The Body Keeps the Score is Bullshit

The popular book from the "world's most famous living psychiatrist" is riddled with blatant errors

Chances are, you’ve heard of The Body Keeps the Score by Bessel van der Kolk. At 79,898 reviews, the book has more reviews on Amazon than the first book of A Game of Thrones.

New York Magazine says Bessel van der Kolk is “currently the world’s most famous living psychiatrist.”

“The Body Keeps the Score has spent 248 weeks on the New York Times paperback-nonfiction best-seller list and counting. To date, it’s sold 3 million copies and been translated into 37 languages.”

Van der Kolk’s big idea is that past mental traumas (as he defines them) can produce actual long-lasting changes in the body and brain, regardless of whether the person has a memory of the trauma or not.

This isn’t just a book about PTSD. Van der Kolk tries to validate his claims with research on people with PTSD, but he strongly emphasizes in the book that practically everyone could have trauma. In fact, he claims that it’s so prevalent that it is “arguably the greatest threat to our national well-being.”

Discussions of PTSD still tend to focus on recently returned soldiers, victims of terrorist bombings, or survivors of terrible accidents. But trauma remains a much larger public health issue, arguably the greatest threat to our national well-being.
—The Body Keeps the Score

Bessel van der Kolk also said on Big Think that:

“Trauma is actually extremely common. There’s a lot of debate about what a trauma is to this day. But, basically trauma is something that happens to you that makes you so upset that it overwhelms you.”

If Dave was on to something then nearly a quarter of people would have PTSD. A 2020 meta analysis suggests that 22% of babies have the cord wrapped around their neck when born.

“Biohacker” Dave Asprey spoke on an Instagram reel about how he suffered childhood trauma from being born with the umbilical cord wrapped around his neck. He’s also said he realized at 30 that he had PTSD from this experience. He claimed on his website that an umbilical cord around your neck at birth can “create an early pattern of feeling unsafe in the world.” This statement in his article was linked to a 1973 paper titled The immediate and long-term outcome of obstetric birth trauma, so I had a look.

The paper in fact very clearly proves Dave’s claim wrong. Actually, considering Dave specifically clarified that he “didn’t suffer oxygen loss or anything like that” during the birth, it proves he’s extra wrong. The paper found that even in newborns whose birth was so physically damaging that they did experience clear damage like oxygen loss or temporary arm paralysis, there was no lasting psychological damage.

“In the vast majority of cases, there was no evidence of long-term effects of the perinatal injury and asyphyxia as judged by the results of neurological examinations at one year or by psychological test scores at 8 months and at 4 years.”

“…we can only presume that these children have gotten by unscathed.”

Still, even if there had been lasting psychological damage, all we could really conclude is that it’s not good for your psychology to have your oxygen supply to your brain cut off when you’re born. Even then, you’d still have to prove that this psychological damage from oxygen deprivation lasted past 4 years and up to 30 years old which is apparently when Dave realized he had PTSD from his distressing birth. Considering Dave didn’t even suffer oxygen deprivation, this paper is not proof that just the experience of distress at birth can give you PTSD.

Where then could Dave have gotten this idea that he has trauma from an experience he couldn’t possibly remember? Probably Bessel van der Kolk.

What if the world’s most famous psychiatrist’s book was mostly bullshit?

When reading The Body Keeps the Score, you’ll be constantly reassured of its authenticity with numerous studies on PTSD victims and very convincing explanations about what science has discovered about how the brain works. Flipping to the back of the book reveals hundreds of citations organized by chapter.

Optics matter, and van der Kolk certainly nailed the optics. Unfortunately it seems van der Kolk took the famous Mark Twain quote “never let the truth get in the way of a good story” to heart. When you peel back the curtain and actually look at the research van der Kolk cited, you realize the book just falls apart.

Dr. Michael Scheeringa, professor at Tulane University School of Medicine has a 29 year career researching and treating PTSD. Dr. Scheeringa expected that after The Body Keeps the Score hit the bestseller list following its publication in 2014, it would quickly lose all credibility and be banished to the bargain bin due to its many blatant scientific errors and grandiose narrative.

