Dr. Bessel van der Kolk: Psychiatry Has a Long, Stubborn History with Trauma

Dr. Bessel van der Kolk argues in his latest Big Think interview that the psychiatric field has a complex history with trauma that has, more often than not, consisted of psychiatrists sticking their fingers in their ears and yelling, “I can’t hear you!”

Okay, so maybe it hasn’t been that churlish, but certainly stubborn. The good doctor explains below:

In a previous video, Dr. van der Kolk discussed the ordeal of creating the PTSD diagnosis. His take is that there is (and has been) ample evidence to suggest the nature of a traumatic experience—not just the reaction to it—has a major effect on the afflicted. Yet Dr. van der Kolk grumbles that psychiatry has ignored these experiences. It had downplayed the effects of war trauma on soldiers in the First and Second World Wars. It neglected the plights of thousands of abused and abandoned kids when Dr. van der Kolk and his colleagues attempted to create a diagnosis called Developmental Trauma Disorder. 

“In fact, vast numbers of people who seek psychiatric care are in fact traumatized human beings,” says Van der Kolk in his interview. Yet the nature of those traumatic experiences is treated as auxiliary information.

“So now we live with weird diagnosis like Oppositional Defiant Disorder, where people don’t ask why did these kids become defiant; or cold and dark disorder, where these kids behave strangely; Bipolar Disorder; kids being mentally unstable; going up and down on their emotions. And people don’t really—psychiatry doesn’t really want to look at what’s behind there. And as a consequence, instead of looking at social conditions as being at the origin of these disorders, these kids get drugged up.”

So what’s the danger of ignoring trauma? Dr. Van der Kolk explains that we’re treating symptoms, not the actual problems. Psychiatry needs to take an active role in examining and preventing trauma rather than just treating it as a given.

“I am extremely concerned that all these medicated children in America are likely to grow up having a deficit in the capacity to engage, a deficit in the capacity to learn, to be original, to be engaged, to be a useful member of the workforce. So the neglect of the issue of trauma in the U.S. in particular is a very serious public health issue.”

Dr. van der Kolk’s latest book is titled The Body Keeps the Score.