Dale Johnson: Today on the podcast, I have with me Dr. Francine Tan. She’s a biblical counselor from Malaysia. She’s been certified with ACBC since 2021. She has a BA from UCLA, her Master of Arts in Biblical Counseling from the Master’s University, and she graduated recently with a PhD in Applied Theology, which is focused in biblical counseling from Midwestern Baptist Theological Seminary. And I’m so delighted that she’s here with me. She also works for ACBC and is a member of Mission Road Bible Church in Kansas City. Francine, it’s good to have you again today.
We’re going to talk today about Bessel van der Kolk, and I’m delighted that you’re here. We’ve just written a dissertation on this topic. Honestly, it was hard for us to narrow down a couple of ideas, but I think Van der Kolk is still very popular, and so I want us to talk about some of the concepts that we see at the popular level from Van der Kolk. And I want us to pay attention not just to his name, but to his ideas that we still see being promoted in not just secular literature, not just in integrated literature, but in several who claim biblical counseling. People would ask maybe, “Why are you guys so hot and bothered? Why are you concerned about this?”
I think that’s a good question for us to consider. We want to address some of those as to why it is that we’re concerned. So, talk a little bit about Van der Kolk, his ideas of the body keeping the score, and get us set up for how we see his influence in many different directions. So, just introduce us to who he is, and the concept of the body keeps the score.
Francine Tan: Sure. So, Van der Kolk, he has been researching on trauma as it pertains to veterans for many, many years. His popular book, The Body Keeps the Score, published in 2014, translated into 43 languages, has placed him in a position straddling scientific celebrity and guru—where he is known for his famous quote, “If the memory of trauma is encoded in the viscera, in heartbreaking and gut-wrenching emotions, in autoimmune disorders and skeletal muscular problems, and if mind-brain visceral communication is the royal road to emotion regulation, this demands a radical shift in our therapeutic assumptions.” So, Van der Kolk’s emphasis on one, memory, and two, emotion regulation, are still being used today. In other words, what he’s saying is that a vast array of physical illnesses, psychological diagnosis, and negative emotions are all at root caused by trauma. It’s important for us to be familiar with Van der Kolk because his school of thought lies at the heart of trauma-informed care today, which has been widely accepted as evidence-based behavioral health care service.
You mentioned an integrated world, but also among policymakers, educators with trauma-informed schools, mental health professionals, and the general public. So, a little bit about Van der Kolk, a brief history about him: He’s a Boston-based psychiatrist and he’s been researching PTSD as it pertains to veterans since the 1970s. He’s a professor of psychiatry at Boston University School of Medicine, the director of National Complex Trauma Treatment Network. In short, his bestseller, The Body Keeps the Score, is complicated enough to sound scientific and accessible enough through anecdotal stories that it qualifies as a pop-psychology book flying off the shelf.
In fact, psychiatrists like Michael Scheringa, you can see his book’s analysis of The Body Keeps the Score in his second part, The Body Does Not Keep the Score. Psychologists like Richard McNally, Elizabeth Lotus, who focus in memory, have long critiqued Van der Kolk for promoting pseudoscientific claims about trauma, memory, and brain development. But Van der Kolk’s concepts continue to be peddled in popular, and in fact, biblical counseling literature, especially as it pertains to the memory of trauma and emotional regulation or dysregulation.
Dale Johnson: I think that’s really important, some of the things that you’re describing and the ways in which Van der Kolk is popular. I mean, we’re talking about to the level of over three million copies being sold since 2014.
I mean, that’s really significant in the influence. And you mentioned not just among popular culture, but this is gaining traction in policymakers, in educational institutions. It’s being popularized in a lot of different places. And I think it’s critical that we understand. So, one of the primary concepts, so just let me put it on layman’s terms for you.
Essentially what he’s saying is that when trauma happens, that we store that trauma in the body, that we have a bodily response that sort of is driving how we respond. And some people describe this in a more technical way as amygdala hijacking. They would describe that the body, yes, is keeping the score, and it can be stored in several ways or repressed in several ways to where it can present itself in trauma responses. It can present itself in cancer. It can present itself in different pains within the body or sickness or illness.
