Trauma Is Not a Memory: Insights from Dr. Bessel van der Kolk
On Healing, the Body, and Connection
Introduction
In a compelling interview, Dr. Bessel van der Kolk—one of the most influential psychiatrists of our time—shares his insights on trauma and its lasting effects on body, brain, and mind. His work, expressed most powerfully in the bestseller The Body Keeps the Score, has transformed the way the world understands psychological distress and trauma. Rather than viewing trauma as a mental problem, he emphasizes that it is above all a bodily and relational wound—a disruption in the way we experience ourselves and others.
The interview—with the populist title “The Body Trauma Expert: This Eye Movement Trick Can Fix Your Trauma! The Body Keeps the Score!”—runs for two hours. It was well worth watching, and I have written this summary article about it—though it has grown rather long—with a link to the interview at the bottom.
Trauma Is Not a Memory, But a Reliving
One of Van der Kolk’s most striking claims is that trauma does not unfold only in the mind but literally becomes lodged in the body. It is not a bad memory but an experience that is relived over and over again as if it is happening in the here and now. This is visible in brain scans: when people re-experience a traumatic event, the rational part of the brain shuts down while the emotional networks become overactive. The sense of time dissolves. What factually belongs to the past feels as though it is happening now.
This also explains why talking about trauma does not always help. “Trauma is a speechless terror,” says Van der Kolk. “You cannot reason people out of their pain, because in that moment their brain is not functioning rationally.” This makes traditional approaches like cognitive behavioral therapy often insufficient. They focus on ‘correcting’ thought patterns, while trauma disrupts the neurological structures that lie far beneath conscious thought.
The Impact of Early Childhood
In his clinical practice, Van der Kolk sees time and again how devastating childhood trauma can be—and how common it is. Around 90% of his patients struggle with the consequences of a difficult childhood. But trauma need not always have been visible or violent. The deepest scars often arise from neglect, belittlement, or the feeling of being unwanted. Children who are consistently made to feel they are not relevant develop a fundamental sense of unsafety. “You become how you are seen,” he says. “If no one really sees you, you essentially do not exist.”
It is precisely these so-called ‘small-t ’traumas’—critical remarks, subtle rejections, emotional absence—that embed themselves deep within identity. Children often draw the conclusion that something is wrong with themselves because their environment has taught them this implicitly or explicitly. That self-image travels with them into adulthood. So these ‘small-t traumas’ are not so small after all…
The Body as Gateway to Healing
Because trauma affects the body so fundamentally, Van der Kolk has advocated for body-oriented therapies for decades. Qigong, dance, massage, and theatre—these are not alternative whims, he argues, but direct pathways to help the body rediscover itself as a safe place. Many people with trauma have (unconsciously) left their body because feeling was too painful. Recovery begins with daring to be present again in one’s own body.
EMDR
EMDR (Eye Movement Desensitization and Reprocessing) has also proven remarkably effective. By combining the reliving of a trauma with back-and-forth eye movements, the brain is enabled to recognize the experience as ‘past’ rather than ‘present.’ Van der Kolk calls EMDR his “gateway drug” into the world of effective treatments—a first step that taught him trauma can indeed be transformed, provided you work at the right level. In the interview he gives a brief demonstration with the host.
What Happens in the Brain During EMDR?
During an EMDR session, a person consciously brings a traumatic memory to mind, including the images, feelings, sounds, and physical sensations associated with it. At the same time, the eyes follow a rhythmically moving object—often the therapist’s fingers or a light—from left to right. This bilateral stimulation activates brain pathways that are not normally active simultaneously.
Van der Kolk explains that these eye movements likely activate certain networks between the temporoparietal junction (the area where we locate our ‘self’ in time and space) and the insula (the center of bodily awareness). This enables the brain to stop experiencing the memory as ‘present’ and to classify it as something that happened in the past.
“Your brain is able to say, ‘Oh, this is what happened to me, but that happened in the past.”
