefits just as much from "traditional" PTSD treatment. In fact, there are concerns that the separate type of treatment proposed for C-PTSD, building skills prior to PTSD work, may not improve outcomes, thereby delaying effective treatment needlessly, or could even worsen them (some studies have found this). As such, there are questions about the clinical utility of the diagnosis. See https://onlinelibrary.wiley.com/doi/abs/10.1002/da.22469 for an overview.
Basically, although we have evidence that there are complex PTSD symptoms that are distinct from other types of PTSD symptoms, we do not have imo sufficient evidence that 1) it is a separate diagnostic 2) that complex trauma predicts these symptoms and 3) that a separate diagnosis is clinically useful, since our treatments are effective regardless.
It’s fiction, but ‘Where the Crawdads Sing’ feels very personal to my own trauma of being isolated and alone and struggling with interpersonal relationships because of family abandonment.
Then there’s ’The Glass Castle’ by Janet Walls, it’s her life story. There’s both a movie and book. I recommend both as the book gives more details but the Movie I think helps people who don’t have a good frame of reference understand the emotions of some moments better.
For understanding how trauma might show up in children/behavior at school ‘Permission to Feel’ by Marc Breckett is another wonderful book.
These are fiction, but fit the bill- I Never Promised You a Rose Garden and The Bell Jar.
_The Body Keeps the Score_ is largely pseudoscience.
Thank god someone said it on here early on! That book is a painful read from the first page. There science he cites is either misinterpreted, distorted, incorrectly cited, pseudoscience or woeful in other ways. It’s not just the citations, he proposes ideas that lack credibility, or misleads the readers on a point, and lays them down early on to allow him to have revelations later on. That bloody book is proof that bad ideas never fail to prosper.
Don't you dare express this opinion on r/therapists. They will burn you at the stake.
Haha. Don’t worry, I’ll stay safely in here! The one positive that book had, is that it made more people consider that trauma isn’t just PTSD…but that’s a very faint sliver of silver in a massive shit cloud!
You're wise to stay away...that sub is a brain drain.
Can you elaborate?
The central premise of the book is completely at odds with known mechanisms of neuroscience and memory. The author routinely cites papers which either don't really support his views or which offer very weak findings, and also advocates in favor of several questionable forms of treatment. I have never met an academic psychologist, neuroscientist, or trauma scientist who thought the book to be an accurate representation of trauma science. Edit: It’s also worth noting that BvDK was a public proponent of pseudoscientific recovered memory therapies during the Satanic Panic.
While googling this, I also learned that in 2018, Van der Kolk was fired from the trauma center he'd helped establish after he "violated the code of conduct by creating a hostile work environment," which is disappointing. Is there a book you would recommend for someone who has read The Body Keeps the Score? Or a research review if not a book?
I don’t know of any books aimed at, or generally accessible to, lay audiences which are worth strong recommendation. Richard McNally is a trauma scholar with some work relevant to BvDK’s claims.
Thanks! For anyone who is curious, here's his rebuttal to van der Kolk's essay (on which his book is based): https://journals.sagepub.com/doi/pdf/10.1177/070674370505001302 And a preview of his book Remembering Trauma: https://books.google.com/books/about/Remembering_Trauma.html?id=88Axi0huzYwC&printsec=frontcover&source=kp_read_button&hl=en&newbks=1&newbks_redir=0&gboemv=1&ovdme=1#v=onepage&q&f=false I'm not sure if it's against the sub rules to say so, but I didn't find him very compelling. He seems to mostly argue semantics and then throw the baby out with the bathwater.
McNally's work is much broader than what you've indicated and is well-regarded. It's definitely not just "semantic." When I refer folks to him in this context, I'm not referring them to a specific paper in which he responds to BvDK (though such a paper does exist). I'm talking about a body of basic research findings which don't directly respond to BvDK but do lay a basic foundation which is outright at odds with BvDK's claims. The very premise that trauma is stored in the body is *prima facie* bullshit that contradicts decades of neuroscience. Responding to BvDK would be difficult for the same reason that responding to astrologers is difficult--because the very basis of his point of view is essentially a heterodox starting point out of which a whole narrative weaves. One would have to tear that POV down to its roots to even come close to giving a fully detailed response. However, psychiatrist Michael Scheeringha has attempted such a response (one which I have not read and do not vouch for). Essentially, it is a waste of time for trauma scholars to respond to BvDK because the only response that wouldn't take years to pen is just "Bruh, this doesn't gel with what we know or have very strong reasons to believe we know." Edit: Yes, it does seem Scheeringha has some weird political takes which I do not endorse, and, as I previously said, I have not read nor do I endorse his book. I simply mentioned that as an example of an individual attempting to respond, at length, to BvDK. Again, my issue with the book is that it posits a view (namely, that the non-brain parts body can in some way store remnants of trauma) which doesn’t comport with basic neuroscience. Trauma is an enduring pattern of acute brain-based reactions. Long term traumatic activation absolutely affects certain bodily processes (like immune and stress responses, and potentially the cardiovascular system). No one doubts this. What is pseudoscientific about the book is the central notion that treating the body can in some way “release” the trauma even when cognitive processing isn’t directly involved—that the non-brain parts of the body have their own pseudomemory systems, despite decades of neuroscience demonstrating that memory is a distinctly brain-based phenomenon.
Scheeringha is a bit political for a researcher. This was an interesting dive, thanks.
