The Body Keeps The Score

What? Let the bodies keep the score, let the bodies keep the score. The bodies keep the. The other one that somebody pointed out was, you know, the Abbasong winner takes it all. No, I do not.

You can also do the body keeps the score, which has been stuck in my head for like three weeks. Sound off in the comments. Are there any other signs? What other songs match this book? Well, what do you have?

Oh, I was just going to do that. Oh, wait, you actually were? Yeah, of course. What else is there? How can you even do that though? You can't just chant into the music, kicks in. Yes, I can. And wait, come up with the better one.

I can't believe I've to come up with a thing about trauma. A thing I don't understand at all. It's a great thing to announce throughout the back.

Trauma never looked into it myself.

Could you just have the score, like a soccer, like a. What don't try to make me do sports? I don't know. Dance for me, monkey. To a sports show.

Well, you have to do something else. Have one.

“Alright, Peter, Michael, what do you know about the body keeps the score?”

All I know is that I've been told the score, my body keeps is a 6.5 at best. So, the full title of the book is the body keeps the score, colon. Brain, mind, and body in healing of trauma by Bessel Vander Coke. What do you know about this book, Peter? Very little.

I don't know a lot about trauma. This will be embarrassing for me because I feel like you're going to send me excerpts and be like, can you believe he said this about trauma? That'll be like, what do you, what did he get wrong? I don't know.

The author is a psychiatrist. Oh, even though I constantly mess up and say psychologist. He runs a trauma center where he works with individual patients. He's an actual, actual guy in the space. Oh yeah, he's like an actual expert, he's like very well known in the field.

He's published widely about this. This isn't a book by just like a guy. Okay. It comes out in 2014, essentially nobody notices it. And then it just starts slowly kind of rising up the Bessel or charts.

Eventually around 2018, 2020, it appears entirely through word of mouth. This ends up on the New York Times bestseller list. And then stays on the bestseller list for 248 weeks. Ooh, one of the reasons I'm doing this is because if you check the random Amazon charts of like non-fiction books, this will oftentimes be in the top five, despite now being

12 years old, like, you know, eventually it gets endorsed by Oprah and there's like various high prominent people that recommend this book.

But at first it was just like, I read this book and you tell your friend about it kind

of thing. I think for this reason, I want to give like a big disclaimer at the beginning of this episode. I think people are probably very clenched for us to talk about this episode because I'm sure you know people like this.

I know a lot of people who read this book and liked it and got something really beautiful out of it. This book is the kind of thing that like people you like and respect will tell you to read it. So I don't want to like take that away from somebody.

“The most important thing about this book, I think is really just the premise and especially”

the title. Yeah. So for this episode, I talk to four different psychologists, all of whom either specialize in trauma or see a lot of patients who've experienced trauma. And all of them said that this was an important kind of corrective to the field and an important

way of broadcasting to the more general public. The idea that when you are traumatized, that has physical symptoms, right? It shows up in your sleep, it shows up in your immune system. It shows up in all of these ways that don't necessarily feel like trauma to you, right? It doesn't feel like a trauma response.

That was like really healing for people to be like, oh, it's not that I'm broken. It's that I'm affected by the thing that happened to me as the child. The other thing that I think was really important about this book is the idea of complex PTSD, the previous kind of old school understanding of PTSD, was that you had to experience a major single event.

You experienced a sexual assault or you were in combat or you were in a car accident. But it turns out you don't have to experience one discrete event. You can experience like more lower level events over a long period of time. Okay. And I also think that's like a really important reframing both within psychology and also

among the public. Is that goes contra what the soprano said about Tony having anxiety attacks whenever he saw me because he traced it to his father's criminal activity when he was young. That's almost like too specific. You're like, give it to me in sopranos.

I'm going to figure this all out based on a series of prestige television shows.

“I think the third thing that was important about this book and is one of the reasons why”

people like it is that the author of this book and the book itself have extremely good politics.

So one of the critiques that you always hear of books like this that are kind of individually

focused efforts to help you deal with your trauma or self-help books in general is that they don't talk about structural forces, right? The entire epilogue of this book is dedicated to talking about structural drivers of trauma. So here is an excerpt.

of food stamps for kids whose parents are unemployed or in jail with a stubborn opposition

“to universal health care in some quarters with psychiatrys of tooth refusal to make connection”

between psych-excephering and social conditions with the refusal to prohibit the sale or possession of weapons whose only purpose is to kill large numbers of human beings. And with our tolerance for incarcerating a huge segment of our population, wasting their lives as well as our resources. When I give presentations on trauma and trauma treatment, participants sometimes ask me to

leave out the politics and confine myself to talking about neuroscience and therapy. I wish I could separate trauma from politics, but as long as we continue to live in denial and treat only trauma while ignoring its origins, we are bound to fail. In today's world, you're zip code, even more than your genetic code determines whether you will lead a safe and healthy life.

Cooking. He's cooking. Absolutely cooking here. So as opposed to many of the other books we talk about on the show, we won't really be criticizing him for things he leaves out of his book.

It is a book focused on individual therapies, but I kind of think that's somewhat defensible like he's a psychologist.

“He treats individual patients, telling the patient like, well, you should solve racism.”

Is it really, like, useful as a therapeutic mode? It's also, it's not what he's an expert at exactly. Right. So I think that's defensible. Yeah.

However, saying all of that, I also was very struck while I was reading this book. By the sheer size of the gap between the book that people described to me and the effect that this book has had on them versus the text of the actual book itself. So we're going to walk roughly chronologically through the book. We start with chapter one.

This is Basil Vandercoke talking about his upbringing, how he ended up as a trauma therapist. He is born in 1943 in the Netherlands in 1962. He moves to Hawaii for college. He gets a summer job in a psychiatric asylum, essentially. And given how many of the patients there are suffering from trauma or have been through

really horrible things, this inspires him to become a psychologist and works specifically on trauma. So the opening scene of the book is in 1978 when he is dealing with a Vietnam veteran. This guy watched all of his compatriots killed in front of him. There was some sort of ambush when they were in Vietnam.

He had a really close friend who he basically watched murder like three feet away from him.

He's super fucked up from that and then Basil Vandercoke continues. Maybe even worse for Tom than the recurrent flashbacks of the ambush was the memory of what happened afterward. I could easily imagine how Tom's rage about his friend's death had led to the calamity that followed.

It took him months of dealing with his paralyzing shame before he could tell me about it. The day after the ambush, Tom went into a frenzy to a neighboring village, killing children, shooting an innocent farmer and raping a Vietnamese woman. After that, it became truly impossible for him to go home again in any meaningful way. And then he continues.

At the end of his tour of duty, Tom was honorably discharged and all he wanted was to put a Vietnam behind him. Outwardly, that's exactly what he did. He attended college on the GI Bill, graduated from law school, married his high school sweetheart and had two sons.

Tom was upset by how difficult it was to feel any real affection for his wife, even though her letters had kept him alive in the madness of the jungle. Tom went through the motions of living a normal life, hoping that by faking it, he would learn to become his old self again. He now had a thriving law practice and a picture perfect family, but he sensed he wasn't

normal. He felt dead inside. So a lot going on in these paragraphs. Can we get Tom in prison, folks? This is like a very complicated sequence of the book.

One of the things that's interesting if you ever look up this book on Reddit is like every three months. Somebody will go on Reddit and be like, "My friend recommended the body keeps this

court to me and then I read it and the first anecdote is a sympathetic portrayal of someone

who raped and murdered a bunch of people, not like as a survivor of sexual assault. This feels really fucking weird." On the other hand, I do want to say that all of the trauma psychologists I spoke to said that if you're a trauma therapist, you are dealing with people who have done horrible things.

A lot of people's trauma is based on what's happened to them, but also how they react to it. People who were traumatized, like beat their spouses, they killed somebody in a drunk driving accident. I mean, this is just part of like being a trauma therapist.

“And maybe murder a bunch of children, this is just, no, I, here's the thing, I get it.”

Even as I was reading it, I sort of get it, right, where there's this chain of events that starts with this horrible trauma and leads to more horrible things. Yeah. It is weird though that the solution it feels like we're working toward is like comfort and peace for Tom.

Exactly. And I think what people are really responding to is not just that this anecdote appears in the book, but the way that it appears in the book. Because at no point does Bessel Vandercoke give a single statement of sympathy to this poor woman in Vietnam who had her children killed and was brutally raped for no fucking

To me, this story is a story of like the cycle of trauma, right? That when you get fucked up, you do something even more fucked up to innocent people. That is what this story is, right?

“And I also think fundamentally, this is a story about racism, right?”

He wants to impose collective punishment on this woman because she's Vietnamese and he considers Vietnamese people to be like such a distinct species that if one of them does something bad to you, then you can just inact revenge on others of them, like he could have also said,

like, yeah, when I first started out as a trauma therapist, it turns out people have

done really fucked up shit and it might seem difficult from far away to talk about this, but also I want to prevent Tom from acting these violent fantasies out in his life now, that was my purpose at the office, that there are ways to present this that keep the same basic facts of the story, but kind of like put it in context of like, yes, Tom should be in fucking prison, but given that that's not really in my power as a therapist, I'm going

to try to work with Tom to make sure that this doesn't happen again. Yeah, it's like he felt that inside, it's like, well, yeah, because you made other people dead outside. You actually killed children, dude. Yeah.

What? I don't know. This, like, it's hard not to read this and be like, wow, this man sure went unpunished for his horrific crimes, but what he's actually saying is just like, Tom is sad. So after Tom, we then meet another Vietnam that are named Bill, oh boy, who is a

participant in the study about the same man. There's a series of work crimes and they're like, Bill sad too.

So I mean, basically, here's this bill, or the Napom King, as they call him, it's part

of that study. We gave our participants a Worshack test, unlike tests that require answers to straightforward questions, responses to the Worshack are almost impossible to fake. The Worshack provides us with a unique way to observe how people construct a mental image from what is basically a meaningless, a blood of ink.

Because humans are meaning-making creatures, we have a tendency to create some sort of image or story out of those ink plots. What people make out of these plots can tell us a lot about how their minds work. On seeing the second card on the Worshack test, Bill exclaimed in horror, that is that child I saw being blown up in Vietnam. In the middle, you see the charred flesh, the wounds,

and the blood is spurting out all over, panting and with sweat beating on his forehead, he was in a panic similar to the one that had initially brought him to the VA clinic. I got to say, that's the most straightforward Worshack example I've ever heard in my life. Dude, yeah, I looked this up. The Worshack test, you know, it's ink plot test. Everyone is kind of seeing these like canonical ink plots, symmetrical ink plot things.

They always use the same tin, so it's always the same ones.

Right. And like, yeah, there's something kind of weird about the way that he describes it here, because like, when I look at them, I see like a bat or like a mask. I'm just like butterfly. That's a butterfly that you got another butterfly there. I'm not like, it's it's my dad emotionally neglecting me.

Like, it's really weird.

“I don't know what it's like to have this level of like trauma, right?”

So I'm not, I don't want to be too flippant, but if you like put that in front of someone, and they're seeing shit like that, I don't know, it just doesn't comport with my understanding of how that would actually play out. But whatever, he then has a long sequence where he talks about all the other veterans that they brought in to use the Worshack test.

He says the veterans interpreted the cards with descriptions like these are the bowels of my friend, Jim, after a mortar shell ripped him open. And this is the neck of my friend, Danny, after his head was blown off by a shell, while we were eating lunch. You're showing them to Elon Musk and he's like, that's someone online being me.