This is essential: trauma is not a memory but a re-living. In the moment of traumatic activation, the brain makes no distinction between then and now. EMDR appears to help restore this distinction by literally moving the brain across the midline—from left to right hemisphere.
Van der Kolk’s own research confirmed the effectiveness: in 78% of adults with single-incident trauma (such as assault or a car accident), EMDR led to complete symptom relief. Complex childhood traumas are more stubborn, but even there EMDR can be a powerful tool, provided it is embedded within a broader, safe therapeutic relationship.
The Body Knows the Way to Healing
That the body and movement are central to trauma recovery became even clearer to Van der Kolk during a visit to China in the 1990s. The country was just emerging from the Cultural Revolution—a period of suppression, violence, and collective silence. In conversations with residents, he was struck by how little people openly spoke about what had happened. Regarding the Tiananmen protest, for example, people simply said, “That never happened.”
And yet he saw something different in the public parks: hundreds of people practicing Tai Chi and qigong together each morning. Slow, flowing movements. Body and breath in a rhythm. No words. No explanations. But something is working deeply on the nervous system.
For Van der Kolk, this was a revelation. “This is how they survive,” he thought. Where the West focuses on talking, analyzing, and taking medication, he discovered a different gateway to recovery: regulation through rhythm, movement, and synchronization. Not through the head, but through the body. Not alone, but together.
It set him thinking about how different cultures cope with pain and dysregulation. In the West, we invest in ‘understanding’—in ’talking about trauma. But what if you have no words for it? What if language disappears, as it does for so many people with deep trauma? Then the body—in movement, in repetition, in rhythm—can open a new path.
Since then he has argued ever more explicitly for recovery through physical processes. Not as a replacement for, but in collaboration with, more conventional approaches. Whether yoga, qigong, dance, breathwork, or martial arts, the path to yourself runs through your body. And often through another person as well.
How Trauma Changes Perception Itself
During his work with traumatized war veterans, Van der Kolk began to explore how trauma affects not only feelings and behavior but literally alters the way people perceive reality. One of the most revealing discoveries came through the use of the classic Rorschach test—the well-known inkblots that invite people to describe what they see.
What Van der Kolk and his team discovered was that traumatized people consistently saw different images than non-traumatized individuals. Where some recognized abstract shapes or animals, war veterans saw blood, mutilated bodies, or violence. Women with a history of sexual abuse saw torn bodies or threatening figures. What was identical on paper was interpreted in entirely different ways internally.
These observations confirmed something Van der Kolk had long suspected: we do not all live in the same reality. Trauma essentially programs a different ‘filter’ into the brain—a lens through which the world is constantly scanned for danger, loss, or betrayal. Even when nothing appears to be wrong, the body remains in a heightened state of readiness. “We all live in different worlds,” he says, “shaped by what we have previously experienced, often without our awareness.”
This insight has far-reaching implications for therapy. It means that healing begins not with persuasion, but with restructuring the sensory and emotional foundations of a person’s reality. Only when the body learns it is safe can the brain begin to rewrite its story.
What Trauma Does to the Brain
Van der Kolk’s work is distinguished in part by its focus on the neurobiological traces of trauma. Using brain scans, he demonstrates that traumatic memories are not merely ‘stories we recall’ but deeply ingrained physical responses in specific brain regions. When someone relives a traumatic experience, the brain responds in a characteristic way.
It begins at the most primitive core: the periaqueductal gray, deep in the brainstem—what Van der Kolk calls the “cockroach center” of our brain. This area, once danger is perceived, directly activates the body in a reflexive fight, flight, or freeze response. In people with trauma, this alarm continues to sound faintly, even without direct cause. The result is a constant state of tense vigilance, as if something is always threatening1.
Above this sits the amygdala, the brain’s ‘smoke detector.’ At traumatic triggers—a smell, a sound, a glance—this area reacts with lightning speed. It recognizes threat patterns based on past experience, often before the rest of the brain has time to think logically. In traumatized people the amygdala is frequently overactive, causing even harmless situations to feel threatening.
