Criticisms of “The Body Keeps the Score”

This article (and author) seems to be something of a trauma-skeptic, which doesn't seem to agree with mainstream science (setting aside Body Keeps the Score)

> 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.

What has been documented about Adverse Childhood Experiences doesn’t agree with this. There is copious evidence that the presence of ACEs, independent of other factors, leads to poor health outcomes [1]

It's also well known that past trauma predisposes you to future trauma [2]

There's also data indicating CPTSD, PTSD, and Borderline are distinct disorders [3]

1 - https://pmc.ncbi.nlm.nih.gov/articles/PMC8882933/ https://bmcpublichealth.biomedcentral.com/articles/10.1186/s...

2 - https://pmc.ncbi.nlm.nih.gov/articles/PMC5858954/

3 - https://www.psychiatrypodcast.com/psychiatry-psychotherapy-p...

I think there is a bit of a crowd that is pushing the idea that you can make events worse by telling people that they are forever scarred from them? That is, yes, some trauma sticks with you. History shows people are also very resilient at moving on from trauma. Kind of have to be, so that we aren't devastated when we ultimately do lose some family.

Would be like saying you should hammer people on how much grieve they must be feeling because they lost a dog. Now, nor should you also scold people for feeling said grief. It is very personal and hard to really know what experience someone will have until they have it.

more information is better if it’s also provided with the context of how to heal.

> History shows people are also very resilient at moving on from trauma

i’m extremely skeptical that people move on

they suppress, they survive, but without deep understanding its impossible to say move on

you can be ignorant and survive, or face reality and climb the deeply uphill battle of real growth.

of course you can be paralyzed by it, but no one is advocating for that as treatment

I mean... depends on the trauma? Do you consider it traumatic to lose a pet? What is the difference between survival and moving on? What sort of growth would you expect there?

It really depends on the person.

I know someone who grew up in rough neighborhoods, has been in fights, been stabbed, divorced alcoholic father and drug using mother, and yet got a master's degree, a fulfilling career, marriage and family.

I know someone else who happened to be in a bank when it was robbed, and has spent years struggling to hold a steady job because the anxiety developed from the experience has persisted. Later divorced and become a poster child for making bad decisions.

The latter has gone to therapy, the former didn't. Small sample size, don't draw any conclusions other than everyone is different, and beware anyone proclaiming universal truths in psychology.

None of these seems to be making a causal claim, did I miss something? The linked article is saying causation runs in the opposite direction.

> History shows people are also very resilient at moving on from trauma.

That's the "classical" mindset that modern empirical studies are refuting.

Actually, no, people are often not very resilient at all in moving on from trauma. They suffer greatly, they traumatize others, and it affects their health.

People who face reality and climb towards real growth are also suppressing their negative emotions, surviving, and moving on. Children are specifically different from adults because they don't have any emotional regulation. They just live fully in whatever emotion smacks them in the gut.

Just because you've got a scar doesn't mean it's bad, nor does it mean you haven't moved on if you haven't spent 6 months staring at the healing process. Some people heal quicker, some heal better, some heal slower, some heal worse. Like pretty much everything in biology, it's something of a spectrum.

The only studies we have are long term longitudinal. IE this one:

> After adjustment for confounding, there were statistically significant positive associations for people reporting four or more ACEs relative to those reporting no ACEs, and this was true for all chronic diseases except hypertension.

https://pmc.ncbi.nlm.nih.gov/articles/PMC8462987

A twin study would be about as close as we could get to a randomized control trial:

https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...

I'm willing to use the term "cause" here, given the copious amount of studies controlling for other confounders. That's the best we can do given there's no ethical way to run a randomized control trial.

Ehh, kind of. But at the same time, EMDR works. So revisiting it in a very particular way can help.

However, I concede that there's kind of a hammer and nail problem in therapy. They learn about how much trauma and childhood experience effects a person and tend to laser focus on that because they feel confident doing so. I think there's a certain unhealthines to spending too much time dwelling on the past. Up to some level it's ok, but there should be at least equal focus on the present, future, and agency+self-confidence+self-discovery. Whereas a typical client would not be unreasonable to feel more like a victim given the focus on past experiences and traumas, which naturally reinforces a past-oriented victim mindset. Meanwhile, what most people need is a sense of being able to make things better now and work toward a better future, and practical tools to do so (agency).

Of course, for severe cases, you should probably focus on dealing with the trauma and get the client to a more stable state before taking off the coddling gloves.