That is a helicopter shot of white genocide. So like, we're eight pages in the book. I'm like, is this really how the Worshack test works? Because like, you know, we've all seen him in movies. Yeah, yeah.

The Worshack test is completely debunked pseudo science. That's kind of what I thought, but I didn't want to say it out loud. I was like, this is real. This isn't the way that it works. Right.

That is a photo realistic image of my exact trauma. So there's an open letter by a bunch of psychologists called call for a more authoritarian on the use of the Worshack Ink Blot test in clinical and forensic settings from 1999. This is not a test that is like given all that much credibility.

It still is used in court sometimes in America, but that's really fucking embarrassing. And it's so weird for him to talk about this in 2014, as if it's just like a cool method that we have for finding out the truth about things. That's not how like anyone credible in the field talks about it anymore. You're allowed to use fake science in Puerto America.

And that's part of what makes this country. I started looking into this and the history of the Worshack test. It was often used to diagnose homosexuality.

“That's the one thing I think it works for.”

They're just like butthole butthole. Peter, Peter, Peter, I'm sending you something. I'm like not even fucking here's Adriatic is the thing. At that time, the five signs most often interpreted as diagnostic of homosexuality were the one buttocks and anuses, two feminine clothing, three male or female sex organs,

four human figures without male or female features and five human figures with both male

I am someone who like knows my way around an anus.

“I do not look at these fucking things and be like, oh my god, it's a buckle.”

Yet again a butt hole. Like if you think you can say I am someone who knows my way around an anus on this podcast and just move forward. Do you need a minute Peter to clip yourself? Actually this is such a sign to me of like this is not real science.

A gay person is not just going to be like this is a butthole they don't look like buttholes objectively. Secondly, I don't think people are just blurting out like you have this random business man who's like a closet at home is sexual and he's like yet again it's buttocks like there's no fucking way.

That's a little boy who's just begging for it.

I didn't mean I didn't mean I didn't mean an underage boy I meant I imagine I've

aged a little twink all right. Spellian B.O.I. it's it's fine it's not problematic that is it that's a beautiful 20 year old boy preventing himself to me.

“So we then get into the next section of the book which talks about how trauma affects the”

brain after he works with Vietnam veterans he then bridges out into people who've experienced child abuse sexual abuse they often have the same types of symptoms as the Vietnam veterans. So he starts to explore this and here is him describing what he sees as the mechanism behind this.

Whether the trauma had occurred 10 years in the past or more than 40, my patients could not bridge the gap between their wartime experiences and their current lives. Somehow the very event that caused them so much pain had also become their sole source of meaning. They felt fully alive only when they were revisiting their traumatic past.

He then has a section called addicted to trauma the pain and pleasure and the pleasure of pain. Okay. So here's more oh I should also say like this is a really rough description of somebody this episode is going to include a lot of like very detailed descriptions of sexual assault

“because that's what the book contains so if that sucks feel free to tap out.”

Many traumatized people seem to seek out experiences that would repel most of us and patients often complain about a vague sense of emptiness and boredom when they are not angry under duress or involved in some dangerous activity. My patient Julia was brutally raped at gunpoint in a hotel room at age 16. Shortly thereafter she got involved with a violent Pimp who prostituted her.

He regularly beat her up.

She was repeatedly jailed for prostitution but she always went back to her Pimp.

Finally her grandparents intervened and paid for an intense rehab program. After she successfully completed inpatient treatment she started working as a receptionist and taking courses at a local college and her sociology class she wrote a term paper about the liberating possibilities of prostitution for which she read the memoirs of several famous prostitutes.

She gradually dropped all her other courses. A pre-frelation ship with a classmate quickly went sour, he boarded her to tears, she said and she was repelled by his boxer shorts. She then picked up an addict on the subway who first beat her up and then started to stalk her. She finally became motivated to return to treatment when she was once again severely beaten.

The mechanism that he's describing is that you're kind of addicted to the neurotransmitters that are firing when you're underdress and so whether you realize it or not you're sort of in a way thrill-seeking or you're seeking out experiences that trigger these kinds of responses because when you're in more functioning relationships you're bored by them. It's not triggering the same kind of pleasure responses that you're getting from these traumatic

experiences. What do you think, Peter? I feel like we're a way out of my depth here. This sounds like it could have some broad element of truth to me, people who experienced trauma tentifying themselves in these scenarios more frequently but I have genuinely no knowledge

about this as a causal mechanism. This phenomenon is real so people who've experienced child abuse or child sexual abuse are more likely to be abused as adults and this is a phenomenon that is very well established but there's tons of work investigating why this phenomenon is real and essentially nobody subscribes to the idea that they are addicted to trauma.

So I read a really interesting paper that sort of goes through the history of this concept, how it's been interpreted over the years. A lot of really interesting qualitative work where they ask people like why did you return to this person who was abusive which again is a very common phenomenon. It's kind of part of the process of leaving an abusive relationship.

But often I'm just going back to that person a couple times, people who've experienced child abuse, child sexual abuse are more likely to go back to an abusive partner. That again is like an actual phenomenon. However, the cause of this is much more kind of obvious and direct so one of them is just poverty, people in poverty are more likely to be abused and people in poverty are more likely to be

abused as adults simply because it's harder to leave an abusive relationship if you don't have money. That is one aspect, another aspect that they think might explain some of it is that people who have experienced abuse and group in really chaotic homes can't spot the red flags of an abusive relationship as well.

They have a sort of higher tolerance for like mid-level toxic behavior, right?

You lack a framework for what like a healthy dynamics are, right? So obviously you're going to be bad at spotting unhealthy dynamics. Yes, and what's really interesting is there's all these qualitative surveys where they ask

“people like why did you go back to this abusive partner?”

And the most common response is I love him. One of the theories is that people have experienced abuse as children because of the cycle of abuse is you get abused and then the abuser apologizes on their do it again. They are more likely to accept the apology. You also think about things like child abuse can cause low self esteem, anxious attachment.

These other kinds of personality drivers that would make you more likely to go back to somebody who is treating you terribly, it's not that you're addicted to it or you like it or you're seeking it out. What was that thing about hating McEye's box or shorts? I don't know where. Was he trying to sort of like hint at the idea that she's coming up with excuses but was actually just bored? I don't know. I was googling around. I found like a

domestic violence research center and like the first like line of their frequently asked

“questions. It says it is important to note that victims do not stay in abusive relationships”

because they enjoy being abused. This idea that like they're addicted to it, they like it. They're bored if they're not getting it. This is like an old trope about people who are abused, right? It's sort of blaming them for the abuse like oh they want to be there and like that's just isn't fucking true. It's not something that people say in the field at all. Like this addicted to trauma framework that he's proposing here has not been the academic consensus about sexual assault

and your personal violence for like decades. Interesting. Yeah, I, this is the part of the episode where I'm just listening and learning. I'm like, you're like, wow. Tell him. Tell him. After he's established this like addicted to trauma model, he then tells us the brain mechanisms behind it. So he walks us through something called the triune brain model. The brain is built from the bottom up. It develops level by level within every child in the womb just as it did in

the course of evolution. The most primitive part, the part that is already online when we are born, is the ancient animal brain often called the reptilian brain. The reptilian brain is responsible for all the things that newborn babies can do. Eat, sleep, wake, cry, breathe, feel temperature, hunger, wetness, and pain. Any effective treatment for trauma has to address these basic housekeeping functions of the body. So now he contrasts the reptilian system with the more advanced parts of the

brain. Right above the reptilian brain is the limbic system. It's also known as mammalian brain because all animals that live in groups and nurture their young possessed one. Development of this part of the brain truly takes off after a baby is born. It is the seat of the emotions, the monitor of danger, the judge of what is pleasurable or scary, the arbiter of what is or is not

“important for survival purposes. It is also a central command post for coping with the challenges of”

living within our complex social networks. And then he gets to the most sophisticated part of the brain. The frontal lobes are responsible for the qualities that make us unique within the animal kingdom. They enable us to use language and abstract thought. The frontal lobes allow us to plan and reflect to imagine and play out future scenarios. They make choice possible and underlie our astonishing creativity. So this is the driver behind the addicted to trauma model. Right? Because your

trauma is embedded in all three parts of the brain, including these sort of reptile instinctive parts. And so childhood trauma is that if you're only addressing it in the prefrontal cortex,

like the sort of logical part of your brain, you're basically leaving the trauma in those

deeper parts of your brain intact. It feels like we're building towards the inadequacy of talk therapy or something. Right? Where it's like, you can't talk out your trauma because you're using the top layer of your brain, but it goes deeper. We are also building toward the total debunking of this entire concept. This lizard reptilian triune brain model thing. It was invented in the 1960s based on extremely thin data from the early 1900s. It was

already controversial by the 1970s and it was essentially discarded by the field by the 1990s. Huh, okay. Humans, first of all, did not evolve from reptiles. It's not like there was a reptile brain and then there's like an extra layer on top of it. Essentially every animal has like the same parts. Like lizards also have a prefrontal cortex. There's different parts of the brain. It adapts. It does different things. But it just is not the case that like they have a

qualitatively different brain than us. There's also not really this like step-by-step evolution.

Like first there's your ancient brain and then there's like the more modern mammalian brain.

That just isn't how evolution works and even beyond the anatomical stuff. One of the core thesis of this book is that there's a clean separation between your emotional brain and your rational brain and that also just isn't true. So there's a really good article about this called the brain is adaptive, not triune that says modern neuroscience research demonstrates that the

during the stress response. Specifically, emotion and cognition are interdependent and work together. The limbic system is not a purely emotional center nor are there purely emotional circuits in the brain and the cortex is not a purely cognitive center nor are there purely cognitive circuits in the brain. I sort of intuitively understand that like we don't know an enormous amount about brains and so a lot of the ways which we talk about it colloquially

sort of metaphorical or you know very very oversimplified. Truly whenever he does this in the book, he like gets it wrong. There are huge sections of this book that are just like absolutely incorrect. He has a whole thing about the polyvagal system which is like a spinal cord thing. You have your sympathetic system and your parasympathetic system. It's a similar thing. It's like one system ramps you up and another system kind of cools you down and then trauma affects it in the specific way.

That's also been completely debunked that was debunked away before this book was ever published.

There was never any good evidence behind it. Anyways like a bunch of like rat studies and monkeys

studies and shit. But like he just includes it in the book. Let's go now with this guy. I thought he was uh uh well we'll get to be here. Well why, why does this world respected guy who

“is sort of legitimately an expert doing this? If the only thing in the book was misinformation”

of this type, like only fucked up the reptile brain thing, I don't think I'd be doing an episode on it. I'd be like whatever. I live the rest of your life thinking we have a reptile brain. Fine. But this starts to get worse when we get into the trauma in the body section. So after we talk about how trauma affects the brain, we talk about a trauma affects the body. I'm gonna send you the vignette. Sure, he had graduated from college, but now she worked in a joyless,

clerical job, lived alone with her cats and had no close friends. When I asked her about men, she told me that her only relationship had been with a man who'd kidnapped her while she was on a college vacation in Florida. He'd held her captive and raped her repeatedly for five consecutive days. She remembered having been curled up, terrified, and frozen for most of that time until she realized she could try to get away. She escaped by simply walking out while he was in

the bathroom. When she called her mother, "collect for help," her mother refused to take the call.

