Anna Keeps the Score (joyfully)
A Commentary on The Body Keeps the Score
by Gaetjens of Chicago with Claude
To the Good Doctor
I know I’m not supposed to say “love,” so I will say that I admire you greatly and am deeply grateful. Nothing I say or write is intended to detract from that. All my resentments and issues—all of that—are just part of my way of managing the challenge of merely being in the world. Kindness is, I have found, the magic “elixir” for trauma: kindness to myself and, in fact, universal kindness.
To the Stakeholder in This Exploration (You, the Reader)
I see you.
As a person deeply steeped in physics, biology and computer science, I saw the power of the scientific method in stark relief. It is, apparently, a systematic and ultimately foolproof knowledge technology—a search for truth that is grounded in measurement, factual observation and, especially, testing. Every step along the way can be checked for validity.
Nevertheless, I am not “cured.” I inevitably experience unpleasant emotions far too often.
If you read the original The Body Keeps the Score and blamed yourself for the residual distress, you did nothing wrong.
It may seem that lasting and complete relief, a cure, can be “earned” by your own careful efforts. In a similar vein, the book Alcoholics Anonymous (4th ed., p. 83) promises, “If we are painstaking about this phase of our development, we will be amazed before we are half way through,” and twelve fantastic promises follow. That has not been my experience. If I participate in my own recovery, from either problem, the results will be joyfully sufficient.
The sadness that is my lifelong companion is not my fault. Your own unpleasant experiences, whatever they may be, are neither your fault nor Dr. van der Kolk’s. His scientific results are deep enough, true enough, complete enough, and thoroughly grounded. His intuitions and speculations about, for example, the amygdala or the vagus nerve, are compelling.
But science, even neuroscience itself, has limitations. The philosopher Wittgenstein said it in 1922:
We feel that even if all possible scientific questions be answered, the problems of life have still not been touched at all.
Blaise Pascal said it three centuries earlier (Pensées, no. 277):
The heart has its reasons, which reason does not know.
I have come to accept that a theory of trauma might simply be unavailable.
In the realm of relationships, feelings and our very dreams, the words we use to name desired states—“healthy,” “balanced,” or even “stable”—may not have the deep and scientifically accessible meaning I hoped for. That has to be OK.
Advice
Keep what helps. If slow breathing calms you, or yoga does, keep them. The calm is real; it just isn’t a certificate that you are healed, and you don’t need one.
What you have to offer your fellow survivors isn’t a better theory. You may sit with someone you love and say, “I am your witness, dear,” and let that be sufficient. That will be your finest moment, no matter how that remark is received.
I see you.
I am your witness.
Not “Just Semantics”
Words like “healthy” or even “normal” seem benign. Likewise, the question “On a scale of one to ten, how do you feel?” has similar issues. Such words look like practical guides to action, for example, something to work on in therapy or in a marriage. But such words can promote premature closure. I call them “ungrounded words.” Once an ungrounded word is attached to a measurement—once we ask, for example, “Is this a healthy relationship?”—the questions stop: nobody asks what the answer predicts, for whom, compared with what, or how anyone would know if it were wrong.
A simple example comes from American advertising. The dairy industry told a generation that milk “does a body good,” and most listeners accepted the matter as settled. The slogan never said which bodies, in what amount, or good for what outcome, and the many adults who cannot digest milk went unmentioned.
Other words do subtler work. “Disorganized,” as in “disorganized attachment,” does not close an inquiry; it forbids one. It carries a verdict that is never stated and therefore cannot be examined. By any measure a physicist would recognize, ice and steel are far more organized than the nervous system of a fish, which makes a strong case for raising children in a freezer!
Organization of the Book
Each section below follows van der Kolk’s order. His text is incorporated by reference to the chapter and section, and the annotation follows.
Prologue: Facing Trauma
To me, speech is seldom as simple as one person attempting to convey a belief to another. Much more often, there is a desired effect beyond that, such as a desire to make an ally or friend of someone. So when I hear or read a remark, I find it helpful to ask, “What was the intended effect?” long before asking, “Would I believe this?”
I call this “constructive provenance.” (Provenance asks, “How did this speech act come to occur? Why was it done?”)
Appeal to Neuroscience
The good doctor remarks “Research from these new disciplines has revealed that trauma produces actual physiological changes, including a recalibration of the brain’s alarm system, an increase in stress hormone activity, and alterations in the system that filters relevant information from irrelevant.”
Regarding this remark, I think I know the provenance. It is a response to a challenge he anticipated: the challenge of disbelief.
Trauma Disbelief
The harshest example of trauma disbelief comes after a rape. First, samples are taken from the penetrated orifice and tested for the attacker’s semen. This is, I hear, a universal practice in emergency rooms.
