Being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives

This quote from Chapter 5, which explores the inextricable link between the body and the brain, explores how social connection can affect physiology. Only when the body is at peace can the mind be at peace. Human beings are an inherently social species, and because of this, one of the ways in which an individual may find that peace is in the comforting safety and understanding of others. Stephen Porges’ Polyvagal Theory, also explained in this chapter, states that the body’s first instinct when threatened is to seek out aid and support from other people.

Erasing awareness and cultivating denial are often essential to survival, but the price is that you lose track of who you are, of what you are feeling, and of what and whom you can trust.

Chapter 8 discusses the physical, mental, and emotional cost of abusive relationships, and this quote highlights one particularly detrimental effect that can affect survivors of all kinds of trauma, not just abusive relationships. Dissociating troubling emotions from trauma may be protection in the short-term, but in the long term, those emotions may run rogue and manifest unexpectedly in overwhelming, harmful ways. This can lead to a loss of one’s sense of self, emotional numbing, and lack of social support, all of which can prevent a survivor from recovering.

The essence of trauma is that it is overwhelming, unbelievable, and unbearable. Each patient demands that we suspend our sense of what is normal and accept that we are dealing with a dual reality: the reality of a relatively secure and predictable present that lives side by side with a ruinous, ever-present past.

In Chapters 11 and 12, the latter of which contains this quote, van der Kolk extensively discusses the nature of traumatic memory, and how its disorganization prevents it from becoming a narrative that can be integrated fully into past memory. When a memory cannot be presented as a narrative with a beginning and end, but rather is only remembered as a blur of physical sensations and emotions, the body and mind will have the same response to the memory as it did to the initial traumatic event. In this way, survivors of trauma find themselves re-experiencing the past even in the present.

As long as you keep secrets and suppress information, you are fundamentally at war with yourself.

This quote from Chapter 14, which explains the use of language for therapy, highlights the first step of dealing with trauma: acknowledging it. As long as trauma is denied or repressed, a survivor cannot identify it as the root of their distressing emotions, and thus cannot fully recognize why their body reacts in the way it does. Refusing to recognize trauma denies the truth that the body is attempting to tell. It is only when this trauma is seen for what it is that the healing process can begin.

The body keeps the score: If trauma is encoded in heartbreaking and gut-wrenching sensations, then our first priority is to help people move out of fight-or-flight states, reorganize their perception of danger, and manage relationships.

This quote, from the epilogue, neatly summarizes the role of physiology and social bonds in the symptoms and treatment of trauma. The intense stress response experienced by trauma survivors, governed by an overactive amygdala that sees near everything as a threat, creates a perpetual state of fight-or-flight that can lead trauma survivors to lash out at their loved ones or impulsively harm themselves as their body attempts to protect them from further harm. Restoring balance to the body is thus an important step of any effective treatment.

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