The Body Keeps the Score

Bessel van der Kolk’s central thesis, first articulated in a 1994 psychiatry paper, argues that traumatic stress re-wires the brain’s attachment system and biological responses. Rather than existing merely as a "bad memory," trauma becomes a physical imprint that dictates how a person perceives safety and threat in their daily environment.

The book focuses on how the social environment and attachment systems act as the primary defense against trauma-related disorders. When these systems fail, the body remains in a state of high alert or dissociation, meaning healing must involve more than just "talking through" the past—it requires addressing the body's current physical state.

Van der Kolk advocates for a "bottom-up" approach to therapy, focusing on the limbic system and the body’s sensory experiences rather than just cognitive understanding. Because trauma often bypasses the rational brain, the book promotes alternative treatments like yoga, EMDR (Eye Movement Desensitization and Reprocessing), and limbic system therapy.

The goal of these interventions is to help survivors regain a sense of ownership over their physical selves. By engaging the body in rhythmic movement or specific neurological desensitization, patients can theoretically "reset" their nervous systems to realize that the danger has passed, allowing them to exist in the present moment without constant hyperarousal.

Despite being a "dense, scientifically rigorous" text published in 2014, the book has become an improbable survivor of the bestseller lists. It saw a massive surge in interest following the COVID-19 pandemic, spending nearly seven years on the New York Times bestseller list and reaching the #1 spot as recently as August 2025.

Its success is described as a "groundswell" of popular interest in trauma and psychology. Available in 36 languages and routinely topping Amazon’s nonfiction charts, it has transcended its origins as a psychiatric monograph to become one of the most influential pop-psychology books of the 21st century.

The book’s massive popularity stands in stark contrast to its reception in some scientific circles. Critics, including psychologist Richard McNally, argue the book is plagued by conceptual problems and promotes "recovered memory therapy"—a practice some describe as one of the most serious catastrophes in the history of mental health.

Recent critiques highlight that Van der Kolk may have distorted original research to fit his narrative. Further, researchers point out that the book lacks consideration for the broader social and political factors of violence, instead focusing on a narrow biological lens that some argue inadvertently "stigmatizes survivors and blames victims."