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The Body Keeps the Score

Page 55

by Bessel van der Kolk MD


  30.Similar results were reported by another group seven years later: W. C. Scott, et al., “Effects of an EEG Biofeedback Protocol on a Mixed Substance Abusing Population,” American Journal of Drug and Alcohol Abuse 31, no. 3 (2005): 455–69.

  31.D. L. Trudeau, T. M. Sokhadze, and R. L. Cannon, “Neurofeedback in Alcohol and Drug Dependency,” in Introduction to Quantitative EEG and Neurofeedback: Advanced Theory and Applications, ed. T. Budzynski, et al. Amsterdam, Elsevier, (1999) pp. 241–68; F. D. Arani, R. Rostami, and M. Nostratabadi, “Effectiveness of Neurofeedback Training as a Treatment for Opioid-Dependent Patients,” Clinical EEG and Neuroscience 41, no. 3 (2010): 170–77; F. Dehghani-Arani, R. Rostami, and H. Nadali, “Neurofeedback Training for Opiate Addiction: Improvement of Mental Health and Craving,” Applied Psychophysiology and Biofeedback, 38, no. 2 (2013): 133–41; J. Luigjes, et al., “Neuromodulation as an Intervention for Addiction: Overview and Future Prospects,” Tijdschrift voor psychiatrie 55, no. 11 (2012): 841–52.

  32.S. Othmer, “Remediating PTSD with Neurofeedback,” October 11, 2011, http://hannokirk.com/files/Remediating-PTSD_10-01-11.pdf.

  33.F. H. Duffy, “The State of EEG Biofeedback Therapy (EEG Operant Conditioning) in 2000: An Editor’s Opinion,” an editorial in Clinical Electroencephalography 31, no. 1 (2000): v–viii.

  34.Thomas R. Insel, “Faulty Circuits,” Scientific American 302, no. 4 (2010): 44-51.

  35.T. Insel, “Transforming Diagnosis,” National Insitute of Mental Health, Director’s Blog, April 29, 2013, http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml.

  36.Joshua W. Buckholtz and Andreas Meyer-Lindenberg, “Psychopathology and the Human Connectome: Toward a Transdiagnostic Model of Risk For Mental Illness,” Neuron 74, no. 4 (2012): 990–1004.

  37.F. Collins, “The Symphony Inside Your Brain,” NIH Director’s Blog, November 5, 2012, http://directorsblog.nih.gov/2012/11/05/the-symphony-inside-your-brain/.

  CHAPTER 20: FINDING YOUR VOICE: COMMUNAL RHYTHMS AND THEATER

  1.F. Butterfield, “David Mamet Lends a Hand to Homeless Vietnam Veterans,” New York Times, October 10, 1998. For more on the new shelter, see http://www.nechv.org/historyatnechv.html.

  2.P. Healy, “The Anguish of War for Today’s Soldiers, Explored by Sophocles,” New York Times, November 11, 2009. For more on Doerries’s project, see http://www.outsidethewirellc.com/projects/theater-of-war/overview.

  3.Sara Krulwich, “The Theater of War,” New York Times, November 11, 2009.

  4.W. H. McNeill, Keeping Together in Time: Dance and Drill in Human History (Cambridge, MA: Harvard University Press, 1997).

  5.Plutarch, Lives, vol. 1 (Digireads.com, 2009), 58.

  6.M. Z. Seitz, “The Singing Revolution,” New York Times, December 14, 2007.

  7.For more on Urban Improv, see http://www.urbanimprov.org/.

  8.The Trauma Center Web site, offers a full-scale downloadable curriculum for a fourth-grade Urban Improv program that can be run by teachers nationwide. http://www.traumacenter.org/initiatives/psychosocial.php.

  9.For more on the Possibility Project, see http://the-possibility-project.org/.

  10.For more on Shakespeare in the Courts, see http://www.shakespeare.org/education/for-youth/shakespeare-courts/.

  11.C. Kisiel, et al., “Evaluation of a Theater-Based Youth Violence Prevention Program for Elementary School Children,” Journal of School Violence 5, no. 2 (2006): 19–36.

  12.The Urban Improv and Trauma Center leaders were Amie Alley, PhD, Margaret Blaustein, PhD, Toby Dewey, MA, Ron Jones, Merle Perkins, Kevin Smith, Faith Soloway, Joseph Spinazzola, PhD.

