Does the Body Really Keep Score?

Over the nearly 13 years I’ve spent writing about therapists and their work, there’s a funny analogy I’ve found myself coming back to again and again: the field behaves a little like a family at Thanksgiving dinner. Its different disciplines are a (mostly) functional cast of characters, supporting and challenging one another, brought together by mutual respect and a shared mission.

There’s the patriarch at the end of the table—Psychoanalysis, of course—who leans back and lights up a cigar. A few seats over, Sex Therapy whispers a raunchy secret in the ear of Nature Therapy, who feigns interest and stares out the window at a flock of geese. Ericksonian Hypnosis shares a card trick with Play Therapy, who claps excitedly. Outside, Psychedelic Therapy lies in the grass, blissfully watching the clouds pass overhead. Attachment Therapy keeps a watchful eye over the kids table, where the newcomers have gathered. And Gestalt Therapy is having an animated conversation with an empty chair. You get the idea.

Like any family gathering, these characters follow a familiar set of rules: keep politics to a minimum, don’t overshare, and listen well. There are consensuses, too: shared gripes about the DSM, a reverence for the therapeutic relationship, and an understanding that “the body keeps the score.”

But what if that last concept—the idea that the body, not just the mind, plays an invaluable role in treatment —isn’t as universally accepted as we think? What if, in this dinnertime scenario, some uninvited guests—four brash researchers—barge into the dining room, decidedly announce that the body does not keep the score, and then mic-drop a thick stack of papers in the center of the table? What if, as the declaration lands with a thud, our cast of characters begins to wonder whether they actually see eye to eye on this body stuff after all?

It turns out this isn’t far from reality. In April, four university researchers—including renowned British neuroscientist Karl Friston—dropped a bombshell report in the journal Frontiers in Systems Neuroscience, provocatively titled, “The body does not keep the score: trauma, predictive coding, and the restoration of metastability.” Within days, it had sparked a firestorm of debate among therapists and non-therapists alike, reviving decades-old tensions over whether trauma is a problem of the mind, the body, or both—and what this means for treatment.

The Frontiers paper opens with a bold challenge to one of the most influential ideas in modern trauma treatment: Bessel van der Kolk’s argument that traumatic experiences continue to affect the body and nervous system long after the original danger has passed, a concept he introduced in his 2014 bestseller, The Body Keeps the Score.

“It’s an enticing metaphor,” the Frontiers authors write, “implying that experience is literally inscribed in flesh, that the body bears the scars of what the mind cannot face.” While emotionally compelling, they continue, van der Kolk’s claim is “biologically inaccurate.” The body proper does not store trauma, they add, but rather, “the brain dynamically reenacts it through maladaptive inference…. Trauma is a disorder of prediction, not storage; and thus why we believe it is inaccurate to say the body is somehow ‘keeping score.’”

But reading further, it soon becomes clear that the authors aren’t actually challenging van der Kolk’s assertions about the body’s importance in trauma treatment. Instead, they’re contesting the literal interpretation of his metaphor—the idea that trauma actually lives in muscles, organs, and tissues as a stored memory, like data on a hard drive.

“Our argument is less an outright refutation of van der Kolk than an updated reframing,” they write. “Van der Kolk’s framing obscures the central role of the nervous system in constructing, maintaining, and—crucially—transforming emotional experience. It can inadvertently imply that somatic intervention is the primary or only path to healing, sidelining the computational and inferential processes through which the brain generates the body’s apparent ‘score.’”

Van der Kolk hasn’t responded, maybe because he doesn’t need to. Or maybe it’s because what he did or didn’t write 12 years ago isn’t really under fire. Rather, the paper’s authors suggest, the problem lies with the field, which over the years has reduced van der Kolk’s complex ideas down to a simple catchphrase.

Regardless, simply calling this out—and appearing to challenge van der Kolk in the process—has created a raging debate on podcasts, nightly newscasts, and, of course, online. Suddenly, it feels like a long-settled battle in the old trauma wars is back on.