Instead, it maintained a streak of being the #1 ranked book in Psychiatry on Amazon.com for years. Just last week, the week of June 29th 2025, The Body Keeps the Score is ranked #5 for most sold for all nonfiction books on Amazon’s official weekly ranking. It’s maintained an unbroken streak on the top 20 most sold nonfiction list for the past 233 weeks - over 4 years and 5 months.

Bessel van der Kolk’s book isn’t just being grabbed up by laymen, it has made its way into many college classrooms.

Texas A&M’s Introduction to Trauma Counseling course syllabus had The Body Keeps the Score on the “required textbooks” list. It was also in the required list on Ohio State University’s trauma seminar course and a trauma focused care course at Northern Kentucky University.. It was on the recommended reading for a trauma course at Bard College and a South University crisis trauma course. It’s in the recommended books list for the department of Psychiatry at Washington University. I could go on with examples but needless to say, the book is having a huge impact.

Sufficiently shocked that no one had written a proper breakdown of all the glaring issues with the book, Dr. Scheeringa decided to write his own. He published The Body Does Not Keep the Score in 2023.

This book should be recommended alongside The Body Keeps the Score at all college campuses promoting Bessel van der Kolk’s theories.

The Chicken, Egg and the Trauma

I had some suspicions about The Body Keeps the Score when I first read it about 4 years ago because van der Kolk wasn’t proving that the trauma-induced brain ‘changes’ he was talking about weren’t already there before the trauma happened.

As I talked about in this article, this confusing the chicken for the egg is the same reason Gabor Mate’s view that trauma causes ADHD is mistaken. ADHD expert Dr. Russel Barkley explained this in his video Why Dr Gabor Mate is Worse than Wrong about ADHD. What happens is that children with ADHD have bad experiences because their easily-captured attention makes them impulsive and willing to take risks, their bad behavior frustrates those around them which leads to social consequences and so forth. That is, the ADHD leads to very negative experiences. Having had negative experiences (trauma) doesn’t lead to ADHD.

I’ve talked some about PTSD briefly on this Substack before. For example, lower testosterone levels before a traumatic event (in this study, deployment to a combat zone) predicted the development of PTSD symptoms. Testosterone seems to have a protective effect from PTSD. Another study found that testosterone literally decreases fear, and testosterone is well known to have anti-anxiety effects. The lack of the protective effect of testosterone may be a reason why women are twice as likely to experience PTSD.

In the textbook Evolutionary Psychology, the authors explain that a particular hunter gatherer population isn’t as susceptible to PTSD despite being exposed to similarly tragic events. They argue that part of the physiological changes that come along with PTSD are increased inflammation in the body. Thus, the inflammatory nature of a standard western diet may make some people more susceptible to PTSD.

A 2020 study on Turkana warriors in Kenya found them to be much less likely to develop PTSD-related symptoms compared to US combat vets despite also experiencing gruesome acts in a war zone.

All this suggests that certain people may have certain physiology or hormonal profiles that make them susceptible to trauma.

What this would suggest is that van der Kolk could be getting everything backwards.

That is, trauma doesn’t lead to dysfunction or abnormal brain function, physiology or hormonal regulation. Rather, an unhealthy person may be more susceptible to trauma.

The Body Does Not Keep the Score

I was gearing up to do a full breakdown of the claims made in van der Kolk’s book when I came across Dr. Scheeringa’s The Body Does Not Keep the Score. It is a systematic, thorough analysis and debunk of all the major claims made in van der Kolk’s book.

One critique that kept coming up was that van der Kolk was using tons of cross sectional research to prove his points. These papers just took snapshots of the brain of people with PTSD. There was no “before” snapshot, so van der Kolk can’t claim with any certainty that trauma caused these brain changes. Just like Gabor Mate, it could easily be the case that van der Kolk was getting the picture entirely backwards.

As Dr. Scheeringa points out, it is likely that any abnormalities in the brains of PTSD victims were present before the event and these abnormalities made the person more susceptible to developing PTSD.

Except it gets worse: It wasn’t like van der Kolk was presenting some kind of well known brain abnormalities consistently present in PTSD victims that scientists had been scratching their heads about. Van der Kolk was grasping at straws to make his claims. Let’s take a look at the first two claims Scheeringa lists in his book.

Does trauma directly damage the brain and body?

