Postcard Rex: The Body Keeps the Score

On sickness and health

Hi, all.

Health memoirs can be useful. They provide reassurance that we are not alone in our experience, and that actually, very few of us are unique enough to be so. That spark of understanding is a shining relief from the loneliness of illness.

I’ve been gifted a few health memoirs, more and less pointedly, over the years. And I have found them helpful, especially in the early, overwhelming days when having someone else put language to chaos was beyond welcome. But I also have issues with them, chiefly because I don’t believe in the simplistic narrative of triumph that so many tout. Health status is complicated and ongoing, which I get to say as someone who is defined as a “survivor,” “in remission,” and “in recovery” in relation to different diseases. I have reveled in the feeling of victory, but I also know that winning and losing are applicable to individual battles, not to health itself. Real life tends to fuck up the ‘hero’s journey’ or ‘happily ever after’ narrative arc: iatrogenic problems arrive; trauma can still deliver a startling slap decades later. Age happens. So I am not exactly triumphant, but I am, happily, alive.

There are moments when I am grateful for the simple miracle of breathing, for my body functioning in harmony without breakdown or malignancy or pain. I am grateful for the research and treatment and care that have enabled me to exist in this state. And there are moments I forget about my scars and limitations, caught up in the everyday tasks of living instead of the fundamentals of surviving. The body and emotions adapt; the lessons of suffering wear off. Illness may be life-changing and perspective-altering, but getting a ‘new lease on life’ is, as the idiom suggests, a temporary state. At this stage, I’m more interested in learning from the complexity and ambiguity that follows. I want the stories of how we move between the states of illness and health, and how we live with the long-term impact of surviving.

The Body Keeps the Score, Bessel van der Kolk

Have you ever read a book that perfectly explained to you why you are how you are? No, me neither. But this accessible text about the psychology of trauma definitely answered a few outstanding questions. There are aspects of the author’s language that I found outdated—particularly around gender and sexuality—but the core concepts in this book are worthwhile for any human, regardless of what you yourself have experienced (more on that later). One idea that stuck with me is that what makes something traumatic is not the event itself, but the way your body and brain encode the memory of it. “History is written on the body” is a phrase I have returned to many times over the years. But that doesn’t mean it’s inscribed the same way on us all.

In The Body Keeps the Score, Dr. van der Kolk explains the neuroscience of trauma as well as the development of PTSD as a diagnosis. The lucid scientific explanations are further illuminated with case stories and anecdotes for those who are not as enthused about brain scans and descriptions of hormone secretions. He finishes with a balanced exploration of treatment modalities, from psychotherapy to EMDR to holistic practices that incorporate yoga, movement, art, and meditation. Dr. van der Kolk is also refreshingly honest about many of his own mistakes, biases, and discoveries as he developed his practice—an admirable reminder that science is not a fixed set of principles but a field of constant learning.

Much of the patient focus is on veterans of combat and survivors of childhood and sexual abuse, and these stories are not a light or easy read. But the instinct to shy away from heaviness speaks to the broader senses of shame and silence around trauma. Dr. van der Kolk quotes an early researcher speaking about about World War I and shell shock: “We have made ‘unspeakable’ mean indescribable: it really means nasty.” Much of the time, pain is not unspeakable so much as unpalatable. Each of these stories shows that while silence may spare us discomfort in the short term, it ultimately exacerbates the problem.

Per Dr. van der Kolk (and Tolstoy), each trauma survivor is resilient in their own way. But the mechanisms developed to cope take their toll. Some strategies manifest poorly, at their root they make sense: they were learned in a context where they helped someone survive. There is always a reason behind our reactions—we are trying to find a way back to safety.

For a long time, I avoided using the word ‘trauma’ because I felt like it should belong to people who had experienced, you know, real trauma. It took reading this book to understand that trauma is a spectrum, and though traumatic events differ wildly, human reactions to them are uncannily similar. The language we use to describe our experiences matters; by naming something accurately, we can face up to it in the way the situation demands. And by not ignoring or dismissing these reactions, trauma can be healed. Recovery is not a process of re-becoming who we were before. Rather, it’s convalescing into a new state: stronger in some places, more vulnerable in others.

I’ve been using “stay well” as a sign-off throughout the pandemic, because being well is a big aspiration when forces in the world are conspiring to make us sick (not just in relation to viruses but also capitalist degradation, climate emissions, etc. etc.). I’m hopeful that the pandemic has taught a few more people to value their health and others’, and to not take any aspect of it for granted. I learned very young how the body can betray; I’ve learned over time how it remembers. The trauma of COVID is being coded now in ways that we may not recognize for years; it will be written on all of our bodies, ill and well. We can’t control that process, but we can recognize the truth of what’s happening and do what we can to heal.

If you like it

If you prefer an individual story to a macro perspective, try the heartbreaking but clear-eyed When Breath Becomes Air by neurosurgeon Paul Kalanithi. More than a cancer memoir, it’s an incisive meditation on mortality and healthcare.

If you don’t

If you prefer illness to remain in the fictional realm (and I don’t blame you), try Debra Levy’s Hot Milk. A mother and daughter grapple with the mother’s mysterious illness and the tension between caregiving and independence as they consult a specialist in Spain. It’s been a few years since I picked this up but I remember it as heady, escapist, and dream-like.

Recommended books on

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