“Every somatic coach on the internet is having a meltdown,” said health and wellness guru Beau Kuhberg in a May 2026 Instagram video. “But here’s the part nobody’s saying out loud: it doesn’t fucking matter. Your brain is in your body. Drawing a line between brain trauma and body trauma is like arguing whether the music is in the speaker or the air.”

“Is trauma in the brain?! Is it in the body?! Who’s right?” asked an Instagram post from Somatic Experiencing practitioner Karden Rabin. “It’s obviously both, and even that is an abstraction, trying to make sense of the age-old dilemma of us humans trying to conceive ourselves a ‘whole being.’”

Some took aim at the Frontiers article’s authors. “The title is deliberately provocative, misleading, and misrepresenting of [van der Kolk’s] beliefs,” wrote one Reddit commenter.

Others, siding with the Frontiers authors, fired back. “The body is not a hard drive,” retorted another Reddit commenter. “Stop trying to delete a file that was never there.”

Some suggested body work had become overhyped. “I worry that we’re entering an era where trauma recovery is being marketed as something you can ‘release’ purely through body-based tools,” wrote trauma-informed child psychologist Robyn Koslowitz on Instagram. “A massage can help regulate your nervous system. A calming tool can lower stress. That’s real. But regulation alone is not the same thing as cognitive reprocessing.”

And of course, some took aim at van der Kolk himself. “The body does not keep the score,” said child psychiatrist Michael Scheeringa on a July 2026 episode of Alex Clark’s podcast, Culture Apothecary. “I believe van der Kolk started with the conclusion, and then cherry-picked the data to fit it.”

Whether you’re Team Mind, Team Body, or somewhere in between, the debate comes down to a deceptively simple question: When we say that the body keeps the score, what do we even mean?

The Somatic Divide

Over the dozen years since The Body Keeps the Score was published, enough praise has been heaped on it to fill books on its own—accolades from therapy legends like Pat Ogden, Jack Kornfield, Dan Siegel, Stephen Porges, Dick Schwartz, Peter Levine, and Jon Kabat-Zinn. Meanwhile, its publication coincided with a huge spike in the popularity of body-based trauma treatments, with methods like Somatic Experiencing and Sensorimotor Psychotherapy establishing international training networks since its introduction.

But there’s a disconnect: most clinicians have not jumped on the body bandwagon. According to a 2024 international survey published in Frontiers in Psychiatry, although roughly 78 percent of clinicians say mind-body therapies are “the most promising” category of treatment for psychiatric conditions, only 38 percent agree that they should be integrated into mainstream practice, 43 percent say clinicians should receive formal education in mind-body therapies, 47 percent said they’d feel comfortable talking with clients about mind-body therapies, and 37 percent said they’d recommend them to clients.

In sum, the enthusiasm is real, but it hasn’t translated into actual practice. The field, it would seem, is split. And it has Ruth Lanius worried.

“I fear we’re back at Descartes—seeing the brain and body as distinct entities,” says Lanius, a prominent clinician-scientist, researcher, and author who’s been studying trauma for over 30 years. “When I read the Frontiers article, which implies that they’re separate, I thought, Wait a minute, the brain, mind, and body are one. All the sensory information we experience in our bodies gets transported through the spinal cord into the brain, which makes sense of it and regulates the body.”

Is the mind-body connection lost on most therapists, as the Frontiers authors suggest?

“My sense is the authors are getting caught up in semantics,” Lanius says. “Saying ‘the body keeps the score’ doesn’t mean we’re just treating the tissues. The tissues could be affected—we know that stress is associated with inflammatory processes. But that’s just one piece.”

So if the issue with the Frontiers article is just a matter of semantics, then why are so many therapists so worked up? Lanius says it’s because, even in this seemingly Golden Age of trauma treatment, the field remains deeply divided—and those divisions go well beyond terminology.

“There are the top-down people, and there are the bottom-up people. We need to bring them together, because our clients need both. Thoughts are critical, but when you’re severely traumatized, the language and awareness parts of your brain aren’t fully online. Sometimes you need a bottom-up treatment to get the full effect of a top-down treatment.” Embracing both isn’t just nice in theory, Lanius adds—it can drastically shift the outcome of therapy. After all, only about half of clients respond to talk therapy alone.

