Case Study 37.2: Bessel van der Kolk and the Body's Memory — The Research

Overview

When Bessel van der Kolk began his career as a psychiatrist in the 1970s, the dominant model of trauma treatment was straightforward: help the patient talk about the traumatic event, process the emotions associated with it, and develop an understanding of how it had affected them. Once understood and integrated into a coherent narrative, the trauma would lose its grip. Talk would heal.

What van der Kolk and his colleagues found, across four decades of clinical work and research, complicated this model profoundly. Trauma, the research increasingly demonstrated, was not primarily stored in explicit memory or verbal narrative. It was stored in the body itself — in patterns of physiological arousal, in somatic tensions, in the nervous system's conditioned responses. And if it was stored in the body, then talking about it might not reach it. Something more than talk might be required.

This case study examines van der Kolk's core research findings, the therapeutic modalities that followed from them, and their implications for conflict practitioners working with individuals whose conflict patterns carry a trauma dimension.

The Core Research: Trauma and Somatic Storage

Brain Imaging Studies

One of van der Kolk's most significant contributions was the use of neuroimaging to study what happens in the brains of trauma survivors when they recall their traumatic experiences. Using PET scans and later fMRI, his research team could observe brain activity during trauma recall.

The findings were striking. When trauma survivors were asked to recall their traumatic events:

• Broca's area (the region responsible for putting feelings into words, for verbal expression) went dark — became inactive. The brain was, literally, unable to put the experience into language.
• The amygdala (the alarm center) activated strongly, as if the threat were current.
• The right hemisphere activated preferentially over the left — producing vivid, sensory, emotional experience rather than the more sequential, linguistic processing characteristic of left-hemisphere dominance.

The implication was radical: trauma was not primarily stored as a story that could be told. It was stored as sensory experience — images, sounds, physical sensations, emotional states — that bypassed the verbal processing systems the brain normally uses to organize and categorize experience. When trauma was activated, the person was not remembering the past event; they were, in some neurological sense, experiencing it again, in the right hemisphere, without the organizing influence of language and narrative that would locate it in the past.

This finding directly explains why trauma survivors often struggle to answer the apparently simple question "What happened?" — and why they may become reactivated when asked to describe their experiences. The experience is not organized in language. It is organized in the body and in sensation. Asking for a verbal narrative requires the person to access a part of their brain that trauma has, temporarily at least, disconnected from the experience itself.

The Stress Hormone Research

Van der Kolk's research on the stress hormone systems of trauma survivors revealed a second critical finding: the stress response systems of traumatized individuals are dysregulated in ways that persist long after the original trauma.

In non-traumatized individuals, the stress response — cortisol release, sympathetic nervous system activation — rises in response to threat and returns to baseline when the threat passes. The system is adaptive: it mobilizes in danger and recovers in safety.

In traumatized individuals, this recovery is disrupted. Cortisol levels may remain chronically elevated. The sympathetic nervous system may remain in a state of lower-level activation even in objectively safe environments. The nervous system has not received the all-clear. It continues organizing behavior around a threat that has passed.

For conflict practitioners, this finding is significant. It explains why a traumatized person may enter a conflict conversation already partially activated — already at an elevated physiological baseline — before a single word has been spoken. The "overreaction" to what appears to be a minor conflict may be occurring on top of a chronic background of physiological readiness that the practitioner doesn't see.

The Reliving Phenomenon

Perhaps the most clinically significant research was van der Kolk's documentation of what he called "reliving" — the phenomenon by which trauma survivors experience traumatic memories not as memories but as current experiences.

The research documented that when trauma survivors are triggered — whether by a smell, a sound, a visual stimulus, a social situation, or any other element associated with the original trauma — their bodies respond as if the trauma were happening now. Heart rate accelerates to the rates observed during the original event. Blood pressure rises. Musculature tenses. The defensive responses that were appropriate to the original threat activate in the present context.

This is not metaphorical. It is neurological. The body is not "remembering" to be afraid; it is afraid, now, in the present, because the nervous system cannot distinguish between the stored pattern and the current activation.