Cherry finally managed to get home with assistance from a domestic violence shelter. While Sherry

due to flea came to every appointment and answered my questions with great sincerity, I did not feel we were making this sort of vital connection that is necessary for therapy to work, struck by how frozen and uptight she was. I suggested she see Liz a massage therapist I had worked with previously. She gets massage, this is what I was talking about, right? It's like talk therapy

“is like too shallow. It's you're not digging deep enough into the brain. You must first get a massage.”

I also think a frozen and uptight is a choice of the way to describe someone who's like brutally raped. All right, a little bit. Juggie, it's like a little. Like uptight is just like a rude judgment person, right? And then at the end of the chapter, he comes back to her and talks about the results. It was fascinating to see how much Sherry benefited from her massage therapy. She felt more relaxed and adventurous in her day-to-day life and was also more relaxed and open

with me. She became truly involved in her therapy and was genuinely curious about her behavior, thoughts, and feelings. She stopped picking at her skin and when summer camp came, she started to suspend evenings sitting outside on her stoop chatting with her neighbors. She even joined a church choir, a wonderful experience of group synchrony. So if you've been raped, get a massage. I can't tell if this is like weirdly shallow and and insensitive or just like totally fine and like things

“that physically relax you might might actually chill you out a little bit. I honestly don't know.”

So for this ice book to any neat field, who is the author of a memoir about trauma called Acceptance

and wrote like one of the first pieces to publicly criticize this book for Mother Jones.

It's excellent. I'll include it in the show notes. As part of the research for that article, she contacted Bessel Vandercope to ask him about another problematic anecdote and he told her that other than Bill, every anecdote in this book is a composite. Oh, meaning they are made up. Wait, other than the guy who looked at the worship and was like, "That's video of my Vietnam experience." According to him, that is the only real anecdote in the book. There's one

other that's kind of like a news story. So that's like available publicly. But other than that, apparently he told her, "These are all composites." And I reach out to him to like double check this. Like, are these really composites? He didn't get back to me. But once you think about it this way, you notice a lot of just like weird fake sounding details in these anecdotes. The fact that this woman lives alone with her cats is like a little on the nose. And also, he says, "She told

me her only relationship had been with a man who'd kidnapped her." I don't know that somebody would describe that as a relationship. If you're a rape victim, have you ever been a relationship? Oh,

It feels very weird to do composite characters with trauma. What parts of this are one person?

“Is like a really important question here. Yeah, and like this is a book about trauma. So you're”

going to change the names of some people. You're going to change some details so that like people aren't identifiable. That sort of stuff is totally fine. I have done this in magazine articles when

I've had sources that I didn't want to identify. But first of all, he didn't disclose anywhere in the

book that he's doing this or described like the extent of that. Secondly, if he's compositing characters, that means he's taking different pieces from different people's stories. This book depends heavily on these miraculous cures for trauma. Yeah, what right? Was the person who benefited from massage therapy, the person who was kidnapped? He also made up the thing that she was uptight potentially. That's a sort of weird move. What if the only composite aspect is the

three cast? You know, he threw that in just like, oh, you got to make it believable. Right. So we're not going to talk all that much about the rest of this section about how trauma affects the body.

“Again, this book, the basic premise is true. This basic mechanism is true. The most notable”

thing though is that this is the section where I started to notice a weird sloppiness when it comes to facts. So a lot of the section is about this work by Frank Putnam, who is examining the effect that trauma has on young girls. He has two groups, a group of abuse girls and a group of non-obuse girls, and he follows them for 20 years, and he gets like their biomarkers. And so here is Bethel Vanercoke describing that study. By the time girls get to middle school, most have begun

to master a whole set of social skills, including being able to identify what they feel, negotiating relationships with others, and pretending to like people they don't, and so on. This sexually abused girls have an entirely different developmental pathway. They don't have friends of either gender because they can't trust. They hate themselves, and their biology is against them, leading them either to overreact or numb out. They can't keep up in the normal

“envy-driven inclusion exclusion games in which players have to stay cool under stress.”

Other kids usually don't want anything to do with them. They simply are too weird, but that's only the beginning of the trouble. The abused isolated girls with incest histories mature sexually a year and a half earlier than the non-obused girls. Sexual abuse speeds up their biological clocks, and a secretion of sex hormones. Early in puberty, the abused girls had three to five times the levels of testosterone and androsinidion, the hormones that fuel sexual desire

as the girls in the control group. So the first thing that stuck out to me was this finding

about friendship. He says, "They don't have friends of either gender. They can't trust. They hate themselves. Other kids don't want anything to do with them." I was like, "Is this really what the study show that they don't have any friends?" He does as a lot through the book where he talks about people who have experienced trauma and he's really totalizing terms. They can't experience pleasures. At one point, he says they're disconnected from their soul. So in a way, I went to

his citation for this. The citation includes five publications. One of them does not appear to exist. The rest of them don't include anything about number of friends, happiness with friends, social, ostracism, etc. One of them includes a citation to a 2000 paper that does look at the number of peers that abused and non-obused girls have when they are young. Pears is defined, though, as the number of people around you like classmates, if you're in school, it's not friendship.

Yeah. So this finding that, like, the girls hate themselves and everybody else hates them too, that just is not supported by the literature at all. Right. The other result that stuck out to me was this result that when you're abused, you hit puberty earlier. This is actually true. Yeah, I've heard that before. This is one of the big pieces of evidence for, like, yeah, they're physiological effects of trauma. Vandercoke says it's 1.5 years. The study that he's

citing says it's 7.5 months or 6 months earlier, depending on which stage of puberty you're talking about. But that one, I mean, I'm kind of willing to forgive that one. It's like a sort of a detail error. There's also the finding that abused girls have three to five times the testosterone and androced in idiom levels of non-abused girls. This also does not appear in any of the sources that Bessel Vandercoke sites. Goddamn it. I reached out to Frank Putnam about this. He said results

like this have never been published. I started Googling around and I found that Bessel Vandercoke

has been saying this for more than a decade. I found a presentation that he gave to Congress in 2010 where he just like says that abuse girls have five times the testosterone of non-abused girls. Oh. This is, as far as I can tell, a super preliminary result that was never published,

This is interesting because sometimes when I'm doing an episode for the podcast or writing

an article or whatever, you're trying to present what is like a relatively small point. But if you're trying to be detail oriented, it can actually take you a while to pin it down and you go down a

“rabbit hole and maybe you decide it's not worth it at the end of the day. Yeah. Yeah. But if you want to”

be good at this shit, if you want to be a reliable author, then you have to do it. Like before you present a fact as a fact, you have to actually track it down and like see, you know, just check the veracity and sometimes that's a lot of work. And so when someone does this sort of like, you know, I heard this somewhere. Yeah. Yeah. And then like they pop it into their book like it's as much of a fact as something that's been the subject of peer review. Yeah. That to me is just a

like an indicator that someone maybe shouldn't be writing a book about this shit. The thing is, I don't want to throw too many stones because like I do fuck up details like this all the podcasts. Like this is an unscripted show. Well, everywhere, everyone fucks up a detail. There's a difference between fucking up a detail and going to Congress and presenting something you you heard your friends say without peer review. And again, I wouldn't be harping on the stuff.

“If this was the only factual error in the book, but like everywhere throughout this book,”

there's just a weird, sloppiness. The opening paragraph of the book includes two factual errors, places where his own citations do not agree with him. He also says that this landmark study showed that women who had an early history of abuse in neglect were seven times more likely to be raped in adulthood. He sights a study that doesn't include rape. But that very much feeds into his narrative that they are consciously seeking it out in some way. It also says at one point traumatized

children have 50 times the rate of asthma versus their non-traumatized peers. 50, 5, 0. That is crazy. I mean, it field looked into this one. This is not in his sighted study. And like the testosterone one, it isn't something you find in the broader literature. It would be a huge deal if it was true. Yeah. So I've no idea where this came from, but it appears to be something that he pulled out of thin air. It must have pulled that out of extremely thin air. Am I right? But asthma and joke.

I'm cooking. So we then get to the section that he has about trauma and childhood. So how childhood trauma affects you as an adult, I'm going to send you. There are hundreds of thousands of children like the ones I'm about to describe. And the absorbent, enormous resources often without appreciable benefit. They end up filling our jails, our welfare roles, and our medical clinics. Most of the public knows them only as statistics, tens of thousands of school teachers,

probation officers, welfare workers, judges, and mental health professionals spend their days trying to help them and the taxpayer pays the bills. The American taxpayer? I love it when people frame these sort of like social Isles as like a taxpayer problem into the day. It's like and even worse, you're paying. Yeah, I love seeing the word welfare roles in a book like this. That feels great to me. So then he gives us a bunch of vignettes of children who have experienced

abuse. Then there's Maria, a 15 year old Latina, one of them more than half a million kids in the

United States who grew up in foster care and residential treatment programs. Maria is obese and aggressive. She has a history of sexual, physical, and emotional abuse and has lived in a more than 20 out of home placements since age eight. The pile of medical charts that are ride with her described her as mute, vengeful, impulsive, reckless, and self-harming with extreme mood swings and an explosive temper. She describes herself as garbage, worthless, rejected. After multiple suicide attempts,

Maria was placed in one of our residential treatment centers. Initially, she was mute and with drawn and became violent when people got too close to her. After other approaches failed to work, she was placed in an equine therapy program where she grew up her horse daily and learned simple dressage. Two years later, I spoke with Maria at her high school graduation. She had been accepted by a four-year college when I asked her what helped her the most. She answered the horse

I took care of. Another person who healed her trauma not through talking about it, but through something separate. Yeah, dressage, the simple key folks. Yeah, this is just a great example of why how sick it is to be rich. You know, you know what helps is a horse. If you guys can just get a hold on one of those. And then okay, then he has one more, Peter. Then he has one more. Virginia is a 13 year old adopted white girl. She was taken away from her biological mother

because of the mother's drug abuse. After her first adopted mother fell ill and died,

she moved from foster home to foster home before being adopted again. Virginia was seductive with any male who crossed her path and she reported sexual and physical abuse by various babysitters and temporary caregivers. Personally, I constantly describe their 10 year old girls as sexually aggressive.

“Yeah, ooh. They're seductive with any male. That's, that's what I say about their 10 year olds.”

She came to our residential treatment program after 13 crisis hospitalizations for suicide attempts.

vindictive, and narcissistic. He described herself as disgusting and said she wish she were dead.

Remember, again, the way that he described the Vietnam veterans? Oh, he did these horrible things, but he felt really bad about it. He's struggling so many of the vignettes of men describe a horrible behavior, but also are like, well, he couldn't help it. It's really hard for him. But a lot of the vignettes of women are just like, she's uptight. She's vindictive. Like, they're just like a tone that's typical to my finger on, but it's just the way that he describes

victims of abuse make me really uncomfortable throughout the book.

“The single sentence, Maria is obese and aggressive. Why would you mention how she looks?”

Maria is obese and aggressive. So he then gets into this adverse childhood experiences study,

which is where a lot of the data on like how trauma affects the body comes from.

He gives a little intro to the guy who is writing the study. In 1985, Vincent Felidi was Chief of Kaiser Permanente's Department of Preventative Medicine in San Diego, which at the time was the largest medical screening program in the world. He was also running an obesity clinic that used a technique called supplemented absolute fasting to bring about dramatic weight loss without surgery. That's a technique called supplemented absolute fasting. Is that sort of a

direct translation supplemented absolute fasting sounds like they give you vitamins and you don't eat food. This is a diet on which you subsist on 420 calories a day. I found like a little manifesto where he like lays out this diet. He says during a year of supplemented absolute fasting, a weight loss

of approximately 300 pounds will occur. Well, yeah. Yeah. Need to be a fucking eat.

