The Body Keeps the Score

The Body Keeps the Score

It was the Tuesday after the Fourth of July weekend, 1978. Bessel van der Kolk had just started his first week as a staff psychiatrist at the Boston Veterans Administration clinic. His first patient was a large, disheveled man in a stained three-piece suit, clutching a copy of Soldier of Fortune magazine. The man smelled of last night's alcohol. He sat down and started talking.

His name was Tom. Ten years earlier, he had been a Marine in Vietnam. He'd been in firefights in the jungle, watched his closest friends die in ambushes, and done things he could not bring himself to describe without his hands starting to shake. When he came home, he did what most veterans did: he put his head down and tried to forget. He attended college on the GI Bill, graduated from law school, married his high school sweetheart, and had two sons. From the outside, Tom looked like a success story. On the inside, he was a ruin.

He told van der Kolk that he felt dead. Not sad, not anxious -- dead. He could not feel affection for his wife, even though her letters had been the thing that kept him alive in the jungle. He could not enjoy his children. He had nightmares so vivid and violent that he had taken to sleeping in the basement so he would not hurt his family if he woke up fighting. Every Fourth of July, when the neighborhood filled with fireworks, he drove three hours north into the Maine woods and waited alone until the explosions stopped.

Van der Kolk was a young psychiatrist with a good education and a head full of theory. He had no idea what to do with Tom. He had never been taught that the past could do this -- that a few months in a jungle ten years ago could hollow a man out this completely, could make him a stranger to his own children, could send him driving north with a six-pack every summer to hide from sparklers and bottle rockets. The diagnosis that would eventually describe Tom's condition -- Post-Traumatic Stress Disorder -- did not yet exist. The American Psychiatric Association would not add it to its official manual until 1980.