The Body Keeps the Score: Key Ideas, the Evidence and the Critiques

The Body Keeps the Score is Bessel van der Kolk's book about how overwhelming experiences may affect the brain, memory and the body, and about the treatments he believes can help. First published in 2014, it is marketed by its publisher as a No. 1 New York Times bestseller (Penguin Random House).

This guide covers the book's central ideas in our own words, what research supports and disputes, who the book may suit, and how its ideas relate to therapy. It is commentary, not a replacement for reading the book.

What Is The Body Keeps the Score About?

The book's core argument, as the author's official website sums it up, is that abuse and violence can leave a person's threat-detection system set far too sensitively, so the body keeps bracing to fight, run or shut down (Bessel van der Kolk, official website). On this view, trauma is not only a memory of the past but a state the nervous system keeps living in, as though the danger has not ended.

The same summary says healing that lasts depends on a person coming to feel secure in their own body and able to bear their own emotions. This helps explain why the book gives so much space to treatments beyond conversation. The publisher's description names yoga, drama, sport, meditation and neurofeedback among them.

What Are the Key Ideas in The Body Keeps the Score?

These are the author's arguments, not settled science. The sections that follow look at how well they hold up.

• →Trauma keeps the threat response switched on. Van der Kolk argues that after overwhelming experiences, the nervous system can stay primed for danger, moving between high alert and shutting down, so ordinary reminders can set off reactions that feel out of proportion to the present. Our post on the window of tolerance explains a model some therapists use to describe that pattern.
• →Traumatic memory behaves differently. In an interview on On Being, van der Kolk describes traumatic memories returning as images, sounds or body sensations that stay unchanged, rather than as a story that fades and updates. He also says that when people are reliving their trauma, Broca's area, a region involved in speech, goes offline, which he links to why such experiences can feel beyond words (On Being with Krista Tippett). Memory researchers dispute parts of this, as described below.
• →Trauma is defined broadly. The book looks beyond single catastrophic events to childhood abuse, neglect and disrupted early attachment, links these to later difficulties with the body, emotions and relationships, and puts safety and connection with others at the centre of recovery. Critics question this wide definition.

Which Treatments Does The Body Keeps the Score Discuss?

Described neutrally, the approaches the book surveys include:

• →EMDR (eye movement desensitization and reprocessing), a structured trauma-focused therapy that pairs recalling a memory with guided eye movements or other back-and-forth stimulation.
• →A parts-and-Self approach associated with Internal Family Systems (IFS), which works with different "parts" of the mind and a core Self.
• →Yoga and meditation, as ways of noticing and tolerating body sensations.
• →Neurofeedback, in which a person watches a display of their own brain activity and practises changing it.
• →Somatic and movement-based approaches, along with theatre, sports, group rhythm activities, language and writing.

The research behind these varies widely. Critics argue that the book is more confident about some of them than the evidence allows, as described below.

What Does the Research Say About Those Treatments?

A useful benchmark is the 2019 PTSD guidelines from the International Society for Traumatic Stress Studies (ISTSS). For adults with PTSD, they strongly recommend Cognitive Processing Therapy, Cognitive Therapy, EMDR, individual trauma-focused CBT and Prolonged Exposure. They place neurofeedback, somatic experiencing and yoga, among others, in a lower category, emerging evidence: results favoured the treatment, but the evidence did not meet the quality criteria for a recommendation (ISTSS PTSD Prevention and Treatment Guidelines, 2019). Of the approaches above, EMDR is the one with a strong recommendation; IFS is not among the strongly recommended treatments.

Some of the research behind the body-based approaches comes from the author's own team. In a 2014 randomized trial, van der Kolk and colleagues compared ten weekly one-hour trauma-informed yoga classes with a women's health education group in sixty-four women with chronic PTSD that had not responded to earlier treatment. At the end, sixteen of thirty-one in the yoga group no longer met criteria for PTSD, compared with six of twenty-nine in the comparison group (van der Kolk et al., Journal of Clinical Psychiatry, 2014). That is encouraging, but it is one small trial run by the book's author, not independent confirmation.

In a BJPsych Bulletin commentary, Michael Scheeringa of Tulane University School of Medicine, who also wrote a 2024 book-length critique of The Body Keeps the Score, argues that structured, trauma-focused talking therapies have the stronger evidence. He counts EMDR as one of the two main recommended trauma treatments alongside CBT, while noting it has not been shown to outperform CBT. He also argues that, although some of the book's other body-based approaches have shown promise in preliminary studies, the evidence does not show them to be better than established treatments such as CBT, and he adds that this does not mean they lack value (Scheeringa, BJPsych Bulletin, 2025).

What Do Critics Say About The Body Keeps the Score?

Claims about the brain. Scheeringa's commentary, published online in November 2025 in the journal's Against the Stream section, examines one hundred and twenty-two claims from the book. He argues that the brain-imaging studies it relies on were cross-sectional snapshots that could not show trauma caused the differences found, and that those findings did not replicate consistently. He adds that three reviews of prospective studies, which measured people before trauma exposure, concluded that the brain differences likely came first, and found little evidence that trauma permanently damages the brain (Scheeringa, BJPsych Bulletin, 2025).

