A traumatic experience is any event or series of events that overwhelms a person’s ability to cope with the present moment, causes intense physical or emotional stress, and leaves a lasting impact on either mental, emotional, and/or physical well-being. Soldiers returning from war, children abused by their caregivers, and people who have experienced a sudden and shocking death or extreme tragedy are all prime candidates for trauma. It rewires our brain and changes “not only how we think and what we think about, but also our very capacity to think.” Trauma encodes itself in our brains, our minds, and our bodies, and after a traumatic incident, the world is experienced with a different nervous system now focused on suppressing inner chaos at the expense of active involvement in life. It burrows deep, and for some people, traumatic experiences can be very difficult to recover from.

This book is filled with both good news and bad news. The good news is that our understanding of trauma and how it affects us mentally, emotionally, and physically has greatly improved, as have the ways in which we treat it. The bad news is that sadly, trauma isn’t as rare as we would like to believe. Research has shown that “one in five Americans was sexually molested as a child; one in four was beaten by a parent to the point of a mark being left on their body; and one in three couples engages in physical violence.” This, of course, doesn’t include trauma we might experience as an adult like natural disasters, car accidents, or acts of terrorism, and, of course, the most common candidates for trauma: soldiers returning from war.

An important question to consider is what all of these disparate events have in common in the way they affect us, and the answer is in how the emotions we experience at the time of the trauma stay with us and become encoded in our brains, minds, and bodies. “Ideally our stress hormone system should provide a lightning-fast response to threat, but then quickly return us to equilibrium,” Van der Kolk writes, “in PTSD patients, however, the stress hormone system fails at this balancing act.” When something traumatic occurs it produces physiological changes including “a recalibration of the brain’s alarm system, an increase in stress hormone activity, and alterations in the system that filters relevant information from irrelevant,”—it literally changes the way we see and understand the world around us and how we interact with it. Then, when something similar triggers us in the future, our brain and body react as if the traumatic event were happening in the present. We may not even be aware that we are re-experiencing and reenacting the past—all we know is that we feel furious, terrified, enraged, ashamed, or frozen. The continued secretion of stress hormones is expressed as agitation and panic and, in the long term, can wreak havoc with our health.

The most common example is the ex-soldier who hears a loud motorcycle and throws himself to the ground for cover because his body reacts as though it’s an enemy tank. It’s also true for the women (and men) who have been sexually assaulted and now can’t stand to be touched by anybody without it feeling like their attacker again. It is likewise true for the adult who was hit by their caregiver as a child and cannot figure out how to connect with others in an intimate way. In each scenario, when the stimulus occurs (a loud motorcycle, someone touching them, or their inability to connect emotionally with others) the brain, mind, and body react as though the original trauma is occurring.

So, what can be done to help people rehabilitate their lives after a traumatic experience? Van der Kolk devotes an entire section of his book to healing and makes a point to include strategies that not only attempt to soften the effects of trauma on the brain and the mind, but also on the body. For some people, talking about the traumatic event with a close friend or therapist is enough to get themselves back to a healthy internal state. The trick is to talk to someone who provides a sense of safety, because “being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives.” Van der Kolk suggests activities like yoga or theater to help us reconnect with ourselves in a physical way. Yoga’s central theme is connecting the breath to the body, which can directly target bodily tension left over from traumatic experiences. When it comes to theater, embodying a fictional character as they tell their story and go through a life transition can aid trauma survivors by helping them vicariously tell their own stories and go through their own transitions. “Traumatized people are afraid of conflict” he writes, and “conflict is central to theater—inner conflicts, interpersonal conflicts, family conflicts, social conflicts, and their consequences.” Performing in a play requires us to use our body, and, similar to yoga, being active in our body can help us locate places where we may hold tension from a previous trauma and help to release it.

An important first step is diagnosing people correctly. All too often patients with horrible histories of trauma are diagnosed with depression and prescribed a medication from a pharmacy which is the equivalent of putting a band-aid on a bullet hole. While depression may be an accurate description, clinicians need to go deeper and uncover what is at the root of the problem in order to treat it successfully because the emotions associated with the traumatic event are stored separately in the mind, brain, and body. Even with a prescription for medication, the right stimulus will send someone with PTSD right back to the pivotal moment in the past when the event first occurred, maintaining their inability to integrate the experience into their sense of self. “Normal memory integrates the elements of each experience into the continuous flow of self-experience by a complex process of association,”—but the problem with PTSD is that memories are dissociated. So getting a prescription from a doctor may block or numb some of the negative feelings, but it doesn’t heal the patient.

Van der Kolk pinpoints childhood as the location of much trauma and describes how “child abuse and neglect is the single most preventable cause of mental illness, the single most common cause of drug and alcohol abuse, and a significant contributor to leading causes of death such as diabetes, heart disease, cancer, stroke, and suicide.” We need caregivers who support and love us in our infancy so that we can develop proper relationships with the other people and experiences we will encounter throughout our lives. This is the same for adults who suffer traumatic experiences—we need people we can trust to support us through the healing process. We need to recognize that trauma imprints itself in our brains, our minds, and our bodies, and that treatment and therapy should target all of these areas so as to best help us heal mentally, emotionally, and physically. It takes the right diagnoses, a proper support network, and the time and perseverance required to do the work. Both individually and collectively, we can heal from trauma, for if all we know is fear, then that’s all we’ll ever know.

For those looking for more information about trauma, its symptoms, effects, and how to heal from it, this book is a wonderful place to start.