Beden Kayıt Tutar (The Body Keeps the Score)
Seeing symptoms as a response did me good; I stopped when it became the explanation for everything. Valuable as a book of perspective, not as a diagnostic book.
Heavy content. The book describes cases of abuse, war and violence in detail. If you have a history of trauma, start knowing this; for some readers it can be triggering.
This book is not on the ADHD shelf and should not be. But it is constantly recommended in the ADHD context, so it is here.
Van der Kolk is a psychiatrist. From the 1970s he worked with war veterans, then with victims of abuse. The thesis of the book is this: trauma is not only something remembered, but something that leaves a mark in the body and the nervous system.
The side that did me good
Explaining the symptoms as a response.
Being constantly on guard. Startling easily. An unexplained tension in the body. Checking the exits in a crowd. Not fully relaxing even in sleep.
There is a big difference between carrying these as character traits and seeing them as a response. The first says "this is how I am," the second says "something happened and the body is holding it."
Van der Kolk writes well. The case stories are powerful and it is hard to put the book down. He also tells of his own career: what he got wrong, which approaches did not work.
The limits of talk therapy
I think this is the most convincing chapter of the book.
Some patients can tell the event, with all its details, many times. And nothing changes. Telling sometimes makes them live it again.
Van der Kolk explains this with the idea that the body keeps a separate record: the narrative of the event is in one place, the body's response in another, and touching one does not change the other.
This observation settled in me, and I have heard similar things from many people.
Then I stopped
As the book went on, it started to become the explanation for everything.
Attention problems, restlessness, relationship difficulties, immunity, every pain in the body.
A book explaining such a wide area with a single framework made me cautious. A theory that explains everything generally explains nothing.
And at one point I slipped there: "So the cause of everything in me is trauma."
When I looked at the numbers
Reviews based on twin studies give the heritability of ADHD as about 74 percent. One of the highest rates among psychiatric conditions.
This does not fit with the claim that trauma produces ADHD.
The two conditions can be present together, and both need to be addressed; this needs to be said. A person with ADHD who has lived through trauma may need to deal with both at once.
But declaring one the cause of the other leads to looking for a solution in the wrong place.
I did this for a while, and the time I lost was a pity. There are many people who read this book and slide to the same place; that is also why I am writing it here.
Differences in evidence
The book describes several treatment approaches positively: EMDR, yoga, theater, neurofeedback, body-based therapies.
The levels of evidence for these differ greatly from one another. The text does not state this difference sufficiently.
When one method is described with the same confidence as the one beside it, the reader assumes both have been tested to the same extent.
The neurofeedback section is especially problematic in this respect. There are meta-analyses that found no significant effect in blinded studies and in comparison with sham treatment; the book does not discuss this.
A note about its author too
There was a controversy about his leaving the center he directed, and it is a subject talked about in the field.
I do not think this invalidates the content of the book. But it is something you need to know if you are reading a book on the strength of its author's authority.
How to read it
Valuable as a book of perspective. Not as a diagnostic book.
For someone with a trauma history it offers a familiar language, and this is truly precious. Being able to name body responses is a gain in itself.
But if it leads you to the conclusion "this is the cause of everything in me," at that point you need to stop and talk to a specialist. ADHD and post-trauma pictures produce overlapping symptoms, and a book cannot make the distinction.
It runs past four hundred pages and its weight is cumulative. Reading many chapters in one sitting is tiring; I read it in pieces.