On this, then, I would generally have a hard time agreeing. I'd be comfortable with the idea that not everyone is very resilient. I'd expect that. If the claim, then, is that there is an absurdly high variance there, I'd agree.

But I'm also growingly sympathetic to the idea that telling people they are, in fact, traumatized, is not healthy. People are, as a rule, susceptible to what they are told. Especially from authority.

No expert, and fully expect to be flamed, but we are now living in a society that has discouraged "sucking it up" or "burying your emotions" for 30 years. It not really possible to study, at macro level, the impact of that thinking.

A lot of people just want to be a victim. They want to be special. They want sympathy.

> People are, as a rule, susceptible to what they are told.

Research shows that suggestibility is actually moderately correlated with trauma.

"What doesn't kill you makes you stronger" - maybe sometimes if you're an adult. But not childhood trauma...that makes you weaker almost every time, and you take that weakness with you and spread it around.

who has discouraged "sucking it up"? what systemic policies have changed to accommodate this? as far as I can tell, someone can explain how they're the victim to anyone and everyone they come across and no one will care. I can't see how anyone emotionally or materially benefits from saying they're a victim. they may want sympathy but they will not get it.

that said, I don't live in a coastal city where there might be more accommodations for such things. where I live, people are generally on their own to find the means to survive. but, in line with the theme of the post, I'm fairly certain people here have a lower life expectancy and generally lower health than people in places where there is a more robust support network. in which case, the body must, in fact, keep the score.

So much modern science is captured by a particular flavor of progressive political orthodoxy that it's very hard to know what's true. This is especially the case in anything that touches on the social science, psychology, or sex. Add in the additional replication crisis and I think it's good to take any scientific claims touted out on HN that back this worldview with a grain of salt.

I didn't say that, though? Some things that don't kill you can, obviously, make you really really weak. Isn't hard to find examples on that front. Polio is the poster case.

But thinking kids are made weaker from any and all trauma is just reductive to the point of not useful.

I suspect we would largely align on the idea that growth is the important part. We would also largely agree that trauma is real. Question is how do you combine those ideas?

The extra confounding factor here is that not all therapy is created equal. Some of my life has parallels with your first example. I did my first therapy session in grad school and it helped me out tremendously. Again, anecdotal, but one of the things he did very well was to not allow me to continually re-traumatize myself by rehashing the potential sources of my (maladaptive, dysfunctional, pathological, whatever word you want) thoughts and behaviours. He would listen for a bit and then steer the conversation back to: what’s the delta you’re trying to achieve? I can help you find a route from here to there without needing to go back to the beginning. As it turned out, getting myself to a better mental state helped me let go of a lot of resentment and blame that I held about the people responsible for my childhood. It wasn’t explicit, it just kind of happened as I tweaked my thinking.

There is also an element of… it’s easier to get out of a shitty headspace if you’re not already stuck in a shitty present. I moved out of my home town when I turned 18 and went to university 3 hours away. Close enough that I stayed in touch with my family but far enough away that the day-to-day chaos didn’t affect me. Cell phones weren’t a thing yet so there were plenty of viable excuses for not answering the phone.

In your second example, unlike mine, the person spirals downwards instead of escaping. They start out as anxious from the robbery, then end up anxious and unemployed. Then anxious, unemployed, and divorced. It’s pretty tough to think clearly about addressing and processing the robbery when you’re not sure if you’re going to have enough money for groceries and rent.

I would have to take more time to read up on Eye Movement Desensitization and Reprocessing (EMDR). The wikipedia intro to it isn't fully favorable, sadly.

And agreed that "severe" cases are almost certainly special cases that should be treated as such. PTSD would almost certainly always qualify as severe?

But the idea that people have "in the womb" trauma just feels patently silly.

It's not about wanting sympathy. In peace and prosperity times, people has more time to reach adulthood and explore themselves, they don't have to suppress pain in order to survive. Not saying everyone, but many.

I'm no expert either, but for sure there are psychology and sociology studies about generational differences, openness, and things like that.

> A lot of people just want to be a victim. They want to be special. They want sympathy.

I dunno, in my experience, not really a lot of people?

And the people that did - and yes, they absolutely exist - seem to have some kind of disorder. They all probably would have benefited from therapy and/or medication. They probably do need sympathy (maybe not the way they wanted), may or may not have been victims, and are sort of special cases.

Most people just want to be normal, to have a job, to go see movies, to play games, to spend time with friends, partners, lovers, family.