You really need to like not have your period. All your hair is going to fall out. You might have

“a heart attack. But like yeah, you'll lose so much of your blood. Why not just go down to zero at that point?”

There's something funny like a lot of people who defend the body keeps the score will be like this is a product of its time. Like some of it's a little outdated. This is 2014. You sort of said that he's going chronologically through his own career. But here we are decades later and a lot of that should have been debunked to what he's sort of writing about it like it hasn't been. Yeah, exactly. And at no point, does he say like, oh, we've now updated these methods or something like that.

But this guy Felidi at the time is famous for exploring this link between trauma and obesity. And in one of his papers, he talks about the need to recognize the what he calls the benefits of obesity. So now we're back to Vandercoke. Here's Vandercoke describing this. One day a 28-year-old nurses aide showed up in his office Felidi accepted her claim that obesity was her principal problem and enrolled her in the program. Over the next 51 weeks, her weight dropped

“from £408 to 132 pounds. Again, this is just fairly impossible. Can this be, is this real?”

How is that? I mean, even on, they had a surgery. You don't see results like this. Losing such a three quarters of your body weight. However, when Felidi next saw her a few months later, she had regained more weight than he thought was biologically possible in such a short time. It turned out that her newly spelled body had attracted a male co-worker who started to flirt with her and then suggested sex. She went home

and began to eat. You've gained more weight than I biologically thought was possible, really, because you're bending the boundaries of biologically. No exactly. Yeah, 300 pounds in a year. As he and his team started to acquire more closely, they were shocked to discover that most of their morbidly obese patients had been sexually abused as children. They also uncovered a host of other family problems. 12 years after here originally treated her

Felidi again saw the woman whose dramatic weight loss and gain had started him on his quest. She told them that she'd subsequently had bariatric surgery, but that after she'd lost 96 pounds, she'd become suicidal. It had taken five psychiatric hospitalizations and three courses of electroshock to control her suicidality. Felidi points out that obesity, which is considered a major public health problem may in fact be a personal solution for many. Oh my god, this was my

like I'm the fucking Joker moment with this book. This is sort of a common trope that obesity is like a trauma response to sexual abuse. And for some people, it is, right? That is the abuse of some people. However, saying most of their obese patients had been sexually abused as children insane. Right. The idea that it's sort of like you are obese. Therefore, this must be a trauma response of some kind, you're reacting to something. And if you did not have this

trauma, you would be normal size. And this gets to a huge problem with this book. He attributes to trauma things that have much more proximate causes. Yeah. Anyone who loses 300 pounds on a fucking diet, 99.9% of those people are going to gain some of the weight back most of the weight back, right? The overwhelming experience of people who lose huge amounts of weight is that they gain it back. That is very common. That doesn't mean that they have trauma or that they haven't

response to not having enough food, right? Your body is screaming at you to put the weight back on.

“Yeah. And like, he can hide behind. Like, oh, well, I'm not saying most fat people in general”

were sexually abused. I'm just saying this one clinic, right? Oh, he founded this one clinic at no point is vessel van der Coke say like, oh, well, we've actually done follow up studies and it turns out they're like at the population level. That's not true. There's also other drivers. He just fucking leaves this there. And then gives the explanation of, ah, it may in fact be a personal solution for many. Right. The numerous sounds are the book. He attributes things like

autoimmune disorders, various like at one point a woman cares her asthma by curing her trauma. It seems like he's taking this idea that like trauma can manifest in these physiological symptoms and starting to invert it. So he sees a physiological problem and he's like, that must be trauma. Peter, I have led you perfectly to what really bugs me about the book and what I want to get into. I think I think I found my way there myself. This is what again is so interesting to me

about like what people have taken away from the book versus what the book actually says. What people have taken away is like, yeah, trauma has physical effects. Trauma is stored in the body. Yeah. Again, I find that lovely and true and accurate. And I think it's great. There's a much broader understanding of that. However, the actual book itself says over and over again,

“that trauma is only stored in the body. And the only way to deal with trauma is to do”

physiological interventions like take care of a horse, do yoga, get a massage. It is a mistake to work on it in a logical way. You should be working on it in these instinctual ways. Do we get to that point where he's sort of like talk therapy is not the correct starting point for most people? Yes. The next two chapters of the book are dedicated to the idea that the standard medical model cannot address trauma because it doesn't get to the root causes

of people's symptoms. This is why he hates talk therapy and this is why he hates medications. Ooh. I want one doctor to be like, you know, every now and then, a pimple or as a pam and half a glass of wine, you will feel unreal. So here's this. Because drugs have become so profitable, major medical journals rarely publish studies on non drug treatments of mental health problems. Practitioners who explore treatments

are typically marginalized as alternative studies of non drug treatments are rarely funded unless they involve so-called manualized protocols where patients and therapists go through narrowly prescribed sequences that allow little fine-tuning to individual patients needs. Mainstream medicine is firmly committed to a better life through chemistry and the fact that we can actually change our own physiology and inner equilibrium by other means,

then drugs is rarely considered. Nobody wants to look into non drug treatments for mental health condition. This sounds like RFK and sometimes my mother. This is very mohawkoded, especially the thing

that because drugs are profitable, they never look into anything else.

Not true, but whatever. Bessel Van der Coat hosts seminars where he charges $1,200 a person, people who give yoga and massages and fucking equine therapy also charge money. Also profitable, like selling bullshit ass supplements is profitable. Wellness retreats costs like tens of thousands of dollars sometimes.

There's sort of like this underlying grain of truth here, which is how this stuff always works, that like, yes, there is money in pharmaceuticals, which means you get a ton of research about the efficacy of pharmaceuticals, and it's probably disproportionate, but the way this always gets used is like, you'll find someone who's eating horse hair. That doesn't work, man.

You can't eat horse hair to make yourself taller. There's never going to research showing that,

and they're like, that's because they won't fund it, dude. And also, key mentions here. Therapists have to go through narrowly prescribed sequences that allow little fine-tuning to individual patient's needs. That's called a study. That's called a randomized control trial where you test something against a placebo to see if it actually has an effect. You can't just say, "Oh, you can't test these medicines."

This is something you always fucking hear from these people. It's like,

“"Oh, I'll turn to the medicines. You can't even really test them." Why?”

You can fucking test them against other things. Peter, I want you, right now, to go to Google Scholar and type into the search bar yoga depression. That's interesting because almost all of our listeners have yoga depression. I'm getting a mere 339,000 results. Of course, there's not all going to be studies in our CT's and shit, but yeah, yeah.

339,000 results. Yeah, yoga for depression, a systematic review in meta-analysis, yoga for depression, the research evidence. There's a ton. All the top ones are meta-analysis. The entire medical system is not like, "Let's do drugs forever." A lot of people, just like he is, are pretty uncomfortable with the amount of drugs

of the American population is taking. Your doctor will oftentimes have you go through a number of non-drug treatments before he will give you a drug, right? It's not like every single person who goes for any kind of mental illness just like gets fucking drugs on the way out. It took me

And what'd you get? Anything good? Well, I gave you a bunch of bullshit and nothing worked. I'm still like this, Peter. We're just too unmedicated ADHD here on a podcast. They were like, "Is it affecting your functioning at all?" I was like, "I actually need it to function." I actually need to be a a wired little weirdo. I'm actually seeing things so clearly. Please don't give me medicine. I actually need to be upsetting as a person to keep my job so

don't medicate me. I actually need to work in waves of productivity and complete collapse. So this issue of not addressing the root causes is his reason why medications don't work. It's also his reason why therapy doesn't work. Nice. He talks about this throughout the book that like, talking won't get at it, talking won't touch the amygdala, talking doesn't do it.

He always wants to push you to these body-based things either as a replacement for

talk therapy or as a prerequisite for talk therapy. So here is another place where he talks about that.

“I think it's like a good articulation of it. Steve Gross used to run the play program”

at the trauma center. Steve often walked around the clinic with a brightly colored beach ball and when he saw angry or frozen kids in the waiting room, he would flash them a big smile. The kids rarely responded. Then, a little later, he would return and, quote, accidentally drop his ball close to where a kid was sitting. As Steve leaned over to pick it up, he'd nudge it gently toward the kid who'd usually give a

half-hearted push in return. Gradually, Steve got a back-and-forth going and before long he'd see smiles on both faces. From simple rhythmically attuned movements, Steve had created a small, safe place where the social engagement system could begin to re-emerge. In the same way, severely traumatized people may get more out of simply helping to arrange chairs before a meeting or joining others in tapping out a musical rhythm on the chair seeds,

then they would, from sitting in those same chairs and discussing the failures in their life.

“Discussing the failures in your life is a wild way to describe therapy.”

Discussing the failures in your life. Do you just talk about victims of abuse? There are sections in the book where he says, like, talking about a trauma is really important for people, but he does it in the way that Barry Weiss says, like, I'm a liberal.

This sort of, like, talk therapy works, but it's always followed by a butt or a however,

and also keep in mind, right? He told the story of that rape victim who, like, she did massages, and, like, it was amazing how much better she felt, right? The other rape victims, like, oh, she took care of horses and I started high school graduations to, like, the most important thing for me was taking care of the horse, this immediate permanent turnaround due to these kind of, like, body-based, non-talk therapy interventions. This book contains probably 50

case studies, like, little vignettes of various, like, victims of trauma. There's not a single person in this entire book that benefits from talk therapy. He infers from this little story about, like, getting a kid to play with the ball, that someone who's severely traumatized, might get more out of helping to arrange chairs, can talk therapy. I don't, I understand the beach ball story and, like, the mechanism he's talking about broadly, but I don't understand how he's, like,

similarly, arranging chairs is better than talk therapy sometimes. I don't get it. Well,

luckily, luckily, Peter, he spends the entire second half of the book, articulating this exact

concept. Yeah. Right, it helps to do body stuff, rather than talking stuff. Okay. But before we talk about his prescription to treat all of this bodily trauma, we have to go on a little interlude, mostly because this book goes on an interlude. So, Peter, are you aware of the recovered memories, panic, recovered memories panic? No. The started in the 1980s. Hold on. I'm going to guess. Oh, yeah, go, go, go. Do it. Let's just really 30 minutes, just speculate, go. I feel like this

sounds familiar, so I'm sort of picking it something, but the idea that, um, due to trauma, memories get buried. Yes. And then you can sort of do certain things to trigger those memories to resurface. This is one of the most embarrassing episodes in the history of modern psychology. And that's saying something folk, fake science. But so the entire thing started, essentially in the 70s and 80s, when, yeah, they're started to be data about the way that trauma was affecting various health

systems in your body, all of the stuff that we've already talked about. But people would go to their therapist and say, oh, I haven't Psalmnia. I'm having panic attacks. I'm having these symptoms, but I don't have any trauma. Like, I had a happy childhood, right? A lot of therapists took this idea way too far. And the therapists were then like, oh, well, what if you have trauma, but you don't

“remember it. You've blocked it out. And so oftentimes, they were using hypnosis or other techniques”

to kind of soften people up a little bit. And then they would eventually get them to quote, remember, abuse that they had suffered. Okay. So the starting pistol for this entire panic was the 1980 book, Michelle Remembers, which means they're at a whole series on where this woman

hundreds of people in a basement in Victoria, B.C. and a suburban neighborhood. People are cutting off their fingers as part of the ritual. They're murdering like 10 to 20 white kittens, like every night that they're doing this, things that if it was happening like you would notice, you'd be like, why are we delivering 300 white kittens to Victoria, B.C. every week? But this was, I mean, this was a really popular kind of understanding of memory, right? So, you know, of course it's

promoted on Oprah. It's on Donahue. There's a million like TV shows about it. There's lots of

other kind of popular books and self-help books. Essentially saying like, if you think you had a happy childhood, there's a chance that you were like systematically abused for years and you don't

