Bessel van der Kolk: trauma affects everything

Trauma is not just about thetraumatic event: for Bessel van der Kolk, the challenge is not just to ‘tell the story’ in words, but to understand what thetraumatic experience does to the brain, the nervous system and the body, and then to create safe, corrective experiences that enable integration.

In this episode of the Quantum Way Chronicles on trauma, Bessel van der Kolk looks back at the complexity of the traumatic phenomenon, the contributions of neuroscience and the value of experiential methods(EMDR, yoga, theatre, neurofeedback, etc.) that he has been exploring for decades, with one constant: remaining curious, non-dogmatic and observing what really helps patients.

Why talk about trauma today?

From the outset, Bessel van der Kolk points out the intrinsic difficulty of the subject: “The human mind and the human condition are very difficult things to study… We are very complex creatures”, capable of both “immense generosity” and “a great capacity for destruction”. The trauma clinic therefore raises some demanding questions.

This complexity explains why no single approach is sufficient. Trauma manifests itself through automatic reactions(fear, rage, freezing), attentional difficulties and bodily hypervigilance. The challenge is to help the body differentiate between past and present, and to find stable sensory support so that it can act rather than react.

When regulation comes before understanding

Bessel van der Kolk insists that before putting words to the trauma and the event, it is often necessary to regulate better.

“When you are traumatised, you live in a very confused and confusing inner world… [you] are not able to pay attention”: fear or anger take over. And when the body is on high alert, attention becomes fragmented and talking doesn’t always help.

So the priority is tocalm the nervous system. Once the physiology has stabilised, the information can be processed and understanding returns, enabling us to distinguish between what is happening now and what has happened in the past.

This pragmatic reversal (calming, then understanding) structures all of Bessel van der Kolk’s work: physiological regulation (breathing, movement, rhythm, voice, interoceptive attention) creates the conditions for speech, awareness and autobiographical memory to be integrated.

Practices that work: EMDR, yoga, neurofeedback…

One of the common threads running through the interview is this: don’t lock yourself into one school, one method, one way of providing support.

“It’s very important to say, ‘What I’m doing now isn’t working’… and then go and find out, ‘What else could work? Bessel van der Kolk regrets the tendency of some therapists to become exclusively adept at one method, instead of remaining focused on how to make their patient feel better.

In concrete terms, over the last 40 years, his team has carried out many different studies on yoga, EMDR, theatre and various interventions for children:

◆ EMDR: useful for reprocessing traumatic memories and reducing their somatic charge;

◆Yogaand somatic approaches: increase body awareness, support self-soothing and tolerance of sensations;

◆ Theatre, movement and play: reintroduce safety, synchrony and expressiveness;

◆Neurofeedback: attentional and emotional training that helps the nervous system move out of extremes (hyperactivation / hypoactivation).

In addition to the ‘what’, we must not forget the ‘how’ and ‘with whom’: in a safe relationship, at an appropriate pace, with tolerable micro-experiences on a bodily level that reconfigure the alert and regulation systems.

From theory to practice

Telling your story can help, but it’s not always enough; as long as the body remains organised around old threats, words won’t help you integrate. Guided practice (lying down to breathe, anchoring the feet, placing the hand on an area of tension, soft vocalisations, rhythmic rocking, etc.) gives the patient a form of control:interoception is refined and the window of tolerance increases.

In a session, this involves :

◆O bserving and monitoring the patient’s physiology (breathing rhythm, tone, gaze),

◆ Alternating explanation and experimentation (a few minutes of practice are enough),

◆ Ritualise the return to safety (pauses, sensory support, co-breathing),

◆ Respect the patient’s ability to act: it is the patient’s body that decides on the dosage.

The proposed ethical axis is clear: remain curious, measure the effects and adjust. “I don’t know all the things that have been invented, I can’t know them all”, says Bessel van der Kolk; hence the need to explore and admit when it doesn’t work.

This approach was the driving force behind the creation of the Trauma Center and, later, the continuation of work and research within the foundation. The aim remains the same: to increase the number of gateways to inner security, so that people can once again take control of their own choices and relationships.

Bessel van der Kolk’s advice to therapists and the general public

For practitioners, it is essential to start by working on their own regulation and posture: the therapist ‘s presence models safety. It is also up to therapists to equip themselves with somatic practices (recumbent breathing, anchoring, voice, rhythmic movement) to insert between two speaking sessions or to offer as practice at home. And, above all, to avoid dogmatism: choose the tool that works for the patient, here and now.

For the general public, Bessel van der Kolk recommends learning to recognise recurring states (warning signals, micro-tensions, attentional confusion). Creating short, repeated and pleasant bodily rituals is also beneficial for calming oneself (breathing longer on the exhale, using a soft voice, walking in sync with someone close to you, practising accessible yoga).

It also encourages you not to remain alone (family member, group, therapist), as the presence of others and the harmony of relationships facilitate regulation. Finally, it may be necessary to admit that not everything works for everyone, and to remain curious and persevering.

Because understanding trauma is not enough; you also need to know how to welcome it. And, as a therapist, that means giving yourself the space for deep, grounded regulation. This is what Bessel van der Kolk and Licia Sky propose to share with us: an immersive, regulating experience, co-hosted by leading figures in the field of psychological trauma.

Join Bessel van der Kolk on 16 and 17 September
for a unique event in France.