What the Most Famous Book About Trauma Gets Wrong

“You have to read this book,” my new psychologist informed me. As a teenager, I was raped by a hostel employee. For years after, I spent every waking moment trying to avoid the gruesome memories—which instead haunted me at night. I wanted nothing more than to share my story, certain that I’d feel immediate relief.

But my therapist stopped me. “Talking about it will retraumatize you,” she said, suggesting that instead I tap on acupressure points while repeating a mantra. Both her admonition not to discuss the assault and her kooky alternative treatment came straight out of the book she said I had to read: The Body Keeps the Score.

It is impossible to exaggerate the book’s popularity. Published in 2014, its author, Bessel van der Kolk, has become like the Colleen Hoover of psychology. It has sold more than 3 million copies and spent more than six total years on the New York Times bestseller list, often in the No. 1 spot. One psychologist I spoke with called it a “cult classic.” It’s required reading in many social work and psychology classes, from the University of Southern California to Rutgers.

Van der Kolk is a Dutch psychiatrist who specializes in post-traumatic stress. The Body Keeps the Score takes the decades-old consensus that chronic, extreme stress can alter the brain and damage the body and goes one step further, claiming that our flesh remembers traumas small and large. According to this theory, even if we have no conscious memory of harm, our muscles, viscera, and DNA bear the evidence. Therefore, our misfortunes can plague us with any manner of physical ailments, from neck pain to emphysema. Treatment, then, should focus on the body first, using techniques including yoga, community theater, or tapping acupressure points while reciting a mantra (called the “Emotional Freedom Technique”).

It helps that it is almost compulsively readable, with dramatic case studies propelling the action forward. And in many ways, it has become the definitive text of our post-Covid era, when trauma is the default explanation for anything, from tight hips to talking to yourself to sleeping with our arms curled like a T. rex.

But something about the text left me feeling gross and ashamed. I couldn’t pinpoint exactly why until I stumbled on a thread by Layla AlAmmar, a scholar of literary trauma theory, who in 2023 tweeted: “This book is trash.” She accuses van der Kolk of advancing an “individualized” view of trauma largely disconnected from the social and political systems in which that trauma occurred. So I reread The Body Keeps the Score, and I was astonished to discover what this supposed trauma bible actually contains.

The Body Keeps the Score stigmatizes survivors, blames victims, and depoliticizes violence. While masquerading as care for survivors, it creates a hierarchy in which marginalized victims are even more marginalized.

And it may be giving people inaccurate information about the impact of trauma. Several scientists I spoke to whose work appears in the book say van der Kolk mischaracterizes their research and steers survivors away from treatments that might help them. “The road of recovery is the road of life,” van der Kolk writes. Jennie Noll, a University of Rochester professor of psychology whose research on the impact of sexual abuse van der Kolk cites extensively, tells me that by treating post-traumatic stress disorder as a lifelong condition, the book sets the stage for “victims and survivors to feel that there is no way out.”

The book opens with the story of Tom, who was an American Marine in the Vietnam War. After his platoon was ambushed, Tom went on a crime rampage, raping a Vietnamese woman, shooting a farmer, and murdering local children. Van der Kolk centers Tom’s torment as what matters. We are invited to step into his conundrum after his honorable discharge: “How can you face your sweetheart and tell her that you brutally raped a woman just like her, or watch your son take his first step when you are reminded of the child you murdered?” van der Kolk writes.

But wait a second, what about that Vietnamese woman or those children? Van der Kolk doesn’t even offer a throwaway condolence for the nonwhite victims or their families, who are treated as mere collateral damage.

This case study is one of several that treat sexual assault survivors with disdain. In a section titled “Addicted to Trauma,” we meet Julia. At 16, she was raped at gunpoint and then “got involved with a violent pimp”—child sex trafficking by another name. Her story could illustrate many lessons: how predators target the vulnerable; that survivors are frequently revictimized; the lethal threats faced by trafficking victims. Instead, Julia’s story immediately follows the claim that “many traumatized people seem to seek out experiences that would repel most of us.”

