How does trauma shape our view of the world — and why does it matter? According to renowned psychiatrist Bessel van der Kolk, M.D., trauma isn’t just a painful memory; it actually changes brain function, often leaving us stuck in a sense of danger.
His 2014 book The Body Keeps the Score sparked a global conversation about the lasting effects of trauma and the path to healing. Translated into 43 languages and a New York Times bestseller for 344 weeks and counting, its reach reflects a growing movement: millions seeking not just to understand trauma, but to recover from it.
We sat down with van der Kolk to learn how to begin.
The anatomy of trauma
After a traumatic experience, the brain shifts into survival mode. The frontal lobe — the part responsible for logic and tracking time — goes offline, while the amygdala, which detects threats, goes into overdrive.
Unable to register that the danger has passed, the brain keeps reliving intense emotional distress. “When that part of the brain is not laid to rest,” van der Kolk explains, “it will keep firing.” As a result, emotional regulation becomes difficult, and behaviors may turn submissive, vengeful, controlling, impulsive, or withdrawn — automatic adaptations that happen outside of conscious awareness.
In this state, it’s hard to feel safe or to even believe that safety is possible. Your perception box — the invisible mental box through which you view the world — shrinks, and everything feels overwhelmingly threatening. “That becomes your reality, and you cannot imagine an alternative reality.”
Reawakening the brain
Van der Kolk once had a patient who’d made little progress in traditional therapy. But after a summer break, she returned noticeably changed. When asked if she had done anything unusual during her time away, she mentioned that she had taken boxing lessons.
“It turned out that the boxing lessons had completely changed the way that her body moves through the world,” van der Kolk explains. In her body, she now knew: If she were threatened, she could fight back.
In some cases, to truly heal from trauma the brain must be reawakened through powerful embodied experiences. Somatic therapy helps people process trauma by increasing their awareness of physical sensations and using techniques like breathwork, movement, and grounding to release stored stress and regulate the nervous system.
This can help shift the brain’s frame of reference — using trauma as one of many experiences rather than a sole, defining one. Through this, your reality can expand again, creating space outside of the limited box that trauma once held them in.
The power of role play
“It’s very important for traumatized people to have experiences that directly contradict the helplessness and despair of the trauma,” van der Kolk explains. Psychodrama therapy invites participants to enact imagined scenarios or unresolved situations to gain insight, express emotions, and explore paths to healing.
Even something as simple as a hug from someone playing the role of a supportive caregiver can shift our perceptions. “Because somebody holds you, touches you, or reassures you, your physiology calms itself down, and the different parts of the brain you need to orient yourself come back online.”
Healing through psychedelics
“Possibly the most significant thing that’s happened in my 50-year psychiatric career is that psychedelics can really change people’s minds,” he says.
With supervision from trained clinicians, psychedelics such as MDMA, psilocybin, and ketamine can reopen areas of the brain that trauma had previously shut down, creating opportunities for emotional breakthroughs often unreachable through traditional talk therapy alone. These substances may enhance connectivity between brain regions involved in memory, emotion, and self-awareness — making it easier to process painful experiences with greater openness.
Living with a new lens
Trauma research and therapies continue to evolve, but the field has come a long way since the early days of viewing trauma solely through the lens of talk therapy. By recognizing how trauma confines the brain, you can learn how to expand your reality beyond pain from the past, transforming your viewpoints and behaviors in the process.
“After your process of trauma, your perception box expands,” van der Kolk affirms. “Absolutely.”
We interviewed Bessel van der Kolk for The Science of Perception Box, a Big Think interview series created in partnership with Unlikely Collaborators. As a creative non-profit organization, they’re on a mission to help people challenge their perceptions and expand their thinking. Often that growth can start with just a single unlikely question that makes you rethink your convictions and adjust your vantage point. Watch van der Kolk’s full interview above, and visit Perception Box to see more in this series.
BESSEL VAN DER KOLK: I don't think anybody's ever come to see me for the first time because of their trauma. They come to see me because my relationships aren't working out, or I cannot sleep, or I get so angry and I don't know why. Basically, trauma is being lived out in the present. It's heartbreaking and gut-wrenching sensations.
