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Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society
This volume presents the current state of research and clinical knowledge on traumatic stress and its treatment. With contributions from the leading authorities, the book summarizes the knowledge that has emerged since the acceptance of PTSD as a defined entity in 1980. It also addresses the uncertainties and controversies that confront the field of traumatic stress, including the complexity of posttraumatic adaptations and the unproven effectiveness of some approaches to prevention and treatment.
Throughout the book, contributors demonstrate that rather than a normal response to an extraordinary situation, PTSD leads to a profound disorganization of the capacity to properly attend to subsequent stresses and to distinguish relevant from irrelevant stimuli. Highlighting the controversies and uncertainties that punctuate the study of trauma--including issues of memory, dissociation, and the interface between culture and trauma and the inextricable relationships between biological and psychological processes--this book examines how effective treatment interventions require a firm understanding of the basic processes involved at various stages in the development of PTSD.
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First published January 1, 1996
63 people are currently reading
3907 people want to read
About the author
Bessel van der Kolk
44 books2,959 followersBessel van der Kolk MD spends his career studying how children and adults adapt to traumatic experiences, and has translated emerging findings from neuroscience and attachment research to develop and study a range of treatments for traumatic stress in children and adults.
In 1984, he set up one of the first clinical/research centers in the US dedicated to study and treatment of traumatic stress in civilian populations, which has trained numerous researchers and clinicians specializing in the study and treatment of traumatic stress, and which has been continually funded to research the impact of traumatic stress and effective treatment interventions. He did the first studies on the effects of SSRIs on PTSD; was a member of the first neuroimaging team to investigate how trauma changes brain processes, and did the first research linking BPD and deliberate self-injury to trauma and neglect in early childhood.
In 1984, he set up one of the first clinical/research centers in the US dedicated to study and treatment of traumatic stress in civilian populations, which has trained numerous researchers and clinicians specializing in the study and treatment of traumatic stress, and which has been continually funded to research the impact of traumatic stress and effective treatment interventions. He did the first studies on the effects of SSRIs on PTSD; was a member of the first neuroimaging team to investigate how trauma changes brain processes, and did the first research linking BPD and deliberate self-injury to trauma and neglect in early childhood.
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Displaying 1 - 26 of 26 reviews
August 15, 2023
OMG
FUH KANG GREATNESSES 👍
Top notch compendium of essays by some really smart people on the topic of PTSD.
Most notably Bessel A. von der Kolk (BVK) who absolutely deserves the huge respect and immense praise he invariably garners.
He’s a lord.
Even though the book was originally written in the 1990’s. It’s still VERRY useful and relevant today.
It’s great to hear the psychodynamic perspectives.
It’s useful and interesting to learn about some of the previous permutations of the diagnostic criteria from previous editions of the DSM (e.g. 3 and 4).
It’s fascinating to hear about the various debates, politics and trends that effected the evolution of the diagnosis and treatment of PTSD.
The writing and research are spectacular throughout.
God.
I wanted to re-read it as soon as I finished it. But it’s like 700 pages so...umm...I’m not actually going to do that. But the mere fact that I even consider it speaks volumes.
That being said. It will make an awesome reference text and I’m very stoked to have it in my arsenal.
GREAT BOOK!
FUH KANG GREATNESSES 👍
Top notch compendium of essays by some really smart people on the topic of PTSD.
Most notably Bessel A. von der Kolk (BVK) who absolutely deserves the huge respect and immense praise he invariably garners.
He’s a lord.
Even though the book was originally written in the 1990’s. It’s still VERRY useful and relevant today.
It’s great to hear the psychodynamic perspectives.
It’s useful and interesting to learn about some of the previous permutations of the diagnostic criteria from previous editions of the DSM (e.g. 3 and 4).
It’s fascinating to hear about the various debates, politics and trends that effected the evolution of the diagnosis and treatment of PTSD.
The writing and research are spectacular throughout.
God.
I wanted to re-read it as soon as I finished it. But it’s like 700 pages so...umm...I’m not actually going to do that. But the mere fact that I even consider it speaks volumes.
That being said. It will make an awesome reference text and I’m very stoked to have it in my arsenal.
GREAT BOOK!
February 28, 2010
The dedication on one of the first pages says: "This book is dedicated to Nelson Mandela and all of those who, after having been hurt, work on transforming the trauma of others, rather than seeking oblivion or revenge." Great dedication of a great resource for anyone interested in knowing about the impact of traumatic experiences on people.
August 8, 2013
I heard van der Kolk on "On Being". He is a sensitive capable scientist and this book sums up all of the research on Post Traumatic Stress. It is very dense and detailed, yet very understandable and would be a great resource for both the suffer and the practitioner.
Listen to him here:http://www.onbeing.org/program/restor...