The idea that trauma causes long-lasting damage to the brain and or body is central to van der Kolk’s thesis. Without solid proof that trauma was the cause of any brain, body, or hormonal abnormalities, van der Kolk’s asserting that “the body keeps the score” falls apart.

Van der Kolk repeats the same deceptive pattern for 3 claims that are key to his theory:
・He presents his claim as being well known within the field, not even bothering to cite research.
・He doesn’t mention that actual investigation into the research reveals plenty of contradictory outcomes. While several papers that show one result, several yield the exact opposite result.
・He doesn’t address the papers that directly prove his claim wrong.

Claim 1 - Trauma wrecks the brain’s insula

The first change in the brain that van der Kolk discusses is “abnormal activation” of a region of the brain called the insula.

Almost every brain-imaging study of trauma patients finds abnormal activation of the insula.
—The Body Keeps the Score

He provided no citation for this claim, but after digging through the literature on the insula, Michael Scheeringa found that:

At the time The Score was published in 2014, there were 21 studies of the insula and 20 were cross-sectional studies. Twelve of those studies had reported more activity, six studies reported less activity, and two studies reported no difference in activity in individuals with the PTSD diagnosis or high PTSD symptom severity compared to a non-PTSD control group.

…van der Kolk neglected to mention the twenty-first study, which was a pretrauma prospective study. When assessing participants both prior to trauma exposure and again 1.5 years later, insula activity had not changed in conjunction with post-trauma symptoms.

—The Body Does Not Keep the Score

・20/21 of the papers available on the insula were these snapshot studies, so we don’t know if the abnormal activation was present before the trauma or not.
・The studies clearly contradicted each other.
・One study directly proved van der Kolk wrong and provides strong evidence for the suspicion that he’s getting trauma completely backwards. The study that assessed insula activity before and after the trauma found that the insula activity was no different after the trauma.

Just last December, he repeated this claim that the Insula is negatively affected by trauma on The Diary of a CEO podcast.

Claim 2 - Trauma rewires the brain’s amygdala

The amygdala is a big part of van der Kolk’s theory about trauma. In the book, he mentions the amygdala 28 times over 8 different chapters. I made a short video pointing out that Gabor Mate’s story about how an abandonment trauma he experienced when he was 11 months old affected his behavior when he was 71 years old. I pointed out that it’s highly unlikely Gabor Mate could remember how that experience affected him considering reliable memories can’t be formed before the age of 2. A criticism I saw a couple times was that his nervous system remembered the event, and more specifically, his amygdala remembered the event.

Scheeringa reveals that Claim 2, van der Kolk’s “trauma can rewire brain centers such as the amygdala,” plays out almost exactly like Claim 1:

At the time The Score was published, there were 23 studies of the amygdala and 21 were cross-sectional studies. Seven of those studies had reported more activity, one study reported less activity, and 13 studies reported no differences in groups with the PTSD diagnosis or high PTSD symptom severity compared compared to non-PTSD control groups. Not even the cross-sectional studies supported his claim. Van der Kolk neglected to mention the twenty-second and twenty-third studies, which were pretrauma prospective studies. When assessing participants both prior to combat deployment and again after 1.5 years of combat service, amygdala activity had not changed in conjunction with post-trauma symptoms.
—The Body Does Not Keep the Score

・21/23 of the papers available on the amygdala were these snapshot studies, so we don’t know if abnormalities were present before the trauma or not.
・The studies clearly contradicted each other.
・Two different studies looked at the amygdala before and after the traumatic event. There was no change in amygdala activity after the traumatic event.

Only a month ago, Bessel van der Kolk appeared on the Big Think channel to claim that the amygdala is where you’ll find the “core imprint of trauma.”

Claim 9 - Trauma leaves you with increased stress hormones

Long after a traumatic experience is over, it [the brain] may be reactivated at the slightest hint of danger and mobilize disturbed circuits and secrete massive amounts of stress hormones.
—The Body Keeps the Score

Again, van der Kolk doesn’t cite any studies for this claim.