“remember it. Yeah. So, for this, I spoke to Richard McNally, who is a Harvard researcher and the author”

of Remembrance Trauma, which is one of the definitive books that debunks this trend, the other one is by Elizabeth Loftus, according to him and in his book, Bessel Vandercoke was a major promoter of this theory. Okay, now we're cooking. So, starting in the 1980s, he starts doing these studies that show that memory is stored kind of in this fragmentary way and that people oftentimes don't really know that they're storing it. And then in 1994, he publishes an article laying out this

entire like repressed memory theory. The paper is called drum roll, Peter. The body keeps the score. So, the original proposal of this concept was about repressed memories. And it predates the disturbed song. He lays out in this paper, and various other things that he writes during the 1990s, his core thesis that Trauma is not stored the way that other memories are stored. So, in this paper, he says, Trauma interferes with declarative memory, i.e. conscious recall of experience,

but does not inhibit implicit or non-declared of memory. So, that's essentially the thesis of

like the first half of the book, right, that your memories of Trauma are being encoded in your body,

and they can't be accessed like other memories, right, that you're getting these like fragmentary glimpses, you're getting pieces of a story, but you're not encoding like first this happened, then this happened, then this happened. To his credits, Bethel Vanercoke is not like a satanic panic guy. I read one of his papers from 1998, where he explicitly decryzed the satanic stuff. He's like, well, some of that stuff's implausible, but he's very focused on this idea that

traumatic memories are not the same as ordinary memories. And so, in this book, the body keeps a score, chapter 11 and chapter 12 are basically recapitulations of this theory. So, I'm going to send you

“this. When people remember an ordinary event, they do not also relive the physical sensations,”

emotions, images, smells, or sounds associated with that event. In contrast, when people fully recall their traumas, they have the experience. They are engulfed by the sensory or emotional elements of the past. The brain scans of Stan and Ut Lawrence, the accident victims in chapter 4, show how this happens. When Stan was remembering his horrendous accident, two key areas in his brain went blank. The area that provides a sense of time and perspective, which makes it possible to

know that, quote, that was then, but I am safe now. And another area that integrates the images, sounds, and sensations of trauma into a coherent story. When those parts of the brain are knocked out, you experience something not as an event with a beginning, a middle, and an end, but infragments of sensations, images, and emotions. So, this is why these bodily-based

“treatments are so important, is because it's embedded in you as these fragments, and you have to”

put them together, and you can only do that by accessing these kind of lower-order, ancient reptile

systems, basically. Here, what do you think about that, but the excerpt? I don't know one of my

fucking brain scientists. That's a fucking old show, Peter. That means, you say a joke, so I can move on. That was my joke. Let me, all right, let me take it for the show. Oh, I think he's missing something. He doesn't, it doesn't seem like he's accounting for some cortex or another. He essentially religates the memory wars throughout the course of this book. So, here is him talking about the fact that repressed memories are proven science. This issue was not particularly

controversial. As early as 1980, the DSM-3 recognized the existence of memory loss for traumatic events in the diagnostic criteria for dissociative amnesia. An inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by normal forgetfulness. Memory loss has been part of the criteria for PTSD since that diagnosis was first introduced. There haven't fact been hundreds of scientific publications spanning

well over a century documenting how the memory of trauma can be repressed only to resurface years or decades later. Memory loss has been reported in people who have experienced natural

abuse. Total memory loss is most common in childhood sexual abuse with incidents ranging from 19% to 38%. As early as 1980 thing stood out to me as maybe he's cherry picking a time when this actually was more when the scientific consensus was on his side and now it's not, now it's shifted away. Is that what's happening? There is still dissociative amnesia in the DSM, like that continues to be there. However, it's like really controversial and a lot of people think

that it shouldn't be in there and it also has really strict criteria. It says that it's amnesia that is defined over and above ordinary forgetting. And that is really the distinction that he refuses to draw and is the important distinction here. Because you forget something doesn't mean that

“you repressed it. You're sibling or something like remember that camping trip we went on,”

when we were kids and you're like, oh, shit, we did go on a camping trip. I didn't repressed the memory of the camping trip. I forgot about it. You forget most things that happen in your childhood. So the fact that there is memory loss in PTSD is not the same as saying that people

are repressing the memory of their trauma. I always thought that I went to Maine when I was young

and then when I went to Portland a few years back, which I talked about on the show. You were at the time of the toy because slurs hit me. But when I was going, I went to my mom and I was like, "Hey, we're going to Maine." Remember when we went to Maine when we were kids and she was like, "We never went to Maine." Oh, really? You totally fabricated it? I was like, no, remember the paddle boats. She was like, that was the poking. I was like, "You're whiny asked to Maine at that age."

Dude, I had a super vivid memory of going up the Chrysler building. My first trip to New York on my own. As an adult, traveling by myself. So indelible that I took a friend there last time I was

“in New York. And I didn't even check the website first. I was like, well, obviously I remember doing this.”

We show up. There's like this security guard guy and he's like, we don't have a viewing platform. We close it in World War II. And I was so sure of my memory that I was like, how long have you worked here? I was like gaslighting the guy that fucking worked there because I was like 100% sure that I'd gone up the Chrysler building. No. But yeah, that's the thing. Memory is very malleable. Right. But I really want to zoom in on this claim. He says total memory loss is most common in

child sexual abuse with incidents ranging from 19% to 38%. 40% of people repressing the memory of their child abuse is a fucking law. Yeah. So I'm like, okay, what is this 38% figure? This is based

on a study where basically they have a bunch of hospital records from 1973 to 1975 where people

were brought in children were brought in with signs of sexual abuse. So they reported to the hospital with like physical symptoms of child sexual abuse. So we have these patient records. We know the names of the patients. 20 years later a researcher contacts around 150 of these people who we know were admitted to the hospital for child sexual abuse and says, hey, we're doing a study on people who went to this hospital at this time. They don't mention anything about sexual abuse. Like,

can we interview you? Kind of like, almost like a customer satisfaction thing like, can we interview you about your experience at this hospital? And what she finds is that of those people who were admitted to the hospital for sexual assault as children, 38% of them did not mention the sexual abuse. Okay. Oh, yeah. I went there because of the sexual abuse. Yeah, to a stranger who shows up in my home. Right. Okay. So the researcher who does a study

says for some women having no recall of the abuse is based on more than just ordinary for getting associated with the passage of time. So she's immediately going from like, they forgot about this to like something else is happening, right? The memories are being deliberately repressed. So this study is so bad that there's like an entire study debunking it. It's called forgetting sexual trauma. What does it mean when 38% forget? This is by Elizabeth Loftus,

who's one of the people who sort of litigated the memory wars on the, this is fake side of

“the debate. So the most important thing that she says about this is that this is not a study of”

repressed memories. This is a study of forgetting. Right. And that's a really, really, really important distinction. So here is the paper for full appreciation of the drama of forgetting. It must be kept in mind that people can forget all kinds of things that might at first thought seem surprising. For example, people over one quarter of those interviewed have failed to recall automobile accidents nine to 12 months after their occurrence, although someone else in the car

had been injured. People over 20% who when they were four years old had a family member die have failed to recall a single detail about the death. People over 15% have failed to recall a hospitalization approximately nine months after discharge. Patients have failed to recall visits to a doctor that they made within the previous year for something that was serious or even very serious. So it's actually kind of shocking how much we forget. You think that something really traumatic

you would absolutely encode it in your memory, but like kind of big things can happen to you

and you can forget about them relatively quickly. Yeah. I mean, one of the most important things

Then what you did wrong or who else you injured in the car. Get a massage. Use a yoga. You're fine.

Do your mind, you know? The other reason this study is a little bit sketchy is because I hate talking about the ship, but the abuse took place when the participants were between zero and 18 years old. Okay. Some of the people were abused when they were like one year old. Right. And they don't have to remember anything that happened to you at that age. Yeah. The biggest issue, of course, is that it might just be that they're not telling a random

person. Like, oh, yeah, there's the time I was sexually assaulted by my uncle. Like, let's talk about this within five minutes of meeting a stranger, right? Right. This is like a much more plausible explanation for this finding. But in the study, they say the same people who didn't remember this admission to the hospital, they did remember other child sexual abuse. Okay. But then it's like, well, wait a minute, they do remember the child sexual abuse. Right. They just don't

remember this specific hospitalization. Yeah. I was going to say, I have memories of being in medical facilities when I was young. And for nothing serious, just for like checkups. Like, I was on a medication when I was young and I would somewhat frequently go to doctors to just to make sure that there were no adverse reactions. And I have like vague memories of that, but I couldn't possibly tell you where I was. Or like dates and months of right now, or is it absolutely not? I

could tell you that this had happened anytime between the age of five and eleven. I have like, and if you told me I was wrong about that, I'd be like, well, that was a good shot. And again, referring to Vandercoke, total memory loss is most common in child sexual abuse with incidents

“ranging from 19% to 38%. This is not total memory loss. They remember that they were abuse.”

Right. They just don't remember a specific event. These poor fucking kids might have been admitted to the hospital numerous times. Yeah. Yeah. Like, if you have an abusive parent or family member, getting admitted to the hospital might have been something that happened to you once a fucking year. So like, you're not going to remember any single hospitalization. That's totally plausible.

Right. So it's just total misrepresentation of the study. He also has never really admitted

that the repressed memory panic was false. Like, at no point in this book, does he say, like, "Oh, some psychologists took it like a little too far." Like, there was some implausible claims of satanic panic abuse. He never gives any context for that. All he says is like, it's not controversial to say that memories can be repressed. Hey, it is very controversial. Be, you should at least give some overview of like, yeah, this is considered in the field to be a

huge fucking scandal. Right. So for this, I also read a book called Trauma, a genealogy, by Ruth Lays. She quotes him as saying, "The, quote, false memory movement claims that thousands of unsuspecting white middle-class women go to therapists who implant false memories of abuse in their minds." However, current research shows that there is no evidence that traumatic memories can be simply implanted in people's minds. But there's tons of evidence that false memories can be

implanted. Right. How else do you explain the satanic panic? Those are traumatic memories being

planted. By Satan. This has now been done like a million times. There's studies where there,

“like, do you remember that your infection that you had in your kid, you had to be hospitalized”

overnight? 10% of people say, "Yes, there's one where 10% of kids remember getting a rectal enema in a doctor's office." Like, again, you'd think that you would know whether or not that happened to you, but people are falsely remembering this. It's actually shockingly and like disturbingly easy to implant memories in people. Your brain just like takes little bits of memories and then like fills out the remainder of the information that may or may not be accurate. That's why I

thought I was in Maine when I was in Central Pennsylvania. What's so frustrating is that he has this idea that traumatic memories are completely different from ordinary memories. But there's tons of evidence at this point that that's not true. So this is from Ruth Ley's book. Contrary to Vandercoke's theory, trauma does not block the formation of narrative memory. Memory for trauma can be expressed as physiologic reactivity to traumatic reminders,

but that does not preclude its being expressed in narrative as well. As Lawrence Langer has thoroughly documented, survivors of the Nazi Holocaust readily provide detailed narrative accounts of their horrific experiences. So it just isn't true that you're encoding traumatic memories in these glimpses, and it has to be unlocked by your body, like people who've experienced insanely bad shit can put it into narrative. This is an entire theory that like you can't possibly

access memories of trauma because they're not stored narratively is just false. And as for sort of repression in general, the therapist that I talked to you said that when you speak to people who are struggling with PTSD, the issue isn't forgetting the issue is intrusive remembering. A lot of people want to forget the traumas that happen to them, but it like pops out, right, you get these flashbacks, or you like hear a sound, or you have a conversation,

or something, and then all of a sudden you're remembering when you don't want to. I don't know, if you're going to include this in your book, then surely you'd have to go through this narrative of like, in the 80s we thought this, and then it seems like maybe not,

“but you were the aspects of it that I still think are true based on the evidence, right?”