Listen to him here:http://www.onbeing.org/program/restor...
August 14, 2014
This is a superb book for learning more about how people respond to stress. Two chapters should be required reading: The Black Hole of Trauma and The Body Keeps the Score. The authors manage to present information about the interaction of trauma, individual characteristics, and cultural influences in an manner that is both easy to read and compelling.
January 3, 2024
I picked up this book, as someone who suffers from PTSD. It was interesting, and had me journaling some things that came up, and connect some dots. I’m glad people are researching and writing about this.
August 19, 2023
this is a LOT of information & a great resource for all things ptsd.
August 20, 2018
Like a Monsters of Rock Festival, this is the Demons of My Head Tour De Force by three of the most capable names in the field. Heavy, heavy, heavy stuff - if you are affected by trauma, a clinician or perhaps both; intriguing science for those that are curious. The authors transcend the ordinary dryness of a massive volume like this and integrate the biology, physiology, psychology, sociology, philosophy, mythology, politics, ethnology and biases of trauma with the clinician perspective mixed with a clinicians wisdom to give us a broader understanding of the field. Unfortunately, the field grows daily and we try to tend, weed and nurture as necessary with the authors providing some custodianship and direction.
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January 4, 2009I know I read this but honestly can't remember much about it--could be my medication. No. I attributed this book to Lars Van der Kolk who actually did write it but I think this is either the translator or an alias. The is absolutely the best book currently out there on Post Traumatic Stress. It is multi-disciplinary and not biased. An excellent resource
January 24, 2018
An excellent text. Admittedly, I read the first edition many years back, so can’t comment on how up to date it is now. It looks like the most recent edition is 2006, so it’s probably worth catching up on developments since then.
August 4, 2014
very research based and informative. useful for practice.
December 8, 2014
Van Der Kolk is the man when it comes to this topic. Like another review noted, he is a very thoughtful scientist.
October 27, 2016
An outstanding compendium of essays by top researchers in the field of psychological trauma.
October 7, 2017
An excellent read.
November 24, 2018
very heavy clinical reading, not for the casual reader in the slightest.
June 3, 2019
An excellent reference and summary of research.
Want to read
February 12, 2020COCC
April 6, 2023
This is an excellent, albeit academic, book on trauma. Having a lived experience with trauma and working with students experiencing trauma, I found this book to be very educational and a little encouraging.
Thoughts I'm still mulling over:
Ch 1
-Freud thought the aim of such repetition is to gain mastery, but clinical experience shows this rarely happens and more often it causes further suffering for the victim and those around them - in this reenactment of the trauma, the victim may play the role of victimizer or victim
- Revictimization - women abused as children are more likely to be abused as adults
Ch 2
-After suffering heart attacks, men with good social supports and good internal locusts of control did much better than men who had neither, but men who had good social supports and poor internal locusts of control did worse than those with poor social supports and a solid internal locust of control - social support in the absence of an internal locust of control may in fact impair healing processes - trauma decreases internal locusts of control
Ch 12
-Co-occurrence of several interlocking pathogenic processes - 1. An alteration of neurobiological processes affecting stimulus discrimination expressed as increased arousal and decreased attention 2.acquisition of conditioned fear responses to trauma-related stimuli 3. Altered cognitive schemata and social apprehension
-When people feel threatened, they experience a narrowing of consciousness and remain focussed on only the central details - sometimes leading to a complete amnesia
-the long-term potentiation of memory stimuluses - how strongly a memory is laid down according to the strength of the hormonal stimulation - this capacity helps organisms evaluate the importance of sensory input in proportion to how strongly the associated memory traces are laid down - emotionally significant material laid down in states of high arousal is accessed more easily in subsequent states of high arousal- traumatized individuals access the memory too easily, even when it is irrelevant to current experience
-traumatized individuals revert to irrelevant emergency behaviors in response to minor stressors
Ch 13
-traumatized individuals are more sensitive to sounds than normal subjects - trouble differentiating between relevant and irrelevant stimuli - attended less to emotionally neutral, but existentially relevant events and required more effort to respond to ordinary experience - inattention prevents them from enjoying the here and now and interferes with building specific skills and feelings of mastery - difficulty knowing what they feel also gets in the way of resolving the trauma itself
Ch 18
-those with ptsd experience internal world as a danger zone with trauma-related thoughts and feelings - spend energy on not thinking and planning - avoidance of emotional triggers diminishes the importance of current reality and increases attachment to the past
-unable to integrate traumatic memories - lost capacity to assimilate new experiences - personality stopped at a certain point - revert to earlier modes of cognitive processing of information when faced with new stresses
Ch 24
-her most precious possession: her autonomy and right to have her views heard and respected - this (having her voice ignored in personal crisis) was the centerpiece of her reaction, not her near death experience - her fear of having her voice taken away came back with anniversaries, but not her more expected fear of losing her life
Ch 25
-”Victim to patient process” - stage 1: consider yourself sick stage 2: make the decision to enter treatment and assume the patient role - accept and acknowledge distress as highly unpleasant and something that can be helped – even in cases where distress dominates daily life, disrupts relationships, and interferes with capacity to tend to what needs to be done, victims are likely to put up with it as long as they see their distress as a natural reaction to an abnormal situation - the setting also plays a role in whether people will tolerate their suffering. In wars and disasters, threshold for suffring is especially high. Complaint tends to be less restrained with more individual accidents, particularly if financial compensation is involved. To complain is a threat to oneself and to others. It sets an individual apart from those who are undamaged and it can undermine a person’s sense of self-control. Becoming a complainer reinforces feelings of sick and damaged. Stage two involves acknowledgement of inability to resolve problem alone and needs help - whether distress and despair outweighs the fear of being misunderstood, humiliated, or re-traumatized.