What counts as trauma. Psychologist Nick Haslam, writing in The Conversation, argues that the book stretches trauma to cover a very wide range of hard life experiences, which risks diluting the meaning of serious trauma. He also argues that the evidence for some of the alternative treatments the book favours does not yet justify its confidence in them, while praising how clearly it presents the science of trauma and the hope it offers (Haslam, The Conversation, 2022).

How traumatic memory works. The book's discussion of traumatic memory enters an older scientific debate. Henry Otgaar, Elizabeth Loftus and colleagues argue that the so-called memory wars over repressed memories have not ended and that dissociative amnesia remains scientifically controversial. They also raise concerns about possible harm from therapy methods aimed at uncovering memories believed to be hidden (Otgaar et al., Perspectives on Psychological Science, 2019). Their paper does not review this book. If reading The Body Keeps the Score leaves you wondering about memories you cannot reach, you can talk that uncertainty through with a qualified professional. Given the concerns above, that conversation does not need to involve trying to recover memories.

How Popular Is The Body Keeps the Score?

Penguin Random House says the book has been translated into over forty languages (Penguin Random House). By August 2022, Haslam noted that it had spent more than one hundred and fifty weeks on the New York Times paperback nonfiction bestseller list, including over six months at No. 1 in 2021, and had reportedly sold close to two million copies (Haslam, The Conversation, 2022). When On Being rebroadcast its 2013 interview with van der Kolk in November 2021, its introduction noted how widely the book was being read during the pandemic (On Being). Popularity is not the same as scientific support.

Who Is The Body Keeps the Score For, and Who Should Read It With Support?

It may suit readers who want a readable introduction to one influential clinician-researcher's view of trauma, students and people in helping professions who want to understand a book that shapes public conversation, and anyone curious about options beyond talking who wants questions to ask rather than a treatment plan. Ideally, read it alongside the critiques above.

It is worth pausing, or reading with support, if:

• →Detailed accounts of abuse and violence are likely to stir up your own memories. Short sections, stopping when your body signals it has had enough, and someone to talk to afterwards can help.
• →You notice flashbacks, panic, numbness or a sense of unreality while reading. That is information about your limits, not a failure.
• →You hope the book will tell you whether you have PTSD. It cannot diagnose you, and neither can this guide.
• →You are in crisis. If you are having thoughts of suicide, call or text 9-8-8 (Canada, 24/7), and call 911 if you are in immediate danger.

How Do the Book's Ideas Relate to Therapy at TEO?

TEO Counselling is an online-only practice for clients in British Columbia, Ontario, Alberta, Saskatchewan, Manitoba, and Newfoundland and Labrador. Here is plainly how the book's approaches, and the guideline-recommended talking therapies its critics point to, relate to what is available at TEO:

• →EMDR. Mohamad Shabib is trained in EMDR, including Advanced EMDR training through an EMDRIA-approved programme, and Alison Shaji, who works with clients in British Columbia only, is also trained in EMDR. Our EMDR therapy page explains how sessions work, and our guide to Francine Shapiro's Getting Past Your Past covers the model behind EMDR and the debate over it. A guideline recommendation describes a treatment in general, not any one person's result.
• →CBT. CBT is included here because the ISTSS guidelines strongly recommend individual CBT with a trauma focus for adults with PTSD. Mohamad is trained in CBT for Trauma (Levels 1 and 2), and Alison is trained in CBT.
• →Internal Family Systems. Mohamad is trained in IFS (Levels 1 and 2). It is offered as one option to talk through, not as a guideline-recommended treatment for PTSD. Our IFS therapy page has more detail, and our guide to No Bad Parts looks at Richard Schwartz's own introduction to IFS and the research on it.
• →Not offered at TEO. Nobody at TEO offers yoga therapy, neurofeedback, somatic experiencing or theatre programmes, and TEO does not prescribe medication. Speak with a doctor or nurse practitioner about anything medical, including medication.

Whether you work with EMDR, CBT or IFS, trauma work at TEO aims to go at a pace you can manage, and you can say no to anything that feels like too much. Our trauma therapy page describes the approach.

Is The Body Keeps the Score Worth Reading?

It can be, if you read it as one clinician-researcher's influential and passionate argument rather than a settled textbook. Haslam, one of its critics, credits its hopeful message and its clear account of trauma science. Its weaker points, as the critics above argue, are its claims about lasting brain change and its confidence in body-based treatments whose evidence is still emerging.

Treat its brain claims as hypotheses, bring treatment questions to a qualified professional, and borrow the book from your public library or buy it from a bookstore. This guide contains no affiliate links.

Talking to Someone About Trauma at TEO

If the book has raised questions about your own experiences, a free 15-minute consultation is one place to start. Mohamad Shabib, MACP, CCC, is a Registered Psychotherapist (Qualifying) with the College of Registered Psychotherapists of Ontario (CRPO), and he works with clients in all six provinces in English or Arabic. Alison Shaji, MA, RCC #22608 (BCACC), works with clients in British Columbia in English, Hindi or Malayalam.

Individual sessions are $150 for 60 minutes, and no referral is needed. The consultation is by video or a scheduled phone call, booked online. Book a free consultation, or text (519) 760-5211 with a question first.

You don't have to work through it alone.