The Body Keeps the Score

Bessel van der Kolk’s The Body Keeps the Score is a landmark work that revolutionized how the world understands trauma. Drawing on decades of clinical experience, neuroscience, and patient stories, van der Kolk reveals that trauma is not confined to the mind—it literally reshapes the body, brain, and nervous system. He argues that trauma is not what happens to you, but what happens inside you as a result of what happened.

Whether it’s the shock of a sudden car accident, years of childhood neglect, or the chaos of war, trauma traps the body in a perpetual state of alarm. Survivors may consciously know they are safe, but their bodies behave as though the threat is still present. Van der Kolk writes that trauma leaves an imprint “on the body, the mind, and the soul.” This imprint can emerge in countless ways—flashbacks, panic attacks, insomnia, chronic pain, and emotional numbness. The body remembers even when the mind wants to forget.

The Science of a Hijacked Brain

Trauma fundamentally alters the way the brain perceives and processes reality. To explain this, van der Kolk breaks down the brain into three parts that evolved over time:

When someone experiences overwhelming fear or helplessness, the rational brain is hijacked by the emotional brain. The amygdala, a structure in the limbic system that detects danger, becomes hyperactive. It sounds the alarm at the slightest trigger—a slammed door, a loud voice, the smell of smoke. Meanwhile, the prefrontal cortex, which normally calms the amygdala by assessing context, shuts down.

Van der Kolk’s brain imaging studies found that during flashbacks, the amygdala lights up like a fire alarm, while the Broca’s area—the speech center—goes dark. Survivors lose the ability to verbalize their experiences, which explains why trauma often feels “unspeakable.” Instead of processing trauma as a past event, the brain experiences it as if it’s happening right now.

For example, a combat veteran might dive under a table at the sound of fireworks, or a sexual assault survivor might freeze during intimacy. Their rational brain knows they’re safe, but their emotional brain is still fighting for survival.

The Body’s Language of Trauma

Van der Kolk’s most powerful insight is that the body keeps a detailed score of what the mind cannot handle. Trauma manifests in posture, breath, muscle tension, and chronic illness. Survivors often live in one of two states: hyperarousal (anxiety, panic, irritability) or hypoarousal (numbness, exhaustion, dissociation).

Over time, this dysregulation affects nearly every system in the body. Constant stress hormones—adrenaline and cortisol—cause heart disease, digestive problems, sleep disturbances, and immune disorders. Many patients develop psychosomatic symptoms —physical illnesses with no medical explanation.

Van der Kolk recalls working with a woman named Marilyn who had survived years of abuse but couldn’t remember the details. Her body, however, told the story. She suffered from chronic neck and back pain, irritable bowel syndrome, and migraines. When she ...