The Body Keeps the Score

Question 1

The Body Keeps the Score

True/False.

Trauma rewrites/modifies the brain.

Answer 1

True.

Question 2

The Body Keeps the Score

How does trauma rewrite/modify the brain?

Answer 2

(1) Recalibrating the alarm system
(2) Increasing sensitivity to stress hormones
(3) Altering the system that filters out irrelevant info

Question 3

The Body Keeps the Score

What are some of the long-term effects of trauma on the mind?

Answer 3

Hypervigilance, difficulty spontaneously engaging with life, repetitive errors

Question 4

The Body Keeps the Score

What are some of the general categories of treatment options for patients who have undergone severe trauma?

Answer 4

(1) Therapy (top-down approach)
(2) Pharmacology (shut down inappropriate stress responses)
(3) New experiences (bottom-up approach)

(Options include therapy, yoga, medications, EMDR, neurofeedback, theater, etc.)

Question 5

The Body Keeps the Score

What fraction of U.S. children are sexually abused at some point during their childhood?

What fraction had marks left from a beating by their parents?

Answer 5

1/5

1/4

Question 6

The Body Keeps the Score

What fraction of U.S. children grew up with alcoholic relatives?

What fraction had witnessed their mother being hit or beaten?

Answer 6

1/4

1/8

Question 7

The Body Keeps the Score

What fraction of U.S. couples have physical violence in their relationships?

Answer 7

1/3

Question 8

The Body Keeps the Score

What did Freud say of a veteran he met who was undergoing severe psychological distress as a consequence?

Answer 8

“I think this man is suffering from memories.”

Question 9

The Body Keeps the Score

What are two of the major psychological issues that veterans face?

Answer 9

PTSD; survivor’s guilt

Question 10

The Body Keeps the Score

In The Body Keeps the Score, Bessel van der Kolk recounts a story of a veteran who refused pharmacology so as not to forget his fallen comrades. During his service, his platoon was ambushed, and he went on a revenge/rape spree on non-combatants (as often happens in these scenarios).

What psychological principle does this story illustrate?

Answer 10

Survivor’s guilt

Question 11

The Body Keeps the Score

How does past trauma affect an individual’s ability to form/maintain relationships?

Answer 11

It makes trust and intimacy difficult.

(“It takes enormous courage to allow yourself to remember.”)

Question 12

The Body Keeps the Score

Describe some of the reasons a traumatized individual may feel shame in regards to their traumatic experiences.

Answer 12

• Possibly due to one’s actions placating an abuser or assisting an abuser
• Imagination can be replaced by flashbacks/blankness
• Potential lack of ability to feel intimacy
• Likely numbness and derealization

Question 13

The Body Keeps the Score

What do patients with PTSD often see in Rorschach tests?

Answer 13

(1) Nothing (imagination inhibited)
(2) Past traumatic experiences

Question 14

The Body Keeps the Score

True/False.

Trauma often ‘fixes’ a person’s brain back at the traumatic point, no matter how long ago.

Answer 14

True.

Question 15

The Body Keeps the Score

How do many traumatized individuals deal with / respond to the shame, guilt, numbness, derealization, and lack of intimacy they often feel?

Answer 15

Alcoholism / substance abuse,

rage / depression / hopelessness,

dangerous activities / obsessions / crime,

lack of interests,

only seeing other soldiers as trustworthy, ‘in-group’ members (veterans-specific)

Question 16

The Body Keeps the Score

What fraction of war zone veterans develop severe S/Sy of PTSD?

Answer 16

1/4

Question 17

The Body Keeps the Score

What medication was discovered in 1950, opening up the way towards pharmacology aimed at mental illness?

When did more psychoactive compounds start to be discovered?

Answer 17

Chlorpromazine

1960s / 1970s

Question 18

The Body Keeps the Score

How many people lived in U.S. mental hospitals in 1955?

And in 1996?

Answer 18

> 500,000

< 100,000

Question 19

The Body Keeps the Score

When did PTSD first become a recognized diagnosis?

Answer 19

1980

Question 20

The Body Keeps the Score

True/False.

The understanding of child-daughter incestuous relationships as traumatic for the daughter was only well-understood in 1952.

Answer 20

False.

The understanding of child-daughter incestuous relationships as traumatic for the daughter was still not understood as recently as 1982.

Question 21

The Body Keeps the Score

Half of all rapes occur before what age?

Answer 21

15

Question 22

The Body Keeps the Score

True/False.

~1/8 of Americans will experience a violent crime during their lives.

Answer 22

False.

The majority of Americans will experience a violent crime during their lives.

Question 23

The Body Keeps the Score

__/__ of individuals seeking psychiatric care have been assaulted, abandoned, neglected, witnessed violence in their families, and/or been raped as children.

Answer 23

1** / **2 of individuals seeking psychiatric care have been assaulted, abandoned, neglected, witnessed violence in their families, and/or been raped as children.

Question 24

The Body Keeps the Score

What example is given in The Body Keeps the Score to illustrate that animals tend to seek home as a known place of refuge, even when safer and/or more welcoming locations exist?

Answer 24

Startled mice run for home, regardless of (1) whether home was loud and food-scarce or quiet and food-abundant and (2) whether there are more welcoming locations available.

Question 25

The Body Keeps the Score

Trauma is often associated with learned what?

Answer 25

Learned helplessness

Question 26

The Body Keeps the Score

“People can never get better without _____ing what they ____ and _____ing what they ____.”

Answer 26

“People can never get better without _know_ing what they _know_ and _feel_ing what they _feel_.”

Question 27

What broad takeaways (in terms of activated and deactivated areas) can be inferred from neuroimaging in individuals experiencing a flashback of a traumatic experience?

Answer 27

Activation: visual cortex; right limbic area

Deactivation: Broca’s area; much of the left lobe

Question 28

How do traumatic experiences (and subsequent flashbacks) affect brain laterality?

Answer 28

The right side (more intuitive, emotional, visuospatial) is overactivated;

the left side (more analytical, linguistic, sequential) is dampened

Question 29

Why is it often so difficult for traumatized individuals to describe their traumatic experience?

Answer 29

Traumatic experience/flashback dampens the left side of the brain, including Broca’s area