Psychiatry Must Stop Ignoring Trauma, with Dr. Bessel van der Kolk
Acclaimed psychiatrist Bessel van der Kolk explores his field's long, complex, and stubborn history with traumatic experiences.
Bessel van der Kolk is a psychiatrist noted for his research in the area of post-traumatic stress since the 1970s. His work focuses on the interaction of attachment, neurobiology, and developmental aspects of trauma’s effects on people. His major publication, Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society, talks about how the role of trauma in psychiatric illness has changed over the past 20 years.
Dr. van der Kolk is past President of the International Society for Traumatic Stress Studies, Professor of Psychiatry at Boston University Medical School, and Medical Director of the Trauma Center at JRI in Brookline, Massachusetts. He has taught at universities and hospitals across the United States and around the world, including Europe, Africa, Russia, Australia, Israel, and China.
His most recent book is The Body Keeps the Score: Brain, Mind, and Body in the Treatment of Trauma.
Bessel van der Kolk: Psychiatry has always had a complex relationship to trauma. It first started off as a discipline that looked at the bizarre symptoms that people have and then they uncovered way back in the late 1800s at the Salpêtrière in Paris particularly that people have very bizarre reactions to trauma and so that defines hysteria 150 years ago. So there was some interest in it. And then they put a kibosh on it; people are no longer allowed to study hysteria. The first World War breaks out; a huge number of traumatized guys have the same symptoms as these women. People come home from the first war, have a terrible experience. They're all being accused of malingering; very traumatized people; probably had a lot to do with the rise of Nazism.
And eventually the second World War, a lot effort the second World War. And then in 1947, the last book about war trauma gets published and there's nothing till 1982 or something. So it takes a long time. And even when I was a student my textbook said that incest is extremely rare and it is really good for people and it doesn't really cause any major damage because it gives women and girls permission to do something that is really forbidden, but eventually protects their mental health. And so there has been a long-term, complex relationship where psychiatry really doesn't want to see trauma and in occurrence DSM, what people call the Bible of Psychiatry, where my colleagues and I, at the National Child Traumatic Stress Network, worked very hard to get a diagnosis in to make room for the hundreds of thousands, if not millions, of kids who get abused and neglected, whose parents go off to jail, whose parents are drug addicts, whose parents are not there for them and them being grown up. We try to get a diagnosis called Developmental Trauma Disorder and the response was after submitting data on 20,000 children with this problem, they said, "Oh we don't really have enough evidence for this niche diagnosis." And in fact vast numbers of people who seek psychiatric care are in fact traumatized human beings.
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. Last year in the U.S., kids got $18.1 billion worth of psychotropic drugs and these drugs actually do calm people down, but they also work on the reward system in the brain and decrease curiosity, openness, experimentation, engagement with people. And 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.
Directed/Produced by Jonathan Fowler, Elizabeth Rodd, and Dillon Fitton
Acclaimed psychiatrist Bessel van der Kolk explores his field's long, complex, and stubborn history with traumatic experiences. Dr. van der Kolk explains how, for the better part of a century, psychiatry avoided progress by relying on outdated misdiagnoses. The results of trauma were deemed "hysteria" or, in the case of shell-shocked soldiers, "malingering." The experiences of abused women and children were more or less ignored, and they're still being ignored in the way diagnoses are given today. Psychiatry is still not cognizant enough of the traumatic experiences that lead to diagnoses. In a way, we're simply treating the symptoms, not the problem.
Van der Kolk's latest book is titled "The Body Keeps the Score."
Nazi supporters held huge rallies and summer camps for kids throughout the United States in the 1930s.
- During the 1930s, thousands of Americans sympathized with the Nazis, holding huge rallies.
- The rallies were organized by the American German Bund, which wanted to spread Nazi ideology.
- Nazi supporters also organized summer camps for kids to teach them their values.
A Bund parade in New York, October 30, 1939.
Credit: Library of Congress
1930s AMERICAN FASCIST BUND CAMP HOME MOVIE BERGWALD NEW JERSEY<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="69d54b175b0d317cf9bfd688e4fa04f3"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/gOPeDaDcw3w?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
Tea and coffee have known health benefits, but now we know they can work together.
Credit: NIKOLAY OSMACHKO from Pexels
- A new study finds drinking large amounts of coffee and tea lowers the risk of death in some adults by nearly two thirds.
