Discussion Questions

The Body Keeps the Score

by Bessel van der Kolk

Van der Kolk tells us about the body’s alarm system

when danger is sensed, about what happens neurologically, chemically,
and physically, which body parts are activated, and which shut down and
what can happen when this alarm system is triggered repeatedly over a
period of time. What does this tell us about the body’s ability to survive and
develop resilience?

Van der Kolk compares childhood and adult traumas in the text. How are
childhood and adult traumas similar and how are they different?

Over the course of his career, Van der Kolk has drawn from many researchers
and teachers who have shaped scientific understanding of trauma, its
diagnosis, and its treatment. Discuss some of the theories he writes about and
how they've evolved over time. Which did you find most compelling?

Van der Kolk mentions “top-down” and “bottom-up” approaches to treating

trauma. What are their effects, advantages, and disadvantages of the different
approaches?

Could widespread use of technology rather than in-person communication

cause or perpetuate trauma? Why or why not?

How have western biomedical health models shaped mainstream

understandings of and responses to trauma and healing. How does the U.S.’s
healthcare system impact society’s relationship to trauma and healing?
Discuss other health systems/models that engage trauma and healing
differently.
What was so important about the establishment of an official PTSD (Post-
Traumatic Stress Disorder) diagnosis in 1980? What does the book posit about
how the current DSM (Diagnostic and Statistical Manual of Mental Disorders)
addresses the needs of, or neglects to address the needs of, trauma survivors?

Based on Van der Kolk’s writing style, what audience do you think this book is
geared toward? In your opinion how could the book's delivery be different (less
or more technical, visual, examples, etc) to effectively reach this audience?

What does the book suggest should be priorities for future trauma research?

How does trauma effect people who are not directly exposed to it, but who are
around someone who has been exposed to trauma?

How does access (or lack of access) to basic survival materials (shelter, food,
warmth, etc) shape someone’s neuropathways? How does poverty play into
experiences of trauma?

How does Van der Kolk’s book grapple with the stigmatization endured by so
many trauma survivors in society? How would Van der Kolk encourage us to
think about the behavior of survivors who engage in high-risk behavior or seem
resistant to healing?

During pandemic times, this book is among many about stress, anxiety, and
trauma that rose in popularity. It has been argued that these books are not that
helpful for the kind of suffering most people experienced during the pandemic.
What do you make of this? Has "trauma" become too much of a catchall phrase,
and if so, to what detriment?

https://www.supersummary.com/the-body-keeps-the-score/essay-topics/
http://www.cusackcounselling.com/wp-content/uploads/2016/03/The-Body-Keeps-the-Score.pdf
 Talking about trauma...
It is normal for readers to turn learning from The Body Keeps the Score inward, and to
reflect on our own memories, sensations, and relationships. While rich and empowering
for us to explore, it can be triggering and uncomfortable, and can open the door to
feelings Van der Kolk describes in the book. This is perfectly normal.

Given this is a “book club kit” and not a “therapy group kit” it can be helpful for the
group to establish an expectation for how the group will explore, or set limits to exploring,
the more sensitive and personal elements of the content, and to support access to
appropriate resources. Here are some guidelines:

The group can decide to what extent book club is a space to share personal traumatic
memories, feelings, and experiences. It's ok to put a limit on personal sharing.
The group can put limits on details of traumatizing experiences (our own, or others’, or
examples given in the book), and whether details are beyond the parameters of the
book club. For example naming violent incidents in summary, but not describing in
detail.
You can establish a follow-up time, either as a group or 1:1, to further discuss topics
that come up. Following up with a qualified mental health professional is always an
option.
How will it be communicated if we’re getting too deep into traumatic sharing? The goal
here can be to validate the sharer’s message, while gently redirecting back to the book.
The group can agree to a confidentiality agreement, meaning if a member discloses
personal information with the club, the other members agree to not share that info
outside the club.
As this book highlights, thinking and talking about trauma can open up our own
fight/flight/freeze response system, which we carry out of the meeting. At the end of
the discussion, each group member can share ways they practice self-care and healing
techniques upon leaving the group.
It's normal if, a few hours after group, or tomorrow, some lingering physical feelings
remain from the discussion! Check in with yourself. Show up for yourself. How are you
showing yourself care?
 Resources for survivors,
friends, and family
Colorado Crisis Services 1-844-493-8255 or text “TALK” to 38255
24/7, clinicians and peer specialists provide free, confidential support

Axis Care Hotline 970-247-5245

24/7 crisis support serving Southwest Colorado

Alternative Horizons 970-247-9619

24/7 serving La Plata and San Juan Counties, support for survivors of domestic violence
and their families

Southern Ute Behavioral Health Division 970-563-4581

Therapies, outpatient treatment, peer coaching, care coordination, vocational & nutrition
education, community education under the Tribal Health Department
Veterans Crisis Line 1-800-273-TALK (8255) or text 838255
24/7, free & confidential support; don't have to be enrolled in VA benefits

Crisis Text Line, text HOME to 741741

24/7 mental health support via text; also available on WhatsApp

Trevor Project LGBTQ Youth Lifeline 1-866-488-7386 or text Trevor to 1-202-304-1200

24/7; connect with a counselor, chat, explore

Trans Lifeline 1-877-565-8860

peer support by and for trans community

National Suicide Prevention Lifeline 1-800-273-TALK (8255)

24/7, crisis counseling & mental health referrals

SAMHSA’s National Helpline 1-800-662-HELP (4357) or text HELP4U (435748)

24/7, for individuals and family members facing mental and/or substance use disorders
(English & Spanish)

SAMHSA Treatment Referral Helpline 1-877-SAMHSA7 (1-877-726-4727)

M-F 8am – 8pm, information on mental health and treatment services in your area