At the same time, the prefrontal cortex—the rational brain—is deactivated. This region, particularly the dorsolateral prefrontal cortex, is responsible for overview, sense of time, self-reflection, and the ability to contextualize. When this area ‘goes offline,’ the awareness that something belongs to the past disappears. What remains is the immediate, overwhelming experience as if the trauma is happening again right now.
Another crucial player is the insula, the brain region that links body and feeling. It is through the insula that we feel what we feel: heartbeat, tension, breathing, and goosebumps. In people with trauma, this connection is often disrupted. Some can barely feel their body at all—as if it has been ‘switched off’—while others are hypersensitive to every internal sensation. In both cases the relationship with one’s own body is fundamentally dysregulated.
What all this makes clear is that trauma is not a psychological weakness but a state of being—above all, a state of the brain. You are not ‘emotionally unstable’ or ‘oversensitive’—your brain has adapted to unsafety. And that also points the direction for recovery: if the brain has adapted, it can also learn to attune itself again—provided you find the right entry points and involve the body.
Psychedelics: A New Revolution
Recently Van der Kolk has also turned his attention to psychedelic therapy, including treatments with MDMA, ketamine, and psilocybin. The results from clinical studies are astonishing: people with chronic PTSD, who had previously derived no benefit from conventional therapies over many years, experience profound breakthroughs. Not only do symptoms diminish, but people rediscover compassion for themselves, feel reconnected with their body and surroundings, and can finally recognize the past as past.
Van der Kolk himself underwent an MDMA session as part of his research. To his own surprise, not pleasure or euphoria arose, but deep grief—a confrontation with the thousands of traumas he had heard as a clinician over the years. “I became a sadder but also wiser person,” he says. This underscores for him how essential the right setting is: safety, guidance, and human presence make the difference between healing and retraumatization.
Healing Requires Community
At least as important as therapy is connection with others. According to Van der Kolk, isolation is one of the most destructive factors in trauma-related conditions. People heal in relationships—through shared experiences, rhythm, and synchronicity. Sport, theatre, music, and dance: these are, in his view, age-old forms of collective regulation that are at risk of disappearing in our modern, digital society. Yet it is precisely there that recovery begins.
He describes how young people in criminal gangs often seek precisely that sense of belonging—the “band of brothers” they never had at home. Or how soldiers, through marching, singing, and training together, restructure themselves into a functioning unit. It is not the talking that heals them, but moving together, existing together.
Attachment: You Become Who Sees You
According to Van der Kolk, psychological well-being does not begin with reason or behavior, but with relationship—from the very first moments of life. He emphasizes that secure attachment to a caring parent or caregiver literally forms the blueprint for how a child experiences itself, others, and the world.
“You become how people see you,” he says. That sounds simple, but the implication is profound. When a child is consistently seen as valuable, loved, and welcome, it grows up with the sense that it is worthwhile. But when it encounters unpredictability, emotional distance, or rejection, that experience becomes a fundamental part of the personality. “If no one truly sees you, you essentially do not exist.”
He gives the example that children do not consciously ask themselves whether they are safe—they become safety, or they become fear. When a mother says, “You are too difficult; that’s why your father started drinking,” that is not merely a hurtful remark but a message that becomes lodged in body and self-image. Subtler forms of misrecognition—a parent who persistently tells the child it is ‘overreacting’ or ‘shouldn’t feel that ’way’—can also have deep consequences. The child then learns not to understand itself but to distrust itself.
Secure attachment does not mean parents are perfect. It means, above all, that there is consistency, availability, affection, and repair when something goes wrong. That a child knows, “When I am frightened, someone comes. When I fall, I am picked up. When I am confused, I am not shamed but understood.” That is the soil in which resilience grows.
Van der Kolk draws an important social conclusion from this. In a culture where parents often stand alone, where childcare and schools are under pressure, and where connection is giving way to screen time, children sometimes lose the mirroring that helps them construct a sense of self. Attachment is not a luxury, he argues, but a neurobiological necessity.