This is just my life's experience though. Maybe I'm the weird one.

I would take any scientific claims touted on HN with a grain of salt - there are plenty claims associated with overlapping orthodoxies and heterodoxies being presented all the time.

I don't know your relationship with the former person, but as for drawing general conclusions, I—as a reader of your comment—can't assume that you have assessed accurately whether their case is better. You might not be aware of subtle abuse in the home, masked depression, overt narcissism, suicidality, etc.

Years in the trenches have taught me that many people who seem successful, put-together, and happy are deeply struggling or causing harm to the people closest to them.

From what I've seen in my direct circle, childhood trauma leaves deep deep traces, and not in a good way. The idea that childhood trauma encourages growth to me sounds like pull yourself up by your bootstraps kind of rhetoric.

And where did I say that? You seem to be purposely misreading my posts.

I said growth is the important part. If you are focusing people on identifying themselves as traumatized, you are doing it wrong. You want to focus them on how to grow. Be that be letting go, coming to terms, whatever. Really depends on the trauma.

> No expert, and fully expect to be flamed, but we are now living in a society that has discouraged "sucking it up" or "burying your emotions" for 30 years. It not really possible to study, at macro level, the impact of that thinking.

> A lot of people just want to be a victim. They want to be special. They want sympathy.

It doesn't really seem like claiming victimhood is a broadly-repeatable way to make a living for the masses more than 30 years ago... many things that were intended in the 60s and 70s to try to make up for historic victimization have been rolled back in recent decades. But I suppose this could apply to Rush Limbaugh and such - beating the "white males are the persecuted ones, actually!" drum of anger leading to the much-aggrieved whiny MAGA brigade.

It seems like all of those things can be true independently of whether or not a traumatic experience, in and of itself, effects permanent neurological/endocrine changes, though, right?

It sounded to me like his issue was with the claim that there are direct, systematic physical effects directly consequent to the psychological experience. It didn’t sound like an argument against claims like “a rough childhood reverberates into adulthood,” or “traumatic experiences have profound consequences for people.”

If anything, it would seem to me that, to effectively treat people struggling with post-traumatic consequences, it would be useful to understand whether or not your efforts would be usefully invested in physical interventions to address these supposed physical changes. Or if the best treatments are not medical but psychological, or social, or spiritual, or whatever.

It also has that tone scientists use when they speak of Malcolm Gladwell: annoyed that he misrepresents careful experimental findings in service of a good accessible narrative. Even if what he’s saying could turn out to be true—taking issue with the claim that it’s been scientifically demonstrated to be so. Which I’m sympathetic to.

If so then its true, telling traumatized people that they are traumatized makes it worse for them.

> as far as I can tell, someone can explain how they're the victim to anyone and everyone they come across and no one will care. I can't see how anyone emotionally or materially benefits from saying they're a victim. they may want sympathy but they will not get it.

This is true for a man, not true for a woman. Women in general get a lot of sympathy and things for saying they are a victim. Men just benefit from hiding it as you say though, there is no reason for men to show this.

This is part of the "persecution of conservatives", where they "can't say a thing anymore". They obviously can, and still do, but feel their voices are being suppressed. The reality is that their opinion isn't popular anymore, and they're used to being listened to unconditionally, and can't stand that people don't agree with them anymore.

The annoying thing here is that it's simply not true, especially in regards to men. It's still the norm to be told to suck it up, or you're not a real man. It's toxic masculinity, and it's obvious that's taken on a massive rise in popularity, thanks to folks like Joe Rogan and the like.

Correlation is ~not~ [actually] causation?

Every serviceman reading this should be hopping mad. He's basically calling anyone suffering from PTS "weak". These are people who enter the service at physical peak (not just personally, globally) and sometimes exit with serious, lifelong, compounding damage. These people aren't weak, they're traumatized. Trauma is real. It can fuck you up.

This is such a weird thing to simply baldly assert.

how do you determine causation from correlation in experiment where you are unable to separate all the factors? you can't.

not agreeing with one side or other - because i frankly don't know enough about it to form an opinion, but using "correlation != causation" is basically a discussion stopper.

Yea, this seems to be an issue with this entire thread. Lots of people making lots of assumption about others.

As a kid into my teens I had plenty of my own trama, but was quiet and generally didn't interact with many other people my age, generally having friendships with people much older than I was. Once I got into my late twenties this turned around and I ended up being the person who many other people my age and younger would come and talk to about their lives. In general I'm just quiet and let them talk. Listening to a lot people talk about their lives has let me see one thing.

