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- Trauma is so ubiquitous
that if you think you have never seen it,
you have not looked.
We meet people who fly off the handle.
We meet people who shut down.
We meet people who are very difficult.
You know, it is a rare family
that doesn't have a drug addict,
alcoholic, disturbed person.
You know, one thing I like to say when I give a lecture,
"Are there any normal people,
who come from normal families, in the audience?"
And sometimes one or two people raise their hands.
I say, "Can I please come to your family for Thanksgiving?
Because I've never been to a normal family."
My name is Bessel van der Kolk.
I'm a psychiatrist, neuroscientist.
I have been studying trauma for about 50 years now.
I've treated a whole variety
of different traumatized populations,
see trauma in many different countries around the world,
and I am the author of the book "The Body Keeps the Score."
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It's important for people to realize
that not every mental health professional knows
what we're talking about here.
The mainstream system of psychiatry-psychology
is that there is something wrong with you
and I need to fix you.
That's a very different attitude than dealing with trauma.
Around the time that I first started to work for the VA,
a group of us started to define what trauma is
and started to define what happens to people.
1978 was the year,
and the Vietnam War was over by about six or seven years.
The very first day that I met Vietnam veterans,
I was just blown away.
They kept referring back to their dead comrades.
Their hearts seemed to be
with the people who were no longer around.
They had a hard time loving their wives and girlfriends.
They had a hard time being in any way meaningfully involved
in the present.
These were guys who were my age,
who were smart and competent,
but they clearly were just a shadow of their former self.
And what was also really striking
is they were sort of passive much of the time.
And then people told them something that was disappointing,
and they went from zero to 10
and blew up and became extremely angry.
Something seemed to have happened to them
that made it very hard for them
to modulate their responses to their environment.
My colleagues and I started to think about
how is what these guys suffer from different
from what other people
who are in psychiatry textbooks suffer from?
So I dug up a book that was written in 1941
by Abram Kardiner who had been working
with World War soldiers.
He wrote, "These guys suffer from a physioneurosis.
Their bodies continue to re-experience
that very terrible, frightening situation,
and that event keeps coming back
in terms of images, behaviors, and physical sensations."
So that became the core of our definition of PTSD.
We write, "These people have been exposed
to an extraordinary event
that's outside of normal human experience."
And in retrospect, that shows us how ignorant
and narrow-minded we were
because it turned out
that this is not an unusual experience at all.
Trauma is actually - unlike what we first thought -
extremely common.
One out of five women in America
has a history of sexual molestation.
Even a lot of men have histories of sexual molestation.
One out of four kids get beaten very hard by their parents.
One out of eight kids see physical fights
between their parents.
People usually think about the military
when they talk about trauma,
but when we started to work with inner city kids,
the amount of trauma
that these kids experienced was just unspeakable.
The nature of trauma is that an experience enters
into your ears, into your skin, into your eyes,
and it goes down into a very primitive part of your brain
that automatically interprets what's going on.
Is this dangerous or is this safe?
An event becomes traumatic when there is nothing you can do
to stave off the inevitable
and your body starts automatically going to the state
of fight/flight or collapse.
The lingering effect of trauma is that you continue
to react to mild stressors as if your life is in danger.
And so you tend to become hyperreactive.
Somebody may irritate you in the supermarket.
You may develop road rage.
You may have a difficult time putting up
with misbehavior from your spouse or your kids.
And most people actually are barely aware
or not aware at all that their reactions
that they're having right now are actually rooted
in experiences that they've had before.
That event itself is over,
but you continue to react to things as if you're in danger.
So the big challenge of treating trauma
is how do we help people to live in bodies
that feel fundamentally safe?
The tradition in mental health
is to dismiss the reality of people's lives.
For example, it's only in the past few years
that people are beginning
to talk about the impact of poverty or the impact of racism
or the impact of unemployment.
And people have sort of been labeling people,
"Oh, there something wrong with you.
Let me fix you."
But if you go to a physician
or a mental health practitioner who doesn't understand that,
they're going to try to fix you with drugs
or cognitive behavioral treatment
to not do these crazy things anymore.
It usually doesn't work very well.
What was very clear is that being in a relationship
where people can hear you,
where you can talk about how badly you feel,
where you can talk about your guilt,
and where you can start opening up
where these feelings come from, how old these feelings are,
and how you develop these feelings in response
to particular things that happen to you,
that was actually quite helpful
because you need to really develop a deep sense of,
"This is what happened to me.
This is what I'm dealing with,
and I need to take care of the wounds
that I'm carrying inside of myself."
This issue of self-compassion
and really knowing that your reactions are understandable
and are rooted in you getting stuck in the past
is a terribly important part
of beginning to recover from trauma.
Most of us are survivors of one thing or another,
some much worse than others.
And so if people say what do you wish your legacy were,
I'd say, I want our society to know about trauma
and to really do all the things that are necessary
so that people who grow up under extreme adverse conditions
can develop a brain and a mind that can help them
to become full fledged members of society.
That's our big issue,
and that's the big challenge that we have.
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