Bessel van der Kolk Takes on the New York Times

Psychotherapy in the Spotlight

Kathleen Smith

Screen Shot 2014-10-15 at 8.55.18 AMIt’s no secret that psychotherapy has had an image problem in the media. Real and fictional clinicians on TV and in the movies are regularly portrayed as jargon-spouting caricatures, or are often shown to break ethical codes without blinking, displaying more personal problems than their clients. But a bigger part of the problem may be that, on the whole, therapists haven’t done a particularly good job explaining what we do or how it works. So when The New York Times Magazine asked trauma expert Bessel van der Kolk if it could have a journalist follow him around for a month to observe his work, it seemed like a golden opportunity to present the latest advances in trauma treatment in one of mainstream journalism’s most highly respected forums.

Medical director of The Trauma Center in Boston, professor of psychiatry at Boston University, and director of the National Center for Child Traumatic Stress Complex Trauma Network, Van der Kolk is recognized in the field for being a pioneer of once unconventional mind-body interventions, such as eye-movement desensitization and reprocessing (EMDR), neurofeedback, and yoga. Over the last 30 years, he has established a reputation as an iconoclastic critic of traditional approaches to trauma—especially Prolonged Exposure therapy, which he’s characterized as “among the worst possible treatments” for trauma, merely desensitizing people to their suffering, instead of healing them.

When he finally read the magazine cover story the Times published last May, he was in for a jolt. Instead of the sympathetic, informed portrayal he’d been expecting, it offered, at best, an ambivalent picture of his contributions and a skeptical perspective on the approaches he’s championed through his career. Although it quotes neuropsychologist Stephen Porges describing him as a “hero” for his “courageous” efforts to confront the conventional wisdom about trauma treatment, the article characterizes Van der Kolk as practicing a “hokey-sounding approach to therapy” and “a lead defender of repressed-memory therapy.” It also strongly implies that he’d been an expert witness in court cases involving therapists accused of implanting false memories of early abuse, cases in which “entire lives were destroyed.”

Van der Kolk demanded the Times retract several of the key assertions in the piece, including its critique of his research on yoga therapy and EMDR for the treatment of PTSD as lacking sufficient sample sizes and blind raters. He also vociferously refuted the idea that he had ever been a “defender” of repressed-memory therapy, protesting that he’d merely testified on behalf of sexual-abuse victims of Catholic clergy when the lawyers had tried to discredit the plaintiffs by claiming they suffered from false memories implanted by their therapists. He even threatened to sue. In response, the Times issued a minor correction, stating that the articles they’d been able to review, in fact, met the standards of state-of-the-art scientific research, but implying that other studies may not. Otherwise, it stood by its reporting and refused to take further action. Neither the Times nor the author of the magazine article responded to requests to comment from the Networker.

Several months after the appearance of the Times piece, Van der Kolk himself sounds philosophical about his treatment in the feature. “Trauma evokes a lot of passion,” he says. “Passion to deny, and passion to assert. I see what happened with this article as a reflection of the incredible difficulties society has with staring trauma in the face and providing people with the facts of what happens, how bad it is, and how well treatments work.”

Janina Fisher, clinical psychologist and trauma expert, was struck by how the article emphasized the melodramatic in its portrayal of trauma treatment. “Bessel lends himself to the portrait of the cowboy, but what a shame that that’s how he got portrayed,” she said. “It really doesn’t represent the seriousness, purpose, and accomplishment in the field of trauma, both in his work and the work of others.” Of course, this may not be surprising, given that trauma work has raised more than a few eyebrows over the years with its embrace of clinical innovations that sometimes borders on the bizarre. “When you’re talking about trauma treatment, you’re often talking about asking someone to revisit and think about the event that they're spending all their time avoiding,” says Elena Newman, Research Director of the Dart Center for Journalism and Trauma at Columbia University. “It all sounds a little crazy, right? All treatments for trauma can be hard to understand and need to be broken down.”

The Times didn’t have to go far to find colleagues willing to be critical of Van der Kolk’s work, which indicates something not only about him, but the conflicts and politics of the profession itself. “People who are in this field---the scientists, the clinicians---have had to fight so hard for trauma to be taken seriously that sometimes we fight within ourselves about theoretical differences and minor disagreements,” says Newman. “The passion with which we fight about smaller differences can get amplified in the news.”

The hundreds of responses to the Times about the story demonstrated overwhelming support for Van der Kolk and unhappiness with the tone of the article and inaccuracies in its reporting. While it remains to be seen what, if any, long-term effect the piece will have, Van der Kolk believes it led several speakers to cancel their appearances at his annual conference this year, and cost him a consultation opportunity.

Van der Kolk was not the only person who felt misrepresented by the Times article. The dramatic centerpiece of the piece’s organizing narrative was an Iraqi war veteran named Eugene, who’s haunted by memories of killing an innocent man on security detail, and who Van der Kolk worked with at an Esalen workshop. The article suggests that the positive impact of his work with Van der Kolk, while immediately dramatic, was not sustained and that ultimately he was left more confused than illuminated by the experience. The last line of the article quotes him as saying, “I still have no idea what he did to me.” But Eugene offers a different view of his experience and insists that he was astonished to read details and facts that were simply fabricated. He recalls that when he corrected the Times fact checkers about the numerous details the article got wrong, they told him that there was only so much they could correct---they had a deadline. The Times refused to publish Eugene’s letter to the editor correcting the errors about his experience.