And just as with trauma, so too here: it is never too late to restore connection. People can still learn to experience themselves—and others—as safe. But it requires attention, a body, and a relationship.
From Burden to Baggage
Van der Kolk also points to an important paradox: although early wounds can leave deep scars, they can also become a source of strength. Those who have had to survive at a young age sometimes develop their own ways of overcoming obstacles. “It is often the people who have had to endure something,” he says, “who later come up with solutions others would never even consider.” Early struggle can kindle creativity and problem-solving capacity—not despite, but precisely because of the necessity to adapt.
Yet this is not available to everyone. Much depends on the environment, the possibilities for recovery, and the support network that happens to be present. For every success story of a ‘resilient survivor,’ there are countless others who have become quietly stuck. Van der Kolk therefore emphasizes that we must be careful about labeling trauma too positively: it can shape people but also break them—and usually does both at once.
How Do You Avoid Traumatizing Your Children?
On the question of how parents can protect their children from trauma, Van der Kolk is clear: make sure you do not do it alone. Children are not only harmed by abuse or mistreatment but also by emotional isolation, unpredictability, and the lack of safe co-regulation. And parents—however well-intentioned—inevitably carry their pain and patterns with them. Parents raising children alone, therefore, risk burdening their child with their own unconscious wounds simply because there is no other perspective in the household.
His advice is therefore radically simple: build a network. Ensure your child has multiple adults around them who are available, calm, and engaged—so that the child learns that safety is not accidental but reproducible. That father is sometimes strict, but grandmother is gentle. That the neighbor is patient when mother is stressed. In this way a child learns: my world is larger than one person’s mood. And I am safe, even when someone else temporarily is not.
Ultimately, says Van der Kolk, raising a non-traumatized child is not about doing everything perfectly but about being present, predictable, and attuned. And about letting the child feel: if you are overwhelmed, someone will come who stays.
Van der Kolk shares a particularly personal moment that moves him to this day. During a visit from his parents, his three-year-old daughter asserted herself at home in the way that is perfectly natural for a toddler. His mother reacted with irritation and said he should discipline her. He immediately felt that reflex rise—the impulse to intervene, to correct her, to repeat the patterns of his childhood. He had even risen to walk towards his daughter when suddenly the realization struck him: “I am about to become like my parents were.”
At that moment he consciously chose differently. He turned to his mother and said, “No, she can go to the bathroom.” For him this was a liberating moment—not only a choice in favor of his daughter but also a release from unconscious loyalty to his parents. It was, as he says, the first time he truly felt ownership of his parenthood and of himself.
Yet he also calls this a painful moment. Because breaking patterns often means leaving one’s ‘tribe’—the group one belonged to, even if it caused harm. “We want to belong somewhere,” he says, “that is deeply human. But when you truly change, you leave something behind. And that can be lonely.” It is a theme he frequently sees in patients: the desire for healing often collides with the implicit fear of being cast out. “You leave your tribe,” he says. “And then you must learn to find a new one.”
In therapy—or in parenting—it is therefore not only about healing but also about choosing: who do I want to be when I am no longer driven by fear, guilt, or old reflexes?
Both Agitated and Numb
One of the most confusing and exhausting consequences of trauma is what Van der Kolk describes as “being agitated and numbed out at the same time.” You feel driven, irritable, and alert—as if something is constantly wrong—and at the same time you are inwardly numb, empty, or shut down. Your body is taut with tension, but you feel nothing that provides direction. Van der Kolk calls this a characteristic state in people with a traumatized nervous system: the body is in a state of threat, while the feeling system has partially shut itself down to avoid being flooded. You can barely tolerate anything, yet at the same time you feel dull and far removed from yourself.