-Direct therapeutic exposure (model mugging/re-imagining) - exposure to feared conditions in contexts with social bonding and some degree of personal control
Conclusion
-when people are put in touch with memories of their own trauma, they’re likely to stop engaging in its repetition
Thoughts I'm still mulling over:
Ch 1
-Freud thought the aim of such repetition is to gain mastery, but clinical experience shows this rarely happens and more often it causes further suffering for the victim and those around them - in this reenactment of the trauma, the victim may play the role of victimizer or victim
- Revictimization - women abused as children are more likely to be abused as adults
Ch 2
-After suffering heart attacks, men with good social supports and good internal locusts of control did much better than men who had neither, but men who had good social supports and poor internal locusts of control did worse than those with poor social supports and a solid internal locust of control - social support in the absence of an internal locust of control may in fact impair healing processes - trauma decreases internal locusts of control
Ch 12
-Co-occurrence of several interlocking pathogenic processes - 1. An alteration of neurobiological processes affecting stimulus discrimination expressed as increased arousal and decreased attention 2.acquisition of conditioned fear responses to trauma-related stimuli 3. Altered cognitive schemata and social apprehension
-When people feel threatened, they experience a narrowing of consciousness and remain focussed on only the central details - sometimes leading to a complete amnesia
-the long-term potentiation of memory stimuluses - how strongly a memory is laid down according to the strength of the hormonal stimulation - this capacity helps organisms evaluate the importance of sensory input in proportion to how strongly the associated memory traces are laid down - emotionally significant material laid down in states of high arousal is accessed more easily in subsequent states of high arousal- traumatized individuals access the memory too easily, even when it is irrelevant to current experience
-traumatized individuals revert to irrelevant emergency behaviors in response to minor stressors
Ch 13
-traumatized individuals are more sensitive to sounds than normal subjects - trouble differentiating between relevant and irrelevant stimuli - attended less to emotionally neutral, but existentially relevant events and required more effort to respond to ordinary experience - inattention prevents them from enjoying the here and now and interferes with building specific skills and feelings of mastery - difficulty knowing what they feel also gets in the way of resolving the trauma itself
Ch 18
-those with ptsd experience internal world as a danger zone with trauma-related thoughts and feelings - spend energy on not thinking and planning - avoidance of emotional triggers diminishes the importance of current reality and increases attachment to the past
-unable to integrate traumatic memories - lost capacity to assimilate new experiences - personality stopped at a certain point - revert to earlier modes of cognitive processing of information when faced with new stresses
Ch 24
-her most precious possession: her autonomy and right to have her views heard and respected - this (having her voice ignored in personal crisis) was the centerpiece of her reaction, not her near death experience - her fear of having her voice taken away came back with anniversaries, but not her more expected fear of losing her life
Ch 25
-”Victim to patient process” - stage 1: consider yourself sick stage 2: make the decision to enter treatment and assume the patient role - accept and acknowledge distress as highly unpleasant and something that can be helped – even in cases where distress dominates daily life, disrupts relationships, and interferes with capacity to tend to what needs to be done, victims are likely to put up with it as long as they see their distress as a natural reaction to an abnormal situation - the setting also plays a role in whether people will tolerate their suffering. In wars and disasters, threshold for suffring is especially high. Complaint tends to be less restrained with more individual accidents, particularly if financial compensation is involved. To complain is a threat to oneself and to others. It sets an individual apart from those who are undamaged and it can undermine a person’s sense of self-control. Becoming a complainer reinforces feelings of sick and damaged. Stage two involves acknowledgement of inability to resolve problem alone and needs help - whether distress and despair outweighs the fear of being misunderstood, humiliated, or re-traumatized.