And said he's just like, look, it's not controversial. It's not controversial, right? He's just

get back to the book. The second half of the book is about how to treat trauma. Okay. So every chapter

“is about one of these sort of woo woo treatments, and they all involve somebody miraculously”

getting better. So he brings back Bill, the Vietnam veteran that he told us about in the intro to the book, Bill recovers through becoming a yoga instructor. He also introduces us to a five-year-old girl who was rescued from an orphanage in China, and she's mute. She cannot speak. And then she starts doing sensory motor therapy. He says, the staff bathed her in the tub with plastic balls that helped her feel sensations on her skin. They helped her sway on swings and crawl under weighted blankets.

After six weeks, something shifted and she started to talk. What? He tells us about a woman who has asthma so bad that she's like constantly going to the ER, put her in the ball pit, put her in the ball pit. He says, her therapy focus on identifying the link between her physical sensations and her emotions, and I also encourage her to enroll in a kickboxing program. She had no emergency room visits during the three years. She was my patient. This almost feels like anti-intellectual. I know

“somewhere someone's like, I have this severe trauma and you're like, "Get a fucking hobby."”

Just get a hobby there. Have you tried volunteering? How about this? Get a job. So we're going to dive a little bit more into this one because he has a whole chapter about it. Are you familiar with neurofeedback, Peter? Neurofeedback? No, that sounds like it's part of a supplement

ad or something. So it's basically the thing where they attach a bunch of electrodes on your head.

And then, in real time, they can see your little brainwaves and then, often, they will be linked to a sound. So if your brainwaves get too big or be like, "Beep." And so they're training you to talk about your trauma or go through therapy without getting the beeps. Yeah, you're managing your brainwaves. Exactly. So then, he has this anecdote, Peter. The first patient I treated with neurofeedback was a professional man in his early 50s who defined

himself as a heterosexual, but he compulsively sought homosexual contact with strangers whenever

“he felt abandoned and misunderstood. His marriage had broken up around this issue and he had”

become HIV positive. He was desperate to gain control over his behavior during a period.

I like how it's treating gay horniness, like a disease of some kind. He's overwhelmed by gay hornies.

But brainwaves can fix it. Look at that as brainwaves. During a previous therapy, he had talked extensively about his sexual abuse by an uncle at around the age of eight. We assumed that his compulsion was related to that abuse, but making that connection had made no difference in his behavior. After more than a year of regular psychotherapy with a competent therapist, nothing had changed. A week after I started a train, his brain to produce

slower waves in his right temporal lobe, he had a distressing argument with a new girlfriend, and instead of going to his habitual cruising spot to find sex, he decided to go phishing. Trump. It's a triumph. Even gayer dude. I attributed that response to chance. However, over the next 10 weeks, in the midst of his tumultuous relationship, he continued to find solace in phishing and began to renovate a lakeside cabin. I like how he's doing this

straightest things imaginable. He's going full broke back dude. One hot cowboy shows up in this experiment and is over. He's like ripping the electrodes off of his head and like, "Fuck it!" When we skipped three weeks of neurofeedback because of our vacation schedules, his compulsion suddenly returns, suggesting that his brain had not yet stabilized. It's new pattern. It's new. It's straight pattern. It's straight. We trained for six more months, and now four years

later, I see him about every six months for a checkup. He has felt no further impulse to engage in his dangerous sexual activity. How did his brain come to derive comfort from phishing rather than from compulsive sexual behavior? At this point, we simply don't know. Neurofeedback changes brain connectivity patterns. The mind follows by creating new patterns of engagement. How I learned to stop being gay through electrodes? We fixed them folks. This is

fucking hilarious. He's like, "I have found the cure for homosexuality." We're not going to discuss like maybe there's something more complicated going on with this guy. Just take try and fishing over rest stops. I can take your gay hornyness and turn it into the straightest shit in the world dude. I can make a catch of the day out of it. This man is a lumberjack now. It's not like homophobic or whatever, but it's just the fucking weird framing of the story. It might be homophobic.

It's a good thing that he's no longer attracted to men, I guess. It's just fucking weird. You know what talk therapy could have gotten? Talk therapy? The therapist could have been like, "Are you gay?" And you would have been like, "No." And the therapist would have been like, "Actually, let's stay with this." Obviously, I had you read this because it's fucking bizarre.

with a competent therapist. Nothing had changed. A week after, I started to train his brain. It's like a year of therapy, nothing, a week of fucking head points. This guy's curative is homosexuality. It's like, "This is such a fucking insane claim to make." I do feel like if this shit worked this well, we would all know about it. Oh, I know dude. If you can care being gay using the power of nodes, then God knows what else you can do. If you can prevent, if you can just

cause the hornyest man on earth to go fishing, if you can overcome the power of horny. This is like the greatest scientific miracle in history. So I did look into neurofeedback. He has a whole chapter about how well it works. He has numerous other stores and he's like turning around their entire lives after one session. Again, this isn't like shocking you with electricity or anything. It's just reading your brain waves. So you kind of have to train yourself to do it. But anyways, all these

anecdotes, I finally looked into it. Essentially, there's a bunch of studies showing that it works,

but as soon as you test it against a placebo, the effect goes away. It's essentially like, there's a guy in a lab coat and he's putting all these electrodes on you and you're talking through your trauma some some some some little studies are like, we did this with people one hour a day for like 28 days and then they had an effect. It's like, well, you have your in therapy for 28 fucking days and a row. You'd also probably have an effect, right? Damn, this guy just got placebo.

Did the fishing? Yeah, seven nightly orgies. This guy's listening to this episode. Like, what am I fishing for? It wasn't even real. He's got his AirPods in on it. Just floating and in solitude and a boat and a bill of a lake. Listening to a book's good pill. Yeah, another sign that you're gay. I don't want to stack the deck. He has this chapter on neurofeedback, which is quite bad,

but a lot of the second half of the book is just these kind of woo woo treatments. Some of

which are actually fine. Like he has a whole chapter on yoga, which has been shown to be effective in like a wide range of mental health conditions. Like it appears to be very effective for depression.

“That's how you if you really want to cure the gay. Good only West Hollywood yoga studio. Yeah,”

it also has a whole chapter on MDMA. I talked to researcher who said that it's actually fairly promising and people in the field are pretty excited about MDMA as a treatment for PTSD. Yeah, that's something that's kind of like evidence-based. But then he also he talks a lot about acupuncture and acupressure. He has a whole chapter about a community theater. There's like some program where foster kids perform and prepare a musical. Like they write a musical and they perform it.

There's a fucking buck wild program in Massachusetts where you can get court-ordered Shakespeare. So instead of going to juvenile detention, the judge can sentence you to putting on a Shakespeare point, which I'm like, this is obviously bullshit, but also it's so much better than sending kids at UV that I'm like, yeah, fine. Like expand it, make it like make it nationwide. I don't give a shit. No, this is too woke. This is like a 90s movie to like turning some kids around. He

like, hey, Hamlet's actually really cool. If rapping is just like poetry. Yeah. Shakespeare was the

first MC. So those things are sort of harmless. But also, I mean, I looked up like RCT for

community theater interventions and like there's no studies of this. I don't dispute that like, I'm sure some people get something out of this. Like being a kid and like writing a play, performing Shakespeare is probably good for yourself, a steam, you make some friends. I mean, it's really like any other like kind of summer camp experience. It's probably great for the kids.

“I don't think it's a treatment for fucking PTSD. Like you need to have rigorous studies before”

you're going to put them in your book. But some of the so that he promotes is like really out there. So here's this. One of my favorite body-oriented ways to build effective fight flight responses is our local impact centers model mugging program model mugging in which women and increasingly men are taught to actively fight off a simulated attack. The program started in Oakland, California in 1971 after a woman with a fifth-degree black belt in karate was in karate was raped.

Wondering how this could have happened to someone who supposedly could kill their bare hands, her friends concluded that she had become desailed by fear. In the terms of this book, her executive functions, her frontal lobes went offline and she froze. The model mugging program teaches women to recondition the freeze response through many repetitions of being placed in the zero hour, a military term for the precise moment of an attack and learning to transform fear

“into positive fighting energy. Maybe you should fight back. Learn to fight back next time.”

Yeah. Great message for victims of sexual assault. One of my patients, a college student with a history of unrelenting child abuse took the course. When I first met her, she was collapsed, depressed, and overly compliant three months later during her graduation ceremony. She successfully fought off a gigantic male attacker who ended up lying, cringing on the floor. Shielded from her blows by a thick protective suit. So that's like a skip that they did apparently. Not long afterward,

she was walking home from the library after midnight when three men jumped out of some bushes yelling,

"Okay guys, I've been looking forward to this moment who wants to take me on first." They ran away.

If you were hunched over and too afraid to look around, you are easy prey to other people's sadism. But when you walk around projecting the message, don't mess with me. You're not likely

“to be bothered. Maybe you were raped because you had bad vibes. I think that's a great message”

to happen in this book. A book about trauma. I think that's great. So first of all, this is obviously you a fake story. Obviously fake. The benefit of taking a self defense class like this is like 99.9% psychological. The idea that someone would be a victim and then take the class and then immediately be mugged, like theoretically possible, but come on. He really likes this role-play thing. He has a thing where you do like family role-play where somebody plays like your mom,

like your mean mom, and then somebody plays like the mom you wish you had. And then you get into a karate stance. Like literally he has a scenario where this guy's like,

"You fucking bitch you left me." And he's like screaming this like actor basically. I don't know if

this would really work. I couldn't find any like good studies of this. It doesn't seem very kind of like widely used. You don't need to pay pay to take like a skit class, just scream at your real mom. But then also when I talked to Emmy Neatfield for this, the way that she got interested in this book was because she was sexually assaulted on a trip through Europe. She then had this therapist that was like really into this body keeps his core stuff who prescribed a bunch of like

crank shit to her. One of which was one of these like role-play scenarios where they wanted to act out the time when she was sexually assaulted and like this time you can fight back. And she's like, "Is this feels like you're saying that if I had fought back in the first place, I wouldn't have been raped, which is precisely the wrong fucking message to give to people who experience trauma?" Like it happened because you did something wrong. Exactly. It's exactly

you're delivering that message. Also, it just feels like very situational like, I don't want to say

“that you should never fight back. I also wouldn't say that you should always fight back. Like”

this very situational thing trying to like diagnose the problem as like people aren't fighting back in of it. That feels like really dangerous. He also has this fucking anecdote which I might cut this but I can't help myself Peter here's this. It was early in my career and I'd been seeing Mary a shy, lonely, and physically collapsed young woman. Again, the way it's just a vibe. It's a tone and the way that he talks about female victims is crazy. If books could kill listener,

bumble profile. I'd been seeing Mary a shy, lonely, and physically collapsed young woman for about three months in weekly psychotherapy dealing with the ravages of her terrible history of early abuse. One day, I opened the door to my waiting room and saw her standing there provocatively dressed in a mini skirt. Her hair died flaming red with a cup of coffee in one hand and a snarl on her face. "You must be Dr. Vandercolk," she said. "My name is Jane and I came to warn

you not to believe any of the lies that Mary has been telling you. Can I come in and tell you about her?