This finding has direct implications for conflict. A person whose conflict behavior is shaped by trauma may appear, in the conflict, to be responding to something much larger than what is in the room. Because they are: they are responding partly to the present and partly — sometimes primarily — to the past. The present conflict has activated the stored one.

The Insufficiency of Purely Cognitive Approaches

Van der Kolk's research led him to a conclusion that was initially controversial in the psychiatric community: top-down, cognitive approaches to trauma are often insufficient on their own.

Cognitive approaches — helping the person understand what happened, develop a narrative about it, identify the distorted beliefs that resulted — work at the level of the prefrontal cortex and explicit memory. They can be highly effective for the cognitive dimensions of trauma: the distorted beliefs, the narrative gaps, the meaning-making.

But they do not directly address the somatic dimensions: the stored physiological patterns, the nervous system's conditioned responses, the body's ongoing readiness for a threat that has passed.

Van der Kolk's formulation — "the body keeps the score" — means that the body is where the tally is held. And if the cognitive treatment doesn't reach the body, the tally remains.

This does not mean cognitive approaches are useless; it means they are insufficient alone for many presentations of trauma. The research points toward integrative approaches that address both the cognitive/narrative dimensions and the somatic/physiological ones.

What Trauma-Informed Therapy Modalities Address

EMDR

Francine Shapiro developed Eye Movement Desensitization and Reprocessing in the late 1980s, initially by accident — she noticed that side-to-side eye movements seemed to reduce the distress associated with traumatic memories. The method was subsequently formalized, studied, and is now among the most evidence-supported trauma treatments available.

EMDR engages bilateral stimulation (eye movements, alternating taps, or auditory tones) while the client holds a traumatic memory in mind. The proposed mechanism involves disrupting the link between the stored traumatic memory and its associated physiological response — allowing more complete processing that places the memory in the past rather than the present.

What EMDR addresses that talk therapy alone often cannot: the reactivation component. After successful EMDR, clients report that the traumatic memory no longer "pulls them in" in the same way. They can recall the event without being transported into the physiological experience of it. The memory is still there; it no longer relives itself.

For conflict practitioners, the implication is significant: a person who has undergone successful EMDR for a trauma that has been shaping their conflict behavior may find their trigger responses substantially reduced — not because they have better communication skills but because the wound has been, to significant degree, processed.

Somatic Experiencing

Peter Levine developed Somatic Experiencing from observations of how animals process threat responses in the wild. A gazelle chased by a lion, if it escapes, undergoes a visible shaking response — a full-body trembling — that discharges the activated survival energy. The animal then returns to grazing. It does not develop PTSD.

Levine's observation: humans often interrupt this discharge process. We freeze in the moment of overwhelming threat, and then the threat passes before the freeze can complete its natural cycle. The survival energy that was mobilized — and never discharged — remains stored in the body, organized as a readiness for a threat that has passed.

Somatic Experiencing works with what Levine calls the "felt sense" — the subjective, bodily experience of a state — to gently titrate into the edges of the stored trauma response and allow the discharge that was interrupted to complete. The work is done in small increments (titration is central to the approach), tracking the nervous system's responses and working within the window of tolerance.

What Somatic Experiencing addresses that cognitive approaches cannot: the stored, incomplete defensive responses. The freeze that was never resolved. The muscular patterns that were activated in protection and never released. This is genuinely different from helping someone develop a narrative about their experience.

Trauma-Focused CBT

Trauma-Focused Cognitive-Behavioral Therapy is an adaptation of standard CBT specifically designed for trauma, including structured trauma narrative development, cognitive processing of trauma-related beliefs ("the assault was my fault," "the world is fundamentally dangerous"), and gradual exposure to trauma-related material in a safe context.

TF-CBT has the strongest evidence base among trauma treatments, particularly for children and adolescents. For adults with PTSD, both TF-CBT and EMDR are considered first-line evidence-based treatments.

What TF-CBT addresses well: the cognitive distortions that trauma produces. The beliefs that the person has developed about themselves, the world, and others based on their traumatic experience. The narrative that has become disorganized or avoided. The cognitive avoidance of trauma-related material.

What it addresses less directly than somatic approaches: the physiological storage component. TF-CBT includes relaxation and stress management components, but its primary mechanism is cognitive and narrative.

