Healing the Heritage of Trauma: a review of The Body Keeps the Score and Running On Empty

by Aimee Murphy


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All of your flaws and all of my flaws

They lie there hand in hand

Ones we've inherited, ones that we learned

They pass from man to man

“Flaws” by Bastille


Pain and suffering do not exist in a vacuum. And as much as we might try to keep our hurt locked away and hidden from the world -- so that it is unable to touch those we love -- our wounds, our flaws, and our traumas profoundly impact all of us in our day-to-day lives. I speak from the gutting realization that this experience is my own: trauma affects our bodies, relationships, and future with an insidious subtlety. We’ve heard the phrase a million times: “hurt people hurt people.” As human animals, we pass on flaws and trauma from generation to generation through neglect, abuse, and violence -- both physical and emotional. Without healing, the inheritance of suffering is almost inevitable: this “Heritage of Trauma” impacts us all, and the only way to stop it is to step out of the cycle and refuse to pass it on to the next era of children.


In a peculiarly personal effort to face my own inner demons, I picked up The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma by Bessel Van der Kolk, M.D., and Running on Empty: Overcome Your Childhood Emotional Neglect by Jonice Webb, PhD. I began reading these books on a journey of self-discovery, in order to explore my life experiences and their connections to my chronic pain, my mental health, and my relationships. In reading these science-heavy and clearly colloquial books, I came to learn what trauma and childhood emotional neglect are. I became educated about how survivors look and function in the world, and how trauma-related pains hurt ourselves and get passed on to those we love. Lastly, I gained practical knowledge of how we all can make an effort through quotidian actions to change the world in lasting ways and build a culture of peace, because when we heal one branch in the family tree, that healing benefit will be the proper and dignified inheritance for future generations.


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The Pain


In The Body Keeps the Score, Van der Kolk speaks in depth about the intertwined nature of brain and body in trauma. The clinical assessment of trauma shifted dramatically with the advent of the diagnostic criteria for PTSD in 1980. With the new diagnosis available to physicians, the medical community was able to piece together many disparate symptoms into the one comprehensive diagnosis that made sense of what people experience after traumatic incidents.


During a traumatic incident, the brain may be engaged on many levels, from our reptilian brain through our mammalian brain all the way up to our rational brain. Van der Kolk explains that during a trauma, if no social support seems available, and fighting back or fleeing seems impossible, the brain will revert to the most basic, reptilian response that exists: freeze. However, if this immobilization happens, the victim is also more likely to suffer from post-traumatic stress as the body attempts to act out the trauma and potentially engage in fight, flight, or freeze. I related to this on a personal level: my ingrained response to trauma over the years has been to freeze in the face of it, and I’m certainly not alone in this.


Post-traumatic stress involves the sensation of constantly being drawn back into the past by various visual, olfactory, auditory, and other sensory triggers. Because this dissociation happens, I learned, it is common for the trauma victim to be unable to integrate new experiences properly into their life and their emotional self. It’s kind of like a part of us gets “stuck” in that traumatic moment (and the aftermath), and this “stuckness” causes a whole domino effect of other psychological and physiological effects.


When the brain gets pulled back into the traumatic memory fragments in flashbacks, the body stays on a high level of alert. Van der Kolk describes the physiology of chronic pain and illness that follow trauma: “In PTSD the body continues to defend against a threat that belongs to the past. Healing from PTSD means being able to terminate this continued stress mobilization and restore the entire organism to safety.” He goes on to describe the various ways that this stress reaction manifests in the body, including chronic pain, fibromyalgia, memory and attention problems, irritability and sleep disorders, muscle tightness, epigenetic changes, etc. I saw so many of these conditions reflected in my own life -- and despite the fact that I was fully aware that I was a survivor of several traumatic experiences, I hadn’t realized how my trauma from decades ago was still damaging my life today.


Many trauma survivors engage in destructive behaviors, not only with themselves, but also with those around them (who are almost invariably those they love). People with PTSD almost unfailingly have an extremely difficult time maintaining harmonious relationships with others; this is in part because, as Van der Kolk declares, “Trauma almost invariably involves not being seen, not being mirrored, and not being taken into account.” Many trauma survivors have explained that they didn’t tell anyone about a traumatic incident in the weeks after it occurred; so in the period when we need support, comfort, and mirroring the most, we often find ourselves isolated in shame. As social animals, humans are built for community; so when trauma victims find themselves isolated in shame, this causes a lack of synchrony between them and other people, and ultimately, their amygdalas become overactive. The amygdala releases stress hormones during a stressful event, consistently well before we might realize what is going on. If recovery after a stressful event is blocked for some reason, in the future we may not be able to discern whether situations are dangerous or safe. Dr. Van der Kolk writes, “You can get along with other people only if you can accurately gauge whether their intentions are benign or dangerous… Faulty alarm systems lead to blowups or shutdowns in response to innocuous comments or facial expressions.” When trauma enters, it can tear families, relationships, and communities apart if it isn’t healed and integrated properly. In an effort to numb out the pain and escape from the constant barrage of psychological reminders, the trauma survivor may resort to alcohol, medication, illicit drugs, or reckless behavior. This sort of activity, meant to anaesthetize the victim against the inner turmoil of their trauma, has the power to destroy peace in our families and throughout our communities.