  13.H. Epstein and T. Packer, The Shakespeare & Company Actor Training Experience (Lenox MA, Plunkett Lake Press, 2007); H. Epstein, Tina Packer Builds a Theater (Lenox, MA: Plunkett Lake Press, 2010).

  INDEX

  The page numbers in this index refer to the printed version of this book. To find the corresponding locations in the text of this digital version, please use the “search” function on your e-reader. Note that not all terms may be searchable.

  Page numbers in italics refer to illustrations.

  abandonment, 140, 141, 150, 179, 301, 304, 327, 340, 350

  Abilify, 37, 101, 226

  ACE (Adverse Childhood Experiences) study, 85, 144–48, 156, 347, 350–51

  acetylcholine, 266

  acupressure, 264–65, 410n–11n

  acupuncture, 231, 410n–11n

  addiction, see substance abuse

  addictive behaviors, 288–89

  see also specific behaviors

  ADHD (attention deficit hyperactivity disorder), 107, 136, 150, 310, 322

  adolescent behavior problems, child-caregiver relationship as predictor of, 160–61

  adrenaline, 46, 61, 77, 176, 225

  Aeschylus, 332

  Afghanistan War:

  deaths in, 348

  veterans of, 222–23, 229, 332

  agency, sense of, 95–98, 331, 355

  as lacking in childhood trauma survivors, 113

  Ainsworth, Mary, 115

  Ajax (Sophocles), 332

  alcoholism, 146

  alexithymia, 98–99, 247, 272–73, 291, 319

  All Quiet on the Western Front (Remarque), 171, 186

  alpha-theta training, 321, 326

  alpha waves, 314–15, 321, 326, 417n

  American Academy of Pediatrics, 348

  American College of Neuropsychopharmacology (ACNP), 29, 33

  American Counseling Association, 165, 393n

  American Journal of Psychiatry, 27, 140, 164

  American Psychiatric Association (APA):

  developmental trauma disorder diagnosis rejected by, 149, 158–59, 166

  PTSD recognized by, 19

  see also Diagnostic and Statistical Manual of Mental Disorders (DSM)

