The Body Keeps the Score

by Bessel van der Kolk MD

  All the directors I’ve worked with agree that the secret is to go slow and engage them bit by bit. The initial challenge is simply to get participants to be more present in the room. Here’s Kevin Coleman, director of Shakespeare in the Courts, describing his work with teens when I interviewed him: “First we get them up and walking around the room. Then we start to create a balance in the space, so they’re not walking aimlessly, but become aware of other people. Gradually, with little prompts, it becomes more complex: Just walk on your toes, or on your heels, or walk backwards. Then, when you bump into someone, scream and fall down. After maybe thirty prompts, they’re out there waving their arms in the air, and we get to a full-body warm up, but it’s incremental. If you take too big a jump, you’ll see them hit the wall.

  “You have to make it safe for them to notice each other. Once their bodies are a little more free, I might use the prompt: ‘Don’t make eye contact with anyone—just look at the floor.’ Most of them are thinking: ‘Great, I’m doing that already,’ but then I say ‘Now begin to notice people as you go by, but don’t let them see you looking.’ And next: ‘Just make eye contact for a second.’ Then: ‘Now, no eye contact . . . now, contact . . . now, no contact. Now, make eye contact and hold it . . . too long. You’ll know when it’s too long because you’ll either want to start dating that person or to have a fight with them. That’s when it’s too long.’

  “They don’t make that kind of extended eye contact in their normal lives, not even with a person they’re talking to. They don’t know if that person is safe or not. So what you’re doing is making it safe for them not to disappear when they make eye contact, or when someone looks at them. Bit by bit, by bit, by bit . . .”

  Traumatized adolescents are noticeably out of sync. In the Trauma Center’s Trauma Drama program, we use mirroring exercises to help them to get in tune with one another. They move their right arm up, and their partner mirrors it; they twirl, and their partner twirls in response. They begin to observe how body movements and facial expressions change, how their own natural movements differ from those of others, and how unaccustomed movements and expressions make them feel. Mirroring loosens their preoccupation with what other people think of them and helps them attune viscerally, not cognitively, to someone else’s experience. When mirroring ends in giggles, it’s a sure indication that our participants feel safe.

  In order to become real partners, they also need to learn to trust one another. An exercise in which one person is blindfolded while his partner leads him by the hand is especially tough for our kids. It’s often as terrifying for them to be the leader, to be trusted by someone vulnerable, as it is to be blindfolded and led. At first they may last for only ten or twenty seconds, but we gradually work them up to five minutes. Afterward some of them have to go off by themselves for a while, because it is so emotionally overwhelming to feel these connections.

  The traumatized kids and veterans we work with are embarrassed to be seen, afraid to be in touch with what they are feeling, and they keep one another at arm’s length. The job of any director, like that of any therapist, is to slow things down so the actors can establish a relationship with themselves, with their bodies. Theater offers a unique way to access a full range of emotions and physical sensations that not only put them in touch with the habitual “set” of their bodies, but also let them explore alternative ways of engaging with life.

  URBAN IMPROV

  My son loved his theater group, which was run by Urban Improv (UI), a long-standing Boston arts institution. He stayed with them through high school and then volunteered to work with them the summer after his freshman year in college. It was then that he learned that UI’s violence prevention program, which has run hundreds of workshops in local schools since 1992, had received a research grant to assess its efficacy—and that they were looking for someone to head the study. Nick suggested to the directors, Kippy Dewey and Cissa Campion, that his dad would be the ideal person for the job. Luckily for me, they agreed.

  I began to visit schools with UI’s multicultural ensemble, which included a director, four professional actor-educators, and a musician. Urban Improv creates scripted skits depicting the kinds of problems that students face every day: exclusion from peer groups, jealousy, rivalry and anger, and family strife. Skits for older students also address issues like dating, STDs, homophobia, and peer violence. In a typical presentation the professional actors might portray a group of kids excluding a newcomer from a lunch table in the cafeteria. As the scene approaches a choice point—for example, the new student responds to their put-downs—the director freezes the action. A member of the class is then invited to replace one of the actors and show how he or she would feel and behave in this situation. These scenarios enable the students to observe day-to-day problems with some emotional distance while experimenting with various solutions: Will they confront the tormenters, talk to a friend, call the homeroom teacher, tell their parents what happened?

  Another volunteer is then asked to try a different approach, so that students can see how other choices might play out. Props and costumes help the participants take risks in new roles, as do the playful atmosphere and the support from the actors. In the discussion groups afterward students respond to questions like “How was this scene similar or different from what happens in your school?” “How do you get the respect that you need?” and “How do you settle your differences?” These discussions become lively exchanges as many students volunteer their thoughts and ideas.