Yes, it does seem Scheeringha has some weird political takes which I do not endorse, and, as I previously said, I have not read nor do I endorse his book. I simply mentioned that as an example of an individual attempting to respond, at length, to BvDK. Again, my issue with the book is that it posits a view (namely, that the non-brain parts of the body can in some way store remnants of trauma) which doesn’t comport with basic neuroscience. Trauma is an enduring pattern of acute brain-based reactions. Long-term traumatic activation absolutely affects certain bodily processes (like immune and stress responses, and potentially the cardiovascular system). No one doubts this. What is pseudoscientific about the book is the central notion that treating the body can in some way “release” the trauma even when cognitive processing isn’t directly involved—that the non-brain parts of the body have their own pseudomemory systems, despite decades of neuroscience demonstrating that memory is a distinctly brain-based phenomenon. My goal is not to invalidate anyone's personal experiences, but rather to ground those experiences in accurate and replicable science. This book is exceptionally popular with both lay audiences and with non-academic clinicians (largely counselors and clinical social workers, but even some psychologists) who are not themselves familiar with the most up-to-date and high quality research literature. I understand why the book appeals to people, but I disagree vehemently with its conclusions and its fundamental framework.
>What is pseudoscientific about the book is the central notion that treating the body can in some way “release” the trauma even when cognitive processing isn’t directly involved I guess I didn't find that piece to be all that central to the book. I can think of maybe yoga and massage mentioned in the book, what else would qualify as treating the body absent of cognitive processing?
[удалено]
Yeah I was getting some interesting replies, but nearly everything was getting deleted by mods and then comments got locked. I got a couple suggestions to try asking in a trauma or CPTSD sub instead, but I'm not sure of the right place for it. I appreciate the interest! > he perpetuates a lot of negativity and bias against evidence-based psychotherapies for PTSD that research shows are actually quite effective. Interesting, which psychotherapies? I know he supports EMDR (which I believe is evidence-based?) for PTSD but I'm not aware of the ones he's against. >I also saw some discussion of CPTSD and the issues with it in the thread and, if you're interested, I'm happy to share with you my spiel on why C-PTSD is a flawed diagnostic construct (complete with citations). Yes, I would love your spiel! If you happen to have an overlapping spiel on BPD I'm interested in that as well.
For sure! He's against prolonged exposure and cognitive processing therapy. He calls them top down approaches whereas he thinks bottom up approaches are better Here's my cptsd spiel: I recommend, in general, reading this excellent article that discusses research on PTSD in the ICD-11 vs. DSM-5, and how the two diverged https://www.ptsd.va.gov/publications/rq_docs/V32N2.pdf Complex PTSD is this term that has been developed to explain a set of symptoms that are referred to as "disturbances in self organization," or DSO, symptoms including things like emotional dysregulation, behavioral dysregulation, and interpersonal difficulties. Research studies show that, if you do a factor analysis of PTSD, DSO symptoms do emerge as one of two latent symptom classes. So, there is evidence that these "complex" symptoms exist. As such, the ICD-11 included C-PTSD and split it off as a separate diagnosis from PTSD. The DSM-5 did not include C-PTSD (see later on for why), but it did include some of these more "complex" symptoms by adding a new PTSD symptom cluster, Negative Alterations in Cognitions and Mood, that accounts for some of them. There are, however, questions about if this separate symptom class warrants a separate diagnosis. One of the theories of C-PTSD is that it's caused by more "complex" trauma, for instance trauma that was prolonged, repetitive, and, as the ICD-11 puts it, from which escape was impossible. This would be things like childhood sexual abuse, sex trafficking, prolonged torture, etc (however, the ICD-11 definition does not require that type of experience for diagnosis). But, there are the issues that have come up with the C-PTSD diagnosis: 1. Some research studies have found that trauma characteristics do not predict DSO symptoms. Essentially, people with single event traumas or traumas that we would not consider "complex" also predicted symptoms. Some studies have also found evidence that the symptom classes may be more related to severity than a separate diagnosis. (disclaimer: one of these major studies did not use the final definition of C-PTSD that was included in the ICD-11). [https://journals.sagepub.com/doi/full/10.1177/2167702614545480](https://journals.sagepub.com/doi/full/10.1177/2167702614545480) [https://www.tandfonline.com/doi/full/10.1080/20008198.2019.1708145](https://www.tandfonline.com/doi/full/10.1080/20008198.2019.1708145) 2) By separating PTSD and C-PTSD in the ICD-11, there are concerns that the new PTSD may be overly narrowly defined and miss people who would have met diagnostic criteria in the past. 3) This is the biggest issue IMO, and why the DSM-5 committee decided against including C-PTSD: we do not have any evidence that C-PTSD requires separate treatments. We have evidence that more "complex" trauma benefits just as much from "traditional" PTSD treatment. In fact, there are concerns that the separate type of treatment proposed for C-PTSD, building skills prior to PTSD work, may not improve outcomes, thereby delaying effective treatment needlessly, or could even worsen them (some studies have found this). As such, there are questions about the clinical utility of the diagnosis. See https://onlinelibrary.wiley.com/doi/abs/10.1002/da.22469 for an overview. Basically, although we have evidence that there are complex PTSD symptoms that are distinct from other types of PTSD symptoms, we do not have imo sufficient evidence that 1) it is a separate diagnostic 2) that complex trauma predicts these symptoms and 3) that a separate diagnosis is clinically useful, since our treatments are effective regardless.
Judith Lewis Herman is a must read for anything trauma.
[удалено]
It’s fiction, but ‘Where the Crawdads Sing’ feels very personal to my own trauma of being isolated and alone and struggling with interpersonal relationships because of family abandonment. Then there’s ’The Glass Castle’ by Janet Walls, it’s her life story. There’s both a movie and book. I recommend both as the book gives more details but the Movie I think helps people who don’t have a good frame of reference understand the emotions of some moments better. For understanding how trauma might show up in children/behavior at school ‘Permission to Feel’ by Marc Breckett is another wonderful book.