  American Psychological Association, 165, 393n

  amnesia, 179, 183

  dissociative, 190

  see also repressed memory

  amygdala, 33, 35, 42, 68–69, 301

  balance between MPFC and, 62–64

  fight/flight response and, 60–61, 61, 247, 265, 408n

  mindfulness and, 209–10

  Anda, Robert, 144, 148

  androstenedione, 163

  anesthesia awareness, 196–99

  Angell, Marcia, 374n–75n

  Angelou, Maya, 356

  animals, in trauma therapy, 80, 150–51, 213

  anorexia nervosa, 98–99

  anterior cingulate, 91, 91, 254, 376n, 387n

  Anthony (trauma survivor), 150

  anticonvulsant drugs, 225

  antidepressants, 35, 37, 136, 146, 225

  see also specific drugs

  antipsychotic drugs, 27–29, 101, 136, 224, 225–27

  children and, 37–38, 226

  PTSD and, 226–27

  see also specific drugs

  anxiety, 150

  ARC (attachment, self-regulation, competency) model, 401n

  Archimedes, 92

  arousal, 56, 107, 153, 165

  flashbacks and, 42–43, 196–97

  in infants, 84, 113, 121, 161

  memory and, 175–76

  neurofeedback and, 326

  PTSD and, 157, 326

  regulation of, 77–79, 113, 160, 161, 205–8

  sexual, 94, 108

  SNS and, 77

  soothing and, 113

  yoga and, 270

  see also threat, hypersensitivity to

  art, trauma recovery and, 242–43

  asanas, 270, 272

  Assault, The (film), 375

  athletics, 349, 355

  Ativan, 225<
br />
  attachment, 109–11, 113, 128–29, 210, 213, 318, 401n

  anxious (ambivalent), 116, 117

  avoidant, 116, 117

  as basic instinct, 115

  ongoing need for, 114–15

  resilience and, 161

  in rhesus monkeys, 153–54

  secure, 115–16, 117, 154–55

  attachment, disorganized, 117, 166, 381n

  long-term effects of, 119–21

  psychiatric and physiological problems from, 118

  socioeconomic stress and, 117–18

  trauma and, 118–19

  traumatized parents as contributors to, 118

  attachment disorder, 282

  attention deficit disorder (ADD), 151

  attention deficit hyperactivity disorder (ADHD), 107, 136, 150

  attractors, 32

  attunement, emotional, 111–14, 117, 118, 122, 161, 213, 215, 354

  lack of, dissociation and, 121–22

  in relationships, 210

  Auden, W. H., 125

  Auerhahn, Nanette C., 372n

  Auschwitz concentration camp, 195

  autobiographical self, 236

  autoimmune disease, 291–92

  Automatisme psychologique, L’ (Janet), 178

  autonomic nervous system (ANS), 60, 63–64, 77, 80, 225, 266–67

  balance (proprioceptive) system, 247

  Baltimore, Md., home-visitation program in, 167

  basal ganglia, 254

  Bastiaans, Jan, 223

  Beebe, Beatrice, 109, 118

  Beecher, Henry K., 32–33

  befriending one’s body, 96, 100–101, 206–19, 206, 273, 274–75, 354

  benzodiazepines, 225, 227

  Berger, Hans, 310

  beta waves, 314, 322, 417n

  binge eating, 120

  Bion, Wilfred, 109

  bipolar disorder, 136, 151, 226

  Blaustein, Margaret, 351, 401n

  Bleuler, Eugen, 24–25

  blood pressure, 46, 61, 66

  body:

  befriending of, 96, 100–101, 206–19, 206, 273, 274–75, 354

  islands of safety in, 245, 275

  self-awareness of, 87–102, 206, 206, 208–9, 236, 237–38, 247, 382n

  body-brain connections, 74–86, 381n

  body functions, brain stem regulation of, 56, 94–95, 266

  body therapies, 3, 26, 72, 86, 89, 207–8, 215–17, 228–29, 245

  see also specific therapies

  borderline personality disorder (BPD), childhood trauma and, 138–41

  Bowlby, John, 109–11, 114, 115, 121, 140–41, 232

  brain:

  bodily needs and, 55

  cognitive, see rational brain

  default state network (DSN) in, 90

  electrophysiology of, 310–12, 328–29

  left vs. right sides of, 44–45, 298

  midline (“Mohawk”) structures of, 90–91, 91, 376n

  old, see emotional brain

  sensory information organized by, 55, 60

  survival as basic job of, 55, 94

  trauma and changes to, 2–3, 21, 59, 347

  triune model of, 59, 64

  warning systems in, 55

  see also specific regions

  brain scans, 21

  of PTSD patients, 102, 347, 408n

  of trauma survivors, 39–47, 42, 66, 68–70, 68, 71–72, 72, 82, 99–100, 319

  brain stem (reptilian brain), 55–56, 59, 60, 63, 176

  basic body functions regulated by, 56, 94–95, 266

  freeze response generated by, 83

  self-awareness and, 93–94

  see also emotional brain

  brain waves, 321

  alpha, 315, 321, 326, 417n

  beta, 314, 322, 417n

  combat and, 324

  delta, 320

  dreaming and, 321

  theta, 321, 326, 417n

  of trauma survivors, 311–12, 311, 320

  breathing:

  ANS regulation through, 64

  in fight/flight response, 61

  HRV and, 267

  therapeutic, 72, 131, 207, 208, 245, 268–69

  in yoga (pranayama), 86, 270

  Breuer, Josef, 181–82, 194, 231, 246

  British General Staff, shell-shock diagnosis rejected by, 185

  British Psychological Society, 165

  Broca’s area, 43, 44, 45, 408n

  Brodmann’s area 19, 44

  Buchenwald concentration camp, 43

  bulimia, 34, 98–99, 286, 287

  calming and relaxation techniques, 131, 203–4

  see also breathing; mindfulness; yoga

  cancer, 267

  Cannon, Katie, 184

  caregivers:

  attunement of infants and, 111–13, 117, 118

  children’s loyalty to, 133, 386n

  children’s relationships with, as predictor of adolescent behavior, 160–61

  infants’ bonds with, 109–11, 113, 128–29

  insecure attachments with, 115–16

  as source of children’s distress, 116–17

  traumatized, and disorganized attachment in children, 118

  catatonia, 23

  Catholic Church, pedophile scandals in, 171–75, 183, 190, 191

  CBT, see cognitive behavioral therapy (CBT)