The event that happens is in fact over, but your mind and your sensations keep reliving it, acting like it, feeling like it. Those are automatic reactions of that core part of the brain having to do with survival. So you cannot talk yourself out of feeling this way. You need to have visceral experiences that are different—create a state in the mind where the mind is able to absorb new ways of looking at things.
By expanding our Perception Box, we can really get to see that the reality that you live in is much bigger than the constructs we have created for ourselves to make sense out of the world.
My name is Bessel van der Kolk. I'm a psychiatrist, author of the book The Body Keeps the Score, and I've been working on trauma all my life.
We all are living by our sensations, and our sensations are translated by our minds into certain emotions. Traumatized people, they're living by their emotions and their sensations, but the rational brain does not modify it.
What you see is big bursts of energy in the right emotional center of the brain. So you feel intense feelings. You feel intense sensations. Sometimes you don't feel any sensations at all, and basically your frontal lobe goes offline and your capacity to tell time goes offline. Your brain is unable to really tell you: this belongs to back then, it doesn't belong to right now.
The core imprint of trauma is in that core part of the brain having to do with survival. And when that part of the brain is not laid to rest, it will keep firing. And this constrains our Perception Box.
If your perceptions are "the world's a dangerous place and people are going to hurt me," then that becomes your reality and you cannot imagine an alternative reality. And so you'll behave in a way with other people that's either very submissive or very controlling or very vengeful, and people generally are not all that aware that that's the adaptation. That's why you go into therapy.
This whole notion that you can really talk people out of feeling a particular way—I think it's really mistaken. I think we cannot do that. I'm not at all saying that talking is not helpful. Having a story for what happened to you is terribly important, but being able to tell the story doesn't make the sensations go away. So it's very important to provide people a visceral experience of how it can be different.
I had a patient who was so chronic, not doing well with supportive therapy, but nothing was moving. And then one September we see each other after the summer break and she walks into my office and there's a new person. I say, "What happened to you?" She said, "Oh, nothing." I ask, "Did you do anything unusual?" "Oh yeah, I took boxing lessons."
And it turned out that the boxing lessons had completely changed the way that her body moves through the world, because the boxing lessons had given her a feeling of: if somebody assaults me, I can hit him and punch him. And it had the experience of, wow, that feels really good. I can stand up for myself.
And so it's very important for traumatized people to have experiences that directly contradict the helplessness and the despair of a trauma.
Psychodrama is one of the things that I really discovered can make a profound difference, because you get a whole different reality. Let's say we are in a room together and I'm your psychodrama coach, and you say, "Well, my father was a real nasty guy."
And then I say, "Okay, would you like to choose somebody to play the role of your ideal dad, who would've been there for you when you were three years old, five years old, whatever?" And then we experiment physically and say, "Yeah, why don't you put your hand over here, and the other hand over here."
Then they have the ideal father say, "If I'd been your ideal father back then, I would've held you like this." Because somebody holds you, touches you, or reassures you, your physiology calms itself down and the different part of the brain that you need to orient yourself comes back online.
You have the visceral experience of: that is what you needed back then. And for a moment you get that reality implanted in yourself.
But possibly the most significant thing that's happened in my 50-year psychiatric career is that psychedelics can really change people's minds.
The psychedelics put you in a different frame of mind where the ordinary organization between different parts gets dissolved. What we oftentimes see is that the insular, which sends you messages for your body, still gets activated—but now it gets connected with the frontal lobe that allows your brain to become aware of: I am really remembering something related to the past, and it's not happening right now.
It's changing the brain circuitry that helps you to move into the present, basically. And what you see is people being able to have compassion for themselves, to be able to articulate what they went through, not be judgmental about themselves, and to really say: this is what happened to me, and it's the best I could, and I feel very sad—but I can now see it, and I will no longer lead my life as if it's still happening right now.
After you process the trauma, your Perception Box expands, absolutely. You don't superimpose that particular horrible experience that you had on most interactions that you have. So you really see the world differently. You see yourself differently, and you get new perspective on who you are and where you come from.
