THE BODY KEEPS THE SCORE

Van der Kolk argues that trauma is not just a past event but an imprint on the mind, brain, and body that keeps survivors stuck in survival mode. Because the body 'keeps the score' — holding sensations and threat responses that words cannot reach — healing requires both top-down work (talk, understanding, connection) and bottom-up work (regulating the body through breath, movement, rhythm, and touch). The book surveys body-based methods like yoga, EMDR, neurofeedback, and communal practices as complements to traditional therapy.

1. Treat the body, not just the mind. Trauma is stored as nervous-system dysregulation, so healing works 'bottom-up' (calming physical arousal, breath, movement) as well as 'top-down' (talk, reasoning, connection); talking alone often cannot resolve it. (source, source)
2. Use slow, deep breathing and gentle movement to calm hyperarousal. Practices like yoga improve heart-rate variability, retuning the nervous system so the body can shift between stress and relaxation more easily instead of staying stuck on high alert. (source, source, source)
3. Practice sensing and naming bodily feelings. Notice and label what anger, fear, or calm physically feel like (tension, tingling, churning gut, openness in the chest). This mindful body-awareness strengthens the part of the brain that quiets the fear response. (source, source)
4. Consider EMDR for intrusive memories. Recalling the distressing event while doing bilateral stimulation (side-to-side eye movements) reprocesses the memory, reducing its vividness and emotional charge, and can work without the person verbalizing every detail. (source, source)
5. Heal in connection with others. Safe, attuned relationships let the nervous system co-regulate and return to calm; supportive people can even soften whether an event becomes traumatic. Isolation deepens trauma, belonging is itself therapeutic. (source, source)
6. Counter shame with self-compassion. Treat yourself with the same kindness you would give a friend; this soothes the self-blame and secrecy that keep trauma stuck and helps regulate emotional storms. (source, source)
7. Restore a sense of agency through physical action. Completing the defensive moves the body could not make during the trauma — striking, pushing, running, self-defense practice — reconditions the freeze response and rebuilds a felt sense of control. (source, source)
8. Join rhythmic group activities. Drumming, singing, dancing, or theater synchronize the nervous system and restore attunement and a sense of belonging, countering the isolation that comes with trauma. (source, source, source)
9. Express yourself through writing, art, music, or dance. Nonverbal and expressive practices help process what words alone cannot reach, letting people reorient, find identity, and restore meaning. (source, source)
10. Be an active participant, not a passive patient. Combine methods rather than waiting for one cure, and expect a process: keep trying new approaches, learning, and growing, because no single intervention heals trauma alone. (source, source)