So, there are different ways in which he describes the concept of trauma being stored in the quote “viscera,” right? One of the keys to his theory that I want us to explore is this concept of dissociation. Now maybe you don’t know this term, and so I’m going to get Francine to introduce us to this term. But this is a term that’s been widely utilized in the DSM literature, in the Diagnostic and Statistical Manual of Mental Disorders with psychotic episodes and different things like that to separate ourself, if you will, from some form of reality. So, introduce us to this concept from Van der Kolk of dissociation.
It is one of the more popular ideas that come from him we see utilized in lots of different areas. So, introduce us to the concept that he’s describing here and then how we should think about it.
Francine Tan: Before that, I’d like to make a connection. So, Van der Kolk uses the term or the concept of dissociation. Herman uses the term repression. Repression comes from Freud and dissociation comes from Pierre Janet. So, you may find terms like dissociate or dissociative amnesia or fragmentation in almost any literature on trauma. It is commonly understood by trauma-informed proponents that dissociation is “a disconnection between a person’s thoughts, memories, feelings, and action. And when an individual has a history of trauma, the body and brain are fading out or shutting down in response to an overwhelming sensation of helplessness and fear.” Now, this is key because according to Van der Kolk, dissociation is the essence of trauma.
He says that overwhelming experience is split off and fragmented, so that the emotions, sounds, images, thoughts, and physical sensations related to trauma take on a life of their own. And this fragmented memory of trauma now intrudes into the present. And as long as the trauma is not resolved, then he says, “the stress hormones that the body secretes to protect itself will keep circulating. Defensive movements, emotional responses keep getting replayed.” Which is what you alluded to; the amygdala being hijacked.
Now, what Van der Kolk here is saying is that trauma results in dissociation and the fragmented memories are re-experienced by a person as physical symptoms like panic attacks, physical sensations, hyperventilation, and eventually physical illness if “chronic stress states becomes prolonged.”
Dale Johnson: Now, you mentioned this concept of re-experience and I want to make sure that we understand this because I want to dive a little bit further into that. I want to make sure that we understand very clearly that when somebody experiences trauma, there’s not a person that has an inkling toward biblical counseling, that our heart of compassion doesn’t rise up. We want to help somebody who finds themselves in the pit of despair or deep anxiety, maybe panic responses. Well, whatever the case might be, when we see somebody who’s walked through difficulty like that, man, our heart just breaks for them, what they’re experiencing, what they’re walking through.
But when we describe some of these concepts and the way this enters into the biblical counseling world is it creates some level, honestly, of timidity when we feel like there’s dissociation happening as Van der Kolk describes. We begin to walk very tenderly—that we’re walking over some sort of repressed concept or maybe that there are bodily responses that are happening that they’re not in control over or whatever. And so we don’t want to encroach upon concepts like that because that seems to be a mishandling of some sort of bodily response that’s happening.
And so, there is this sort of timid like, what’s going on here? How do we understand this? And so, we don’t want people to re-experience trauma. And so in the counseling room, the way that that looks is in the form of some level of timidity. How do we go about addressing this very prominent bodily response that’s happening? Because Van der Kolk or some neurologist has told me that this is a bodily response. It’s been stored up. It’s not something that they’re morally responsible for. How do we address this? And so, we start thinking about all these other ways that we might can help them with “bodily responses.”
We’re not here to say that the body is not responding in some way, but we have to remember we can never biblically discount moral agency from the person. And number two, we can’t say that the body is dictating as if it’s the driver. Does it influence us? Without question. Do we see bodily responses based on a person’s perception? One hundred percent. God made us body and soul. We will see that connectivity. But when we see physiological effects, it does not mean physiological causes. And this is very critical because we have to bring a biblical anthropology to bear here.
So, I want you to describe this level of tension, this timidity of re-experiencing. Because I don’t want a person that I’m sitting in front of to have to walk through, let’s say it’s a legitimate traumatic experience. I don’t want them to have to re-experience the feelings of that “unresolved trauma.” And this is really where I think Van der Kolk has preyed upon the Christian compassion that we have.
And yet, it’s been misleading because of the ideas that he’s promoting to try and entice that Christian compassion, they’ve not been demonstrated to be true neurologically. They’ve not been demonstrated empirically true relative to his scientific approach, as you mentioned with Scheeringa and George Bonanno and several others. So, talk about re-experiencing unresolved trauma and how Van der Kolk utilizes that concept.