A lot of people are really screwed up from their childhood and bring it into their adulthood

The number of women that have been sexually assaulted or raped that disclose it is downright depressing, especially in their childhood. More depressing is the number of 'high status' people that cover it up.

The number of men that have some kind of depression coping mechanism such as alcoholism or hidden drug use is disturbing too. And a lot of these people are the ones you can't tell. They have successful jobs and make good money, have a wife and kids. All the checkboxes of supposed happiness. But so often these are things they had to do at some point after being driven by narcissistic parents for years. Trama driven workaholics with no at home coping mechanisms are common too.

I have no idea how much people that have had trauma can be fixed. What I'd really like to see is the signs if it taught younger so kids and learn how to avoid it and call it out.

> pushing the idea that you can make events worse by telling people that they are forever scarred from them

I have known a few people who had they not dwelled so much on events, I wonder if their trauma would have been middling instead of major. Hard to say for sure, but I am not the only person to observe these folks seemed to be making their trauma more traumatic.

None of that controls for socioeconomic status which is likely the most common factor in poor health outcomes. In particular some of these try to put a measure on "family dysfunction"... yeah, good luck with that.

Trauma is a very politically charged topic anyhow with at least a few modern political movements tying themselves to it, it would be very inconvenient for it to not be an all encompassing problem.

> who has discouraged "sucking it up"? what systemic policies have changed to accommodate this?

When I reported being assaulted, I was vigorously encouraged to attend counselling, and it was suggested to me that if I felt fine I should allow myself to be persuaded otherwise.

I have heard anecdotes of e.g. rape victims not being believed because they don't seem to be traumatised enough.

> The annoying thing here is that it's simply not true, especially in regards to men. It's still the norm to be told to suck it up, or you're not a real man.

It's also the norm to be told that you need to be vulnerable and share your trauma and you're lesser if you don't. Men get shamed for both not being enough of a victim and being too much of a victim, and have no winning move.

> you can be ignorant and survive, or face reality and climb the deeply uphill battle of real growth.

> of course you can be paralyzed by it, but no one is advocating for that as treatment

Nominally yes. But in practice what are the effects of the treatments that people advocate for? Do people end up better or worse off?

Doesn't matter, suggestibility was correlated with trauma, which means they are likely to be suggestible to becoming miserable if you tell them they are.

That requires someone to tell them they are miserable rather than observing them to be miserable.

There’s a lot of historic terms to describe people suffering from traumatic experiences like shell shocked (WWI), soldier’s hart (US civil war), lost/bewildered (US Revolutionary War), etc going back literally thousands of years.

> Men get shamed for both not being enough of a victim and being too much of a victim, and have no winning move.

Can you expand on that? When you say that they get shamed, who or what is causing it?

> I think there is a bit of a crowd that is pushing the idea that you can make events worse by telling people that they are forever scarred from them?

There was certainly a fairly prominent British psychologist (IIRC) a handful of years ago who disparaged some of the anxiety and depression awareness campaigns on the grounds that being more aware of psychological ailments like that, when they were on the minor end of the scale and not actually debilitating, was probably unhelpful. That actually in his opinion "suck it up and get on with your life" might be the best advice sometimes, because such conditions can become self-fulfilling, and getting on with your life, doing stuff and achieving things might be the best remedy. Rather than dwelling on the problem and giving yourself the excuse "I am depressed/anxious"

I don't know how/if that maps to trauma, and there was a lot of backlash...

The blog post very much agrees with mainstream science.

The Body Keeps Score is pseudoscience. This sort of pseudoscience has a pretty long history. Arguably it's repackaged Freud. Freud aside, therapists have a long history of advocating theories that are not supported by science. For example, repressed memories, multiple personality disorder, etc.

CPTSD is an area where there is a lot of bad research partially because it's not a recognized disorder by the DSM and partially because of its political affiliations. This works from two sides. You get downward pressure on good research because it isn't recognized by most American psychologists. You also get upward presure from researchers whose motivations are political rather than scientific. I don't understand why political groups are interested in CPTSD, I just know that they empirically are [0]. There have previously been strong political interest in other pseudosciences like Freudian psychotherapy and Jung etc. I don't understand this either, but I'm sure there's an explanation.

