Dr. Bessel van der Kolk, Psychiatry Research
Dr. Bessel van der Kolk, PTSD / Trauma Research
Dr. Bessel van der Kolk and the Neurobiology of Trauma: A Paradigm Shift in Mental Health
Introduction
"Dr. Bessel van der Kolk is a globally renowned psychiatrist and researcher who has significantly influenced the field of trauma treatment. With a career spanning over four decades, his work has focused on understanding how trauma reshapes both the body and the brain, and how these changes manifest in psychological symptoms. His best-selling book The Body Keeps the Score (2014) synthesized decades of research and clinical experience, offering a compelling new perspective on how trauma is stored somatically and cognitively. This report explores van der Kolk’s contributions to trauma theory, his criticisms of conventional psychiatric approaches, and his advocacy for body-based therapies that have transformed trauma recovery.
The Origins of Trauma Research
Bessel van der Kolk began his trauma-focused work in the late 1970s at the Veterans Administration, where he treated Vietnam War veterans suffering from what would eventually be called post-traumatic stress disorder (PTSD). In the early stages of his career, van der Kolk noticed that trauma symptoms went far beyond the conventional psychiatric frameworks. Patients experienced recurring nightmares, emotional numbing, flashbacks, and somatic symptoms that traditional talk therapies and pharmacological treatments struggled to alleviate (van der Kolk, 2014).
At the time, the DSM-III (1980) was only beginning to conceptualize PTSD. Van der Kolk’s early studies helped validate trauma as a neurobiological condition with specific effects on memory, emotion regulation, and perception (van der Kolk, 1989). His groundbreaking neuroimaging research demonstrated how traumatic experiences could alter brain regions such as the amygdala, prefrontal cortex, and hippocampus, disrupting the brain’s ability to accurately process threat, safety, and emotion (Rauch et al., 1996).
The Body Keeps the Score: Trauma and the Mind-Body Connection
Published in 2014, The Body Keeps the Score presented a revolutionary synthesis of neuroscience, clinical practice, and narrative case studies to argue that trauma is fundamentally a mind-body disorder. Van der Kolk (2014) posits that trauma fragments consciousness, disconnects individuals from their physical bodies, and alters core neurobiological functions involved in memory, attention, and emotion regulation.
One of the key insights of the book is the role of the autonomic nervous system in trauma. Survivors often become stuck in states of hyperarousal (fight-or-flight) or hypoarousal (freeze or collapse), resulting in chronic dysregulation of bodily systems. These physiological states explain many trauma symptoms, from chronic pain to emotional numbing, and show why trauma recovery must go beyond cognitive processing (Porges, 2011; van der Kolk, 2014).
Van der Kolk challenges the dominance of pharmaceutical and purely cognitive approaches to trauma treatment. He asserts that medications like SSRIs may suppress symptoms temporarily but do not address the root physiological and relational disconnection caused by trauma. His work has therefore emphasized integrative therapies that include movement, touch, breath, and emotional safety as essential elements of healing.
Trauma and the Brain
Van der Kolk’s neurobiological research revealed several key findings:
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The Amygdala: Often hyperactive in trauma survivors, the amygdala continuously scans for danger and triggers the fight-flight response. This hypervigilance can cause exaggerated startle responses, anxiety, and intrusive memories (Shin et al., 2006).
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The Hippocampus: This region helps contextualize memories. In trauma survivors, hippocampal volume can shrink, impairing the ability to differentiate between past and present, leading to flashbacks and disorganized memory (Bremner et al., 1995).
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The Prefrontal Cortex: Responsible for executive functioning and emotional regulation, this area often shows reduced activity in PTSD, explaining difficulties in impulse control and emotional self-regulation (van der Kolk, 2014).
Through brain scans and clinical trials, van der Kolk and colleagues demonstrated that trauma leads to a disintegration of the brain’s coordinated response to stimuli, requiring therapeutic approaches that target neural reintegration rather than just thought modification.
Somatic Approaches to Trauma Treatment
Van der Kolk’s clinical advocacy focuses on somatic and experiential therapies that help individuals regain a sense of safety in their bodies. These include:
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Somatic Experiencing (SE): Developed by Peter Levine, SE emphasizes completing the body’s natural stress response cycle by releasing stored energy through bodily sensations. Van der Kolk has praised SE as a gentle, effective way to discharge trauma without re-traumatizing patients (Levine, 1997).
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Yoga and Movement Therapy: One of the most researched body-based interventions endorsed by van der Kolk, yoga has been shown to reduce PTSD symptoms by increasing bodily awareness and calming the autonomic nervous system (van der Kolk et al., 2014).