-Direct therapeutic exposure (model mugging/re-imagining) - exposure to feared conditions in contexts with social bonding and some degree of personal control
Conclusion
-when people are put in touch with memories of their own trauma, they’re likely to stop engaging in its repetition
November 7, 2024
Seriously useful textbook for understanding the physiological effects of traumatic stress.
Particularly liked this table:
I. Psychophysiological effects
A. Extreme autonomic responses to stimuli reminiscent of the trauma
B. 1--Iyperarousal to intense but neutral stimuli (loss of stimulus discrimination)
1. Non habituation of the acoustic startle response
2. Response below threshold to sound intensities
3. Reduced electrical pattern in cortical event-related potentials
II. Neurohormonal effects
A. Norepinephrine (NE), other catecholamines
1. Elevated urinary catecholamines
2. Increased plasma NE metabolite response to yohimbine
3. Down-regulation of adrenergic receptors
B. Glucocorticoids
1. Decreased resting glucocorticoid levels
2. Decreased glucoconicoid 1·esponse to stress
3. Down-regulation of glucocorticoid receptors
4. Hyperresponsive nes to low-dose dexamethasone
C. Serotonin
1. Decreased serotonin activity in traumatized animals
2. Best pharmacological responses to serotonin uptake inhibitors
D. Endogenous opioids
1. Increased opioid response to stimuli reminiscent of trauma
2. Condition ability of stress-induced analgesia
E. Various hormones: Memory effects
l. NE, vasopressin: Consolidation of traumatic memories
2. Oxytocin, endogenous opioids: Amnesias
Ill. Neuroanatomical effects
A. Decreased hippocampal volume
B. Activation of amygdala and connected structures during flash backs
C. Activation of sensory areas during flash backs
D. Decreased activation of Brocas area during flashbacks
E. Marked right-hemispheric lateralization
IV. Immunological effects
A. Increased CD45 RO/RA ratio (
Particularly liked this table:
I. Psychophysiological effects
A. Extreme autonomic responses to stimuli reminiscent of the trauma
B. 1--Iyperarousal to intense but neutral stimuli (loss of stimulus discrimination)
1. Non habituation of the acoustic startle response
2. Response below threshold to sound intensities
3. Reduced electrical pattern in cortical event-related potentials
II. Neurohormonal effects
A. Norepinephrine (NE), other catecholamines
1. Elevated urinary catecholamines
2. Increased plasma NE metabolite response to yohimbine
3. Down-regulation of adrenergic receptors
B. Glucocorticoids
1. Decreased resting glucocorticoid levels
2. Decreased glucoconicoid 1·esponse to stress
3. Down-regulation of glucocorticoid receptors
4. Hyperresponsive nes to low-dose dexamethasone
C. Serotonin
1. Decreased serotonin activity in traumatized animals
2. Best pharmacological responses to serotonin uptake inhibitors
D. Endogenous opioids
1. Increased opioid response to stimuli reminiscent of trauma
2. Condition ability of stress-induced analgesia
E. Various hormones: Memory effects
l. NE, vasopressin: Consolidation of traumatic memories
2. Oxytocin, endogenous opioids: Amnesias
Ill. Neuroanatomical effects
A. Decreased hippocampal volume
B. Activation of amygdala and connected structures during flash backs
C. Activation of sensory areas during flash backs
D. Decreased activation of Brocas area during flashbacks
E. Marked right-hemispheric lateralization
IV. Immunological effects
A. Increased CD45 RO/RA ratio (
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July 31, 2023Traumatic experiences have the capacity to change us at a genetic level. We can be so burdened by our traumas that we’re unable to appreciate the gift of the present. Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society is a journey into what trauma is, how it impacts us, and what we can do about it. One of the editors, Bessel van Der Kolk, is the author of The Body Keeps the Score and a friend of Gabor Mate, who wrote The Myth of Normal. In short, it’s edited by people with huge respect in the trauma space.
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May 6, 2020
A thorough and technical book that does not overwhelm.
April 3, 2022
Great author who is a true content expert.
This particular book is out of date and not a useful tool in regards to more recent research.
Recommend his more current books
This particular book is out of date and not a useful tool in regards to more recent research.
Recommend his more current books
June 7, 2022
If you've read The Body Keeps the Score, this earlier work focuses on PTSD and at times feels like a precursor to the later book.
October 24, 2024
3.5 stars. Lots went over my head as too technical and had to skip some cases/examples as too traumatic but I still got a lot from it. Audiobook.
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October 29, 2024A highly helpful and valuable book that provides various perspectives on strategies applicable during both the analysis and treatment phases of patient care.
January 29, 2025
Palasīju enciklopēdiju, lai pārliecinātos, ka esmu uz “pareizā” ceļa. Enciklopēdija kā jau enciklopēdija - laba :)
January 4, 2015
Unparalleled reading and attention to the subject.
Displaying 1 - 26 of 26 reviews