That paradoxical field of tension—hypersensitivity and numbness in one—makes life unpredictable and difficult to navigate. You do not know whether you are going to explode or collapse. It also makes it so difficult for the outside world to understand what is going on: you appear ‘flat’ or ‘disinterested,’ while inwardly you are flooded. Van der Kolk emphasizes that this state is not a character flaw but a neurological defense strategy of the body. And that from it—slowly, through safety, rhythm, and body work—one can emerge.
Mirror Neurons and Co-Regulation: How We Influence Each Other’s Nervous Systems
During the conversation, Van der Kolk points to the existence of mirror neurons—brain cells that become active when we see someone else do, feel, or undergo something. These neurons cause us to resonate with the other person, even when we ourselves are doing nothing. They form the neurological basis for empathy, attunement, and intuitive understanding. “We pick up each other’s energy,” says Van der Kolk, “often without noticing.”
This aligns seamlessly with the polyvagal theory of professor of psychiatry and neuroscientist Stephen Porges, in which the concept of co-regulation is central. According to this theory, our autonomic nervous system is not only attuned to internal signals (such as breathing or heart rate) but is constantly scanning the environment for social signals: voice intonation, facial expression, rhythm, and proximity. When we feel safe with another person—because their voice is calm, their face soft, and their breathing quiet—our own nervous system calms in turn.
In other words, we regulate each other. Not through words, but through eye contact, body language, voice, and rhythm. Van der Kolk and Porges describe, each in their own way, the same thing: that trauma is not a purely individual problem and that recovery rarely takes place in isolation. You cannot ‘talk yourself out of hyperarousal,’ but another person can—by being present, attuned, and safe—help your system to come to rest.
This is why Van der Kolk advocates for therapeutic approaches in which not only talking occurs, but where rhythm, proximity, and bodily attunement also have a place: from psychodrama to dance, from qigong or yoga to shared breathing. The body only learns to feel safe in the proximity of another body that radiates safety.
What Screens Take From Us
Precisely in light of these deeply relational processes, Van der Kolk is concerned about the advance of screen culture. Instead of bodily proximity, shared rhythms, and sensory attunement, we are spending ever more time in virtual worlds. Screens provide information, but not regulation. They offer stimulation, but not safety. “You get a small dopamine spike,” he says, “but you do not learn how to truly connect—with yourself or with others.”
The result is a society in which people increasingly live alone, fragmented, and disconnected from their bodies. Even young children grow up with less physical touch, fewer live facial expressions, and fewer shared rituals. In doing so they lose something fundamental: the capacity to attune their inner world to another. And that, warns Van der Kolk, makes us more vulnerable than ever to dysregulation, stress, and loneliness2.
Love as a Neurological Experience
For Van der Kolk, love is not a poetic side note to life—it clearly has a neurological foundation. “Love,” he says, “does not reside only in words, but in glances, touches, rhythms—in the subtle coordination of two nervous systems learning to trust each other. Someone says, I am here for you. And your body believes it.”
In his work with war veterans, he saw how deep, life-saving bonds can form under the most terrible circumstances. “Combat taught me more about male love than anything else,” he says. Real love arises where people protect, mirror, and carry one another—especially when it is difficult. Not the absence of danger makes love possible, but the experience that someone stays with you when you are afraid.
This is why healing is never a purely individual journey. We are wounded in relation to others—and we heal in relation too. Whoever is seen lovingly, touched, or held can gradually learn that the world may not, after all, be only unsafe. And that the body—in which the pain had lodged itself so tenaciously—can also become a place of homecoming.
The Culture of Loneliness
Beneath everything Van der Kolk says—about brains, attachment, rhythm, love, and recovery—lies a simmering warning: we live in a world that is slowly unraveling us from one another. A world in which screens replace faces, voices are filtered through earbuds, and physical proximity is increasingly experienced as uncomfortable. “The average American,” he cites, “now has zero people they can turn to in a crisis. Twenty years ago that number was three.”
It is as if society is being increasingly organized around autonomy, self-reliance, and productivity—but not around connection. And so we become ever more efficient, but also ever lonelier. We seek safety in information, distraction in pixels, and recognition in algorithms—but our bodies continue to long for something else: rhythm, touch, proximity, and togetherness.
