Attachment and the Gospel

The Body Keeps the Score

by Bessel van der Kolk, M.D.

Purpose and Audience:

This book is written for clinicians, trauma specialists, medical professionals, and informed readers seeking to understand how trauma alters the brain, body, development, and relational life of survivors. Van der Kolk’s purpose is to demonstrate that trauma is not solely a psychological event, but a whole-body imprint that shapes attention, memory, physiology, emotional regulation, and identity. By weaving neuroscience, clinical cases, developmental research, and treatment innovations, he argues for a holistic approach to healing — one that incorporates body-based modalities alongside traditional therapy. Although accessible, the book is primarily intended for serious students of trauma.

Identification of key themes or ideas:

• Trauma as a Whole-Body Experience
  Trauma leaves a measurable imprint on the alarm systems of the brain and on the physiology of the body. It affects arousal, attention, interoception, memory processing, and the ability to stay oriented to the present moment. Traumatic stress becomes embedded in patterns of activation that persist long after the event has passed, shaping emotions, behavior, and relationships in ways that often fall outside conscious control (Chapters 2–6).
• Developmental Trauma and the Lifelong Impact of Early Harm
  Chronic childhood trauma alters the developing brain in ways that shape emotional regulation, attachment, identity, and stress reactivity. Many children who present with behavioral or attention struggles are responding not to “disorders” but to relational disruption, neglect, or abuse. Early relational trauma restructures the child’s sense of safety and can create lifelong patterns of hypervigilance or disconnection if not addressed (Chapters 7–10).
• Limitations of Talk-Based and Cognitive-Only Therapy
  Certain brain regions that support language, sequencing, and meaning-making can shut down during traumatic activation. Because traumatic memories are often encoded in sensory and subcortical systems, talking about the trauma does not necessarily resolve or integrate it. Without addressing bodily regulation, clients may remain dysregulated even with insight. Effective treatment requires building the capacity to tolerate internal sensation and to remain present without becoming overwhelmed. (Chapters 11 & 12).
• Bottom-Up, Body-Based Approaches to Healing
  Many survivors benefit from approaches that work directly with bodily rhythms, arousal, and interoceptive awareness. Methods such as EMDR, yoga, neurofeedback, Internal Family Systems, and movement-based practices help restore regulation and support the integration of traumatic memories. These treatments aim to re-establish a sense of ownership and safety in one’s own body—a key step in healing from trauma (Chapters 15-20).
• Healing as the Restoration of Safety, Connection, and Agency
  Recovery from trauma involves rebuilding the capacity to connect with oneself and others with stability rather than fear. It requires experiences of safety, empowerment, and embodied presence. The later chapters emphasize that healing is not merely symptom reduction but the gradual reclaiming of curiosity, self-compassion, and relational engagement (Chapters 13-14 & 17).

Points of interest and points of personal agreement and disagreement

Points of interest

• His explanation of how the body “keeps the score” through physiological memory was compelling and clarifying (Chapter 1).
• The introduction and argument for Developmental Trauma Disorder expanded my understanding of chronic childhood adversity (Chapter 8).
• The discussion of neurofeedback as an emerging treatment broadened my view of integrative approaches (Chapter 19).
• The clinical stories of combat veterans and children were powerful and emotionally gripping, especially in the early chapters on trauma’s imprint (Chapters 2–4).

Points I agreed with

• I appreciated the emphasis on the therapeutic relationship, attunement, and embodied safety as the bedrock of trauma treatment (Chapter 13).
• His explanation of developmental trauma’s long-term effects resonated deeply with my own training and clinical observations (Chapter 8).
• His integration of body-based treatments—EMDR, yoga, neurofeedback—mirrors what I am learning in my own counseling program (Chapters 15–19).
• His critique of purely cognitive or talk-based approaches aligns with contemporary trauma-informed practice (Chapters 12–14).

Points of disagreement

• His discussion of therapy is almost entirely secular, rarely acknowledging the spiritual dimensions many clients bring into the room. This felt like a missing layer in understanding how people heal.
• His progressive clinical orientation was noticeable. While I appreciated his openness to innovative modalities, I occasionally sensed a leaning toward approaches that may not fit all clinicians’ frameworks or philosophical starting points.
• Knowing his broader professional trajectory, I am cautious about some of the more controversial future directions he has discussed outside the book. Although the text itself does not advocate psychedelic treatments, his later interviews reveal interest in areas I am personally less comfortable with. This shaped how I read certain sections.
• The treatment chapters left me wanting more practical “how-to” detail. The case studies were excellent, and the overviews of EMDR, yoga, neurofeedback, and other modalities were helpful, but I frequently wished for more specific steps, techniques, or examples. I recognize this was beyond the book’s scope, yet it was still something I noticed.

Significance of the book to the counseling field:

The Body Keeps the Score has become a foundational text in trauma-informed counseling because it synthesizes neuroscience, attachment theory, and clinical practice in an accessible way. It pushes the field beyond symptom-focused, talk-only or medication-only approaches and makes a compelling case for integrating body-based, experiential, and relational treatments. For clinicians, it offers both a theoretical framework and a list of evidence-informed modalities that honor the complexity of trauma and the resilience of survivors.

Critique of the overall work:

Overall, I found the book deeply engaging, even when it was heavy. The clinical stories kept me emotionally invested, and the integration of research and practice was both inspiring and stretching. At times the sheer amount of information felt dense, and some of the more progressive treatment approaches raised questions for me. I also wished for a bit more practical “how-to” detail in the treatment chapters. Still, as an overview of trauma’s impact on body and mind, it is exceptionally thoughtful, humane, and hopeful.

Usefulness of the book for potential clients

I would recommend this book selectively for clients. It could be very helpful for motivated adult clients—especially those in ongoing therapy—who want to understand why their bodies and brains respond the way they do after trauma and who can tolerate reading detailed case material (including some potentially triggering stories). It would likely be most useful for clients with complex or developmental trauma who are ready for psychoeducation and curious about body-based treatments. I would not hand it out as casual reading for clients in acute crisis, early stabilization, or with limited support.

‌van der Kolk, B. A. (2015). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin Books.