Book Reviews 131

techniques are explored in Chapter 9 regarding the stage of action, as well

as in Chapter 10, which focuses on the stage of maintenance and relapse
prevention and Chapter 11, which addresses relapse. Chapter 12 addresses
the treatment of comorbid trauma and addiction with EMDR therapy. Part
III presents the reader with six case studies involving trauma, addiction, and
the use of EMDR therapy.
One positive aspect of this book is the presentation of tools to help
clinicians (and students) work through a decision tree about EMDR proto-
cols under different circumstances. For example, in Chapter 12 the authors
present a list of 10 questions to help make complex clinical decisions about
using the standard protocol. Practitioners and students alike would most
likely appreciate the appendices, where instruments are presented in their
entirety, along with a description of how to interpret clinical results. Similarly,
the protocols presented in the appendices are very detailed and helpful to
a practitioner. One negative aspect of the book is in the assessment section
(Chapter 5), where the assessment tools discussed are not necessarily the
“latest and greatest” or best supported by evidence, and there is a lack of
distinction between tools for addiction screening versus assessment. My only
other disappointment was in the lack of evidence presented in the book to
support the use of EMDR therapy in addiction treatment.

Audrey Begun
Ohio State University

Bessel van der Kolk. (2014). The Body Keeps the Score: Brain, Mind,
and Body in the Healing of Trauma. New York, NY: Penguin, 356 pp.
Hardcover, $27.95. ISBN: 9780670785933.

The Body Keeps the Score gives readers an insightful look at how trauma
affects the brain, body, and mind. It deftly interweaves practice wisdom
and research findings. For example, van der Kolk beautifully describes
case scenarios that illustrate mental fragmentation resulting from trauma,
with seamless discussion of the underlying biology. The author describes
innovative approaches for treating people who have experienced trauma,
emphasizing the importance of creating a safe environment by ground-
ing the client in the present moment as the critical first step in trauma
recovery.
In the first three chapters the author sets the stage by describing symp-
toms of trauma through the stories of several patients he treated as a young
psychiatrist. The author gives readers a brief introduction to early neuro-
science research on trauma, as well as a look at the history of treating
trauma. The second part of the book describes what our brains do when we
reexperience trauma. van der Kolk masterfully explains the mind–body con-
nection with brain scan images and describes brain activity occurring when
132 Book Reviews

someone reexperiences trauma (e.g., flashback). He compellingly argues that

reexperiencing trauma is, in fact, a physiological phenomenon in which
patients experience trauma as if it were happening in the moment, even
if it occurred years earlier. In the final chapter of the second section, the
author discusses which brain regions become deactivated for trauma patients,
triggering autonomic “fight or flight” responses. That is, when certain vital
regions are not activated, primal instincts that normally promulgate survival
(e.g., amygdala activation that differentiates fear responses) do not function
the same way as for those who have not experienced trauma. This and
other content will be especially useful in guiding difficult discussions about
what constitutes the best treatments for trauma victims, as therapists might
sometimes erroneously rely on talk therapies prematurely.
In the four chapters of Part III, the author discusses how trauma
profoundly affects attachment relationships, coping mechanisms, and devel-
opment. The author provides useful discussion regarding the difficulty of
diagnosing trauma disorders in children and suggests that many mental
health problems and their related social costs stem from trauma. He also
exposes the political process behind canonizing diagnoses in the Diagnostic
and Statistical Manual of Mental Disorders (DSM) by discussing the denial
of his proposed Developmental Trauma Disorder (DTD) by the American
Psychological Association. In short, he claims there is a widespread lack
of societal recognition for the large impact of childhood trauma on health.
In Part IV, the author takes a bold stand on the controversial issue of
repressed traumatic memories, claiming that these memories are valid for
some trauma victims.
In Part V, the author supports the use of various treatments such as eye
movement desensitization and reprocessing (EMDR); movement therapies
such as yoga, dance, and theater; family systems therapies such as inter-
nal family systems therapy (IFS); and neurofeedback treatment. The author
makes a compelling case for the use of mindfulness-based treatments over
evidence-supported desensitization models, arguing that although exposure
treatment can make individuals less prone to hyperarousal, they do not nec-
essarily improve symptomology. His comments about exposure treatment
reflect a core component about the critical thinking required to determine
the applicability of research data in practice. In that regard, instructors could
use this book to illustrate the difference between an empirically supported
treatment that has reached a bare minimum evidentiary criterion to support
its use and the process of evidence-based practice.
This book would appeal to therapists and researchers, as well as the
general public. Although the book presumes some advanced knowledge of
diagnostic criteria as well as basic biological functioning, the author conveys
difficult material in a clear and understandable way. This book would serve
well as a textbook in an advanced practice course on treating trauma. Several
anecdotes, such as refraining from taking trauma histories for “voyeuristic”
 Book Reviews 133

purposes, will challenge the implicit practice models of students and veteran
practitioners alike. van der Kolk’s storytelling and readable research cri-
tiques are highly engaging. This book is a must read for those working
with individuals who have experienced trauma.

Jordan P. Davis and Douglas C. Smith

University of Illinois at Urbana–Champaign
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