What is Trauma?

Returning Vietnam veterans.
When Bessel van der Kolk was at the Veteran’s Administration (VA) in 1978, he was one of many clinicians fascinated by the complaints of returning Vietnam veterans. At the time, there was no definition of trauma related to combat, rape, involvement in fatal accidents — none whatsoever. When van der Kolk submitted a grant to do research on trauma symptoms it was denied. “It has never been shown that PTSD is relevant to the mission of the Veterans Administration” the VA stated flatly. (The quote is taken from Mary Sykes Wylie’s excellent profile of van der Kolk and his work “The Limits of Talk” — which you can find here.)

DSM diagnosis.
Van der Kolk is well versed in the limitations of defining trauma in terms of diagnostic category. He helped write the definition. Post-Traumatic Stress Disorder (PTSD) first appeared in the Diagnostic Statical Manual III (DSM-III) in 1980. So what’s so important about a diagnosis? Without one you will not get treatment, or your treatment will not get reimbursed.

The current DSM-IV description begins “…exposure to an extreme traumatic stressor involving direct personal experience of an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, seriuos harm, or threat of death or injury experienced by a family member or other close associate.” But at its core, the kernel of the diagnosis is not so much the experience itself as the feeling of helplessness that it arouses in the victim. Another trauma expert, Judith Herman, M.D., describes this in Trauma and Recovery, as “its power to inspire helplessness and terror.” Continue reading “What is Trauma?”

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The Trauma of Bessel van der Kolk

Renowned trauma expert.
Bessel van der Kolk, M.D., internationally renowned trauma expert, spoke at the Los Angeles County Psychological Association (LACPA) convention this past Saturday. It was an engaging and thought provoking presentation. His seminal article “The Body Keeps the Score: Memory and the Evolving Psychobiology of Post-Traumatic Stress“(1994) caught the attention of both clinicians and researchers alike — appropriate, as van der Kolk has a foot in each camp.

Psychobiology, psychotherapy.
With a solid background in neuroscience and physiology, one of van der Kolk’s basic assertions is that traumatic memories are hard wired into somatic (body) memory. As such, these “memories” are associated with primitive areas of the brain, inaccessible to talk therapies. The speech centers of the brain are located in the left hemisphere, in the cerebral cortex, on the very surface of the brain. It is generally believed that the cerebral cortex is the most recent product of human evolution. In contrast, the parts of the brain that regulate bodily sensations, temperature, respiration, and so on, are in the primitive, reptilian lower brain. Inaccessible to talk therapies.

Clinicians and researchers: Debate over EMDR.
That simple assertion, that traumatic memories rest in a part of the brain unaffected by talk therapies, causes a stir, among both researchers and clinicians. Both find van der Kolk’s espousal of Eye Movement Desensitization and Reprocessing (EMDR) as trauma treatment provocative, for different reasons. Continue reading “The Trauma of Bessel van der Kolk”

Blog Action Day

Here are some links for [the day after!] Blog Action Day. I must admit this is not my original post, which seems to have been eaten by my dog, or something.

Internet Mindset

Old Media, New Media.
Just a reminder that Blog Action Day is Monday, October 15 — just a handful of days away, at this writing. I’m compiling a list of environmentally conscious links for the occasion. The probably too-long post likely highlights my old-media bias — at least in terms of presentation. On that topic, an interesting post I stumbled upon about the importance of concisely presenting information on the internet. This strikes me as visual-culture bias, but comes with some interesting statistics. It’s mostly about how people only scan internet content, rather than read it. Interesting points about efficient transmission of information.

Kalea Chapman, Psy.D.