The idea that trauma persists in the body is having an immensely productive cultural moment. Bessel van der Kolk’s The Body Keeps the Score has been a New York Times bestseller for more than six years: As of this writing, it sits at number 2 on the paperback nonfiction list after 319 weeks. Beyond talk, analysis, and behaviorism, psychologists are developing novel, promising therapies, such as Ogden, Minton, and Pain’s sensorimotor therapy and Peter Levine’s somatic experiencing. Social movements are integrating embodied practices as part of their mission to abolish unjust social structures that produce marginalization and illness. Focus on the body can lead to healing and social change, according to Staci K. Haines, author of The Politics of Trauma, as well as offer better understanding of how extreme experiences and unjust social systems shape our soma. Attention to embodiment—the relationship among body, self, and society—she argues, can “support collective practices of building power, deepening presence and capacity, increasing our emotional skills and range, and developing the embodied skills we need to generate large-scale change.”
But outside a small number of clinicians’ offices and healing justice circles, the uptake of somatic approaches to healing has been somewhat ham-fisted. A quick browse through social media turns up voluminous snake oil–sounding advice: Stand like a superhero for two minutes a day to boost testosterone and lower cortisol. In order to process trauma, don’t talk about the past. Nervous system dysregulation can be solved with dopamine supplements and magnesium oil.
In fact, there is a quiet backlash underway against the laser focus on the body’s role in healing trauma. For example, neuroscientist Lisa Feldman Barrett systematically challenges many shibboleths of somatic healing: We have a single brain, not a “triune” (lizard, mammal, and human) one. The brain, not the body, creates and processes trauma. The story you tell yourself about your experiences is more important than how you feel. Brains don’t have circuits dedicated to fighting or fleeing—the brain predicts, it doesn’t react.
How do we make sense of such wildly different approaches to healing trauma, diverging over whether to focus on the body or the mind? It is tempting to read the somatic approach as: Your issues are in your tissues, so distrust your thoughts. It is equally easy to interpret the neuroscientific evidence as: Trauma is all in your head, so ignore embodied sensation. But—as someone with very mild and mostly manageable post-traumatic stress disorder—I haven’t found either extreme useful. For me, EMDR did not offer substantial relief on its own. But neither did cognitive behavioral therapy. Perhaps, for those of us reeling from trauma or severe mental illness, the grinding work of healing might be easier if those around us dechambered their silver bullets.
After the violent attacks that shattered my partner, Jason, and upended both of our lives, we posted a list titled “Stupid Advice” on the refrigerator. On it were panaceas offered by well-meaning people: Cognitive processing therapy (“Cures PTSD in ten sessions!”). Restorative justice circles (“Cured my PTSD overnight!”). Getting a therapy dog. Tapping. MDMA. Mushrooms. Bone broth. God.
Embodied therapies help many people rebuild their lives. But no approach to healing psychological damage works in isolation. While clearing emotional blocks that feel embedded in the body might fortify us for calm reflection, it doesn’t rebuild a life. Or change a society that produces so much harm.
Fortunately, last year, two of the most incisive giants writing about trauma and mental health published career-defining books: Kay Redfield Jamison, with Fires in the Dark: Healing the Unquiet Mind, and Judith L. Herman, with her long-awaited Truth and Repair: How Trauma Survivors Envision Justice. The authors are among the world’s foremost experts in their respective subjects: bipolar and psychotherapy for Jamison, sexual assault and its survivors for Herman. Moreover, they are consummate stylists: Jamison is as lyrically profound as William Styron. Herman offers all the clarity of van der Kolk, but with politics.
Herman and Jamison provide blueprints for a vision of survivors’ justice that encompasses all aspects of ourselves.
Both books are now available in paperback. Engaging them, especially together, offers an opportunity to imagine psychological healing beyond simple wellness, to imagine recovery as a three-legged structure. The body, yes. And also the mind, and also society.
