"The body does not keep the score" — new opinion piece by Kotler, Mannino, Fox, and Friston
the title is inflammatory and in my view misleading.
the basic claim is ‘trauma is more like a trapped prior than an inscription”. trauma is an maladaptive lack of responsivity, not like a bullet wound or physical injury
but there are two parts to the debate here:
Anti-inscription - their main argument: we should not think about trauma as something that is stored and accumulated (they are basically pushing back against the ‘storehouse model’ of trauma).
Brain-only - trauma is in the brain, not the body
They smuggle in ‘Brain-only’ when really they are arguing about ‘Anti-inscription. But we can look at these in turn.
I think anti-inscription is basically right.
van der Kolk’s The Body Keeps the Score is vague on what constitutes trauma.
“the score” he refers to is about debt, like an accounting debt, but he also uses metaphors like ‘watchtower’ and ‘smoke detector’ throughout the book — though the end message is that you need to get into the body to resolve the stored trauma.
Kotler et al. say that this is wrong. you shouldn’t see the body as ‘storing’ trauma. most people don’t get PTSD from war, death of a spouse, etc (though very many do) — which would not happen if it were permanently inscribed in the body.
(note: i doubt anyone (incl van der Kolk) believes that trauma is permanently inscribed in the body; ‘watchtower’ and smoke alarm are pretty compatible with the trapped prior view of trauma)
instead, kotler etc say that trauma is about a stuck prediction. “loss of metastability — the brain’s ability to fluidly switch among semi-stable network states”. They try to relate everything to free energy minimization — a move that I’ll just note confuses more than clarifies things for me.
This is basically compelling, and I do think ‘trapped prior’ is far better than ‘storehouse’ for how to think about trauma.
Then they basically try to explain that because trauma is about predictions, it must be about the brain (which they use interchangeably with the central nervous system).
my basic objection to this is that it is experientially obvious that memories in general (not just trauma) involve parts of the body outside the central nervous system. very obviously, the enteric nervous system and cardiac neurons encode memory that can be linked with trauma. more speculatively, i think something like
@johnsonmxe idea of smooth muscle acting as a form of ‘prior’ is quite plausible.
annoyingly, this whole piece feels like an old rehash of the perennial mind-body debate, where the predictive processing people are insisting ‘trauma is in malformed prediction (mind)’ and the somatic people insist ‘trauma is in the viscera (body)’
the way forward is what the somatic scientists like Thomas Hanna and Feldenkrais gestured at, which I think in principle the PP people should be on board with, but probably in part because there isn’t yet a mature science of somatic memory tend to default to reducing everything to the brain.