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Are we creating Trauma for ourselves?Joseph Everett (WIL)·September 17, 2023

Chances are, you’ve heard of The Body Keeps the Score by Bessel van der Kolk. At 79,898 reviews, the book has more reviews on Amazon than the first book of A Game of Thrones.

New York Magazine says Bessel van der Kolk is “currently the world’s most famous living psychiatrist.”

Van der Kolk’s big idea is that past mental traumas (as he defines them) can produce actual long-lasting changes in the body and brain, regardless of whether the person has a memory of the trauma or not.

If Dave was on to something then nearly a quarter of people would have PTSD. A 2020 meta analysis suggests that 22% of babies have the cord wrapped around their neck when born.

The paper in fact very clearly proves Dave’s claim wrong. Actually, considering Dave specifically clarified that he “didn’t suffer oxygen loss or anything like that” during the birth, it proves he’s extra wrong. The paper found that even in newborns whose birth was so physically damaging that they did experience clear damage like oxygen loss or temporary arm paralysis, there was no lasting psychological damage.

Where then could Dave have gotten this idea that he has trauma from an experience he couldn’t possibly remember? Probably Bessel van der Kolk.

Optics matter, and van der Kolk certainly nailed the optics. Unfortunately it seems van der Kolk took the famous Mark Twain quote “never let the truth get in the way of a good story” to heart. When you peel back the curtain and actually look at the research van der Kolk cited, you realize the book just falls apart.

Dr. Michael Scheeringa, professor at Tulane University School of Medicine has a 29 year career researching and treating PTSD. Dr. Scheeringa expected that after The Body Keeps the Score hit the bestseller list following its publication in 2014, it would quickly lose all credibility and be banished to the bargain bin due to its many blatant scientific errors and grandiose narrative.

Instead, it maintained a streak of being the #1 ranked book in Psychiatry on Amazon.com for years. Just last week, the week of June 29th 2025, The Body Keeps the Score is ranked #5 for most sold for all nonfiction books on Amazon’s official weekly ranking. It’s maintained an unbroken streak on the top 20 most sold nonfiction list for the past 233 weeks – over 4 years and 5 months.

Bessel van der Kolk’s book isn’t just being grabbed up by laymen, it has made its way into many college classrooms.

Sufficiently shocked that no one had written a proper breakdown of all the glaring issues with the book, Dr. Scheeringa decided to write his own. He published The Body Does Not Keep the Score in 2023.

This book should be recommended alongside The Body Keeps the Score at all college campuses promoting Bessel van der Kolk’s theories.

In the textbook Evolutionary Psychology, the authors explain that a particular hunter gatherer population isn’t as susceptible to PTSD despite being exposed to similarly tragic events. They argue that part of the physiological changes that come along with PTSD are increased inflammation in the body. Thus, the inflammatory nature of a standard western diet may make some people more susceptible to PTSD.

A 2020 study on Turkana warriors in Kenya found them to be much less likely to develop PTSD-related symptoms compared to US combat vets despite also experiencing gruesome acts in a war zone.

All this suggests that certain people may have certain physiology or hormonal profiles that make them susceptible to trauma.

That is, trauma doesn’t lead to dysfunction or abnormal brain function, physiology or hormonal regulation. Rather, an unhealthy person may be more susceptible to trauma.

I was gearing up to do a full breakdown of the claims made in van der Kolk’s book when I came across Dr. Scheeringa’s The Body Does Not Keep the Score. It is a systematic, thorough analysis and debunk of all the major claims made in van der Kolk’s book.

One critique that kept coming up was that van der Kolk was using tons of cross sectional research to prove his points. These papers just took snapshots of the brain of people with PTSD. There was no “before” snapshot, so van der Kolk can’t claim with any certainty that trauma caused these brain changes. Just like Gabor Mate, it could easily be the case that van der Kolk was getting the picture entirely backwards.

As Dr. Scheeringa points out, it is likely that any abnormalities in the brains of PTSD victims were present before the event and these abnormalities made the person more susceptible to developing PTSD.

The idea that trauma causes long-lasting damage to the brain and or body is central to van der Kolk’s thesis. Without solid proof that trauma was the cause of any brain, body, or hormonal abnormalities, van der Kolk’s asserting that “the body keeps the score” falls apart.