If that wasn’t enough to sway skeptics of the idea that the body keeps the score, there’s another reason Lanius says it’s worth taking seriously: It perfectly describes what many trauma survivors actually feel.

“It was actually Bessel’s patients who came up with the concept of the body keeping the score,” she says. Lanius has heard similar descriptions from her own clients—like the one who’d been stabbed and continued to feel blood dripping down his neck long after the wound had healed, or the assault victims who, when triggered, said they felt like they were being forcibly held down all over again.

“Traumatic memories can be experienced as sensations in the body,” Lanius explains. “Hence clients feel that the body keeps the score. After treatment, that changes. It’s like the body lets go of the memories.” None of this may be visible under a microscope, but Lanius says the experience of trauma living in and leaving the body feels very real to clients—“and we need to take that subjective experience seriously.”

Setting the Record Straight

Psychologist Arielle Schwartz still remembers when the words somatic psychotherapy were met with raised eyebrows, even from fellow therapists. “Thirty years ago, they’d look at me a little cross-eyed and say, ‘semantic therapy?’” She says the uptake since then has been dramatic—and when The Body Keeps the Score debuted, it confirmed what she’d long known as an EMDR specialist and yoga practitioner: tuning into the felt experience could provide crucial feedback about the process of healing from trauma.

The Frontiers article, she says, felt like a step backward.

“Unfortunately, I think it gets mired in the old Cartesian error that the mind and brain aren’t part of the body. When you look at the interaction of the nervous system and every other system of the body, you see how deeply they’re intertwined. That you can’t possibly separate the mind or brain or nervous system from the fascia, the cardiovascular system, the endocrine system, or your digestive system. Do the issues live in our tissues? Absolutely. And does the brain contribute to the problem with predictive processing? Absolutely. So it’s both/and, not either/or.”

As reasonable as this may seem, Schwartz admits that focusing on the body at the expense of the psyche happens frequently in our field, and it can be problematic.

“If we’re only focusing on the felt sense and not realizing that we need to unpack where the mind gets caught in feedback loops, or if we don’t know how to interrupt the mental processes that become our self-confirming biases, then that also contributes to the problem,” she says.

For Schwartz, the solution is an integrative mind-body approach. In her own work with trauma survivors, she often begins with a memory reappraisal and reconsolidation process. When the client notices a sensation, she asks them to notice the automatic interpretations their mind is making about it. It’s bad. I can’t handle it. It’s never going to go away. There’s something wrong with me. Then, she introduces a somatic intervention that allows the client to stay with the sensation and notice that none of their worst-case-scenario beliefs came true. I could handle it. It ended. I’m okay. With repetition, they eventually “update” how the memory and sensation are held in the brain.

“Over time, how we relate to our body begins to change,” Schwartz explains. “We get to befriend it, and think Oh, I’m not so scared of that feeling anymore. I’ve got this.”

For Schwartz, the integrative mind-body approach makes intuitive sense—“and that’s what Bessel’s been saying all along,” she adds. “That’s where I think it got misconstrued. He never meant to say the body only.”

Shiny Objects

Just when it seemed the trauma field had settled the brain versus body debate, psychotherapy researcher Scott Miller offers a dissenting take: Maybe these tidy concepts of brain and body are more appealing than they are accurate.

“Research is the great leveler,” he says. “And frankly, I don’t see the scientific support for much of what van der Kolk claims. I see the interest, and his book title is definitely memorable. But the evidence is limited.”

Miller doesn’t side with the Frontiers authors either. “We’re talking about two takes that are highly questionable,” he says. “It’s like, which narrative do you want? I do think that Bessel’s work is still primarily understood as trauma being stored in the tissue. If you listen to his early talks, it sure sounds like that.”

Miller clarifies that he isn’t questioning the importance of the body in trauma treatment. “There’s no reason not to focus on the body,” he says. “But mediums and psychics and tarot card readers have outcomes that are just as good.”

So why has the idea that the body keeps the score had such staying power?

