how a bestselling book helps us understand trauma – but inflates the definition of it
- Written by Nick Haslam, Professor of Psychology, The University of Melbourne
In a new series, we look at books that have become cultural touchstones.
If new books are lucky they enjoy a brief honeymoon of attention before ebbing away into oblivion. Not so The Body Keeps the Score[1], a publishing phenomenon that has kept selling long after it first hit the shelves in 2014. The book has spent more than 150 weeks on the New York Times best seller list for paperback nonfiction, including over half a year in the coveted #1 spot during 2021. It has reportedly sold almost 2 million copies.
Why a long, dense, and demanding book on the psychology and neurobiology of trauma should occupy so bright a spotlight for so long is not immediately obvious. Post-traumatic stress disorder is old news, a staple of psychological chatter for over four decades, and the book doesn’t offer any quick fix solutions for self-helpers.
Clues to what has driven The Body Keeps the Score’s success can be found in its sales trajectory. On bookriot.com[2], writer Gina Nicoll notes that sales began to liven up around 2018 and then grew in spurts, reaching a peak in 2021. The pandemic may have contributed to this surge by bringing collective trauma to our doorsteps, she speculates, but the pre-pandemic upswing suggests other factors are also at play.
Van der Kolk is enthusiastic about therapies including eye movement desensitisation and reprocessing.
Shutterstock
His enthusiasm for these interventions, some of which veer towards the fringe and the faddish, sometimes outstrips the evidence for their efficacy, but has contributed to their growing popularity.
Understanding the book’s appeal
The Body Keeps the Score has been remarkably popular for reasons beyond its alignment with our current cultural preoccupations. For one, it is a hopeful book. Although it underscores the sweeping extent of traumatic experiences and the severity and range of their impacts, it also argues that therapy works and post-traumatic distress need not be a life sentence.
The same optimism shines through in the book’s dialectical account of the history of the mental health disciplines. A period of “brain-less” psychoanalytic interest in the meaning of psychological distress – carried out with no eye for biological processes – gave way to an era of “mind-less” psychopharmacology. We have now arrived at a stage in which neurobiology and a deep appreciation of human psychology can go hand in hand.
The book also contributes to an ongoing de-masculinising of trauma studies. Psychiatric thinking about trauma was long dominated by investigations of combat reactions in soldiers, described variously as shell shock[8] or battle fatigue. The flood of psychological casualties among Vietnam veterans spurred the official recognition of PTSD in 1980.
Van der Kolk pays much more attention to sexual abuse and violence as sources of trauma. These disproportionately affect women and girls and account at least partially for women’s higher rates of PTSD diagnoses.
Van der Kolk sees trauma lurking beneath an array of somatic complaints.
Shutterstock
Similarly, Van der Kolk’s work expands the range of events that are considered traumas. When PTSD was first defined in DSM-III, the condition could only be diagnosed if the event that precipitated it was life-threatening and outside the range of normal human experience.
Later editions of the diagnostic manual loosened the definition to include unpleasant events witnessed indirectly, which are not physically endangering.
Van der Kolk uses the term “trauma” more freely still, often employing it to refer to almost any form of life adversity, including enduring circumstances rather than only discrete incidents. Trauma can easily be stretched to encompass minor illnesses, normal romantic breakups and disappointing exam results.
On this broadened definition, all but the most cosseted among us have been traumatised and can view our struggles and sufferings through the potentially magnifying lens of trauma.
This expansion of the meaning of trauma has taken place in parallel with a steep rise in the cultural prominence of the concept. Research[10] shows that the word “trauma” appears in everyday discourse much more frequently now than it did even two decades ago.
That rise has been even more dizzying within the mental health professions, a recent study[11] finding that “trauma” appeared at an almost 20 times higher rate in psychology journal articles in the 2010s as it did in the 1970s.
Read more:
More than half of Australians will experience trauma, most before they turn 17. We need to talk about it[12]
Backlash
It should not be surprising to learn that this sharply spiking interest in trauma has generated some push-back. In 2021, Eleanor Cummins[13] observed in The Atlantic that the concept of trauma has become “uselessly vague – a swirl of psychiatric diagnoses, folk wisdom, and popular misconceptions”. In the same year, writer Will Self[14] criticised “how everything became trauma” and Parul Sehgal[15] decried how trauma-driven plots flatten fictional narratives and hollow out characters in The New Yorker.
Will Self: argues ‘everything has become trauma’.
Goodreads
In 2022, in the New York Times, Jessica Bennett[16] asked “if everything is trauma, is anything?” and denounced “post-traumatic hyperbole”. Lexi Pandell[17], writing for Vox, argued this “word of the decade” has become close to meaningless.
Like Bennett and Pandell, several writers have queried whether trauma is now being used too promiscuously. Some have distinguished big “T” trauma from less severe little “t” trauma to resist this concept creep[18].
Others worry that the growing popularity of trauma narratives represents an encroachment of medical language into the realm of ordinary adversity, reducing unjust social arrangements to individual pathologies, or promoting personal fragility. Still others have voiced concerns that the concept of trauma has become politicised[19].
The argument that broad concepts of trauma produce fragility rests on the belief that defining moderate life challenges as mind-shattering traumas might undermine our resilience.
Understanding an adversity as a trauma implies that it overwhelms our capacity to cope and is likely to have lasting effects. In the popular mind, trauma still carries a connotation of indelibility.
Of course, many adversities do take people beyond their breaking points and have enduring consequences. The question is whether perceiving less severe experiences as traumas makes them loom larger and longer than they need to. Emerging research[20] evidence suggests that it might.
Van der Kolk can’t be held entirely responsible for the runaway success of his book or for the runaway semantic inflation and popularity of its central concept. The Body Keeps the Score has been successful because it resonates with its cultural moment, and it has helped to mould that moment for millions of readers.
The recent elevation of trauma attests to a time in which people are keenly attuned to their individual and collective suffering, increasingly attribute it to causes beyond their control, and look to a therapeutic mindset to resolve it. Van der Kolk’s book is a lucid guide to this new reality.
References^ The Body Keeps the Score (www.goodreads.com)^ bookriot.com (bookriot.com)^ Six psychiatric concepts that have mutated: for better or worse (theconversation.com)^ Bessel van der Kolk (en.wikipedia.org)^ the amygdala (www.britannica.com)^ encephalographic (www.dictionary.com)^ EMDR (en.wikipedia.org)^ shell shock (en.wikipedia.org)^ What is complex PTSD and how does it relate to past abuse and trauma? (theconversation.com)^ Research (muse.jhu.edu)^ recent study (psycnet.apa.org)^ More than half of Australians will experience trauma, most before they turn 17. We need to talk about it (theconversation.com)^ Eleanor Cummins (www.theatlantic.com)^ Will Self (harpers.org)^ Parul Sehgal (www.newyorker.com)^ Jessica Bennett (www.nytimes.com)^ Lexi Pandell (www.vox.com)^ concept creep (www.tandfonline.com)^ politicised (www.commentary.org)^ Emerging research (psycnet.apa.org)