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Eye Movement Desensitization and Reprocessing (EMDR): Van der Kolk has supported EMDR for its ability to facilitate memory reconsolidation without requiring the patient to verbally relive traumatic events. EMDR’s use of bilateral stimulation helps integrate traumatic memories within a broader cognitive and emotional context (Shapiro, 2001).
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Neurofeedback: In recent years, van der Kolk has explored the use of neurofeedback, a technique that trains individuals to self-regulate brain wave patterns. Early studies have shown promise in using neurofeedback to restore regulatory control in trauma-affected brains (van der Kolk et al., 2016).
Critique of Traditional Psychiatry
Van der Kolk is a vocal critic of the overreliance on psychiatric medication and DSM-based diagnostic models. He argues that many trauma survivors are misdiagnosed with depression, bipolar disorder, or borderline personality disorder, when their core issues stem from developmental or complex trauma (van der Kolk, 2005).
He has also advocated for the inclusion of Developmental Trauma Disorder (DTD) in diagnostic manuals—a condition characterized by chronic emotional neglect, attachment disruption, and prolonged exposure to adversity in childhood. Despite accumulating evidence, the proposal for DTD has yet to be formally adopted by the DSM, which van der Kolk sees as a failure to recognize the systemic roots of trauma (van der Kolk, 2005).
Legacy and Influence
Dr. van der Kolk’s work has redefined how trauma is understood and treated in modern psychiatry and psychology. He has brought attention to the limitations of talk therapy and the importance of integrating the body into healing. His advocacy has led to increased funding and research into alternative modalities, the development of trauma-sensitive yoga programs, and the growth of trauma-informed care in schools, healthcare, and justice systems.
Today, van der Kolk serves as the founder and medical director of the Trauma Research Foundation, where he continues to educate clinicians and the public on the latest innovations in trauma therapy. His work remains a cornerstone of trauma-informed mental health practice around the world.
Conclusion
Dr. Bessel van der Kolk has profoundly reshaped the field of trauma therapy by illuminating the deep interconnection between body, brain, and emotion. His pioneering research and clinical work demonstrate that trauma is not merely a psychological wound but a neurobiological disruption that affects the whole self. Through The Body Keeps the Score and decades of advocacy, van der Kolk has empowered both professionals and survivors to understand trauma not as a life sentence, but as a treatable condition that requires holistic, embodied, and compassionate care. His legacy continues to guide a paradigm shift toward healing that honors both science and the lived experience of survivors." (Source: ChatGPT 2025)
References
Bremner, J. D., Randall, P., Vermetten, E., Staib, L., Bronen, R. A., Mazure, C., ... & Charney, D. S. (1995). MRI-based measurement of hippocampal volume in patients with combat-related posttraumatic stress disorder. The American Journal of Psychiatry, 152(7), 973–981. https://doi.org/10.1176/ajp.152.7.973
Levine, P. A. (1997). Waking the tiger: Healing trauma. North Atlantic Books.
Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W. W. Norton & Company.
Rauch, S. L., van der Kolk, B. A., Fisler, R. E., Alpert, N. M., Orr, S. P., Savage, C. R., ... & Pitman, R. K. (1996). A symptom provocation study of posttraumatic stress disorder using positron emission tomography and script-driven imagery. Archives of General Psychiatry, 53(5), 380–387. https://doi.org/10.1001/archpsyc.1996.01830050014003
Shapiro, F. (2001). Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures (2nd ed.). Guilford Press.
Shin, L. M., Rauch, S. L., & Pitman, R. K. (2006). Amygdala, medial prefrontal cortex, and hippocampal function in PTSD. Annals of the New York Academy of Sciences, 1071(1), 67–79. https://doi.org/10.1196/annals.1364.007
van der Kolk, B. A. (1989). The compulsion to repeat the trauma: Re-enactment, revictimization, and masochism. Psychiatric Clinics of North America, 12(2), 389–411.
van der Kolk, B. A. (2005). Developmental trauma disorder: Toward a rational diagnosis for children with complex trauma histories. Psychiatric Annals, 35(5), 401–408.
van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.
van der Kolk, B. A., Hodgdon, H., Gapen, M., Musicaro, R., Suvak, M., Hamlin, E., ... & Spinazzola, J. (2016). A randomized controlled study of neurofeedback for chronic PTSD. PLOS ONE, 11(12), e0166752. https://doi.org/10.1371/journal.pone.0166752
van der Kolk, B. A., Stone, L., West, J., Rhodes, A., Emerson, D., Suvak, M., & Spinazzola, J. (2014). Yoga as an adjunctive treatment for posttraumatic stress disorder: A randomized controlled trial. Journal of Clinical Psychiatry, 75(6), e559–e565. https://doi.org/10.4088/JCP.13m08561
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