As Scheeringa points out, “stress hormones” could refer to anything from prolactin, glucagon, progesterone to epinephrine. However, the main stress hormone that gets attention is cortisol. Scheeringa provides a timeline of conflicting results from research on cortisol and PTSD:

・1986 - First study on cortisol and PTSD. Cortisol levels were lower in PTSD.
・1989 - Cortisol levels were higher in PTSD.
・1989 - Cortisol levels were normal in PTSD.
・2007 - Meta-analysis of 37 studies on individuals with PTSD. The conclusion based on these 37 studies was that cortisol levels were normal in PTSD.
・2012 - another meta-analysis of 37 different studies. Conclusion: cortisol levels were not different between trauma-exposed and non-exposed indviduals.

Despite all this, van der Kolk would go on to claim that elevated cortsiol causes serious health problems in people who experienced trauma:

In PTSD patients, however, the stress hormone system fails at this balancing act. Fight/flight/freeze signals continue after the danger is over, and, as in the case of the dogs, do not return to normal. Instead, the continued secretion of stress hormones is expressed as agitation and panic and, in the long term, wreaks havoc with their health.
—The Body Keeps the Score

---

A baffled Michael Scheeringa tried to make sense of how van der Kolk could so brazenly misrepresent the research to support his ideas. He assumed there must be some sort of ideology at play because:

If it’s not ideology, a better explanation has not presented itself. It can’t be that he just doesn’t understand cross-sectional studies. He can’t be that naive. There were just as many cross-sectional studies that disagreed with his theory that he ignored.
—The Body Does Not Keep the Score

---

Did you think that was it?

What we just reviewed was about 4% of van der Kolk’s book. There are still plenty of fatal shortcomings in The Body Keeps the Score. Let’s get a birds eye view of them:

Claims 1, 6, 8, 9, 22, 23, 24, 25, 30, 33, 34, 35, 40, 42

△For all 14 of these claims van der Kolk either didn’t bother to cite a study or the citation he listed couldn’t be found in the scientific literature.

Claims 3, 10, 26, 28, 29, 31, 32, 41,

△Van der Kolk completely misrepresents the study he cites in each of these claims.
For example:
・in Claim 3, van der Kolk says a certain part of the brain goes “offline” during a flashback. Van der Kolk cited a study which he said was designed to understand flashbacks. The complete lack of discussion of flashbacks reveals this was not the aim of the study. It mentioned “flashback” only once and that was simply referring to a different study.
・In Claim 26, van der Kolk claims that trauma damages the ability to literally feel touch on parts of the body. The paper van der Kolk cited made zero mentions of insensitivity to touch.
・In Claim 28, van der Kolk claims that trauma causes fear centers to shut down. Van der Kolk cites a study on 11 females with dissociative identity disorder. The researchers measured neither trauma experiences nor PTSD.

---

The misrepresentations just keep on coming

Before I end this article, I want to impress upon you that the criticisms of van der Kolk’s book are not nit-picks at small exaggerations or flowery language. Let’s break down just two more claims to show how van der Kolk exaggerates and misrepresents the research to support his narrative that trauma is far more prevalent and far more damaging than we think :

Claim 19 - Lack of warm memories wrecks your brain? A leap based on a complete misunderstanding

In Chapter 9 of his book, What’s love got to do with it?, Van der Kolk claims:

“…if you lack a deep memory of feeling loved and safe, the receptors in the brain that respond to human kindness may simply fail to develop.”

At first glance, this sounds nice and science-y, receptors developing, upregulating, or downregulating reminds me of how repeated exposure to addictive substances can downregulate dopamine receptors.

Dr. Scheeringa explains that the issue with van der Kolk’s evidence for his claim is he is cited 3 review articles of animal research. Scheeringa says:

Animal research cannot measure memories of feeling loved. There is no such thing as receptors for responding to kindness.

Now since I really enjoyed Jaak Panksepp’s textbook Affective Neuroscience, the person whose work van der Kolk cited, I’ll include some of my own digging on this point to show just how badly van der Kolk is winging it.

In footnote #9 of Chapter 9, Van der Kolk cites 3 of Panksepp’s studies and claims that Jaak Panksepp found that:

“young rats that were not licked by their moms during the first week of their lives did not develop opioid receptors in the anterior cingulate cortex, a part of the brain associated with affiliation and a sense of safety.”

First off, none of these three cited studies of Panksepp’s (1,2,3) said anything about mice or rats being licked.