- This is the first study to suggest the known benefits of these drinks are additive.
- The findings are great, but only directly apply to certain people.
Maybe you should enjoy this article with a cup of coffee or tea.<p> The <a href="https://drc.bmj.com/content/8/1/e001252?T=AU" target="_blank" rel="noopener noreferrer">study</a> involved 4,923 type 2 diabetics living in Japan. The average participant was 66 years old. All of the participants were taken from the rolls of the Fukuoka Diabetes Registry, a study geared at learning about the effects of new treatments and lifestyle changes on the health of diabetics. <br> <br> The participants filled out questionnaires concerning their health, diet, habits, and other factors. Among the questions were two focused on determining how much green tea or coffee, if any, the participants consumed over the course of a week. The health of the participants was recorded for five years. During this time, 309 of the test subjects died from a variety of causes. <br> <br> Subjects who drank more than one cup of tea or coffee per day demonstrated lower odds of dying than those who had none. Those who consumed the most tea and coffee, more than four and two cups a day, respectively, enjoyed the most significant reductions in their risk of death. This level of consumption was associated with a 40 percent lower risk of <a href="https://www.sciencedaily.com/releases/2020/10/201020190129.htm" target="_blank" rel="noopener noreferrer">death</a>. </p><p>Most interestingly, the effects of drinking tea and coffee appear to combine to reduce risk even further. Those who reported drinking two or three cups of tea a day and two or more cups of coffee were 51 percent less likely to die during the study, while those who drank a whopping four or more cups of tea and two or more cups of coffee had a 63 percent lower risk of <a href="https://www.medicalnewstoday.com/articles/diabetes-coffee-and-green-tea-might-reduce-death-risk" target="_blank" rel="noopener noreferrer">death</a>. </p>
So, should I start swimming in a vat of coffee and green tea?<iframe width="730" height="430" src="https://www.youtube.com/embed/LY0E-JQxeoY" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe><p> Not quite. </p><p> The primary takeaway from this study is that Japanese adults with type 2 diabetes who drink a lot of green tea and/or coffee die less often than similar people who do not. If this effect is caused by something in the drink, lifestyle choices people who drink that much tea all make, or something else remains unknown. The finding must be considered an association at this point. <br> <br> The eye-popping reductions in mortality rates are compared to the risk of death of others in the study. The people who died reported drinking less tea and coffee than those who lived. Unless you have several demographic and conditional similarities to the subjects of this study, you probably won't suddenly be at a two-thirds lower risk of death than your peers because you drink green tea. </p><p> Like all studies that depend on self-reporting, it is also possible that people misstated how much they consumed any one item. The study also did not look into other factors like socioeconomic status or education level, also known to impact death rates and potentially linked to coffee and tea consumption. </p><p> However, it is yet another study in the pile that suggests that <a href="https://www.healthline.com/nutrition/top-13-evidence-based-health-benefits-of-coffee" target="_blank" rel="noopener noreferrer">coffee</a> and <a href="https://www.healthline.com/nutrition/top-10-evidence-based-health-benefits-of-green-tea" target="_blank" rel="noopener noreferrer">green tea</a> are good for you. That much is increasingly <a href="https://www.health.harvard.edu/press_releases/health-benefits-linked-to-drinking-tea" target="_blank" rel="noopener noreferrer">agreed</a><a href="https://www.rush.edu/health-wellness/discover-health/health-benefits-coffee" target="_blank" rel="noopener noreferrer"> upon</a>. This study also suggests the benefits are additive, which is a new development.</p><p><br> So, while it isn't time to start the IV drip of green tea, a cup or two probably won't <a href="https://www.webmd.com/diabetes/news/20201022/coffee-green-tea-might-extend-life-for-folks-with-type-2-diabetes" target="_blank" rel="noopener noreferrer">hurt</a>. </p>
Logic puzzles can teach reasoning in a fun way that doesn't feel like work.
- Logician Raymond Smullyan devised tons of logic puzzles, but one was declared by another philosopher to be the hardest of all time.
- The problem, also known as the Three Gods Problem, is solvable, even if it doesn't seem to be.
- It depends on using complex questions to assure that any answer given is useful.