Jamison’s and Herman’s books offer useful correctives to the idea that trauma and serious mental illness—and therefore healing—live outside the realm of narrative and beyond culture. Bringing story and social action back into the healing process, these authors suggest, is the unfinished work of addressing existential suffering.
Before she dared write a memoir about her own struggle with the condition, Kay Redfield Jamison wrote the textbook on manic depression. Professor of psychiatry and behavioral sciences and co-director of the Mood Disorders Center at Johns Hopkins School of Medicine, she co-authored a 1990 textbook, Manic-Depressive Illness (the term she still prefers to bipolar disorder) with Frederick Goodwin. The book is considered a “Bible” and “definitive text.”
But it was sharing her personal story with a broad audience in her memoir An Unquiet Mind in 1995 that truly launched her as a global figurehead in mental health. Thoughtful, frank, and often searing, her work was lauded by reviewers and readers alike. The Journal of the American Medical Association called her “touched with fire”; the New York Times said the book was “at once medically knowledgeable, deeply human and beautifully written.” She appeared on Oprah. She won a MacArthur Genius Grant. She received 30,000 letters from readers, ranging from the deeply grateful to the truly vicious.
Thirty years later, Fires in the Dark pivots away from the traditional narrative arc of illness—normalcy, descent into chaos, quest for understanding/diagnosis/cure, and return to a measure of peace and happiness—to reflect more expansively on the complexities of the author’s own life-long healing journey. The book is a paean to competent, rigorous psychodynamic therapy: Jamison has joked that if she could have subtitled the book “A Love Song to Psychotherapy,” she would have. But more deeply, Jamison offers a moving ode to healers, chronicles how healing became medicine (and what it lost in the process), and provides resources for restoration after profound mental crisis.
Jamison argues that psychotherapy is the oldest human science. Before Hippocrates broke the link between medicine, religion, and philosophy, she writes, healers created sanctuaries where ritual, drama, food, herbs, dream interpretation, spirituality, magic, and touch all combined to restore unbalanced minds and bodies. A similar playbook was adopted by the great psychic healers of the 20th century (Jamison takes as her models William Osler, W. H. R. Rivers, and nurses in WWI-era military hospitals): they listened deeply, challenged patients to become active in their own recovery, and tenaciously abided with death and despair.
Healing is “a powerful journey undertaken by healer and patient,” Jamison writes, requiring rigorous self-examination, hard work, and regular infusions of hope. She argues that less ambitious approaches to treating mental illness, such as mostly medication strategies or cognitive behavioral therapy, tend to deprioritize the difficult trek to self-understanding, the work of rewriting your story after trauma, loss, or illness. It’s difficult to measure or manualize such narrative healing. But without it, the afflicted “cling close to shore, avoid risk, and fear returning to the fray of life.”
This is why Jamison chooses restoration as the goal of healing—that is, a never quite finished process—rather than recovery. Restoration requires play, imagination, curiosity, a willingness to rethink ourselves down to our psychic bones. We must reconsider the basic building blocks of our lives, recalibrate our personalities, and reassess the values that guide us.
In this quest to put suffering to purpose, Jamison offers resources by drawing from heroes, artists, and storytellers she admired in her childhood. She uses the islands of Le Guin and Stevenson as models for cultivating and mapping internal sense-making territory. The tragedy of King Arthur illustrates that our hopes for the future—even if we fail—should be drawn from our deepest values. The life and songs of Paul Robeson teach about turning pain outward, bending sorrow to the common good.
Treatment and cure are not the same as healing, Jamison reminds us in Fires in the Dark. Catastrophe forces thoroughgoing reckoning, and it is this reckoning—and the restoration that can follow—that Jamison urges us to undertake. Thus the cover image of Notre-Dame in flames.
“Restoration, whether of stone or soul, offers choices,” Jamison writes of the wrenching decisions faced by the French public after the decimation of the beloved medieval cathedral. “Is it better to restore only what existed before, to stay within the chalk lines, or to venture into new territory? In the wake of pain comes the opportunity to innovate, and with possibility come questions: what to keep of the past, what to discard; … whether to go beyond the historical boundaries … how to seek out new ways and places, new ideas and people; how to gather courage for the nights to come.”