Francine Tan: So, any physiological human response is not devoid from interpretation. The heart is always active. You’re interpreting what’s going on and responding. Now this is why Van der Kolk’s association—it’s important to understand what he is saying. He’s saying that traumatic memory is not like ordinary memory. That now trauma becomes a literal state of the body that bypasses conscious recall through dissociation where a memory split off from consciousness. So, the person is divorced from any moral agency and is not even aware that this is happening.
And then he says, “now dissociated memory resurfaces later as physical or psychological issues if the trauma is unresolved.” Now, it is also a very helpless, hopeless view because then he says the person now who is traumatized will keep on re-experiencing it until that is resolved. And again, as you put it, we’re not questioning that traumatic events are real and they are difficult and suffering as the Bible would call it, but the goal is not for the person to never ever again experience the effects of the fall. And interpretation is always happening at every level.
Dale Johnson: Yeah, I think that’s a critical distinction— that we’re not trying to recreate some sort of experience, but we are trying to deal with what reality is. You mentioned something that I think is important and I want to step back and address because Van der Kolk and many others, I think, utilize this supposed neurological explanation for what is actually happening in the brain.
And you talked about this concept of re-experiencing, even this concept of dissociation that people feel or interpret that they’re feeling, that it’s memory split off from consciousness. And man, I think that’s really, really helpful. Because again, in something like that, it does remove us from the concept of moral responsibility.
And I want to trace a little bit about where somebody like Van der Kolk gets that from. I’m thinking of Joseph LeDoux. Joseph LeDoux is a primary researcher in neurology. He’s the world leading researcher on the concept of fear and worry. I want you to just express some of the concepts in two ways:
First, I want to be very clear, the way in which LeDoux has been misunderstood. Let’s start there. And then I want to give some form of clarification from him that would be helpful where he recognizes people have misused his ideas. People like Van der Kolk have misused some of his ideas in a way that could be helpful for us and be appropriately cautious.
And again, I’m going to remind you as listeners, Joseph LeDoux is a Darwinian neuroscientist. So, his views are not the same as our views. We would not promote many of his concepts. As the leading scientific researcher on this concept of fear and worry and the memories that go along with it, and particularly the brain center of the amygdala, LeDoux is a secular expert. And we need to pay attention because he’s a watershed guy.
What that means is that lots of people like Van der Kolk are downstream from him. And we need to pay attention to some of the things he says and the way in which he’s interpreted. So, I want you to start first with: how is somebody like Van der Kolk impacted by LeDoux, at least first the way that he’s often interpreted at the popular level?
And then, I’ll remind you when we get to this point, but then I want you to describe how Joseph LeDoux is trying to correct that misunderstanding. I think people will start to see how Van der Kolk is taking what is supposedly good neuroscience in a direction that’s unhelpful. So, describe a little bit about LeDoux and how his science has been misused by people like Van der Kolk.
Francine Tan: So, Van der Kolk really eclectically takes different theories from all over, one of them being LeDoux. So, Van der Kolk’s idea is that after trauma, now the person has a different nervous system that has an altered perception of risk and safety. And he proposes that this happens through two mechanisms: one, the amygdala being hijacked and two, a chronic stress state. So, Van der Kolk says that the amygdala is, he calls it, the smoke detector or fear center of the brain or alarm bell system of the brain—where when a person faces threat or danger, the amygdala goes off. And if the person is constantly in a state of danger, then trauma now makes that part of the brain hypersensitive and malfunctioning.
LeDoux, who is known for his research on memory and emotion, specifically fear and anxiety for many, many years. And this has made him one of the leading figures on amygdala’s role in emotional processing. So, it’s not surprising that people like Van der Kolk would now take it and say, “He gives us the explanation as to why emotional dysregulation, fear center, now is being hijacked.”
However, LeDoux, he would say that one, the amygdala is not solely responsible for fear. It’s also responsible for many other phenomena like thinking, eating, drinking, smelling, feeling pain, using language, and so on. But more than that, he has said that he has long taken a different view, that emotion and fear, they’re conscious. They’re not unconscious. In fact, he and his co-author, they said that no emotion is unconscious.
