The Body Keeps the Score by Bessel van der Kolk, pub. Penguin Psychiatrist and trauma specialist Bessel van der Kolk believed America was on the verge of becoming “a trauma-conscious society” when he wrote the 2014 tour de force The Body Keeps the Score . His book, densely packed with hard science, compelling storytelling and years of clinical experience, struck a chord, garnering accolades from eminent medical colleagues, the world’s top science journals and even modern master of mindfulness Jon Kabat-Zinn. Despite its often harrowing accounts of sexual abuse and the brutal intrusions of war, it found a general audience, too, and a place on The New York Times ’ bestseller list, one it has tenaciously held on to, in ever more buoying waves of relevance, for 180 or so weeks. Two long years into the Covid-19 pandemic, it still periodically regains the No 1 spot in paperback non-fiction. In 2022, we see trauma everywhere, and not just in the uncertainty, disruption and tragic losses of the pandemic, or the senseless rain of shells in Ukraine. #Traumatok, an actual place on the internet perhaps thankfully inaccessible to most readers in Hong Kong, documents any number of “trauma responses” – from social media addiction to indecisiveness. The word “triggering”, avidly appropriated from the science of post-traumatic stress disorder (PTSD), now one of the most commonly understood manifestations of trauma, is similarly applied to the slightest social rebuff, technological frustration or insufficiently milky latte. Even the Google Books word-usage graph charting the most recent examples of “trauma creep” is as exponential as an Omicron spike. As one recent New York Times op-ed asked, “If everything is trauma, is anything?” The answer – found in our schools, psychiatric institutions and consulting rooms – is a resounding yes. Trauma (from the Greek word for “wound”) retains a very real psychological and – as van der Kolk argues so persuasively – physiological definition with profound personal and societal effects. These wounds are neither ubiquitous nor rare. ‘People are feeling trapped’: Covid-19 stress for expats in Hong Kong Trauma in The Body Keeps the Score is specific, identifiable, and still more pervasive than our politicians care to admit. This was not always the case. It took Freud and his early contemporaries to understand that the “hysterical” (today we would say “psychosomatic”) symptoms with which their then mostly female patients presented were, in fact, the result of trauma, often sexual. Many of these experiences were buried – “repressed” – under a taboo of silence, and the radical invention of psychoanalysis sought to bring them to light through speech. The “talking cure” persists today, though not all such articulations are direct. As therapists, we also listen carefully for the crab-like emergence of pain that has been minimised: the bruised arms and legs of the mother; the airless, locked cupboard of childhood punishment; the inebriated father brought naked into the young daughter’s room at midnight as proof of his perfidy. And trauma can remain “invisible”; van der Kolk, through his work with Vietnam war veterans, spent years trying to get PTSD fully recognised as a psychiatric disorder. The central thesis of The Body Keeps the Score is that trauma alters the body, not just the mind. This means both the brain as an organ and the system of hormonal responses we call endocrinology. While, like Freud, van der Kolk believes all trauma victims are “suffering from memories”, either consciously or not, he also outlines – alongside other trauma experts such as Bruce Perry ( The Boy Who Was Raised as a Dog , 2006), Daniel Siegel ( Healing Trauma , 2003) and Judith Herman ( Trauma and Recovery , 1992) – a detailed map of physical harm that must also be deciphered to fully understand their pain. The contours of this map are increasingly well-drawn: incest survivors with abnormal CD45 cells, “the memory cells” of the immune system; traumatic emotional recall decreasing those parts of a brain scan marking signals from the skin, indicating “numbness”; the overactivation of the outsized, primitive nerve shared across all mammals, including fish, the vagus – the body’s ultimate SOS – in situations of perceived (but exaggerated) threat. As the title of the book suggests, there is a tally, and it is inscribed in our physical as well as psychological being. This insight also suggests a more holistic cure. Psychiatric pharmacology, in van der Kolk’s view, is a temporary Band-Aid at best, patching over both the meaning and the somatic experience of trauma with medication. But talk therapy alone also runs the risk of leaving sufferers stuck in their chemistry, more articulate, but still traumatised. For the wound to heal, the body must be retrained, both in relation to the self, through mindfulness, and to others, through group therapies that help people experience support rather than persecution from participants-as-proxies. But linguistic and somatic cures are not at odds; they are symbiotic. Alexithymia – or not having words for feelings – is a recognised symptom of post-traumatic stress. Despite van der Kolk’s revolutionary insistence on treatments that reconnect mind and body – yoga, meditation, or the rapidly expanding practice of Eye Movement Desensitisation and Reprocessing (EMDR) famously embraced by Britain’s Prince Harry – he never abandons the centrality of talking. Indeed, the path out of trauma “is paved with words, carefully assembled, piece by piece, until the whole story can be revealed”. It is the interpersonal nature of this psychic and physical healing – in the clinic or in the community centre – that perhaps gives the biggest lie to the idea that our “age of trauma” is solipsistic. Maybe The Body Keeps the Score is popular again not from a place of self-absorption, but because it offers a communal perspective of trauma, even if the elements of that trauma vary from person to person. Tara Westover , bestselling author of Educated (2018), calls the book the “trauma Bible”, reinforcing its status as consolatory shared text “for anyone struggling with […] well […] anything”. While Covid-19 may reinforce much of the social and racial inequality that contributes to trauma, it also represents a globally collective event on a scale unprecedented since the last world war. We are well beyond “the verge”: trauma is indelibly in the consciousness. Van der Kolk’s book is an enduring classic precisely because it grounds that consciousness, even if too exhaustively – in both the ever-evolving insights of science and the universal stories of patients facing and overcoming real and present pain. Neither the science nor the storytelling are “easy”, but they are important. Simon Westcott, co-founder of Maple Tree Counselling, is a publisher, writer and psychotherapist.