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Running on Empty (and it’s successor book, Running on Empty No More) came very highly recommended by my therapist as an educational tool to help navigate my own journey in growth to emotional maturity and self-knowledge as a young adult. I was, quite understandably, hesitant to pick it up because I love my parents dearly, I know that they love me, and would never want to blame them for any wrong-doing nor ill intent. So as I read, I found myself caught somewhat off-guard by how relatable the text was.

In a way that is meant to compassionately inform, Jonice Webb shares her research on a newly-understood phenomenon: Childhood Emotional Neglect (CEN). She outlines the ways that emotionally neglectful parents distinguish themselves: “either they emotionally fail their child in some critical way in a moment of crisis, causing the child a wound which may never be repaired (acute empathic failure) OR they are chronically tone-deaf to some aspect of a child’s need throughout his or her childhood development (chronic empathic failure).” Dr. Webb even explains that the experience of CEN is often passed down unknowingly from generation to generation, perhaps because we have a society that has been so uncomfortable with displaying powerful emotions and has, in particular, shamed men as “weak” for showing any sadness. Our entire culture is steeped in emotional illiteracy and suppression, and this approach to emotion often gets tacitly transferred from parent to child, often unintentionally.


When I read through the list of common traits of adult children who experienced emotional neglect, I got choked up and felt seen in a way I hadn’t before. Dr. Webb described feelings of emptiness, a sense of counter-dependence, constant unrealistic self-appraisal, a sense of no compassion for oneself (but plenty of compassion for others), consistent guilt and shame, a lot of self-directed anger and blame, difficulty nurturing, poor self-discipline, alexithymia (inability to identify or describe one’s own emotions), and the ever-evasive “Fatal Flaw” (the feeling that “if anyone knew the real me they would hate me”). All of these aspects of the adult child of emotional neglect result in a vicious cycle that I personally like to call the “Sneaky Self-Hate Spiral”: my anxiety, added to by perfectionism, multiplied by alienation from others and from myself, all melds into one mess of emotions. I related to many of the patients that Dr. Webb cites in her pages, as they talked about how big emotions like anger or frustration or grief cause a downward spiral into vicious self-hate.


As Dr. Webb explains, as many survivors of CEN grew older, they unfortunately were subconsciously sent the message that emotions were unacceptable. When we humans receive this message, we fail to integrate fully; many survivors go so far as to do their best to dull the physiological sensations of emotions because they view them as bad and unwanted, and then fail to understand what their body is trying to tell them when they have migraine headaches, stomachaches, and other pains. All of these complaints are common when we consistently suppress our normal emotions. When the Sneaky Hate Spiral comes around during the next instance of heavy emotions, it could result in self-harm, irresponsible health choices, or, worst of all, in suicidal ideation.


Childhood emotional neglect, while not violent like physical abuse, still causes many hang ups in self-empathy as its compounds over time. Regrettably, it can result in badly broken relationships between family, friends, partners, and others. Adult children who experienced CEN often display explosive anger, excessive drinking, missed deadlines, and are emotionally distant. These behaviors are a recipe for compounded trauma and pain being passed on to others, not to mention the initial emotional distance and the difficult relationships that likely exist between a child and parent after years of CEN.


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Unfortunately, the Heritage of Trauma through both Childhood Emotional Neglect and more severe traumatic incidents get passed down without much thought on our part as adults. In Van der Kolk’s writing, he explains how a research study once demonstrated that “...hostile/intrusive mothers were more likely to have childhood histories of physical abuse and/or of witnessing domestic violence, while… withdrawn/dependent mothers were more likely to have histories of sexual abuse or parental loss (but not physical abuse).” These parents passed down trauma and emotional neglect to their children because they had suffered trauma in their own young lives. Statistics have shown, time and time again, that abused children will go on to experience more mental and physical illness as they grow older, that they will learn patterns of emotional neglect and parenting from their own negative experiences, and without proper healing, can enter into the same awful Heritage of Trauma with their own children. For example, “...girls who witness domestic violence while growing up are at much higher risk of ending up in violent relationships themselves, while for boys who witness domestic violence, the risk that they will abuse their own partners rises sevenfold.” This is all not to mention that the trauma can, and often does, manifest through seemingly unexplained physical illness, and that the physiological strife can result in changes down to the DNA level. At that level, the study of epigenetics has shown that trauma in life can manifest in a change in methylation properties within the body, which can “turn on” or “turn off” select genes that can manifest different disease and syndrome conditions. These epigenetic changes to our DNA expression can even be passed down from one generation to the next in our prenatal genetic code, so that a trauma that affected our grandmothers could cause us to experience a specific physical illness today.