This is in 2017, where he said it more explicitly, “that our view is that emotions can never be unconscious.” So, there’s no such thing as an unconscious emotion from a neuroscience perspective, from his perspective, that’s devoid of interpretation, that’s devoid of cognition. And this is what he would call it, that his view of emotions have always had a cognitive view on any emotional response.
Dale Johnson: For you to say something like that, Francine, I mean, that is like a lead balloon in the world. Okay? Because for Joseph LeDoux, who’s a Darwinian neuroscientist, to say that cognition is involved in emotion is like the biggest bomb on the planet. Because a Darwinian should not be equating the concept of consciousness as being involved specifically.
That’s actually going counter (against) that philosophy of a Darwinian approach. And yet LeDoux is willing to say, you know what? People have misused this concept. I’ll take some of the things that you said a little bit further with the amygdala. When he describes fear and worry, anxiety, our emotional responses, what he’s saying is that those things are connected to memory.
And amygdala is not the only brain center that’s involved in memory. So for those instantaneous responses to happen, it’s not like the body’s interpreting and responding. The body’s responding to cognitive perceptions that are happening in minute moments. And what’s critical is that more than one brain center is involved. And here he gets into describing some of the complexity, where we like to oversimplify and overreduce this down to an explanation of saying, “Well, it’s the amygdala and is it involved?”
I think neuroscience reveals that, yes, it is absolutely involved. Is it an oversimplification to say that your amygdala is not working properly? That’s why you have these fear responses? That seems to be, based on reading Joseph LeDoux, an oversimplification that removes cognition and it removes the influence and the variability of many other brain centers like the hippocampus and so on. So, we have to be cautious and careful about the research that’s being used, how it becomes popularized, and how we’re taking theory and now describing it like Van der Kolk does, often as factual.
Those two things are very different. And so, Scheeringa has helped us to understand Van der Kolk a little bit better by challenging the theoretical disposition, the way in which Van der Kolk states these things as fact. And so we have to be cautious here. And I think that’s helpful. There is a lot more we could say about that.
I want us to maybe finish today talking about this “storing up in the viscera” and not just in fear responses, but also in the disease connection that we see. So, this concept of stress rising, there’s a disease connection in his particular mind—there becomes an emotional dysregulation. So, I want you to present those concepts in the way Van der Kolk does in a way that might be helpful for us.
Francine Tan: It really is an oversimplification because it’s not a one-to-one—even with the amygdala, it’s not a one-to-one relationship. In fact, neuroscientists have said, you know, the brain is not structure X causes function Y. It’s more of a complex network. Van der Kolk would say the Broca’s area gets shut down and hence speech impairment. And then the amygdala gets shut down and hence fear response. So, all of that too, it kind of pedals this idea of, you know, structure X of the brain now equals the function Y. It’s untenable.
Dale Johnson: Well, what’s interesting about that, I’ll just say a quick word is that doesn’t explain, you know, some people who seem to be deeply affected, and I’m not minimizing this, deeply affected by traumatic events that happen. And yet, other people who go through the same exact traumatic event or something deeply similar, they don’t have the same types of responses. It doesn’t deal with the variability that you see in reality. It doesn’t deal with what one researcher describes as resiliency.
How do we account for that if these things genuinely are stored in the body in the ways in which we respond? There’s no way neurologically to describe that variability of resilience responses or deep traumatic responses. We just have to be cautious about what we’re hearing. So, continue on sort of making the connection of the stress-disease connection and then the emotional dysregulation, which we hear a lot about today.
Francine Tan: Sure. So, Van der Kolk‘s view is that if we don’t resolve the trauma, the body keeps thinking it’s in danger, and then the stress hormones will keep getting produced. And he says, “Stressful experiences, whether divorce or final exams or loneliness, they have a negative effect on one’s immune function.” So, a person now is said to be in a chronic stress state, and because they’re constantly in a stress mode, their cortisol level is elevated for an extended time. Now this also has been debunked. Cortisol is not the body’s sole stress hormone.
It’s involved in a whole range of other things. In fact, PTSD researchers were very surprised that when they study it, cortisol levels tend to be low in those who were diagnosed with PTSD. So, even the idea of high cortisol level, your chronic stress state, immune function gets impacted, that kind of oversimplification, and say that now its causation is not proven.