The survivor’s very credibility is challenged in the courtroom: “Were you drinking?” “What about this detail… and that detail… and the other detail?” or “Did you do anything to encourage the assailant?”
In more informal situations, for example, involving unwelcome touch of a less frank nature, one might hear “was it really that bad?” Or, in my case, “It didn’t happen,” followed by “If it did, they were only playing.”
The subtext is, “It isn’t real—it is only subjective.” It is very likely that our doctor-author used words like “actual physiological changes” to defend against this aggression.
Medical Disbelief
When the very self is split by a horror, and the survivor has multiple personalities, the matter gets ugly. Hundreds of research projects have been undertaken to scientifically prove or disprove the amnesia that comes with it.
The ultimate medical disbelief is the repeated refusal of the committee overseeing psychiatric diagnosis to allow a “complex PTSD” diagnosis. This prevents research.
Another question we are forbidden to ask: “Why did the author not spell out his reasons for returning over and over again to the paradigm of neuroscience?” Almost certainly, he did not know but merely wanted to be heard. He wanted a “witness” but, socially, as an adult and an expert professional, he would not be allowed to express anything like the loneliness of trauma authorship.
Annotation
Part One: The Rediscovery of Trauma
A Lesson about Blind Spots
On van der Kolk, Chapter 1: Lessons from Vietnam Veterans
Incorporated by reference: van der Kolk, The Body Keeps the Score, chapter 1, from his first day at the Boston VA Clinic through the section “Trauma and the Loss of Self”: the account of Tom, the ambush in the rice paddy, and the atrocities that followed.
Annotation
Rules the story sets aside. Van der Kolk himself teaches careful handling of trauma detail:
- In this same chapter, he observes that pressing veterans for the precise details of their trauma often set off full flashbacks.
- In chapter 8, he declines to push a patient to remember.
- In chapter 13, he advises revisiting trauma only once a person feels safe.
Chapter 1 nevertheless opens with graphic images: a dead friend face down in a rice paddy, and then children killed, a farmer shot, and a woman raped. They arrive without warning, in the book’s first pages. Readers who carry trauma of their own may want to approach the chapter with care.
Blind spots. Blind spots are everywhere in trauma, and often they are necessary stabilizing measures of the brain, or of the mind itself. The chapter is his origin narrative, the morning he knew he would give his working life to trauma. When exposure is as intense as his was with that man, anyone would space out a little. That state must have persisted, and that’s why he momentarily lost awareness of his own rules. It is an example of the many sinkholes, or catch-22s, that await anyone who works with the raw emotions of trauma. It is, or was, a stabilizing measure against the conflict the rules created.
Appendix: About the Author
Anna Gaetjens was adopted. Her parents, whom this book calls Walter and Ruth, struggled to adopt: the agencies tested their capacity to parent, and age pressed on them. When they adopted her older brother, Carl, Walter was 41 and Ruth 39.
The child, then named Gene, was channeled into physics. Ruth wanted Gene to have a calling she could stick a fork in and trust it was solid food. Gene earned a degree in theoretical physics.
Later came her gender transition, with complex motives related to social expectations around emotion. In the end she took the course Admiral David Farragut set at the Battle of Mobile Bay in 1864, during the American Civil War, when floating mines, then called torpedoes, blocked his way: “Damn the torpedoes, full speed ahead!”
Most recently came a simple spiritual experience. She had turned for comfort to someone this book calls Mac, and she quickly committed to Mac. When Mac faced a medical crisis, her peers called her on her codependence. In a conversation with her inner child, she came to a radical acceptance of her fear, and she arrived at the words Franklin Roosevelt spoke during the Great Depression, in his first inaugural address in 1933: “The only thing we have to fear is fear itself.”
William James argued in The Varieties of Religious Experience (1902) that spiritual experience comes in many kinds. The AA Big Book points its readers to him: “The distinguished American psychologist, William James, in his book ‘Varieties of Religious Experience,’ indicates a multitude of ways in which men have discovered God” (4th ed., p. 28). Its appendix on spiritual experience borrows his phrase “the educational variety” (p. 567). Anna prefers to share her spiritual experiences face-to-face, in an appropriate setting.
Anna believes strongly that spiritual matters reside in the physical world and, although extremely diverse, are all explainable.
References
Alcoholics Anonymous: The Story of How Many Thousands of Men and Women Have Recovered from Alcoholism. 4th ed. New York: Alcoholics Anonymous World Services, 2001.
James, William. The Varieties of Religious Experience: A Study in Human Nature. New York: Longmans, Green, 1902.
Pascal, Blaise. Pensées. Translated by W. F. Trotter. New York: E. P. Dutton, 1958.
van der Kolk, Bessel A. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. New York: Viking, 2014.
Wittgenstein, Ludwig. Tractatus Logico-Philosophicus. Translated by C. K. Ogden. London: Kegan Paul, Trench, Trubner, 1922.