Trauma & the Body

The conventional understanding of trauma treats it primarily as a psychological problem — a distressing memory, a set of distorted thoughts, a narrative about what happened that needs to be processed and integrated. Talk therapy follows from this understanding: if trauma is a story, the treatment is to work with the story — to examine it, reframe it, make sense of it.

The work of Bessel van der Kolk, Peter Levine, Gabor Maté and others in the somatic trauma field has fundamentally challenged this model. In their account, traumatic experience is held not only in narrative memory but also in the body’s learned stress responses — a view consistent with research on conditioned fear and altered stress physiology in PTSD. “The body keeps the score” is a metaphor rather than a literal storage mechanism, and some of van der Kolk’s claims are disputed (see below). The traumatised person is not primarily someone who thinks bad thoughts about the past. They are someone whose nervous system is continuously responding to the present as if the past danger were still happening.

The title of van der Kolk's landmark 2014 book says it precisely: The Body Keeps the Score. The body remembers what the mind cannot process. It stores the incomplete threat response — the energy that was mobilised for fighting or fleeing but had no outlet — as chronic muscular tension, altered breathing patterns, hypervigilance, digestive disruption and a pervasive sense of unsafety that no amount of rational reassurance can reach. Rational reassurance relies on prefrontal control, whereas fear responses are driven by faster subcortical circuits (amygdala, brainstem); in PTSD, prefrontal regulation of those circuits is often reduced (Shin & Liberzon, 2010).

Peter Levine — the developer of Somatic Experiencing — arrived at his understanding of trauma through an observation about animals. Animals in the wild are regularly under life-threatening stress — predator attacks, near misses, physical injury — but, in Levine’s account, they rarely develop chronic trauma in the way humans do (an observation based on clinical experience and animal-behaviour accounts rather than controlled research). After a threatening event, animals literally shake and tremble, discharge the fight-or-flight energy through the body, and then return to normal baseline functioning. The biological energy mobilised for survival is completed — and completion is what makes the difference.

Humans, Levine observed, often prevent this completion. We inhibit the shaking and trembling because it feels out of control. We suppress the crying, the rage, the terror because it is socially unacceptable. We use cognitive control to "manage" our response. And in doing so, we freeze the survival energy mid-cycle — the energy that was mobilised for action but never discharged remains in the nervous system as chronic activation, looking for a threat to respond to because the original threat response was never completed.

In Levine’s model, trauma is a biological process that got interrupted, and healing is correspondingly physiological as much as psychological. It is an influential clinical theory; controlled evidence for its specific mechanism (the discharge of “held energy”) is limited. It involves creating the conditions in which the interrupted response can complete — safely, slowly, with adequate support — so the nervous system can finally discharge the held energy and return to baseline. This is why somatic approaches to trauma often involve tracking physical sensations rather than processing memories, and why the shaking and trembling that arise spontaneously in safe therapeutic conditions are read in this model as discharge rather than worsening (an interpretation not yet tested in trials).

Talk therapy has genuine value — for many psychological difficulties, working with the narrative, examining patterns of thought and developing insight is effective and sufficient. But some people find that insight alone does not settle bodily alarm responses, because fear responses are driven in part by faster subcortical circuits than those that support language and reasoning.

An early PET study (Rauch et al., 1996; eight participants, later widely cited by van der Kolk) found reduced activity in Broca’s area when trauma survivors listened to scripts of their traumatic experiences. It is an intriguing finding that fits many survivors’ experience of “speechless terror”, but it came from a very small sample and has not been established as a general rule. What is better supported is that traumatic memories are often fragmented or sensory-heavy, and that people can become overwhelmed when recalling them without adequate support.

It is sometimes argued that retelling a traumatic narrative without changing the underlying arousal can reinforce rather than heal the trauma. This is a hypothesis, and it runs against the clinical trial evidence: structured trauma-focused psychotherapies that involve revisiting the memory — prolonged exposure, cognitive processing therapy, trauma-focused CBT and EMDR — are the best-evidenced treatments for PTSD, and most participants improve (Bisson et al., 2013; Watkins et al., 2018). Unstructured, unsupported retelling can indeed be distressing, which is why pacing, preparation and a trained clinician matter.

The relationship between trauma and spiritual practice is more complex and more important than either the psychological or spiritual communities typically acknowledge.

Unresolved trauma in the body directly affects the quality of spiritual experience. A nervous system in chronic sympathetic activation or dorsal vagal shutdown cannot fully access the ventral vagal state in which genuine presence, openness and connection — the ground of authentic spiritual experience — arise. The practice may produce experiences, but they arise above a foundation of dysregulation rather than from a foundation of genuine safety. The result can be spiritually stimulating but not deeply integrating.

Conversely, spiritual practice can sometimes serve as spiritual bypassing — using meditation, prayer, positive thinking or any other practice to float above unprocessed trauma rather than moving through it. The practitioner achieves genuine altered states and genuine experiences of peace or expansion, but the trauma remains held in the body underneath, occasionally erupting in relationship, in stress responses disproportionate to circumstances, in the body's physical symptoms.

Trauma work and spiritual work are not separate paths. The body's stored history is material for transformation, not an obstacle to it. Many contemplative traditions have always known this — the purification processes of serious spiritual practice have always involved confronting and releasing what the body has held. Modern somatic trauma work has developed precise, effective methods for exactly this — methods that complement and deepen spiritual practice rather than competing with it.