Something to add to that, Van der Kolk also uses Stephen Porges’ view of the polyvagal theory that was coined in 1994 to now give this idea of the nervous system being dysregulated and things like that. And Stephen Porges, basically his polyvagal theory introduces an evolutionary perspective on the nervous system to explain behavioral problems and psychiatric disorders.
Porges, he would summarize his theory in this way: In 2023, he says, “that it is about understanding that our bodily state influences how we respond to the world and how we experience the world. It’s really about how you feel. Polyvagal theory is about whether you feel safe enough.” And then he goes on to say that “trauma is not an event, but a physiological experience, which is why people need to listen to their body.”
I want to point out that Porges, in 2014, he coined this theory. It’s basically a repackaging of Paul MacLean’s triune brain theory, which was already debunked in the 80s. And Porges himself says that his theory, “was not proposed to be either proven or falsified, but rather to be informed by research and modified.” Now, this is key because, you know, listeners should be able to identify that one of the features of pseudoscience is the presence of unverifiable claims. And polyvagal theory, which undergirds dysregulated nervous system, emotional dysregulation, is considered pseudoscience when Porges, the theorist himself really acknowledges that he did not propose the theory to be proven or falsified.
And it’s just a theory. And Van der Kolk endorses polyvagal theory as the explanatory science behind a dysregulated nervous system due to trauma, and that now the individual is supposed to now remain stuck in a fight or flight state even after the threat has passed.
Dale Johnson: What you’re doing is very helpful to us because it begins to explain the shaky foundation upon which Van der Kolk has built. And really there are crevices and holes and instability in the varied ideas and theories that he tries to put together to create his own. He’s trying to present a grand theory of trauma that really borrows from lots of different people in history, right?
Back from Judith Herman and then moving forward to Porges and the polyvagal and the concepts of Joseph LeDoux, misinterpreted, misunderstood, and an oversimplification trying to popularize it, so that people can understand these concepts. And we’ve taken it not just as theory, but as factual. And we’re seeing people affected by this trauma-informed approach. I want us to revisit at some point, Francine. We don’t have time to do this today, but I want us to revisit this concept.
So, if we’re saying, okay, this framework is unhelpful, because I don’t think it leads us to a biblical response for people who are really experiencing, you know, trauma. I think we need to run back to Scripture to understand not this trauma-informed approach, but how do we understand people who are walking through this? And so I want to make sure that we revisit this again. Again, we don’t have time for this today, but I want us to revisit, okay, how do we see this from a biblical perspective? How does the Bible give explanation?
How does the Bible give a better explanation than the way Van der Kolk has framed this on such shaky ground? Not just scientifically, but even theories that have already been debunked and questioned and looked at as pseudoscience and not verifiable. So I want us to revisit, understand the experiences that people are having, notice that the body does influence, doesn’t dictate. And so how do we take what people are experiencing and feeling and run back to the Scripture to see a proper worldview that gives an explanation for how and why people are experiencing certain things and how we help them best deal with some of these bodily responses that are happening as we deal with certain beliefs about reality and perceptions and so on. So, that’ll be another topic for another day.
Today has been really helpful because you’ve helped us not just to understand Van der Kolk as the person, but also, you’ve helped us to understand a little bit more about his ideas. And that’s what you’re looking for in discernment, the ideas that people are promoting moving forward.
Francine Tan: If I may, Van der Kolk himself admits that he says, you know, “my colleagues and I sort of invented this trauma stuff in the late 70s, early 80s. And we thought that the world would become a better place. We are part of each other; the way you behave affects the way I am and that most mental illnesses are the result of environment and the individual being at odds with each other.” So, even his admission that this is fabrication in the 70s, in the 80s, and back then—he viewed it as a result of environment, and now he’s packaging it with pseudoscientific jargon to give an appearance of neurobiological explanation.
Dale Johnson: The reason that happens is because in the 70s, it was much more the influence of nurture. And now as we see the cycles happen in the history of psychology and psychiatry, the biological movement now gives more emphasis on the nature of a person. And so, same theories that are now reinterpreted through a nature lens, a biological lens, that you see coming forward in someone like Van der Kolk.
Very helpful today. Thanks, Francine, for setting the stage and helping us to understand these concepts at a deeper level. To describe, to make sure that we’re biblically accurate; at ACBC, we think it’s important to continue to study and to grow in our understanding of God’s Word and how it applies even to complex issues like trauma.