As Jamison seeks restoration rather than recovery, Judith Herman asks for reparation rather than reconciliation. When she wrote her 1992 classic, Trauma and Recovery, Judith Herman was not just a Harvard psychiatrist. She was a veteran of the women’s health movement in Boston: she worked in free storefront clinics and helped create a Victims of Violence program at the public safety-net Cambridge Hospital, working with survivors of child abuse and sexual assault. From these experiences, she writes, she learned that “just as oppression is oppression, trauma is trauma, whether in the public domain of war and politics or the supposedly private domain of sex, reproduction, and family life.”
This led her to make a remarkable claim, one that resonated with many readers: women in the United States are veterans of an ongoing sex war. And like other combatants, their experiences with sexual assault, rape, and other gendered abuse can result in PTSD. In her New York Times review, Phyllis Chesler called Trauma and Recovery “one of the most important psychiatric works to be published since Freud.”
Perhaps, for those of us reeling from trauma or severe mental illness, the grinding work of healing might be easier if those around us dechambered their silver bullets.
In 1992, Herman offered a three-step process of healing: 1) Establish safety, control, and choice; 2) Grieve your losses, establish social support, and make new meaning; and 3) Refocus on the present and future. Now, more than 30 years later, in Truth and Repair, she posits the fourth step in trauma recovery: justice.
Truth and Repair reflects Herman’s lifetime of clinical work and draws on 30 new interviews with survivors of “childhood sexual abuse, sexual assault, sex trafficking, sexual harassment, and/or domestic violence.” Some of her informants are visible anti-violence activists—Chicago writer and organizer Kyra Jones; Vermont attorney and founder of Have Justice—Will Travel, Wynona Ward; Minneapolis founder of Break the Silence, Sarah Super—but many toil out of the limelight as nurses, teachers, and counselors. They are diverse in terms of race, class, age, and region; 26 are women, four are men.
While their experiences are wildly varied, the survivors Herman interviews agree that recovery from intimate and community violence is neither an individual nor a solely internal process. Much of the damage of interpersonal trauma comes from the rupture of social relationships, the betrayal of bystanders, and the failures of institutions, they tell Herman. The silence of friends, neighbors, and family isolates survivors and abandons them to their fates. Communities, unwilling to face their collective culpability, often rally behind perpetrators. Churches and schools protect themselves from liability at victims’ expense. Since the harm is social, recovery must be collective, based in forming new moral communities and creating structural change.
Early in the book, Herman locates the origin of much trauma in tyranny, especially patriarchy. Tyrants have techniques of asserting power and control in addition to physical violence, many of which leave lasting psychic scars. Tyrants breach bodily integrity. They break wills and dissolve autonomy. They degrade, humiliate, and isolate. They shame and bully targets into betraying their most closely held values. They barrage with propaganda, gaslighting, confounding untruths, and denials.
But tyrants don’t work alone. They cannot rule without bystanders, “implicated subjects” whose cynicism, indifference, collaboration, and silence—while generally born of fear and exhaustion—can feel to survivors like a deeper betrayal.
Repairing the harm of tyranny thus begins with the larger community recognizing their moral responsibility for harm and acting in solidarity with those who have been victimized. “[Bystanders] must find the courage to seek out and acknowledge the truth, to overcome their fear and cynicism, to denounce the crimes of tyranny, and to ally with survivors in the name of human dignity,” Herman writes. “It is this reconciliation with the larger community that many survivors seek when they speak of justice.”
In the remainder of the book, Herman lays out a six-step program of survivors’ justice that establishes how to best acknowledge truth and achieve repair. Survivors of intimate violence crave acknowledgement, genuine apology, and ongoing accountability. They want restitution for the harms they endured, rehabilitation of perpetrators, and prevention of future violence.
