Wednesday, August 2, 2023

My Critiques of van der Kolk's Bestseller The Body Keeps Score

I have severe chronic emotional distress and trauma. When society wants to learn about that condition, one of the top resources they turn to is a book written by Bessel van der Kolk called The Body Keeps Score. It's spent over 248 weeks (almost five full years) on the NY Times Bestseller List.

It was written without the consent or input of myself and my peers. And it's dead wrong about a dozen different aspects of the painful condition I live with and van der Kolk doesn't. To be clear, Bessel had his own deeply hard life growing up in the Dutch famine surrounded by Holocaust survivors. That doesn't make him an expert on my life, yet that's the authority he claims and is celebrated for.

He wrote about me, without me. I'm here to correct the record. Here's three things van der Kolk gets fundamentally wrong about my emotional distress.

1) Too Much Emphasis on Past Trauma

Most of the modern trauma model is centered on an assumption of "it happened to you in the past and you're safe now". That's certainly true of some situations. But, for example, what about current domestic abuse victims? What about those experiencing ongoing racism every single day? What about the trauma of not past, but very current and present poverty?

That doesn't discount the existing work, nor the existence of a "trauma then, safe now" subset of mental health community needs. But the omission of current emotional distress from current, present stressors is glaring omission. And omission becomes a form of denial and oppression itself. When aspects of a full conversations are always and constantly excluded, it starts to sound like they don't exist at all. They aren't validated. They aren't helped. At worst, it leads to a climate where such experiences can be called non-existent. If they're not present in the top-ranked book on the subject, are you sure it's a real thing?

This is a problem. 

2) Too Much Emphasis on Individual-Focused Healing

Dovetailing in with point #1, van der Kolk is squarely centered is a vast overemphasis on "self journey of healing". Yes, that self journey might involve "treatment" help. But is squarely centered in the so-called medical model, which assumes that the person is the problem and that it's the person that needs to be fixed.

The book completely fails to co-diagnosing medical hypotheses alongside external social issues (the so-called social model) and point at least some causality and remedies at external factors. Instead, the entirety of modern conceptualization of trauma is explained as a solely and only medical issue.

This isn't to say there's no place for the medical model. But it's been swung much too far into a deeply oppressive, "don't blame society ever" mentality that at best, sometimes offers healing. And, at worst, is deeply victim-blaming and even directly abusive.

A useful story of a social model is Jane Goodman's work in Detroit during the auto collapse (can learn more in the 10 minute discussion here, 5 min to 16 min mark). There was widespread depression and rather than offer brain hacks, DBT, EMDR, pills, etc., she correctly assessed the problem was that there were no jobs. And she herself took the initiative to contact local community colleges and start up job retraining programs. She diagnosed a social structure root cause, and developed a social structure treatment.

Semi-famously, van der Kolk's former work partner Judith Herman directly critiqued him on this, and he ignored her.

3) Lack of Respect for the Hard Problem of Consciousness

What is this odd sounding phrase? Coined by David Chalmers, the Hard Problem of Consciousness is a shorthand way to say that science has zero, none whatsoever, established consensus mechanism for how neural activity gives rise to higher-level cognitive functionality including emotions, personality, etc.

Saying "no mechanism", to be clear, does not mean "doesn't exist". I hate to discuss this in neurodiversity forums of all places, because a lynchpin of the ND movement is "our brains are wired that way". We can observe a thing, trust that our observations and the mountains of evidence of "hey, this is how how my mind seems to operate" are accurate while still lacking mechanistic explanation of exactly why it's happening. It's also fine to have theories. But, reports like below keep coming out all the time. The Duke article itself fails to acknowledge the hard problem of consciousness, but it does show the folly of extending neuroscience "findings" too far...

Another excellent read of the limits of mechanistic science when it comes to matters of the mind is this piece...

Concluding Thoughts

It is true that, for some, The Body Keeps Score has been a life-saving book. It is also true that while helping push trauma into the mainstream, it pushed some deeply harmful conceptualization of what trauma is and isn't along with the arguable positives.
I still don't have a foundational read to send you to for a respectful, non-oppressive view of trauma emotional distress. One that tries to keep the usefulness of existing tools. One that works to not invalidate and to protect success stories, however they came about. But also to build an understand that accounts for the rampant colonial ableism, sanism, racism, and sexism in modern psychology, behavioral science, and psychiatry. One that accounts for the bias of a Western neoliberal view on "health" on "functionality". One that understands and shows the nuances of science as a tool to a depth modern academics rarely seem to demonstrate skillfulness in operating with.

That book, I fear, hasn't quite been written yet. Bits and pieces exists, most certainly. This won't be built from scratch. But, for me at least, I can report that book that correctly explains me as I'd want to be explained hasn't been written yet. Even though hundreds of books that explain me in hurtful, bigoted, and erroneous ways certainly have. And it's those texts who's standards I'm held to. It's those books that failed attempts at help are based on. It's those books that are used to judge me in deeply oppressive ways.

I've asked for help in writing an accurate new set of texts, since it doesn't currently exist. And places like Harvard and the Trauma Research Foundation and Boston University keep refusing to help support my community in writing those text.

Note, for example, the polite letter for inclusion and support ignored by Boston University School of Public Health this spring.

I'm happy to help write this book. But I need funding. I need communal support. I need at least some parts of this world to not openly hate me, call me a danger, or call me delusional while attempting to do so.

Those rejecting experiences have been happening for 6+ years. And it is those experiences, and not my original issues, that have led to the worst mental health of my life. These are experiences that have been ignored and denied directly because people read books like The Body Keeps Score while the book that's about me, as I'd choose to be seen, doesn't yet exist. 

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This article brought to you by the currently unfunded Peer Voices Network.

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