I asked Noll, who worked on a 32-year longitudinal study of incest victims that van der Kolk repeatedly references, for her take. “‘Addicted to trauma’? That’s a term that means absolutely nothing,” Noll tells me. “It is not a scientific term. It is not a clinical term. It is wide speculation, and it does not describe the vast majority of any accounting of recovery from sexual abuse that I’ve heard.” Noll’s study did find that sexual abuse survivors face a higher chance of being revictimized, she says, but no one definitively knows why. Incest survivors also had higher instances of teen pregnancies and stis. “But it’s by no means ‘addicted to trauma,’” she reiterates, “and it can be treated.” Van der Kolk told me that addictions to trauma are “widely discussed in the psychiatric literature” and pointed me to a paper he published on the topic as evidence.

In a section about social development, van der Kolk paints a damning picture of sexually abused girls: “They don’t have friends of either gender.” “They hate themselves, and their biology is against them.” “Other kids usually don’t want anything to do with them—they are simply too weird.”

“God, that’s so awful,” Noll says. She allows that perhaps van der Kolk had met “one or two people” who fit that mold, but that “in no way describes an entire group of survivors.” George Bonanno, a Columbia University psychology professor and a co-author of some of the papers from Noll’s study, also took issue with van der Kolk’s claims. Implying that sexually abused girls have an entirely different developmental pathway, he says, “is bullshit.”

Van der Kolk’s approach does more than just demean individual survivors. It flattens violence into “trauma,” ignoring the social forces that allow it to flourish.

Halfway through the book, we meet adolescent Ayesha, a patient described as having been raped “again,” this time by a gang after running away from her group home. Despite the many forces working against an institutionalized teenager who has been brutally attacked by multiple assailants, van der Kolk frames the story of Ayesha’s gang rape around her decisions: smoking some “dope” and doing “some other drugs,” getting into a car with boys, being “so impulsive and lacking in self-protection.”

Psychologist Jennifer Mullan, author of the 2023 book Decolonizing Therapy, points out that van der Kolk fails to acknowledge intersectionality and the ways that identity impacts experiences. A perspective that considers the structural forces shaping Ayesha’s experiences would reveal a girl repeatedly failed by the entities—the child welfare system, the group home—meant to help her. Women often move through the world differently due to the threat of violence, Mullan says, and “people of color experience trauma differently due to other compounding factors like racial trauma, anti-Blackness, or anti-­immigrant feelings.” But the words “racism,” “sexism,” and their variations never appear in the text.

It’s not that the concept of intersectionality didn’t exist prior to the book’s publication in 2014. As AlAmmar pointed out in her scathing review, “The 2000s saw rapid ‘de-colonization’” as psychologists began to address non-Western traumas. But, she writes, “all of this is ignored in Kolk’s book.”

Notably, The Body Keeps the Score does include male survivors of sexual abuse. Van der Kolk paints himself as a fierce advocate for men who have suffered at the hands of Catholic clergy. Those victims are depicted as adults taking back their power and fighting for justice, a portrayal that makes the book’s broken women stand out in stark relief. (Van der Kolk said anyone who thinks the book is skewed toward healing men “hasn’t read it carefully.”)

Van der Kolk himself can’t so easily avoid debates about male privilege. In November 2017, while van der Kolk says he was on a sabbatical, the executive director of the Trauma Center that he founded was fired for alleged sexual mistreatment of female employees. Two months later, van der Kolk was canned too, for allegedly creating a hostile work environment. He denied wrongdoing, painting himself as the victim as he called the dismissal a “very public character assassination.” But the incident hasn’t made much of a dent on van der Kolk’s reputation. In Mullan’s eyes, this shows how “white maleness is protected by all systems, almost at all costs.”

Perhaps the gravest consequence of The Body Keeps the Score is how it could make survivors feel like they are irrevocably harmed.

After Stephanie Foo, author of the 2022 memoir What My Bones Know, was diagnosed with complex PTSD, her first Google search led her to van der Kolk’s book. Foo found the book “pathologizing” and “dehumanizing” in how it treated survivors with “pitying revulsion.” “I came away from the book not feeling very hopeful and quite ashamed.”

Van der Kolk paints a grim picture of life after trauma, matching the mood of many mired in PTSD. But several experts whose work is cited in the book say van der Kolk used their research to draw inaccurate conclusions.