> It's also well known that past trauma predisposes you to future trauma

Many people are targeted for abuse because they are different. For example autistic women are especially frequently targeted for abuse. Thus being autistic (genetic) can cause abuse (environmental) and hence trauma. Many people who are especially isolated or have especially poor social skills will be predisposed to being abused multiple times. Partially this is because abusers can tell if you've been abused and, if you have, there's a good chance your previous abusers got away with it.

If you look at the subreddit overlap for CPTSD linked below, you'll notice that there's significant overlap with genetic psychological conditions that predispose people to getting abused. This makes correlational data hard to interpret, especially because so many psychological papers study a small group over a small period of time and ask only a small number of questions.

> This article (and author) seems to be something of a trauma-skeptic

This doesn't mean that mainstream science is skeptical about trauma. There is a great deal of good mainstream research on trauma. However, there is also a ton of systematically bad and wrong information on social media about trauma that is popular despite being wrong. So mainstream science is rightfully skeptical about claims that are unsupported by science.

> There's also data indicating...

Finding good psychology articles is something that's much harder than it sounds. Psychology articles are easy to read compared to, say, physics. But there is a lot of really bad psychology out there that you won't be able to filter out without a background in research psychology. In some ways, familiarity with applied psychology but not research psychology makes things harder because so much of the bad research comes from applied psychology.

For example, is this a good study? https://pubmed.ncbi.nlm.nih.gov/26488918/ "Extrasensory Perception Experiences and Childhood Trauma: A Rorschach Investigation"? Well ESP isn't real. Trauma is real. The Rorschach test is nonsense. But it has an nih.gov link. Is J Nerv Ment Dis a high quality journal? What are the biases of its editors?

What about this one? https://pmc.ncbi.nlm.nih.gov/articles/PMC7342092/ "Personal Experiences With Auditory Verbal Hallucination and Extrasensory Perception" from Schizophr Bull 2019.

I pick on ESP because it's obviously a violation of the law of physics. Yet applied psychologists keep churning out ESP research just like they keep churning out research about things like repressed memory like The Body Keeps the Score.

[0] For example see the list of subreddits similar to r/cptsd https://subredditstats.com/subreddit-user-overlaps/cptsd. It's a mix of subs for people with genetic psychological disorders (narcissism, bpd, bipolar, asd, adhd, etc). And a mix of politicized and religious subreddits (FDS, witchesvpatriarchy, menlib, christianity, etc). Also see https://www.reddit.com/r/CPTSD/comments/pr6wh4/cptsd_and_lef...

No it doesn't, I didn't say the source of their misery was people telling them that they are, but it could make it worse.

Often the best cure is for your friends and family to treat you just like normal, except maybe demand a bit less and give space.

I think you're both right, but you're talking about different things. People (as in mankind, the human species) do have the ability to bounce back from severely traumatic circumstances. But people (as in most individuals) don't often have the kind of coping skills that would let them tap into this capability. Fortunately, they can be learned and applied even in adulthood.

To heal trauma, you have to actually feel your feelings, without getting sucked into them. If you continually repress/avoid/try to control them, you won't get better. If you wallow in them, you also won't get better.

I think this latter point is what causes some people to think that it's harmful to tell people that they are trauma victims, because they might develop a victim mindset. But people who subscribe to this view often go to the opposite extreme and try to deny that trauma exists, which is just as harmful (and useless).

Well, has anyone ever even tried to tell the veterans to man up, stop dwelling, and get over it? Didn't think so.

> But I'm also growingly sympathetic to the idea that telling people they are, in fact, traumatized, is not healthy

If the message is, "you are traumatized and therefore permanently damaged", you're right - that's not healthy and also not true. But if the message is "you are traumatized and need to process your trauma", then it's more like telling someone that they have a treatable injury. I think this a pretty critical distinction that rarely gets addressed in these kinds of discussions.

Agreed.

This 1000x.

Discovering you have trauma is a kind of diagnosis, so now you can figure out the kind of professional help you need.

I don't think there's really an epidemic of trauma hypochondriacs. It's not an excuse to play victim or anything. It's simply important to recognize that trauma means you're probably not going to get better on your own, and you should find help.

My point is their claim assumes causation despite the fact that we may never be able to prove it. I.e. a strong claim with no evidence besides a correlation.

That’s a common response by friends and family but it’s simply not the best cure. Often it makes things worse and can lead to suicide through feelings of alienation.

> But thinking kids are made weaker from any and all trauma is just reductive to the point of not useful.

Huh? No, that's the whole point, how important and useful it is.