Three Steps Toward Healing According to Bessel van der Kolk
Rather than beginning with a diagnosis or problem description, Van der Kolk starts his treatments with a simple but deeply personal question: “Tell me who you are.”
This question forms the beginning of a three-part approach he sketches in the interview3:
Self-inquiry: Who are you? What works? What blocks? Therapy begins with curiosity, not labels. Van der Kolk wants to know who someone is, what gives them energy, what gets stuck, what has helped before, and what has not. Not “How ill are you?” but “What does your inner world look like?” This first phase revolves around meaning-making, self-knowledge, and building a respectful therapeutic relationship.
Bodily regulation: first calm the nervous system. Only when the body feels safe is there space for processing. Many people with trauma are constantly flooded or numbed, or both at once. Van der Kolk uses techniques such as yoga, neurofeedback, breathwork, massage, or EMDR to help stabilize the nervous system. “If you are overwhelmed, don’t start with talking,” he says, “but with moving, feeling, and regulating.”
Processing the core experience: gently touching the trauma. Only once sufficient safety is established is the core experience itself approached. This can occur through EMDR, psychedelic therapy, psychodrama, or other experiential methods. The memory is relived, but this time from the here and now, in a controlled, guided context in which the brain learns to feel the difference between then and now. Central is not digging in the past but reprogramming the senses and the nervous system.
“That was then. And now it is safe.”
Trauma Is Never One Story
Gabor Maté, another prominent voice in the trauma field, argues that ADHD, addiction, and many forms of psychological suffering can very often be traced back to early childhood trauma or stress. Van der Kolk recognizes himself partly in this view but also emphasizes that reality is more complex. Not everything is trauma—and not everyone develops difficulties from the same origin.
“Almost all traumatized children meet the criteria for ADHD,” he says, “but that does not mean everyone with ADHD necessarily has a trauma.” He points to multiple causes: genetics, neurodiversity, environmental factors, and toxins during pregnancy—all can contribute. Psychological symptoms are, in his view, often the tip of the iceberg; what lies beneath varies from person to person.
The nuance he introduces is essential: it is not about imposing trauma as the explanation but about remaining curious with each person about the story beneath the symptoms—whether that is trauma, temperament, or chance. Healing does not begin with a label, but with listening.
A System That Falls Short
Van der Kolk makes no bones about it: the current psychiatric diagnostic system—as codified in the DSM (Diagnostic and Statistical Manual of Mental Disorders)—falls seriously short. “It totally sucks,” he says bluntly. Not because psychological distress is not real, but because the system categorizes symptoms without looking at the context from which they arise. Whether someone is anxious, withdrawn, aggressive, or addicted—the DSM does not ask, “What happened to you?”
According to Van der Kolk, this leads to treatments that focus on managing behavior rather than understanding causes. And this suits a society more interested in productivity than in healing. Instead of helping people recover, their suffering is medically translated into ‘disorders’—often ’with an accompanying prescription, but without genuine contact.
“The focus is not on healing, but on keeping the system running.”
What he proposes is no simple alternative, but a radically different approach: listening, slowing down, and looking at the whole story—body, brain, relationships, and history. Not: What is wrong with you? But what happened to you?
No Scientific Foundation
According to Van der Kolk, most psychiatric diagnoses are not based on hard science but on consensus agreements between experts—often reached in meeting rooms, not in laboratories. There is little to no biological grounding, and most categories are superficial descriptions of behavior, not of causes.
“They’re just very primitive ways of categorizing the human mind.”
An exception, in his view, is PTSD (post-traumatic stress disorder), which does have brain scans, neurobiological patterns, and clinical research as its foundation. Not coincidentally, Van der Kolk himself was involved in introducing PTSD into the DSM in the 1980s. But even there he sees limitations: PTSD focuses primarily on single-incident trauma (such as accidents or violence), while early childhood, relational trauma—which leaves deep traces in the brain and in attachment patterns—is barely recognized within official diagnostics.