Going past these three citations, I couldn’t find any studies of Panksepp’s anywhere where he manipulated the licking behavior of a mother mouse. However, in one of the papers van der Kolk cited, Endogenous Opioids and Social Behavior, Panksepp did write that:

“It has recently been demonstrated that social isolation of animals can lead to increases in number of opiate receptors in the mouse brain.”

1. Remember, van der Kolk said the rats that didn’t get licked “did not develop opioid receptors.”

2. Panksepp’s claim is exactly the opposite of what van der Kolk’s. Not only did opioid receptors develop, they increased.

3. Further, this study was on social isolation. This is dramatically worse than a mouse just not being groomed by their mother.

However, even if van der Kolk wasn’t misrepresenting Panksepp’s work, his point still wouldn’t stand.

We know what social isolation looks like, but what is the human equivalent of a rat’s experience of being licked? Is it having their hair cleaned? Is it being held? Is it being breastfed? Being played with? Being taught the words for water bottle, paper and socks?

Further, van der Kolk claims that simply lacking a “deep memory” of feeling loved and safe is sufficient to prevent ‘human kindness receptors’ from developing. So if someone received the most loving care one could imagine but couldn’t remember it, would that make them dysfunctional?

Based on work like that of Harlow’s where he isolated monkeys in a box he called the Pit of Despair, we already know that social isolation and other sadistic upbringings can have terrible effects on animals.

However, van der Kolk seems to be attempting to downgrade this such that even something as vague as lacking a “deep memory of feeling loved and safe” can have measurable effects on the developing brain.

Claim 7 - Trauma damages the ability to make eye contact and interact with others

In Chapter 6 of his book, van der Kolk refers to a 2012 study to support his idea that reason people with trauma who come into van der Kolk’s office are gripped with shame to the point that they “feel disgusting and that they can’t stand having [van der Kolk] see how despicable they are.” He offers the 2012 study as proof “that these intense feelings of shame [are] reflected in abnormal brain activation.”

First off, there is absolutely no mention of “shame” in the paper he cited.

Scheeringa zeroes in on a big error with how van der Kolk characterizes the study:

“the subjects with PTSD did not activate any part of their frontal lobe, which means they could not muster any curiosity about the stranger”
—The Body Keeps the Score

This is in fact, the opposite of what the study found. Based on the results in table 3 of the study, Scheeringa notes that:

The PTSD subjects not only increased activity in frontal lobes (inferior frontal gyrus and superior frontal gyrus) in some of the tests, they did so significantly more than control subjects.
—The Body Does Not Keep the Score

Also, the study didn’t ask the participants about their “curiosity” in the stranger.

---

The problem

It is frankly amazing that Dr. van der Kolk’s book got this far despite so many blatant errors.

One of the big issues with van der Kolk is that his narrative paints this hopeless picture of trauma victims as being people who most aspects of their lives are “dictated by the imprint of the past.”

Now, I don’t have PTSD and I’m not trying to make a case for how PTSD should or should not be treated.

What made van der Kolk stand out to me was his trying to say that the majority of people have trauma. Van der Kolk claims trauma is so prevalent and so many people are suffering from the consequences of trauma without realizing it. He goes as far as to say that trauma is “arguably the greatest threat to our national well-being.”

Why does van der Kolk say trauma “extremely common?” Because according to him, it can be almost anything. Van der Kolk says it’s simply “something that happens to you that makes you so upset that it overwhelms you.”

So, maybe you have trauma.

Maybe you should go on a wild goose chase to identify your trauma, because as van der Kolk implies, it might be at the root of your irritable bowel syndrome.

Sarcasm aside, I think Bessel van der Kolk and Gabor Mate’s heavy handed trauma narrative is sending far too many people on a wild goose chase for what their ‘trauma’ might be and various alternative therapies for treating the treating the trauma. For many people, these end up being a waste of time. However if they ‘treat’ their trauma with things like yoga, meditation, psychedelics and have some benefits, it’s very likely they would have had the benefits regardless of whether they viewed it as some sort of trauma treatment or not.

Sure, self reflection can be good, this isn’t a black and white assertion that you should ‘never consider your past.’ I’ve done plenty of self reflection, meditation, psychedelics and so on and it was all very meaningful and beneficial in various ways.

If you’d like to get more into what problems this kind of trauma narrative brings forth, start with my my article Are we creating Trauma for ourselves? from September 2023.