Survivors’ justice goes beyond the aspirations of restorative justice and other alternatives to the criminal justice system. Jamison argues that restorative justice practices do not necessarily prevent future harm, and that, with their “sentimental emphasis on apology and reconciliation,” they can increase perpetrators’ coercive control of victims. The cycle of harm, apology, and escalation is, in fact, a key strategy in the tyrant’s toolkit. “Just outcomes can be measured by the survivor’s healing, whether or not the offender is healed,” Herman writes. “Survivors’ visions of justice combine retributive and restorative elements in the service of healing a damaged relationship, not primarily between victims and offenders but rather between victims and the bystanders in their communities.”
Healing the afflictions of powerlessness endemic to living under tyranny—whether interpersonal or national—requires acknowledging reality, re-establishing equitable power and control, and building more responsive moral communities. “When the community comes through with these reparations,” Herman writes, “the damaged relationship between the community and the survivor is healed, trust is restored, and a better kind of justice is done.”
The corollary to van der Kolk’s insight that “the body keeps the score” is that the mind lies. In a 2021 interview with Ezra Klein, he summarized the tension most succinctly:
Your core survival part of the brain picks up the danger signs and keeps continuing to secrete stress hormones … the body continues to behave as if it’s in great danger while the mind says, don’t pay attention to him, he’s lying, he’s a terrible person. So it’s really the conflict between the body feeling very unsafe and the mind not wanting to accept the reality of what has happened to you [that] is at the core of [post-traumatic stress disorder].
Repression happens. Memory is notoriously tricksy. Trauma and psychosis are particularly difficult for our sense-making apparatus to grasp; they are nearly indescribable experiences. But we should be wary when we are told to distrust our minds. That’s a classic trick of cult leaders and con artists. And tyrants.
Healing is a kind of time traveling; the process stretches before the inciting harm and well beyond the moment of acute crisis. What both Jamison and Herman offer is a true measure of the long tail of surviving survival, that awful and awe-inspiring post-intermission journey of the scathed.
“It is hard. It is really hard. There is no easy way,” Jamison’s doctors and correspondents told her after a psychotic break. “But it is possible, you can do it, life comes back again.” Jamison is grateful to not be simply told that she would be fine. “They said, You will be fine,” she writes, “but then there was the sting, the truth, the chaser: It is really, really hard.” Simple stories are seductive, but only to those not living through a particular complexity. To borrow a phrase from poet Adrienne Rich, for those of us on the inside of the mess, the ways others interpret our experience has been “o’er simple all along.”
After enduring extended psychic suffering, the goal is not to hit the reset button. It is to learn to inhabit the confusing and altered new afterworld with kindness and dignity until we can reassess ourselves, gather strength and resources, and establish a new destination for what remains of our lives. We don’t move on from the earth-shaking breaks that define us. We aren’t cured. We can, however, hope for healing, as Jamison writes, by remembering, mourning, and trying to rebuild.
In this particular moment of economic, community, and state violence, exhausting disinformation, bitterly disappointing collusion and complicity—and care, truth telling, and solidarity, as well, of course—we should build stout and balanced foundations for healing grounded simultaneously in mind, body, and society. Approaches that focus on only one leg of that healing tripod are over-simple and unsound; they neither serve those of us healing from trauma nor adequately reflect our experience. Herman and Jamison provide blueprints for a vision of survivors’ justice that encompasses all aspects of ourselves.
To heal psychic suffering, our bodies give us crucial information about what we know and how we’re feeling, provide our point of contact with others and the world, and offer all the wisdoms of pain and pleasure. But Jamison reminds us that we need our reason, our imagination, and maybe a competent therapist to discern a new destination after our plans and personalities are disrupted. And Herman maintains that none of us will linger long in the privileged space of the “post” in post-traumatic stress if we don’t radically reshape our dangerously unjust and violent world.
This article was commissioned by Liz Bowen