This book took a long time to get through. I think I started reading it in January, maybe earlier. It was worth the journey. Dr. Van Der Kolk proposes that many of our issues, both individually and as a society, stem from certain types of trauma. He explores the development and creation of the PTSD diagnosis after Vietnam, and how being a part of the creation of the diagnosis led him to see how many other issues his patients had stemmed from other types of trauma. He advocates for a society that uses multiple ways of dealing with trauma, as there are multiple types and different strategies work for different people.
I think what I liked the most about his explorations, experiments and examples is how so many of them are based in recognizing that what works for one person may not work for another. He is also adamant that many conditions that we believe are irreversible may in fact have remedies- a line of dialogue I found refreshing. I’ve spoken with so many people who are diagnosed with a major condition and just feel trapped in it, often because medical professionals specifically tell them they cannot and will not ever live without medication and that it is the only way through a mental health condition.
The beginning of the book, where Van Der Kolk describes different types of PTSD, can be quite difficult at times. His descriptions of child molestation and sexual violence are a bit too graphic for my tastes, and I found the stories he related from patients very upsetting. Its not gratuitous, but he does use some patient’s own words, and those descriptions can be graphic. They are also piled on in certain chapter and it starts to feel a bit like a parade of misery. I found myself wishing for the anecdotes from the war vets more than these stories. It’s worth it to push through those chapters or just skim them, because he does get to hopeful things down the line.
The second half of the book explores alternative treatment methods and discusses how many have high rates of success, and how they work in contrast to just medication. There are a lot of stories from patients who made full recoveries from conditions that seemed completely unmanageable and unresolvable. There’s a lot of hope in this part of the book. He makes an extremely compelling case for alternative treatments, especially for people dealing with PTSD. Of other interest is the way he describes the ongoing fight with the makers of the DSM to recognize Complex PTSD as a valid diagnosis, and how the politics of that decision may have affected the decision to exclude it as a valid diagnosis, despite a mountain of evidence that it does exist and is different from PTSD.
Overall, it was a great resource for me. We’re all dealing with a societal trauma right now, and reading about the ways to apply treatment beyond medication was very helpful. It helped inspire me to return to playing the piano, to garden, and to journal more. Hopefully, part of the recovery from the pandemic will be in recognizing the need to treat trauma as a persistent, prevalent ailment in society, and to stop shoving everyone into the same box over how to deal with it, and research like this can be part of that solution.
“Why does tragedy exist? Because you are full of rage. Why are you full of rage? Because you are full of grief.” – Anne Carson