It's to separate out the non-traumatic experiences where you recover just fine... from the genuinely traumatic experiences that do harm you, and for which professional help is really useful in recovering from.

> It's also the norm to be told that you need to be vulnerable and share your trauma and you're lesser if you don't.

I think the norm now is that you should share your trauma with a therapist, to help heal. I can't imagine telling anyone to share their trauma, regardless of gender.

> and have no winning move.

This is a common incel talking point, and to be honest I don't think it has basis in reality. It's totally fine to share with a therapist and I don't know who would criticize someone for it. If a friend criticizes you for going to therapy, they aren't a friend.

Should you be able to also share with your friend? Yeah, but there's also the concept of trauma dumping, where you use your friends as a therapist, and that has its own problems. Sometimes folks aren't in the right mental space to hear your problems, especially depending on the context (like, were you abused as a child? maybe they were too).

jaybrendansmith is talking specifically about childhood trauma not any trauma that happens in childhood.

> But not childhood trauma...that makes you weaker

I have only seen "childhood trauma" defined and used as something that has lasting impact. That definition likely comes from studies that study trauma that happens in childhood and how it can have a lasting impact.

Regardless of where it comes from that is how the phrase is typically used.

It would be nice if the field came up with better terms or a better scale that separated out the different traumas by lasting impact, but my assumption is that if it was easy to come up with that kind of scale it probably would have already happened, here is hoping it is easy and it is low hanging from some soon to come along phd student though.

Adverse childhood experiences definitely correlate with socioeconomic status. It's possible to disentangle their separate effects on some statistical level, but very difficult on a practical level. For instance, losing your home and living with your mom in a car when you're 6 is a socioeconomic ACE.

Someone else in the discussion here made a comment that service members should be mad at this blog post, as it is essentially saying that people cause their own adverse experiences. Well, again, the US armed services tend to draw disproportionately from lower socioeconomic groups, who tend to have higher numbers of adverse experiences. It's very hard to disentangle these correlated variables when it comes to outcomes for real people. And it's a total copout to then blame servicemembers for their PTSD.

We have the language of a cycle of abuse, a cycle of poverty, a cycle of violence. People have recognized the cyclicality of this for millennia. It's good the blogpost brings that out.

The thing that disappoints me about the discussion here (and in the blog post) is that there is this relentless focus on the psychology of things. Being homeless as a child, having a parent die, having family die violently, etc all do correlate with higher rates of cardiac disease, diabetes, etc. Again, can't disentangle from the socioeconomic aspects, but you also can't blame a kid for their family member dying. The idea that "unhealthy people may be more susceptible to trauma" has some veins of validity, but is also just deeply unkind, inhuman, and inaccurate taken to an absolute. Kids in foster care, kids who experienced a school shooting, kids who had a parent die of cancer, etc -- it is immorally self-serving to say it's their own fault. You know it's not.

The blog post itself cherry-picks by focusing on PTSD and the brain, ignoring correlations between ACEs and cardiac problems and diabetes. By focusing on the brain, the author can easily imply it's made up weakness (no lab results to confront) and then move on to "just get over it", which is adjacent to "it's not my problem". I'm not a fan of over-therapizing and I don't think therapy or crystals will fix your diabetes. But don't throw the baby out with Bessel van der Kolk's bathwater.

The person you replied to specifically listed multiple studies that do account for socioeconomic factors. Take a look at the second paper, and in the introduction you’ll see that they did sub group analysis for multiple socioeconomic factors. I.e. among people of the same geographic, economic, and ethnic backgrounds, those with higher ACE were at higher risk for a bunch of diseases.

Not to say that I think it’s useful to focus so much on personal trauma outside of therapy, I don’t. But dismissing evidence presented to you without engaging with it doesn’t feel useful either.

OTOH the nocevo effect is real.

If you tell prople guten intolerance is a thing, you will cause some people will feel real pain. https://theconversation.com/your-gluten-sensitivity-might-be...

If you tell people trauma is probably no big deal in most cases but to seek help in the unlikely event that it does cause more issues then maybe that's better?

Your reference to Freud is funny, given that he not only rejected the trauma theory but based all of psychoanalysis on his rejection of the trauma theory.

OTOH the nocebo effect is real.

If you tell people gluten intolerance is a thing, you will cause some people will feel real pain. https://theconversation.com/your-gluten-sensitivity-might-be...

And when it comes to stuff that's all in your head anyway, what's the difference between a real disorder and a psychogenic one?