“Our field is prone to generating new ideas,” he says, “and my theory is that they tend to reflect the cultural interests of the time. This is true of psychodynamic therapy, CBT, EMDR, and EFT. They feel relevant, and are attractive as such. And the claim is always ‘If you don’t know this or do this you’re going to be less effective.’ That’s not supported by the science. To paraphrase an old expression, ‘Culture eats psychotherapy for lunch.’”

The dilemma, Miller adds, is that most of these interventions work. But over the last 50 years, he says there’s been virtually no improvement in clinical outcomes, regardless of the approach. And over time, these ideas—like the body keeping the score—are prone to totalism and oversimplification.

“Concepts meant for the therapy room have escaped, aided and abetted by algorithms on social media,” he says. “We’re no longer in control of them, and that’s alarming. You don’t see the same kind of drift in other sciences, like physics or mathematics.”

So what’s the solution?

“To me, this isn’t about the Frontiers article or the question of whether the body keeps the score,” Miller says. “It’s about something bigger: We need to take a hard look at whether our interventions are actually helping our clients, to monitor and measure them over time. Without evidence, these ideas are just stories,” he says. “They’re neither good nor bad. But all stories have the potential to help and heal.”

Doing Our Part

Therapists like Morgan Starr-Riestis, a holistic nervous system regulation expert whose practice pulls heavily from the work of somatic therapy pioneers, have been tracking the mind-body debate closely.

But regardless of where the field lands, she says her clinical foundation feels sturdy. The Body Keeps the Score was part of her clinical upbringing—and she believes it’s still incredibly relevant—but she also draws inspiration from other approaches, like Peter Levine’s Somatic Experiencing and Dan Siegel’s Interpersonal Neurobiology. Taking these multiple perspectives into account, she says the importance of the body in trauma treatment is undeniable.

“Stress and trauma cause an unfathomable amount of measurable change. Literally every organ system—our nervous system, immune system, cardiovascular system, respiratory system, musculoskeletal system, and reproductive system—is impacted. Trauma increases your risk of heart disease and stroke. It increases your risk of cancer. So I don’t think van der Kolk’s claim of the body keeping the score is grossly inaccurate.”

As someone who also boasts a considerable online presence, with over 750,000 Instagram followers, Starr-Riestis says there’s something else about the Frontiers article that gives her pause: how it was marketed.

“I’m in the belly of the online beast,” she says. “So my first thought was, This is just for clicks. It makes sense that it blew up. Imagine if it had been titled differently. I think it was made to be sensationalized.”

Starr-Riestis acknowledges that complex ideas often get watered down on social media. But even in limited formats like Instagram posts, where brevity is not only encouraged but rewarded, she says clinicians have the room—and the responsibility—to offer context.

On her Instagram page, Starr-Riestis shares the proactive nervous system regulation routine she offers clients, in which she helps them customize their mornings and evenings using a palette of nervous system regulation tools, like humming while brushing your teeth or doing bilateral stimulation while brewing your morning coffee. They work, she says, but there’s also more to the story.

“It’s unethical to think I can solve people’s problems with a one-minute post,” she explains. “So at the end of almost every video, I’ll try to direct people to my program where my team and I can offer the nuance and customization needed to get results. I try to be transparent by saying there’s more to the equation than what we can fit into one-directional social media posts.”

The mind-body debate has hardly been settled. But maybe that’s not an entirely bad thing. Psychotherapy works, at least in part, because of the friction between competing ideas. Because no single theory gets to operate without being questioned, tested, and held accountable when it goes off the rails. Sure, it’s frustrating, but it’s also protective. It keeps us from mistaking an enticing explanation for a complete one.

Maybe the goal isn’t to decide which guest at the Thanksgiving dinner table has been right all along. Maybe it’s to keep the conversation going, to make sure no single voice drowns out the others. To bring our combined strength to the table. Heated debates will continue to occur, but like most families, we usually find our way back to each other. If not for us, then for those we serve.

“We need to move into conversation and connection,” says Lanius. “To resist the polarizing pull of choosing one viewpoint over another. We live in polarized times, but when we move toward reconnection, it ripples outward—from individuals, to groups, to the world.”