Criticisms of “The Body Keeps the Score”

> 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.

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?

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.

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.

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?

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.

> 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.

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?

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).

> 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.

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?

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.

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.

> 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.

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 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'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.