Internal Family Systems (IFS)

Richard Schwartz's Internal Family Systems model offers a different framework entirely: it conceptualizes the psyche as a system of "parts" — different aspects of the personality that have developed different roles, some of which carry traumatic burdens.

In IFS, the parts that carry trauma are understood not as deficits but as protectors — they developed in response to real experiences and have been doing their best to keep the person safe, often at significant cost. The "exile" (the part that carries the traumatic wound) is protected by "managers" (who prevent the wound from being exposed) and "firefighters" (who activate urgently when the wound is touched, often through addictive or impulsive behaviors).

IFS therapy works with these parts directly, developing a relationship with them from the "Self" (the stable, curious, compassionate core). The goal is not to eliminate the protective parts but to unburden the exiles — to process the traumatic burden they carry so the protectors no longer need to work so hard.

For conflict practitioners, IFS offers a particularly useful frame for understanding why "just behave differently" fails for traumatically organized conflict patterns. The conflict behavior is maintained by a protective system. Telling the person to just change the behavior is like telling the firefighter to stop fighting a fire without addressing the fire itself.

Implications for Conflict Practitioners

Van der Kolk's research has several direct implications for those working in conflict resolution, mediation, coaching, and interpersonal skill development.

1. Conflict practitioners are likely to encounter trauma regularly.

Given the prevalence of adverse childhood experiences (ACEs research: approximately 64% of US adults report at least one ACE; 17% report four or more), trauma history is not exceptional. It is common. Any practitioner working with people in conflict is regularly working with people whose conflict patterns carry a trauma dimension, whether or not that dimension is visible or disclosed.

2. Standard confrontation skill protocols may not transfer to trauma-activated individuals.

The skill-based approach that underlies this book — and much of the conflict coaching and mediation field — assumes access to prefrontal cortex function. When trauma is activated, that access is interrupted. Practitioners need to assess whether a client or participant is within their window of tolerance before proceeding with skill practice; and they need protocols for what to do when they're not.

3. "Resistance" to skill development sometimes indicates trauma activation, not obstinacy.

A client who keeps "falling back" into old conflict patterns despite genuine effort and considerable skill practice may be doing so because the patterns are maintained by a trauma-level system that skill development cannot reach. Understanding this — and distinguishing it from lack of effort or commitment — changes how a practitioner responds.

4. Practitioner scope of practice is a genuine ethical issue.

The implication that some conflict patterns require clinical trauma intervention raises genuine scope-of-practice questions for conflict coaches, mediators, and trainers. Practitioners who work with interpersonal conflict need to have clear referral protocols, know how to recognize when a client's needs exceed their scope, and have established relationships with trauma-informed therapists to whom they can refer appropriately.

5. Trauma-informed communication is a professional competency.

Understanding trauma's effects — even for practitioners who are not therapists — is increasingly considered a basic competency in fields that involve human services, education, healthcare, organizational consulting, and conflict practice. The principles of trauma-informed communication (safety first, choice and control, pacing, non-retraumatization) are accessible to non-clinicians and meaningfully change how practitioners approach their work.

Key Research Findings Summary

Discussion Questions

1. Van der Kolk's research showed that Broca's area goes dark during trauma recall. What are the implications for how we ask people to talk about traumatic experiences in conflict or mediation settings? What alternative approaches might reach what verbal narrative cannot?

2. The ACEs research suggests that approximately 64% of US adults have experienced at least one adverse childhood experience. Given this prevalence, what does it mean for how conflict coaching, mediation, and training programs should be designed? What does it mean for what practitioners need to know?

3. Van der Kolk's argument that cognitive approaches are "insufficient alone" for trauma treatment attracted resistance from cognitive-behavioral clinicians. Evaluate both sides of this debate. Where does the evidence most strongly support van der Kolk's position? Where does it remain genuinely contested?

4. IFS offers the frame that protective conflict behaviors are maintained by a system of parts doing their best to protect a wound. How does this frame change the practitioner's relationship to a client whose conflict behavior appears dysfunctional or resistant to change?

5. The case study ends with implications for practitioner scope of practice. What specific indicators should a conflict coach or mediator use to recognize when a client's needs exceed their scope? What makes this recognition difficult in practice?