The Three Gods Problem<iframe width="730" height="430" src="https://www.youtube.com/embed/UyOGZk7WbIk" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture" allowfullscreen></iframe><p> One of the more popular wordings of the problem, which MIT logic professor George Boolos <a href="https://www.readersdigest.ca/culture/hardest-logic-puzzle-ever/" target="_blank">said</a> was the hardest ever, is:<br> <br> "Three gods A, B, and C are called, in no particular order, True, False, and Random. True always speaks truly, False always speaks falsely, but whether Random speaks truly or falsely is a completely random matter. Your task is to determine the identities of A, B, and C by asking three yes-no questions; each question must be put to exactly one god. The gods understand English, but will answer all questions in their own language, in which the words for <em>yes</em> and <em>no</em> are <em>da</em> and <em>ja</em>, in some order. You do not know which word means which."<br> <br> Boolos adds that you are allowed to ask a particular god more than one question and that Random switches between answering as if they are a truth-teller or a liar, not merely between answering "da" and "ja." <br> <br> Give yourself a minute to ponder this; we'll look at a few answers below. Ready? Okay. <strong><br> <br></strong>George Boolos' <a href="https://www.pdcnet.org/8525737F00588A37/file/31B21D0580E8B125852577CA0060ABC9/$FILE/harvardreview_1996_0006_0001_0060_0063.pdf" target="_blank" rel="noopener noreferrer">solution</a> focuses on finding either True or False through complex questions. </p><p> In logic, there is a commonly used function often written as "iff," which means "if, and only if." It would be used to say something like "The sky is blue if and only if Des Moines is in Iowa." It is a powerful tool, as it gives a true statement only when both of its components are true or both are false. If one is true and the other is false, you have a false statement. </p><p> So, if you make a statement such as "the moon is made of Gorgonzola if, and only if, Rome is in Russia," then you have made a true statement, as both parts of it are false. The statement "The moon has no air if, and only if, Rome is in Italy," is also true, as both parts of it are true. However, "The moon is made of Gorgonzola if, and only if, Albany is the capitol of New York," is false, because one of the parts of that statement is true, and the other part is not (The fact that these items don't rely on each other is immaterial for now).</p><p> In this puzzle, iff can be used here to control for the unknown value of "da" and "ja." As the answers we get can be compared with what we know they would be if the parts of our question are all true, all false, or if they differ. </p><p> Boolos would have us begin by asking god A, "Does "da" mean yes if and only if you are True if and only if B is Random?" No matter what A says, the answer you get is extremely useful. As he explains: <br> </p><p> "If A is True or False and you get the answer da, then as we have seen, B is Random, and therefore C is either True or False; but if A is True or False and you get the answer ja, then B is not Random, therefore B is either True or False… if A is Random and you get the answer da, C is not Random (neither is B, but that's irrelevant), and therefore C is either True or False; and if A is Random...and you get the answer ja, B is not random (neither is C, irrelevantly), and therefore B is either True or False."<br> <br> No matter which god A is, an answer of "da" assures that C isn't Random, and a response of "ja" means the same for B. </p><p> From here, it is a simple matter of asking whichever one you know isn't Random questions to determine if they are telling the truth, and then one on who the last god is. Boolos suggests starting with "Does da mean yes if, and only if, Rome is in Italy?" Since one part of this is accurate, we know that True will say "da," and False will say "ja," if faced with this question. </p><p> After that, you can ask the same god something like, "Does da mean yes if, and only if, A is Random?" and know exactly who is who by how they answer and the process of elimination. </p><p> If you're confused about how this works, try going over it again slowly. Remember that the essential parts are knowing what the answer will be if two positives or two negatives always come out as a positive and that two of the gods can be relied on to act consistently. </p><p> Smullyan wrote several books with other logic puzzles in them. If you liked this one and would like to learn more about the philosophical issues they investigate, or perhaps if you'd like to try a few that are a little easier to solve, you should consider reading them. A few of his puzzles can be found with explanations in this <a href="https://www.nytimes.com/interactive/2017/02/11/obituaries/smullyan-logic-puzzles.html" target="_blank" rel="noopener noreferrer">interactive</a>. </p>
But most city dwellers weren't seeing the science — they were seeing something out of Blade Runner.
On Sept. 9, many West Coast residents looked out their windows and witnessed a post-apocalyptic landscape: silhouetted cars, buildings and people bathed in an overpowering orange light that looked like a jacked-up sunset.