In short, the system gives names but no insight. It describes symptoms but does not ask about the origin. For Van der Kolk, this is unacceptable. Psychological pain deserves more than a label—it deserves a context, a story, a human being.
A Message of Hope
Despite the weight of the subject, Van der Kolk is emphatically hopeful. “Everything that has been disrupted can be set in motion again.” Trauma is persistent, yes—but not unchangeable. The key lies in taking bodily and relational processes seriously, in daring to experiment with new forms of therapy, and in cherishing genuine connection.
His message is clear: we must stop treating people as symptoms and learn again to listen to their story—with heart, mind, and body.
That movement is not a straight line. It requires time, attention, and proximity—and sometimes new forms of therapy that do not proceed only through language but through touch, rhythm, breath, and space. And above all, it requires something that costs nothing but has become rare: genuine presence. People who stay. People who look without judgment. People who say, I see you. I am not going anywhere; I will stay with you.
Based on the interview with Dr. Bessel van der Kolk, The Diary of a CEO, March 2025.
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In the interview, Van der Kolk uses this term literally when explaining the function of the PAG in relation to threat and survival responses:
“There’s one part of your brain that I call the cockroach center of your brain—the periaqueductal gray—that lights up itself underneath...”
The PAG is one of the oldest parts of the nervous system in evolutionary terms and is also found in more primitive animal species such as fish. It governs the most basic survival responses: freezing, going rigid, fainting, or collapsing in the face of acute danger.
However, insects have no brainstem, no aqueduct of Sylvius, and no PAG. Van der Kolk’s expression is best understood as a metaphor: just as a cockroach vanishes under the refrigerator the instant a light comes on, the human equivalent switches with lightning speed and pure instinct into survival mode—without any involvement of thinking, feeling, or reflection. The PAG in humans is thus the animal brain in its most elemental form, oriented toward survival rather than meaning-making. In people with trauma, this ancient defense mode often remains chronically activated, giving rise to inexplicable fear, physical tension, or emotional numbing.
I would like to add a personal note here: sometimes a person’s nervous system is so sensitive or easily dysregulated—something that Saskia Ebus and I at terugnaarhetmidden.nl pay a great deal of attention to—that the value of the weekly online sessions we offer there is deeply felt by participants. They too experience healing and regulating qualities in this work.
The following is what is usually meant by Van der Kolk’s three pillars of trauma processing—though in this particular interview he uses different pillars.
Top-down approach: understanding and meaning-making
This is the classic psychological route: through language, insight, and reflection, you try to gain a foothold on what you have experienced. Think of talking therapies, cognitive therapy, reconstructing your life story, finding words for the unspeakable. But, Van der Kolk warns, with deep trauma this approach often falls short. “Trauma is a speechless story,” he says. “When you are in your trauma, language disappears from your brain.” Yet meaning-making remains an important element of recovery—but only once the body feels safe again.Bottom-up approach: re-learning to regulate the body
Because trauma lives primarily in the body, the body is also the gateway to healing. Yoga, qigong, breathwork, movement, touch, theatre, dance, EMDR, and neurofeedback—these are all forms of embodied therapy that help the nervous system to calm and reset. This approach is crucial, according to Van der Kolk, because the nervous system must first come to rest before the brain can reflect. “You cannot think your way out of trauma,” he says, “but you can move your way through it.”Social connection: restoring safety in relationship
The third pillar is equally important: co-regulation and connection. Trauma often arises in relationships—through misrecognition, neglect, or violence—and healing also takes place in relationships. This may be a therapeutic relationship, but it can equally be friendship, touch, making music together, a sports team, or a dance group. Van der Kolk emphasizes repeatedly how important it is to experience, “When I am confused, someone stays. When I am afraid, someone looks me in the eye.” Without relational safety, the nervous system remains on high alert. With connection, rhythm, and proximity, it can learn once more to attune itself.