“I was stunned but fortunately kept myself from confronting Jane and instead heard her out.”

Over the course of our session, I met not only Jane but also a hurt little girl and an angry male adolescent. This was the beginning of a long and productive treatment." So this is fake for so many reasons. The detail I'm stuck on is the fact that she died her hair to be one of her like alter egos? What? Surely she's going to switch back to Mary at some of it is just she then have to die her hair again? Yeah, do you die your hair before or after you mentally switch? You

mentally switch to the other person and then you're like, "This is like outlandishly fake. This is

like a completely debunked thing where you'd have a bunch of different altars. There's a million

academic articles about this that it was basically sort of approval seeking or attention seeking by patients. They thought their doctors like wanted this and would get subtly rewarded for it and so they would create these altars. This is a phenomenon that essentially only ever existed in United States. I read a super interesting article about this that they've looked at the patterns of people as different altars and like people would constantly say like, "I have a four-year-old,

like that's one of my altars." And then they would look at the linguistic patterns and it's like this is not the language patterns of a child. This is the language of an adult pretending to be a child. It's like really easy to identify. And then they also said, "Over time, people at first would say, like, "Oh, I have four altars." But then by the end of the trend, people were saying like, "I have 250 altars." Right. Right. Right. Right. Right. It's like a tolerance builds up. You're like,

"Oh, I got it. I got to get my therapist hooked in somehow." That's like that brief period in Tumblr history when people were just like, I'm a wolf. Yeah. Yeah. They don't actually know what anything about wolves. Yeah. They're just like doing a little bit of howling. I love that Jane still went to therapy. She's like, "Oh, I'm like stay away from Mary. She's the worst, but also it's two, it's two, it's two, it's four. I got to make my appointment." She wakes up as Jane. She's like, "I hate this hair."

Time to put on my hot ass skirt, which I also have. She looked at the calendar and she's like, "Dr. appointment." So I do want to talk a little bit about the research for all of these. Their classified is mind-body interventions. I also really want to be sensitive to people who have tried

trauma affects people in very different ways. And so for somebody to be able to get a massage,

“like to be touched in a safe environment, that can be like really healing for people, right?”

And things like yoga can be really healing. There's a self-esteem aspect, a community aspect. All of this stuff feels like it's real in some sense. It's not just like, it's not just like this magical cure in the way that he presents it, right? Like, I was joking about it, but like, getting a hobby is actually a good idea. Yeah. Yeah. If you have anxiety, if you have depression, like this, as far as I know, the research is pretty clear that that sort of stuff can help.

It's so important to me to not take anything away from people. And if you've benefited from dance therapy or equine therapy or whatever, like that is a real effect. I don't really feel the need to like debunk that. If you have multiple personalities and one's very crappy and one's very sexy, that's cool. There's also a lot of research on this. And a ton of research shows that these interventions are affected. Like, I looked up dance therapy. And there's actually a lot of studies

on dance therapy. And most of them find a positive effect. Like, they're small. They're early. You can quibble with the methodology stuff. But it's like, it's not remotely implausible that a lot of these interventions would in fact work. I do just want to talk about that. I also, however, want to talk about the academic consensus for what works for PTSD. Like, the most strongly evidence-based approaches. So for this, I talked to Keith Cox, who is a PTSD researcher

and the author of an entire academic paper about how this book is incorrect. So here is the intro. Most individuals with PTSD do not receive science-based treatment. This is a massive problem

“and the systems and individuals best able to address it misunderstand key components of the problem.”

Advocates of research supported treatments have substantial influence and authority in federal agencies, university settings, and medical centers, and limited influence authority with the public at large and with many providers, especially those in private practice settings. Figures such as Bessel Vandercoke and Peter Levine, who are not consistently science-based, have limited influence in government and research settings and enormous influence

with the public and many individual providers. We see such figures as a main contributor to the problem. So this is like a huge problem for the field that like academic research is not speaking to in practice therapy all that much. And a lot of therapists are really bought into these frameworks, which are not evidence-based. A lot of them don't know that they are not evidence-based or don't care. But researchers, like he has a whole section about

how academic researchers do not refer to Bessel Vandercoke's book. He's not considered influential

“in like PTSD studies and he hasn't been for decades. He estimated only around 10% of people”

with PTSD get effective treatments. It's mostly this like wild west shit. So that is like a huge problem in society. Like a lot of people have PTSD or these other symptoms of trauma that they experience when they were growing up and they're not getting effective treatments. Right. So he walked me through the official guidance from like all of the major institutions. So the American Psychological Association says the most effective treatment is a CBT,

which is cognitive behavioral therapy specifically something called cognitive processing

therapy and something called prolonged exposure therapy. Where you basically you sit there and you

talk about your trauma. You describe what happened to you. Typically you're getting like these physiological symptoms when you talk about it. Right. Your heart rate goes up. You're sweating. It's really stressful and over time it becomes less and less stressful and you're also processing it with a professional therapist who can say things like you know it's not your fault and like put it into context of like how to think about it and how to integrate it into your life.

This works astonishingly well. This is the most evidence-based treatment. I also checked the guidelines for the VA. They also recommend this the British institution that does this nice also recommended cognitive behavioral therapy. Right. Best of a better code does address CBT in his book. He has an entire chapter about how it's bad. So we are going to spend a little bit of time on this chapter. Here's this. In September 2001 several organizations including the National

Institutes of Health, Pfizer Pharmaceuticals, and the New York Times Company Foundation organized expert panels to recommend the best treatments for people traumatized by the attacks

on the road trade center. Because many widely used trauma interventions had never been carefully

evaluated in a random communities as opposed to patients who seek psychiatric help, I thought this presented an extraordinary opportunity to compare how well of a variety of different approaches would work. My colleagues were more conservative and after lengthy deliberations the committees recommended only two forms of treatment, psychoanalytically oriented therapy and cognitive behavioral therapy. Why analytic talk therapy? Since Manhattan is one of the last

passions of Freudian psychoanalysis, it would have been bad politics to exclude a substantial proportion of local mental health practitioners. Why CBT? Because behavioral treatment can be broken down and do concrete steps and manualized into uniform protocols. It is the favorite treatment

committee were Freudian therapy and CBT, basically for political reasons. After the recommendations

were approved we set back and waited for New Yorkers to find their way to therapist's offices. Almost nobody showed up. Dr Spencer ETH, who ran these psychiatry department at the now-defunct St. Vincent's Hospital in Greenwich Village, was curious where survivors had turned for help. And early in 2002, together with some medical students, he conducted a survey of 225 people who had escaped from the twin towers. Asked what had been most helpful in overcoming

the effects of their experience, the survivors credited acupuncture, massage, yoga and EMDR in that order. At the survey, suggests that the most helpful interventions focused on relieving the physical burdens generated by trauma. Physical burdens don't talk about it. Let's do physical first.

“Doesn't really suggest that that's what's most helpful, right? Just that people didn't go to the”

therapy. Also, this is not true. I couldn't find the committee that he was talking about, but there is a FEMA supported program in New York City after 9/11 to get mental health counseling to people, and it was used by, I've seen different numbers, but somewhere between 100,000 and 750,000 people. It just factually is not true that nobody wanted therapy after 9/11. There's also this survey by Dr Spencer ETH, who talked to 225 survivors from the twin towers, and then it turns out,

like, oh, we don't want therapy. We actually want acupuncture. So the citation for this in "Bessel Vanercoke's Book," just says, "Dr Spencer ETH, too, "Bessel Vanercoke, March 2002." So this is something that the personal conversation from 2002. From like 12 years ago, my buddy told me

this thing. It's, first of all, just really fucking weird to not point to like a real study.

Yeah, it's a survey, right? I reached out to Spencer ETH. I was like, hey, this is the passage from the book. Can you send me anything on this study? He wrote me back. He sent me a bunch of background documents. He sent me one document that was like a study, like a before and after study of acupuncture in his clinic, which had nothing to do with 9/11. And then the second thing that he sent me was essentially just an advertisement for the clinic and the kinds of things that they were doing.

He also sent me a JPEG of a woman giving acupuncture. Here's the Wikipedia for acupuncture. It's just a walk-in clinic. Some of the people that they were treating, I'm sure, were 9/11 victims, but they weren't reaching out to like people who were there in the twin towers.

“And like, they were just providing a bunch of services and the only thing he has as far as”

like a survey of what people liked is this document that just quotes a bunch of like a patient

satisfaction survey results. So it says, I felt so cared for and cradled. I experienced great healing here. This provides a sense of tranquility. So like great, but this is not a survey of 225 9/11 survivors. Yeah, what survey does not appear to exist? I'm just, I'm just surprised that people whose job is to some degree science are so like disinterested in like the precision of the statements being made. Also, he's doing this in service of a conclusion that it's not true.

Bessel Manicoke is including this one survey of 225 people, hundreds of thousands of people got counseling after 9/11. There's numerous evaluations. So I found one evaluation that found 89% of people who got this like counseling service were happy with it. So it isn't the case that nobody showed up. It isn't the case that like I benefited from acupuncture way more than

“therapy. None of this is true. Yeah. He then specifically talks about CBT and these forms of”

prolonged exposure therapy, cognitive processing therapy, he says, in contrast to its effectiveness for irrational fears such as spiders, CBT has not done so well for traumatized individuals, particularly those with histories of childhood abuse. Only about one in three participants with PTSD who finish research studies shows them improvement, those who complete CBT treatment usually have fewer PTSD symptoms, but they rarely recover completely. Most continue to have substantial

problems with their health, work, or mental well-being. Wow. He's explicitly saying it doesn't work for PTSD, right? Yeah. I mean, he failed in her mother Jones article tracks down the author of some of these studies that he's citing. So I'm just gonna send you an excerpt from her paper. Medical claimed that only about one in three participants with PTSD who finished CBT research studies show some improvement, citing a paper by Julian Ford, a professor of psychiatry at the

University of Connecticut School of Medicine, and several other papers including a meta analysis. The meta analysis in fact included that 67% of people who complete a treatment benefited and four disagrees with Vandercokes interpretation of what the numbers imply. As a frontline treatment, I don't think there is anything better for the treatment of PTSD than CBT. He tells me. One study by the Department of Veterans Affairs and Academic Researchers that Vandercokes sites

the largest of its kind when it was published in 2007 found that after just 10 weeks of CBT, 75% of patients improved significantly, and 47% 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. This says Polish-Nur co-author of that study and executive director of the VA's National Center for PTSD.

only one in three participants of PTSD who finished studies show some improvement.

