People / Trauma, attachment and body-oriented
Bessel van der Kolk
Studied traumatic stress and neuroimaging, proposed developmental trauma disorder and wrote about body-oriented approaches to trauma care.
At a glance
Born 1943. Dutch-American. Psychiatrist & Trauma Researcher.
Active 1978 to present. Landmark year 2014. Clinical era: 2010 to present, pluralistic, somatic and cultural.
Lineage: Trauma, attachment and body-oriented. Roles: Process and outcome researcher; Clinical theorist; Ethical, cultural and institutional reformer.
Associated modalities: Phase-Oriented & Somatic Trauma Therapy; Trauma-Sensitive Yoga; Neurofeedback & Multimodal Trauma Care.
Psychiatrist and trauma researcher whose work has examined traumatic stress, memory and body-oriented approaches.
Review status: Educational draft, subject review pending. Source status: source checks not documented for this draft. Dates, sources and clinical statements require independent verification and specialist review.
Clinical overview
Born in The Hague during the Nazi occupation of the Netherlands and educated in medicine at the University of Chicago before completing his psychiatric residency at Harvard Medical School, Bessel van der Kolk began his career treating Vietnam veterans on his first day at the Boston VA Clinic in 1978. In 1982 he founded the Trauma Center in Brookline, Massachusetts, and later the Trauma Research Foundation.
Van der Kolk has researched traumatic stress and written about relationships between traumatic experience, memory, bodily responses and mental health. His interpretations and proposals should be distinguished from established findings and from evidence for particular treatments.
Historical and clinical context
A 1996 PET study with Scott Rauch and colleagues examined responses to trauma-related scripts in eight people with PTSD. Such early imaging studies investigated brain activity during recall; they did not establish a universal way in which traumatic memories are stored.
Van der Kolk has advocated integrating several approaches, including trauma-focused and body-oriented methods. Evidence differs across methods, populations and outcomes. He also proposed developmental trauma disorder as a possible diagnosis for children exposed to chronic interpersonal trauma.
Core therapeutic contributions
Traumatic memory and neuroimaging. Van der Kolk and colleagues studied brain activity during recall of traumatic events and advanced interpretations of traumatic memory. Researchers disagree about the extent and meaning of memory fragmentation; it should not be treated as a universal storage mechanism.
Developmental Trauma Disorder (DTD). Formulated a comprehensive diagnostic framework for children exposed to chronic interpersonal victimisation and attachment disruption whose pervasive dysregulation across affect, attention, physiology, and relationships was fragmented across multiple comorbid DSM labels.
Body-oriented and multimodal approaches. Advocated investigating and incorporating a range of body-oriented and experiential approaches. Evidence for one approach does not establish the effects or mechanisms of all of them.
Revival of Pierre Janet's Dissociation Legacy. With Onno van der Hart, retrieved Pierre Janet's nineteenth-century insights separating narrative memory from traumatic dissociation and vehement emotion.
In the consulting room
Therapeutic stance. His writing emphasises attention to bodily sensations, safety and the therapeutic relationship as part of a broader approach to trauma care.
Signature practices. Discussing bodily sensations and responses in the context of a person’s experience; Considering trauma-focused and body-oriented approaches within an individual treatment plan; Attending to safety, preferences and the therapeutic relationship
Common misreadings. Assuming that every unexplained physical sensation contains a hidden literal trauma memory; Assuming that a single body-oriented or verbal technique is necessary for everyone’s recovery
Landmark clinical works
1987, Psychological Trauma (book). Early clinical volume integrating psychobiology, attachment disruption, and developmental trauma.
1994, The Body Keeps the Score: Memory and the Evolving Psychobiology of Posttraumatic Stress (paper). Seminal paper in Harvard Review of Psychiatry outlining the neurobiology of traumatic memory and somatic storage.
1996, Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society (co-edited with Alexander C. McFarlane and Lars Weisaeth) (book). Comprehensive international reference synthesising research on dissociation, memory, neurobiology, and phase-oriented treatment.
2005, Developmental Trauma Disorder: Toward a Rational Diagnosis for Chronically Traumatized Children (paper). Proposed Developmental Trauma Disorder to capture the developmental sequelae of complex childhood abuse and neglect.
2014, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma (book). Internationally read synthesis of trauma neuroscience, developmental attachment, and body-inclusive therapeutic modalities.
Clinical critiques and limitations
Researchers disagree about how often traumatic memories are fragmented and how to interpret different measures of memory coherence. A 2011 study found no general pattern of reduced coherence in its sample; subsequent work continues to debate measurement and findings.
Developmental trauma disorder was proposed as a diagnosis but is not a standalone DSM-5 diagnosis. Evidence for specific treatments and their mechanisms varies.
Clinical genealogy
Influences and mentors: Pierre Janet; Abram Kardiner; Edward John Mostyn Bowlby; Elvin Semrad.
Collaborators: Judith Lewis Herman; Onno van der Hart; Alexander C. McFarlane; Pat Ogden; Richard C. Schwartz; Ruth Lanius.
Students and successors: Julian Ford; Joseph Spinazzola; David Emerson; Sebern Fisher.
Sources and inspection notes
van der Kolk, B. A. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking.
Supports: A dated check of its relevance to this profile is not recorded for this draft
van der Kolk, B. A. (1994). The body keeps the score: Memory and the evolving psychobiology of posttraumatic stress. Harvard Review of Psychiatry, 1(5), 253-265.
Supports: A dated check of its relevance to this profile is not recorded for this draft
van der Kolk, B. A. (2005). Developmental Trauma Disorder: Toward a rational diagnosis for chronically traumatized children. Psychiatric Annals, 35(5), 401-408.
Supports: A dated check of its relevance to this profile is not recorded for this draft
Supports: A dated check of its relevance to this profile is not recorded for this draft
Supports: A dated check of its relevance to this profile is not recorded for this draft
Supports: A dated check of its relevance to this profile is not recorded for this draft