“The takeaway when I read the article was that I was confused by the experience and that it didn't help, which just isn't true,” he says. “When I spoke with the reporter, I said very positive things about the concrete ways that it helped me in terms of physical symptoms that disappeared, and also the fact Dr. Van der Kolk recommended people for me to work with afterward. He really spent some time finding a good recommendation for EMDR, and it really helps.”

Eugene expressed concern that the piece wound up depicting him as more hypnotized by Van der Kolk’s personality than an active participant in the work. “I don’t know where that came from,” he says, adding his concern that the article not only misrepresented him, but did a disservice to vets who need treatment. “Military people are very hesitant to talk about traumatic events,” he says. “It’s not easy to talk about what happened, so there’s a duty that goes along with reporting about them. It goes beyond what makes for good copy in a magazine article."

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Topic: Trauma

Tags: add | Bessel van der Kolk | child trauma | clinical psychologist | complex trauma | desensitization | EFT | emdr | exposure therapy | HEAL | Janina Fisher | neurofeedback | prolonged exposure therapy | psychologist | psychotherapy | PTSD | SPECT | Stephen Porges | TED | therapist | therapists | trauma treatment | traumatic | traumatic stress | treatment of ptsd | yoga | yoga therapy

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Sunday, October 26, 2014 5:35:23 PM | posted by Mark Robinett
I went to a training on Trauma from Bessel Van Der Kolk about 16 years ago in San Francisco and have followed his work ever since. I have just received his new book "The Body Keeps the Score" and it is excellent. I feel very good about his work and contributions to our field. I believe he tells the truth about trauma work - talk therapy very often does not work with trauma and we need stronger tools such as EMDR, Somatic Experiencing, Neurofeedback, Yoga etc. I use EMDR and LENS Neurofeedback see the best results on trauma with EMDR - and when I talk with colleagues who use it they report the same. It sounds like the NY Times got it all wrong and they should correct their errors. We are very fortunate to have Bessel in our field to help us breakout of our illusions that talk therapy is a cure all, as well as other methods that do not help our clients enough. He is pushing the trauma field further and in the process helping a lot of people.

Saturday, October 25, 2014 10:23:44 PM | posted by Paula Susan, Trauma
Francine Shapiro made a huge contribution to the field of psychotherapy. Many of us doing trauma work have reaped the benefits.. Bessel Van Der Kolk is a well-respected pioneer in the field of traumatology. When I heard him speak at a conference, expecting him to diminish the process of EMDR, I was gratified to hear him describe his change of heart as h e watched the results he was getting with it... As a research scientist, she invited validation through continued research. These studies continue to appear in a Journal of EMDR. She cares about the quality of work which carries her reputation.. Some of us have gone on to integrate other approaches, still utilizing her concepts. With 32 years of accumulated knowledge and experience I attribute my transformational work to EMDR.(I was trained in EMDR by Francine Shapiro in 1991.) Perhaps other therapists don't want to give up the idea that it is their skills that are doing the healing. Perhaps other people think it is too mechanistic (I thought that, too). Perhaps other therapists enjoy the long-term relationships with their clients that just talk therapy sustains. Perhaps they like the income flow from that. Whatever their convictions, I am convinced that my integrative approach offers deep healing and wonderful changes in people's self-perception and their approach to life, I use the process in all of my work. My results are clear. I work with deeply damaged human beings, such as the man who systematically raped his wife for twenty years, holding her hostage,and such as people traumatized by their hateful mothers with no protection from their fathers, men raped by other men when they were boys...and I thank God or whatever pushes me to learn as much as I can in the service of my clients, Having seen Bessel van der Kolk on stage, anticipating his diminishing EMDR, I was so excited to hear this brilliant man defending its value. My work is not putting bandaids on deep, oozing sores, and it's not about helping people have insight as to why they hurt so much and why their are unable to sustain intimate relationships. My mandate is to do deep healing as effectively and lovingly respectful as possible and EMDR affords that. I use it in my work with couples where their resentments have created distance. It allows for those memories which trigger reactivity between them, to diminish as those old traumatic wounds dissipate. I am proud to do this work and I am grateful for EMDR.

Friday, October 24, 2014 7:37:49 PM | posted by Careyleah MacLeod
A week spent with Bessel van der Kolk, Peter Levine and Pat Ogden totally revolutionized my practice (this was several years ago). Besides teaching me so much about the visceral response to trauma, I learned much about helping people deal with it. I went on to train in EMDR, and mindfulness-based therapy. I agree that talking about the 'art' of the work we do is very different from talking about the 'science' and can lead to misunderstanding. I'll have to read the NYT article; it sounds as though trauma-treatment in general and van der Kolk in particular got caught in the crossfire of incomplete and erroneous information...

Friday, October 24, 2014 3:55:28 PM | posted by Lisa Sergentanis
I agree with the Times article. Unfortunately, our field, (I'm a clinical social worker) along with psychiatry, adherence to the psychoanalytic/psychodynamic approaches to therapy is one reason we remain the least respected profession. There are over 400 approaches to psychotherapy most not tested and those that are are week, i.e. EMDR. I have a colleague who practices past life regression. I'm disturbed by this especially when we are paid a fee we should be providing nothing less than evidence based approaches.