Van der Kolk repeats the same deceptive pattern for 3 claims that are key to his theory: ・He presents his claim as being well known within the field, not even bothering to cite research.・He doesn’t mention that actual investigation into the research reveals plenty of contradictory outcomes. While several papers that show one result, several yield the exact opposite result. ・He doesn’t address the papers that directly prove his claim wrong.

The first change in the brain that van der Kolk discusses is “abnormal activation” of a region of the brain called the insula.

He provided no citation for this claim, but after digging through the literature on the insula, Michael Scheeringa found that:

At the time The Score was published in 2014, there were 21 studies of the insula and 20 were cross-sectional studies. Twelve of those studies had reported more activity, six studies reported less activity, and two studies reported no difference in activity in individuals with the PTSD diagnosis or high PTSD symptom severity compared to a non-PTSD control group.

…van der Kolk neglected to mention the twenty-first study, which was a pretrauma prospective study. When assessing participants both prior to trauma exposure and again 1.5 years later, insula activity had not changed in conjunction with post-trauma symptoms.

・20/21 of the papers available on the insula were these snapshot studies, so we don’t know if the abnormal activation was present before the trauma or not.・The studies clearly contradicted each other. ・One study directly proved van der Kolk wrong and provides strong evidence for the suspicion that he’s getting trauma completely backwards. The study that assessed insula activity before and after the trauma found that the insula activity was no different after the trauma.

Just last December, he repeated this claim that the Insula is negatively affected by trauma on The Diary of a CEO podcast.

Scheeringa reveals that Claim 2, van der Kolk’s “trauma can rewire brain centers such as the amygdala,” plays out almost exactly like Claim 1:

・21/23 of the papers available on the amygdala were these snapshot studies, so we don’t know if abnormalities were present before the trauma or not.・The studies clearly contradicted each other. ・Two different studies looked at the amygdala before and after the traumatic event. There was no change in amygdala activity after the traumatic event.

Only a month ago, Bessel van der Kolk appeared on the Big Think channel to claim that the amygdala is where you’ll find the “core imprint of trauma.”

As Scheeringa points out, “stress hormones” could refer to anything from prolactin, glucagon, progesterone to epinephrine. However, the main stress hormone that gets attention is cortisol. Scheeringa provides a timeline of conflicting results from research on cortisol and PTSD:

・1986 – First study on cortisol and PTSD. Cortisol levels were lower in PTSD.・1989 – Cortisol levels were higher in PTSD.・1989 – Cortisol levels were normal in PTSD.・2007 – Meta-analysis of 37 studies on individuals with PTSD. The conclusion based on these 37 studies was that cortisol levels were normal in PTSD.・2012 – another meta-analysis of 37 different studies. Conclusion: cortisol levels were not different between trauma-exposed and non-exposed indviduals.

Despite all this, van der Kolk would go on to claim that elevated cortsiol causes serious health problems in people who experienced trauma:

A baffled Michael Scheeringa tried to make sense of how van der Kolk could so brazenly misrepresent the research to support his ideas. He assumed there must be some sort of ideology at play because:

△For all 14 of these claims van der Kolk either didn’t bother to cite a study or the citation he listed couldn’t be found in the scientific literature.

At first glance, this sounds nice and science-y, receptors developing, upregulating, or downregulating reminds me of how repeated exposure to addictive substances can downregulate dopamine receptors.

Dr. Scheeringa explains that the issue with van der Kolk’s evidence for his claim is he is cited 3 review articles of animal research. Scheeringa says:

Now since I really enjoyed Jaak Panksepp’s textbook Affective Neuroscience, the person whose work van der Kolk cited, I’ll include some of my own digging on this point to show just how badly van der Kolk is winging it.

In footnote #9 of Chapter 9, Van der Kolk cites 3 of Panksepp’s studies and claims that Jaak Panksepp found that:

Going past these three citations, I couldn’t find any studies of Panksepp’s anywhere where he manipulated the licking behavior of a mother mouse. However, in one of the papers van der Kolk cited, Endogenous Opioids and Social Behavior, Panksepp did write that:

However, even if van der Kolk wasn’t misrepresenting Panksepp’s work, his point still wouldn’t stand.

We know what social isolation looks like, but what is the human equivalent of a rat’s experience of being licked? Is it having their hair cleaned? Is it being held? Is it being breastfed? Being played with? Being taught the words for water bottle, paper and socks?