  Our Trauma Center team evaluated this program at two grade levels in seventeen participating schools. Classrooms that participated in the UI program were compared with similar nonparticipating classrooms. At the fourth-grade level, we found a significant positive response. On standardized rating scales for aggression, cooperation, and self-control, students in the UI group showed substantially fewer fights and angry outbursts, more cooperation and self-assertion with peers, and more attentiveness and engagement in the classroom.11

  Much to our surprise, these results were not matched by the eighth graders. What had happened in the interim that affected their responses? At first we had only our personal impressions to go on. When I’d visited the fourth-grade classes, I’d been struck by their wide-eyed innocence and their eagerness to participate. The eighth graders, in contrast, were often sullen and defensive and as a group seemed to have lost their spontaneity and enthusiasm. Onset of puberty was one obvious factor for the change, but might there be others?

  When we delved further, we found that the older children had experienced more than twice as much trauma as the younger ones: Every single eighth grader in these typical American inner-city schools had witnessed serious violence. Two-thirds had observed five or more incidents, including stabbings, gunfights, killings, and domestic assaults. Our data showed that eighth graders with such high levels of exposure to violence were significantly more aggressive than students without these histories and that the program made no significant difference in their behavior.

  The Trauma Center team decided to see if we could turn this situation around with a longer and more intensive program that focused on team building and emotion-regulation exercises, using scripts that dealt directly with the kinds of violence these kids experienced. For several months members of our staff, led by Joseph Spinazzola, met weekly with the UI actors to work on script development. The actors taught our psychologists improvisation, mirroring, and precise physical attunement so they could credibly portray melting down, confronting, cowering, or collapsing. We taught the actors about trauma triggers and how to recognize and deal with trauma reenactments.12

  During the winter and spring of 2005, we tested the resulting program at a specialized day school run jointly by the Boston Public Schools and the Massachusetts Department of Correction. This was a chaotic environment in which students often shuttled back and forth between school and jail. All of them came from high-crime neighborhoods and had bee
n exposed to horrendous violence; I had never seen such an aggressive and sullen group of kids. We got a glimpse into the lives of the innumerable middle school and high school teachers who deal daily with students whose first response to new challenges is to lash out or go into defiant withdrawal.

  We were shocked to discover that, in scenes where someone was in physical danger, the students always sided with the aggressors. Because they could not tolerate any sign of weakness in themselves, they could not accept it in others. They showed nothing but contempt for potential victims, yelling things like, “Kill the bitch, she deserves it,” during a skit about dating violence.

  At first some of the professional actors wanted to give up—it was simply too painful to see how mean these kids were—but they stuck it out, and I was amazed to see how they gradually got the students to experiment, however reluctantly, with new roles. Toward the end of the program, a few students were even volunteering for parts that involved showing vulnerability or fear. When they received their certificate of completion, several shyly gave the actors drawings to express their appreciation. I detected a few tears, possibly even in myself.

  Our attempt to make Trauma Drama a regular part of the eighth-grade curriculum in the Boston public schools unfortunately ran into a wall of bureaucratic resistance. Nonetheless, it lives on as an integral part of the residential treatment programs at the Justice Resource Institute, while music, theater, art, and sports—timeless ways of fostering competence and collective bonding—continue to disappear from our schools.

  THE POSSIBILITY PROJECT

  In Paul Griffin’s New York City Possibility Project the actors are not presented with prepared scripts. Instead, over a nine-month period they meet for three hours a week, write their own full-length musical, and perform it for several hundred people. During its twenty-year history the Possibility Project has accrued a stable staff and strong traditions. Each production team is made up of recent graduates who, with the help of professional actors, dancers, and musicians, organize scriptwriting, scenic design, choreography, and rehearsals for the incoming class. These recent grads are powerful role models. As Paul told me: “When they come into the program, students believe they cannot make a difference; putting a program like this together is a transforming experience for their future.”

  In 2010 Paul started a new program specifically for foster-care youth. This is a troubled population: Five years after maturing out of care, some 60 percent will have been convicted of a crime, 75 percent will be on public assistance, and only 6 percent will have completed even a community college degree.

  The Trauma Center treats many foster care kids, but Griffin gave me a new way to see their lives: “Understanding foster care is like learning about a foreign country. If you’re not from there, you don’t speak the language. Life is upside down for foster-care youth.” The security and love that other children take for granted they have to create for themselves. When Griffin says, “Life is upside down,” he means that if you treat kids in foster care with love or generosity, they often don’t know what to make of it or how to respond. Rudeness feels more familiar; cynicism they understand.

  As Griffin points out, “Abandonment makes it impossible to trust, and kids who have gone through foster care understand abandonment. You can have no impact until they trust you.” Foster-care children often answer to multiple people in charge. If they want to switch schools, for example, they have to deal with foster parents, school officials, the foster-care agency, and sometimes a judge. This tends to make them politically savvy, and they learn all too well how to play people.