  CD45 cells, 127

  Celexa, 35, 254

  Centers for Disease Control and Prevention (CDC), 1, 144

  Chang, C.-C., 22

  Charcot, Jean-Martin, 177–78, 178, 182, 184

  Chemtob, Claude, 119

  childhood trauma survivors, 123–35, 351

  agency, sense of, as lacking in, 113

  arousal in, 161

  attachment coping styles in, 114–20

  attention and concentration problems in, 158, 166, 245–46, 328

  borderline personality disorder and, 138–41

  disorganized attachment in, 118–19, 166

  dysregulation in, 158, 161, 166

  high-risk behavior in, 120, 134, 147

  home-visitation program for, 167

  hypersensitivity to threat in, 158, 161, 310, 328

  increased risk of rape and domestic abuse in, 85, 146–47

  inhibition of curiosity in, 141, 350

  internal world maps of, 127–30

  loyalty to caregivers of, 133

  misdiagnosis of, 136–48, 150, 151, 157, 226, 282

  numbing in, 279

  rage in, 304

  relationship difficulties of, 158

  safety, sense of, as lacking in, 141, 213, 301, 317

  school problems of, 146, 158, 161

  schools as resources for, 351–56

  self-harming in, 141, 158

  self-hatred in, 158, 279

  sense of competence lacking in, 166, 350

  social engagement and, 161

  social support for, 167–68, 350

  substance abuse by, 146, 151

  suicidal behavior in, 141, 146

  temporal lobe abnormalities in, 416n

  trust as difficult for, 141, 158, 340

  see also developmental trauma disorder (DTS)

  childhood trauma survivors, of emotional abuse and neglect:

  abandonment of, 141, 304, 327, 340

  depersonalization in, 72

  numbing in, 87–89

  prevalence of, 20–21

  psychotherapy of, 296–97

  Sandy as, 97

  self-harming in, 87, 88

  self-respect lacking in, 304

  s
ense of safety lacking in, 296–97

  submissiveness in, 97, 218

  substance abuse by, 327

  suicidal behavior in, 88, 290

  trust as difficult for, 150

  childhood trauma survivors, of sexual abuse and family violence:

  dissociation in, 132–33, 162, 172, 265, 316, 329

  flashbacks of, 20, 131, 135, 172, 173

  “hallucinations” in, 25

  helplessness of, 131, 133–34, 211, 265, 289–90

  hypersensitivity to threat in, 17, 143

  of incest, see incest survivors

  incoherent sense of self in, 166

  intimacy as difficult for, 143

  isolation of, 131

  legal cases involving, 174–75, 183, 190

  Lisa as, 316–18, 325, 329

  loyalty to caregivers of, 386n

  Maggie as, 250–51

  Maria as, 300–304

  Marilyn as, 123–35, 289

  Mary as, 130, 277–78

  nightmares of, 20, 134–35

  numbing in, 124, 265–66

  obesity in, 144, 147, 266

  prevalence of, 1, 11, 20–21

  public acknowledgment of, 189

  rage in, 285

  repressed memories in, 190

  seizures in, 172, 174

  self-blame in, 131

  self-deceit in, 2, 23–24

  self-harming in, 20, 25, 141, 172, 264, 316, 317

  self-hatred in, 134, 143

  shame in, 13–14, 67, 132, 174

  substance abuse by, 327

  suicidal behavior in, 141, 147, 150–51, 286, 287, 316

  TAT test and, 106–7

  trust as difficult for, 134

  children:

  abuse of, as most costly public health issue, 148, 149–50

  antipsychotic drugs prescribed to, 37–38, 226

  attachment in, see attachment

  caregivers’ relationships with, as predictor of adolescent behavior, 160–61

  internal world maps of, 109, 127, 129

  loyalty to caregivers of, 133

  see also infants

  Children’s Clinic (MMHC), 105–9, 111, 121

  Child Sexual Abuse Accommodation Syndrome, The (Summit), 131, 136

  China, traditional medicine in, 207

  chlorpromazine (Thorazine), 22–23

  chronic fatigue syndrome, 330

  clonidine, 225

  Clozaril, 28

  cognitive behavioral therapy (CBT), 182, 230–31, 246, 292

  in treatment of PTSD, 194, 220–21

  Coleman, Kevin, 336, 342, 344

  collapse, see freeze response (immobilization)

  combat:

 

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