If you tell people trauma is probably no big deal in most cases but to seek help in the unlikely event that it does cause more issues then maybe that's better? It's like they say on the legal disclaimer on Tylenol in Australia - if pain persists see a doctor.

And while I'm couching my words a lot because I don't want to play fake internet doctor, the other side of the argument is also likely not too competent medical opinion.

You need to separate physical trauma from psychological trauma. There's no debate that getting hit in the head or having explosives go off nearby can cause physical brain damage. That's empirically proven (at least in animal models) and so obvious that it's hard to argue against.

What I'm unclear on is the details: is physical trauma a necessary factor in shell shock as it was understood a century or more ago? Is that shell shock the same thing as the combat stress reaction and/or post-traumatic stress disorder? Is PTSD an amalgamation of two different things that aren't the same? To what extent does suggestion worsen the physical vs psychological sides of PTSD? Is suggestion the only thing that causes shell shock, the CSR, and/or PTSD in the absence of physical damage? Etc.

Nobody suggested there was a causation here as that doesn't matter for what was talked about.

This. Totally resonates with me, from personal experience.

I had radiation therapy and 2 years of chemo starting from the age of 1.5 years. During that time, my mother left me alone for a MONTH in the hospital. I've been told the chemo was so bad that at the end, they had to search for veins on my head, since all the veins in my body were already retracted...

I neither am afraid of needles, nor have I ever had therapy in my life. Simply because I didn't need it. I have no PTSD, nor any other aftereffects. The only thing that is obvious now, is that the bond to my mother broke, and I basically feel no "love" towards here, nor do I want to give her any slack for her past and current failings.

This is not intended as a "I am so cool" post. It is simply how my life turned out. Later on, when I learned about PTSD and Trauma, I asked myself several times why I haven't got anything like that. However, the more I think about it, the more it feels like I could unearth something if I really tried.

I think you might look harder, it's not necessarily overt. I'd bet it underpins a lot of peculiar political behaviors. I'd also say not always sympathy but sometimes revenge.

In my experience, he is right.

> > History shows people are also very resilient at moving on from trauma

> i’m extremely skeptical that people move on

Historically, essentially everyone who lived long enough to have children had some of those children die [1]. So either:

- that wasn't traumatic

- they managed to deal with that trauma

- or they didn't move on, and everyone was somewhat traumatised

You can take your choice from the above, but on the whole this was the normal state of affairs for most of human history and prehistory.

[1]: from https://acoup.blog/2025/07/18/collections-life-work-death-an..., 50% of children died by age ~5

> That is, yes, some trauma sticks with you. History shows people are also very resilient at moving on from trauma. Kind of have to be, so that we aren't devastated when we ultimately do lose some family.

This is textbook survivorship bias. If you try hard enough you'll eventually discover a never-ending list of examples where people never recovered from trauma and even outright died directly or indirectly die to it.

> It's simply important to recognize that trauma means you're probably not going to get better on your own, and you should find help.

There is no evidence for this, and it is exactly the harmful mindset being criticized. Developing PTSD from traumatic events is the exception, not the rule. The majority of people do get better on their own.

> Is suggestion the only thing that causes shell shock, the CSR, and/or PTSD in the absence of physical damage? Etc.

I think you're venturing into denialism territory. There is a mountain of evidence supporting the fact that traumatic experiences have a negative impact on health. See for example the impact of stress on, say, cardiac issues, and even growing grey hair and/or going bald altogether.

> No it doesn't, I didn't say the source of their misery was people telling them that they are, but it could make it worse.

It sounds like you're advocating for repressing traumatic experiences hoping to not cause inconveniences.

The hazard I'm pointing at, though, is that this will be very individual. And what is a difficult thing to overcome for some kids, will be trivial for others. And seemingly flat out impossible for others, still.

But you haven't separated these things out. You have definitionally stated that some things exist. But you have no method to separate the genuinely traumatic from the potentially traumatic.

Broken bones. Death in the family. Death of the family. Moving. Friends changing. Attacks from coyotes. Loss of pets through unknown reasons. Loss of neighborhood friends to suicide? Which of these is genuinely traumatic?

My point is that this is very individual to the kid. I further posit that many kids will make things more traumatic if you ask them to do so.

Worse, I have seen "was rude to me at camp two years ago" be a significant source of grievance to kids. The whole elevator scene of "I hate you" versus "I never even think of you" is very very real.

