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Criticisms of “The Body Keeps the Score”

(josepheverettwil.substack.com)
249 points adityaathalye | 1 comments | | HN request time: 0.258s | source
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softwaredoug ◴[] No.45674571[source]
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...

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casey2 ◴[] No.45677092[source]
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.

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1. kaitai ◴[] No.45677802[source]
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.