The key, as Webb mentions, is to not run on auto-pilot as an adult. She says, “A parent who grew up emotionally neglected cannot follow her default settings for parenting. Since her default settings were determined by her primary caregivers, those settings will likely result in her passing down her own Emotional Neglect to her child. As a parent, it’s vital to work hard to override your own settings and create healthier ones for your child.” In short, as adults who are conscious of the pain that we endured at the hands of prior generations, we have the responsibility to be fully aware of our actions. We have to make deliberate decisions to not pass on the Heritage of Trauma. We must make a commitment to ourselves to be the last in this tragically long line.


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I have crossed the horizon to find you

I know your name

They have stolen the heart from inside you

But this does not define you

This is not who you are

You know who you are

“Know Who You Are” from Moana

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The Salve


When reading through these books, I was unsurprised to see how much overlap existed between them. One important theme stuck out to me as vital for our understanding of how we bridge the gap between crisis and creating a solution: Attachment Theory.

In The Body Keeps the Score, this theory is described as “...mastering the skill of self-regulation [which] depends to a large degree on how harmonious our early interactions with our caregivers are. Children whose parents are reliable sources of comfort and strength have a lifetime advantage -- a kind of buffer against the worst that fate can hand them.” Van Der Kolk then describes experiments which display this theory of attachment by demonstrating how young children play, with their primary caregiver often as a secure “home base” for them to return to at any point. This ability to return to the parent allows the child to explore new things, but to also have the comfort of knowing that the parent will always be there and attentive to their emotional needs.


Children who grow up without this secure base to return to will likely lack the skills to emotionally regulate themselves; instead of experiencing security, they learned to suppress emotions as inconvenient and undesirable. So, it makes sense that Running on Empty would explore Attachment Theory as a necessary foundational theory for how we relate to our children. Dr. Webb describes her emotional safety model through the lens of Attachment Theory as follows: “1) The parent feels an emotional connection to the child. 2) The parent pays attention to the child and sees him as a unique and separate person, rather than, say, an extension of him or herself, a possession or a burden. 3) Using that emotional connection and paying attention, the parent responds competently to the child’s emotional need.” Both this Attachment method of emotional literacy, and the crucial place of Attachment Theory in Van der Kolk’s method of healing from trauma, point to a larger truth in our work towards creating a peaceful world: in order to integrate our trauma and our emotions into our selves, and integrate ourselves into our communities, we must begin with a secure sense of ourselves within the context of those who love us. We must feel seen and heard, respected and reciprocated within the first context: in our families, however our families look.


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To start earnestly on the journey to healing, we must begin with self-knowledge and self-compassion. Often, as children, we learn who we are from mirroring those around us and from being affirmed in our passions. However, many adults who endured trauma and CEN when younger, they must re-parent themselves and affirm their dignity and their identity while on a personal journey of self-discovery. When we can extend self-compassion, we can begin our own healing by rewiring the neural pathways in our brains and creating new mental paradigms. As Van der Kolk says in The Body Keeps the Score, “Our great challenge is to apply the lessons of neuroplasticity, the flexibility of brain circuits, to rewire the brains and reorganize the minds of people who have been programmed by life itself to experience others as threats and themselves as helpless.” I learned that survivors of trauma and Childhood Emotional Neglect can begin their healing by learning Self-Leadership, and as they develop new habits of thinking, they will have the core agency to overcome their old feelings of helplessness and take charge of their journey to emotional maturity. Beyond basic Attachment within our families, we as survivors can work as our own Self-Leaders to heal the Heritage of Trauma by actively laying foundations for emotional self-awareness, working to heal ourselves and our relationships.


In an effort to give the reader a taste of what sorts of methods can be discovered from these books, I’m going to share a brief sampling of the major items recommended by Van der Kolk and Webb that can help us build a more peaceful world, both internally with ourselves, and with others.


As both Dr. Webb and Dr. Van der Kolk point out, our journey to emotional growth and healing begins with internal practices: we have to start reacquainting ourselves with our emotions and our bodily manifestations of those emotions. Because traumatized and emotionally neglected people are often alexithymic, they tend to have trouble understanding what is going on with their bodies; beginning the process of mindful self-reflection can bridge the mental gap that exists between mind and body. In The Body Keeps the Score, Van der Kolk lays out the necessity of making mindfulness practice the cornerstone of all future healing:


“When we pay focused attention to our bodily sensations, we can recognize the ebb and flow of our emotions and, with that, increase our control over them… Learning to observe and tolerate your physical reactions is a prerequisite for safely revisiting the past. If you cannot tolerate what you are feeling right now, opening up the past will only compound the misery and retraumatize you further.”