For example, van der Kolk claims “traumatized children have fifty times the rate of asthma as their nontraumatized peers.” He footnotes a paper co-authored by Noll about the long-term impact of incest. That paper doesn’t contain the words “asthma,” “breathing,” or any related terms. Noll confirmed over email: “We’ve never published on asthma.”

Van der Kolk’s citations appeared off in several other instances. The idea that sexually abused girls “don’t have friends,” as van der Kolk posits, citing the paper Noll co-wrote, “was not accurate,” Noll asserts. His claim that girls who survived incest experienced the onset of puberty a year and a half earlier than other girls? Noll says the puberty paper published from the incest study he cites contradicts that as well. (Van der Kolk told me he sometimes relied on preliminary, unpublished data.) “He’s talking about sexual abuse as an inevitable assault on development. That’s just not true,” Noll says. And the problem with this, she explains, is that it makes people feel as though they have been rendered “irreparable.” Instead, there are many evidence-based interventions designed for sexual assault survivors that decades of research have shown can rapidly relieve symptoms.

Van der Kolk derides many of the interventions with the strongest evidence, particularly cognitive behavioral therapy, a family of talk therapies backed by 60 years of research. In CBT, patients process their negative beliefs and compare them to reality. When used to treat PTSD, it often involves some form of exposure as patients repeatedly confront the memories, feelings, and beliefs that terrorize them.

Van der Kolk makes CBT seem not only useless, but dangerous, citing scores of veterans who were “retraumatized” by talking about their experiences and flew into rages, relapsed into alcoholism, and got carted away by police to psych wards.

But one of the main researchers van der Kolk cites believes the opposite. Van der Kolk claims that “only about one in three participants with PTSD who finish [CBT] research studies show some improvement,” citing a paper by Julian Ford, professor of psychiatry at the University of Connecticut School of Medicine, and several other papers, including a meta-analysis. The meta-analysis in fact concluded that 67 percent of people who completed treatment benefited. And Ford disagrees with van der Kolk’s interpretation of what the numbers imply. “As a frontline treatment, I don’t think there is anything that is better for the treatment of PTSD than CBT,” he tells me.

Meanwhile, the book’s popularity has meant countless people may have steered clear of evidence-based regimens that could help them. A 2023 editorial in Research on Social Work Practice argues that the “influence and authority” of van der Kolk and related figures means those suffering from PTSD are often “not offered a first-line treatment by providers and do not seek one out.”

One study by the Department of Veterans Affairs and academic researchers that van der Kolk cites—the largest of its kind when it was published in 2007—found that after just 10 weeks of CBT, 75 percent of patients improved significantly and 47 percent no longer had PTSD at all. “We used to think that PTSD was chronic and that we had to help people live with their symptoms,” says Paula Schnurr, co-author of that study and executive director of the VA’s National Center for PTSD. “We now know that PTSD is treatable.”

Given the apparent inaccuracies and the appalling examples, why has The Body Keeps the Score been so impervious to criticism? Psychology professor Inna Kanevsky, known as Dr. Inna on social media, made her first TikTok debunker about van der Kolk’s idea that trauma is stored in the hips. But today, she avoids the book and its claims. Fans have “just been so abusive, frankly, whenever you bring up The Body Keeps the Score even slightly.” Questioning the science is seen as invalidating people’s trauma.

Because of The Body Keeps the Score’s enormous success, a single perspective has dominated the conversation about trauma over the past decade. The antidote might not be so simple. But there are several books that can help place our pain in a political context and deepen our understanding of trauma—see my list of recommendations at the bottom of this page.

For people who are interested in evidence-based treatments, the VA’s website offers extensive guidance on what might be the best fit. In the middle of the night, when I couldn’t sleep, I took solace in its videos that gave me hope that things could get better, fast.

Through this, I learned about prolonged exposure therapy, the gold standard CBT approach; talking about what happened again and again until it no longer tormented me sounded exactly like what I needed. My therapist called the treatment “inhumane” and compared it to “torture,” citing van der Kolk. But I wanted to talk about the assault—telling me not to had only amplified the shame I felt. Luckily, by then, I no longer accepted van der Kolk’s or my therapist’s ideas as truth. I broke up with them both and immediately felt better for it.