This is just taking my point to be maximal that people always recovered from these things. I don't think that. But nor do I take what seems to be the near maximal other side, where everyone is fighting some hidden trauma from their childhood.

Indeed, and it's an odd position to take, even if one simply approaches it from common sense.

Someone with psychological trauma is obviously going to spend more time in a state of stress, which in turn is unhealthy by itself, even before secondary effects like use of drugs and alcohol to try self-regulate psychological state.

Makes me wonder if it's motivated by some kind of denial

If you listen to the people who have bounced back - they’ll not tell you that their being traumatized is good. The truth is there is very little support for survivors, and a hell of a lot of support for perpetrators, who often abuse from a position of safety and authority. Of course very few are publicly against survivors, but an entire political structure is arrayed to cast doubt on any accusation, especially if a traumatized person acts traumatized, or the powerful person acts cool and rational.

Tinnitus is another good example for this idea. Bringing awareness to it makes it worse.

Indeed, in the end it comes down to the skill of the therapist.

It's unfortunate both that more people don't succeed in getting the therapy they need. A skilled therapist can make an absolutely transformative difference, but only if they decide to find them.

This is a big point that really blows my mind in the discussion. It is basically indisputable that we are exposed to less trauma than people in the past. To a laughable degree.

And it wasn't just children. Before the advent of antiseptics, a prick from a briar could basically kill you. Before modern supply chains, you almost certainly had parasites. Before modern vaccines... The list is remarkably large.

I suppose there is an argument that it is the reduction of traumatic events that makes them more traumatic? Feels like a shaky reason to think "focus more and make sure you fully grappled with how traumatic it was" is the default correct approach.

This is so frustrating because I agree with the beginning, but the statement you make after I find to be also misleading if not technically true.

I’d posit that the people on hacker news are often very far away from even a yeoman understanding of social sciences, except in a few profitable niches like attention, personalization and motivation.

That pressure is largely coming from other men. I don't know many women who want to date a guy who's unable to be vulnerable. I think if men made more space for each other to be something other than angry y'all would find life a lot more pleasant.

I've read the book, and it's, IMO, mediocre. However, I don't think anybody who has (for example) worked with foster children could possibly deny that trauma leads to dysfunction.

> But nor do I take what seems to be the near maximal other side, where everyone is fighting some hidden trauma from their childhood.

I think you're trying too hard to downplay a problem by questioning the extent it exists. Perhaps a more productive approach is to try to learn about the topic, starting by learning about the definition of psychological and emotional problem. It's quite possible that your denial is founded on a misplaced sense of what trauma is or isn't.

I'm less saying "it definitely isn't" and more trying to show the complexity of understanding this and the paucity of evidence. Is long-term stress different from a one-off traumatic incident? How much stress does trauma cause? Is therapy effective at preventing stress caused by trauma? What part of therapy is effective: can you stick someone in a room with a nice doctor and no therapeutic plan and achieve a result? Does therapy make things worse for some patients? Which patients are those, and how do you tell?

My personal opinion is that trauma probably has an effect, it's a lot worse in sustained cases, many of the symptoms are mixed up with other conditions, treatment for it is effective (in that it hits statistical significance) but not particularly effective (in that the effect size is small), treating healthy people can make them worse, some traumatised patients probably also get worse after treatment, and the symptoms of e.g. ASR/CSR are so vague that some of them apply to most of the people who read them.

Also just survivors bias. People either survive or they don't. Plenty of lethal gun cleaning accidents used to happen. Still do.

I think you are still taking my point to a maximal position that I don't hold. People need help all the time. It shouldn't take trauma to get people to agree on that point.

Good help will be goal oriented, though. And the goal is not to maximize your focus on the trauma to make sure you have experienced it all. The goal is to grow for whatever you need, now.

This is true of physical trauma. You don't sit with people and teach them all of the ways that their body has been broken when they get a physical injury. You identify the goals and exercises that they will need to do to achieve them. In many cases, you have to reset realistic goals.

I'm sympathetic to the idea that sometimes you have to tease out what the actual blockage is. In that search, you may be helped by discussing the underlying trauma. But that is firmly in the land of probabilistic approaches where we explicitly don't know a lot.

> It is basically indisputable that we are exposed to less trauma than people in the past. To a laughable degree.

And standards of living and life expediencies have gone up and to the right.

That 100 years ago people managed to cope with the traumatics of daily life doesn't translate to their coping being healthy or their lives being better (consider the massive drinking culture of the mid 1800s that ultimately led to prohibition)