Some ways to engage in mindfulness practices include deep breathing, grounding exercises, yoga and slow stretching, physical and occupational therapy, martial arts and self-defense courses, writing to yourself and processing emotions throughout the day, and intentional self-care. I’ve begun to incorporate some of these activities into my daily life, and as I’ve done so, I have noticed how I hold my stress in my body, how I struggle to breathe deeply at times, how I hang onto emotions in an effort to suppress them. Deliberate work on my own self-care has helped me to see how I have neglected my own needs for so long, as well. By following Dr. Webb’s principles from Running on Empty, I’m learning to put myself first (to eat, exercise, and rest when my body needs it), to improve my self-discipline, learn to self-soothe, and overall to have more compassion towards myself.


These mindfulness practices are so crucial and foundational because the work of healing oneself is heavy, difficult, and often painful. For me, it has been probably one of the most worthwhile undertakings of my entire life, but I will not deceive you: it has been extremely hard. Some of the methods that I have been grateful to learn from personal experience in junction with my therapists include Internal Family Systems (IFS) therapy, Eye-Movement Desensitization and Reprocessing (EMDR) therapy, and massage therapy. Additionally, Van der Kolk also recommends a few other types of therapeutic work that can help, that I myself would be curious to try: Creating Structures (psychomotor therapy), neurofeedback therapy, and a type of psychomotor therapy that specifically engages our need for communal rhythms: theater. Related to healing trauma, I’ve found EMDR to be among the most helpful modalities at this point; for healing myself after CEN, a combination of mindfulness and IFS have helped me to integrate my emotions. I can’t speak for what will be fruitful for each individual, but Drs. Webb and Van der Kolk have laid out a comprehensive docket of therapy opportunities that should certainly be explored in cooperation with a professional counselor.


Speaking of counselors and therapists, often a relationship with a competent therapist is among the first healthy relationships that a person who has endured trauma or CEN will encounter. A good counselor has the power to help take down emotional walls, build trust, and create opportunities for further growth. Van der Kolk outlines the need for a capable and trustworthy therapist when he says,


“You have to find someone you can trust enough to accompany you, someone who can safely hold your feelings and help you listen to the painful messages from your emotional brain. You need a guide who is not afraid of your terror and who can contain your darkest rage, someone who can safeguard the wholeness of you while you explore the fragmented experiences that you had to keep secret from yourself for so long.”

After establishing a solid relationship with a therapist, I learned that there is a mountain of work to be done for the survivor of Childhood Emotional Neglect in order to start or rebuild relationships with friends, partners, and perhaps most importantly -- family. Dr. Webb covers some of the first steps for a CEN adult to ensure that they will not pass on Childhood Emotional Neglect to future generations in Running on Empty. These steps include being emotionally “filled up with premium grade”, being mutually interdependent, having a strong and clear sense of self, having compassion, having healthy self-acceptance, being forgiving, being likable and lovable, being giving and caring, being in control, and perhaps most importantly: being emotionally aware. Additionally, Dr. Webb also includes a discussion about healthy boundaries, both mentally and physically, that can begin the path to relationship growth. Of course, I would be remiss if I didn’t mention that Dr. Webb has written a follow-up book specifically on how to navigate relationships (including parental and romantic/partnered relationships) in light of CEN and healing this Heritage of Trauma; it is called Running on Empty No More, and it has profoundly impacted my life.


I truly wish that I had the space and the time to share with you every nugget of useful information that I learned about repairing and establishing healthy relationships, about self-knowledge, about trauma, about neglect, about emotions, and about the human experience from these impactful books. Whether we have experienced trauma or not, we have the power to be emotionally intelligent, to be invested in the well-being of others, to listen, to act compassionately, and to refuse to pass on trauma. I must also note that these books were difficult for me to read at times, because there are patient stories interwoven into the academic prose, and many of the patient stories are full of hurt and pain, and some are rife with violence.


If you decide to take the journey which I have already begun in order to reach emotional health and to heal the Heritage of Trauma in your own life, I commend you for your courage; but I also ask you to be patient with yourself, to have compassion, and to have confidence that you will find who you are beneath the layers of pain. Nonetheless, I’ve learned that there are so many little things that we can incorporate into our lives to heal the Heritage of Trauma and create a more peaceful world, so I encourage every reader to consider adding The Body Keeps the Score and Running on Empty to their library. Whether or not you lived through these pains, someone in your life almost certainly has. And together, through little actions each day that tell those in our lives that “I see you” and “I hear you”, I think we can make this journey to a more peaceful world. To paraphrase and echo what Mother Teresa of Calcutta once said, “If you want to change the world, go home and love your family (whatever your family looks like to you).”


This article originally appeared in Volume 7 Issue 3 of Life Matters Journal.


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