“You then go to his citation and it says in the abstract, the majority of patients treated with”

psychotherapy for PTSD, recover or improve, rendering these approaches some of the most effective psychosocial treatments devised today. They do compare these against yoga, equine therapy,

all of these other things. They basically say the evidence is very strong for CBT, the effects are very

large, and the evidence for all of these other things is pretty weak. A lot of them aren't controlled, a lot of them are just before and after studies, a lot of them are like 15 people. We have good evidence on CBT. We have some slightly maybe preliminary evidence and a lot of anecdotes about the other things. Well, it's hard to scale equine therapy. You can't give everyone a New York after 9/11 a horse, you know? So the other thing that he says about CBT is that it has really

high dropout rates. So it's kind of a point whether it works or not because nobody can stick with it for long enough. So here's this. A 2010 report on 49,425 veterans with newly diagnosed PTSD from the Iraq and Afghanistan wars who sought care from the VA showed that fewer than 1 out of 10 actually completed the recommended treatment. As in Pitman's Vietnam veterans, exposure treatment as currently practiced rarely works for them. We can only process horrendous experiences

if they do not overwhelm us. And that means that other approaches are necessary. It rarely works, is what he's saying. We're getting into like actually harmful territory, right? Because there's a high level view of this book that's just like trauma can manifest in different ways and can be treated in different ways. And there are like alternative treatments that have shown have been shown to have some efficacy. And that's like this perfectly defensible disease and fact like

correct. But then he just goes that extra step where he's like actually like this is the treatment that is best and should be focused on. And it appears to be recommending it over the most effective known treatments for severe PTSD. Exactly. And the problem in PTSD in our medical systems that not enough people are getting access to effective treatments. And he's saying, oh, well, they don't they don't work anyway. Make sure you get a massage. Right. So in this passage, he says there's this

report on a bunch of veterans and 90% of them dropped out of CBT before they finished the program.

I've never heard of a fucking 90% dropout rate before in a study. Like you would just not publish

the study if you had to drop out rate that high. Yeah. But that would be a major part of the study. You're like, oh, everyone fucking hated this. So I go to the study. This is not a dropout rate. This is the percentage of people who went to a primary care provider said, I think I have PTSD got a referral to therapy and either didn't follow up on the referral or didn't go to 10 sessions. Oh, that's not a dropout rate. A dropout rate is like you sign up for a study. Like you're going to

do yoga for 10 weeks. Yeah. Yeah. You can't hack it for whatever reason or another. This is just people who didn't follow a referral. I did this last year. I got a referral for my hands. And I just like never called the place to schedule the physical therapy. I'm skipping 50% of referrals at a minimum.

“Okay. You have to keep them guessing. CBT does actually have relatively high dropout rates. It's”

like between 20 and 30%. Mostly because like it's really painful to talk about your trauma over and over again for like week after week after week. It does work. But for a lot of people, it's extremely painful. And so there's meta analyses of the various dropout rates. Like some of this higher, some of it's lower. But this is an identified issue that is actually really difficult to solve. And like there is consternation in the medical field about this. It's not fucking 90% right?

Right. He also in his own section sites, numerous studies of like yoga and dance therapies have also a huge dropout rates. Like I found one study of equine therapy with 23 participants and 10 of them dropped out. Any therapeutic treatment is going to have like dropout being a problem. This is also why it's very important to me to stress. It's really malpractice to say that CBT doesn't work. I think it's also just a fucking huge dick move to be like, have you tried CBT?

What about CBT? Yeah. It's the most effective treatment that we have. But it's like 47% right, meaning 50% of people don't have their PTSD cured. Maybe there's something more complex going on. Like I've heard from trauma victims shut the fuck up at CBT. Like I've tried it and it didn't work. Right. Like it's not right for me. You also don't want to be this asshole who's like, the study say that you should do this. Like individuals are very diverse.

Trauma is so different for different people. You also don't want to write a book saying it doesn't

“work. Yes, exactly. You have to find a middle grad. I think it would be defensible to say like CBT”

is the most effective treatment. However, it can be really expensive. It can be really difficult access for people for some people. It doesn't work. But he's just openly saying it doesn't work. Right. Right. The other thing that is evidence-based is, do you know what EMDR is, Peter? I am familiar with the acronym in that I believe it was in one of the excerpts you sent me and I skipped over it. Yes. I was like, please don't ask me about it because we're going to talk about it later.

This stands for eye movement, desensitization, and reprocessing. Okay. So this is basically a procedure

back and forth. So sometimes it's kind of like rapid eye movement. Sometimes it's like your therapist like hold a pen. Oh, okay. Okay. So you're speaking and you're very purposefully looking back and forth. Yes. Exactly. Okay. And so this is one of those things that started out. It's like a woo-woo intervention. Like, oh, move your eyes back and forth. But like over and over again, it's been shown to be incredibly effective. So in like the APA guidelines and the VA guidelines,

everybody says like EMDR is the other thing that people should probably think about doing.

“Honestly, even though it's real and worked, I'm still mad at how stupid that is.”

You guys don't. I remember the first time I heard about it. I was like, uh, we're going to

do a fucking maintenance phase on this arm. We like this is such trash. This is like having a revelation while you're like cooking eggs and then you're like, I have an idea. This is one of the woo-woo things that he recommends. It is actually very evidence-based. So like, that's good. Okay. However, over the course of time, as more and more studies have come out about this, the consensus in the field seems to be tilting toward the reason it works is not the eye movement.

The reason is that it's basically exposure there, but you're talking about your trauma and you're processing your trauma with somebody else, right? So he has an entire chapter about EMDR. And here is what he says about it. People may be able to heal from trauma without talking about it. EMDR enables them to observe their experiences in a new way without verbal give-and-take with another person. EMDR can help even if the patient and the therapist do not have a

trusting relationship. This is particularly intriguing because trauma understandably rarely leaves people with an open trusting heart. In the years since, I have done EMDR with patients who spoke Swahili, Mandarin, and Briton. All languages in which I can say only notice that the key EMDR

instruction. I always had a translator available, but primarily to explain these steps of the process.

Because EMDR doesn't require patients to speak about the intolerable or explain to a therapist why they feel so upset, it allows them to stay fully focused on their internal experience

“with sometimes extraordinary results. How does he know when to say notice that?”

So what's amazing to me here is even when he's referring to an evidence-based practice. He recommends the non-evidence-based part of it. He says, "You shouldn't be talking about your trauma as you're doing the eye movements. I can do this with people who speak any language. It's not about the talking. It's about the eye movements. When all of the evidence indicates that it's mostly about the fucking pocket." Right. He stumbled on the one thing that he's like, "Okay,

you're dog tailing with the actual meta analyses here," but he's like, "No, don't do it in the way that the meta analyses say to do it." Right. Because why the fuck would just moving your eyes back and forth do anything? To be fair, why does it help at all? I don't know. It sounds fake as shit. I can't believe it. I can't believe this shit works." So that's the book. I want to give a couple of concluding thoughts. Okay. When I was talking Emmy neatfield, she told me about the

story of her therapist that she went to the therapist and was like, "I want to talk about this horrific trauma that happened to me in Europe." And she says she started telling the story and she sort of got to the build-up of it and then eventually they ran out of time and the session and they were like, "Okay, we'll pick this up next week." And then Emmy went next week and she started telling, "Okay, we'll bing up where we left off." And the therapist was like, "Ah, let's talk about your

childhood. Let's go back." And she says this went on for like many weeks. She's like, "I'm ready to talk about this, but you don't seem to want me to talk about this." And her therapist

basically said, "You're too traumatized to talk about it. It will make you relive your trauma

if you talk about it." And then recommended acupressure. This is a story that I've heard from many people that these ideas have gotten really entrenched in the field of psychology, like the individual experience often does. Focus on these body-based treatments over and above talking about your trauma. And that is very, very bad. Suppress the memory and go get on a horse. Another one of the therapists that I talked to. I can't say what city it is, but it's like a major

hospital in a major city. He had to attend a mandatory 12-hour training on somatic treatments, like mind-body stuff. He said he went to his boss and was like, "Sorry, there's no evidence for this stuff. Why are we doing it?" And his boss was like, "Oh, yeah, it's bullshit." But like, take what you can from it. You know, there might be something in there that's useful. The field is actually like kind of falling for this stuff. And like making it a big part of practice. And again,

some of the stuff may work under certain conditions. But this is fundamentally a 1950s understanding of trauma, right? Do not talk about it. Do something else. It's being repackaged as like woo-woo, new-age hippy stuff. But fundamentally, he's telling you that talking about your trauma is totally pointless may be harmful when all of the evidence shows the exact opposite. And we're talking about actively suppressing things that we know are effectively. It's like, "Exactly."

“Ooh, don't talk about it. In saying. Just go to yoga. So even as it's very important to me to”

acknowledge that this book has like a good premise. And like the core insight of the book is absolutely true. I'm so glad that people took that away from the book. A lot of people seem to have taken away from the book that you should talk about your trauma, which I think is great. But there are

a New York magazine profile of him in this kind of this new understanding of trauma where the

“author just keeps talking about like how much of a dick he is. So here's this. In conversation,”

he sometimes radiates impatience and is prone to interrupting to give the dialogue, the shape he thinks it should take. When I mentioned that I was not convinced by a claim he made in a lecture that a nationwide program of early childhood attachment intervention could end a mass incarceration. He told me matter of factly that I was not qualified to have an opinion. Great time. Hell yeah, dude. And also he doesn't have that chapter where he talks about like the

structural forces. So like, okay, good for him, you know universal healthcare, Trump sucks, etc. But the word racism does not appear in this book. The word Bumphobia transphobia does not appear in

this book. He never talks about any of his patients experiencing discrimination in any way.

Well, it's not about what you experience. It's about what type of massage to get at the moment.

“What kind of horse you have to be riding? It's just like it's really weird that this has been”

taken up. So strongly I think by like progressive, very well-meaning people who I align with politically when like the book itself is not particularly progressive, right? I think it's terrible on gender. You didn't like the part where he was like Mary showed up, but this time she was hot. But then there's also, I don't know if he knows about this Peter, but in 2017, he was pushed out of his own treatment center for bullying. Me too casualty. The guy that was running the like sort of day

today, running the center got me to and got pushed out and then like a couple of days later, he got pushed out and the center like announced that it was for, it says he created a hospital work environment. His behavior could be characterized as bullying and making employees feel denigrated and uncomfortable. I should say Bessel Vanicoke denies the allegations. He puts a statement on Facebook that says as far as I know, none of you have ever confronted me with such misbehavior. If I have

inadvertently denigrated or bullied any of you, I would like to know about it, apologize and make immense. I think I've talked about this on the show before, but there's certain type like at hedge funds. Hedge funds are built around the investments, rages of one person and so like they are like untouchable, like you've had not fired that. Exactly. This is like one step down from that. This center is built

around your ideas and they fire you. You know, we always like go out of our way to like be nice in

these things and not sort of. Yes. I do know how I do that. Thank you. Honestly, I think people should not be recommending this book. People should not be using this book in curricula for academic courses. Sometimes we're sort of a corrective, right? Everyone has been very nice to this book already.

“So if we're too mean, that's just us bringing balance into the universe. That's how I view the”

fact that I'm always too mean. This book is bad. Like the text of the book is bad. Even if at a civilian level, I don't think that the effect of this book is harmful, I think the effect within the field has been very harmful. And I think the book itself is fucking bad and there are other

books written by people who are like basically promoting the same ideas. But are not reactionary

assholes who are like both people at work and lying to you about like basic scientific discoveries. There's a little bit of Mahah to it, right? Where it's like the primary voices in the fields are focusing on the wrong thing. And they're doing it potentially for profit, right? I mean what they need to be focusing on is making an EEG that makes people gay. If you just reverse the circuitry. Look, look, I don't want to throw the baby out with the bath water. He did cure homosexuality

in the course of this book. He buried the lead in it.