  In the foster-care world, “permanency” is a big buzzword. The motto is “One caring adult—that’s all you need.” However, it is natural for teenagers to pull away from adults, and Griffin remarks that the best form of permanency for teens is a steady group of friends—which the program is designed to provide. Another foster-care buzzword is “independence,” which Paul counters with “interdependence.” “We’re all interdependent,” he points out. “The idea that we’re asking our young people to go out in the world completely alone and call themselves independent is crazy. We need to teach them how to be interdependent, which means teaching them how to have relationships.”

  Paul found that foster-care youth are natural actors. Playing tragic characters, you have to express emotions and create a reality that comes from a place of depth and sorrow and hurt. Young people in foster care? That’s all they know. It’s life and death every day for them. Over time, collaboration helps the kids become important people in one another’s lives. Phase one of the program is group building. The first rehearsal establishes basic agreements: responsibility, accountability, respect; yes to expressions of affection, no to sexual contact in the group. They then begin singing and moving together, which gets them in sync.

  Now comes phase two: sharing life stories. They are now listening to one another, discovering shared experiences, breaking through the loneliness and isolation of trauma. Paul gave me a film that shows how this happened in one group. When the kids are first asked to say or do something to introduce themselves, they freeze, their faces expressionless, their eyes cast down, doing anything they can to become invisible.

  As they begin to talk, as they discover a voice in which they themselves are central, they also begin to create their own show. Paul makes it clear the production depends on their input: “If you could write a musical or play, what would you put in it? Punishment? Revenge? Betrayal? Loss? This is your show to write.” Everything they say is written down, and some of them start to put their own words on paper. As a script emerges, the production team incorporates the students’ precise words into the songs and dialogue. The group will learn that if they can embody their experiences well enough, other people will listen. They will learn to feel what they feel and know what they know.

  The focus changes naturally as rehearsals begin. The foster kids’ history of pain, alienation, and fear is no longer central, and the emphasis shifts to “How can I become the best actor, singer, dancer, choreographer, or lighting and set designer I can possibly be?” Being able to perform becomes the critical issue: Competence is the best defense against the helplessness of trauma.

  This is, of course, true for all of us. When the job goes bad, when a cherished project fails, when someone you count on leaves you or dies, there are few things as helpful as moving your muscles and doing something that demands focused attention. Inner-city schools and psychiatric programs often lose sight of this. They want the kids to behave “normally”—without building the competencies that will make them feel normal.

  Theater programs also teach cause and effect. A foster kid’s life is completely unpredictable. Anything can happen without notice: being triggered and having a meltdown; seeing a parent arrested or killed; being moved from one home to another; getting yelled at for things that got you approval in your last placement. In a theatrical production they see the consequences of their decisions and actions laid out directly before their eyes. “If you want to give them a sense of control, you have to give them power over their destiny rather than intervene on their behalf,” Paul explains. “You cannot help, fix, or save the young people you are working with. What you can do is work side by side with them, help them to understand their vision, and realize it with them. By doing that you give them back control. We’re healing trauma without anyone ever mentioning the word.”

  SENTENCED TO SHAKESPEARE

  For the teenagers attending sessions of Shakespeare in the Courts, there is no improvisation, no building scripts around their own lives. They are all “adjudicated offenders” found guilty of fighting, drinking, stealing, and property crimes, and a Berkshire County Juvenile Court judge has sentenced them to six weeks, four afternoons a week, of intensive acting study. Shakespeare is a foreign country for these actors. As Kevin Coleman told me, when they first turn up—angry, suspicious, and in shock—they’re convinced that they’d
rather go to jail. Instead they’re going to learn the lines of Hamlet, or Mark Antony, or Henry V and then go onstage in a condensed performance of an entire Shakespeare play before an audience of family, friends, and representatives of the juvenile justice system.

  With no words to express the effects of their capricious upbringing, these adolescents act out their emotions with violence. Shakespeare calls for sword fighting, which, like other martial arts, gives them an opportunity to practice contained aggression and expressions of physical power. The emphasis is on keeping everyone safe. The kids love swordplay, but to keep one another safe they have to negotiate and use language.

  Shakespeare was writing at a time of transition, when the world was moving from primarily oral to written communication—when most people were still signing their name with an X. These kids are facing their own period of transition; many are barely articulate, and some struggle to read at all. If they rely on four-letter words, it’s not only to show they’re tough but because they have no other language to communicate who they are or what they feel. When they discover the richness and the potential of language, they often have a visceral experience of joy.

  The actors first investigate what, exactly, Shakespeare is saying, line by line. The director feeds the words one by one into the actors’ ears, and they are instructed to say the line on the outgoing breath. At the beginning of the process, many of these kids can barely get a line out. Progress is slow, as each actor slowly internalizes the words. The words gain depth and resonance as the voice changes in response to their associations. The idea is to inspire the actors to sense their reactions to the words—and so to discover the character. Rather than “I have to remember my lines,” the emphasis is on “What do these words mean to me? What effect do I have on my fellow actors? And what happens to me when I hear their lines?”13