Skip to main content

Chapters 1 & 2

 I started reading The Body Keeps the Score on a little puddle jumper flight from Glendive, MT to Billings, MT and I could not put this book down. Van Der Kolk starts by detailing his experience working with veterans from the Vietnam war. The story of Tom was very eye openings as he filled the reader in on Tom's day to day life experience and the trauma that he endured long past the end of the war. While I have no experience working with veterans, I was intrigued by Tom's story and I wanted to know more - more about him, his wife, his kids, and his law practice. One specific section in chapter 1 that stood out to me came from page 13 in which Van Der Kolk stated, "Trauma, whether it is the result of something done to you or something you yourself have done, almost always makes it difficult to engage in intimate relationships. After you have experiences something so unspeakable, how do you learn to trust yourself or anyone else again"? Man - that hit home for me. On my current caseload, I have various representations of trauma from physical abuse, removal from home or from a parent, and an attempted suicide. My sweet five-year-old client who has disclosed how mom's boyfriend is mean and hits her goes through phases of aggression, cussing, spitting, and hitting me. However, at the end of our time together she pleads me with to let her stay- specifically under my desk where no one can get her. When I or others in the office praise her for positive behavior, she turns and quickly becomes defensive reverting back to negative behavior and will attempt to push us away. She will let us in, but then just as soon will second guess herself and withdraw. My 18-year-old client who is still recovering from a failed attempt in November will regularly come to my office and sit down to visit. He will share about his past, and share about his future goals, and yet there is still a strong wall in between us and I think he questions me - Can I trust her? Will she be there for me? Just last week he asked, " how long do you think you will be here for...I can't keep losing people and I don't want to get close if you decide I'm too much and you leave". I did my best to assure him that at this time I wasn't going anywhere. 

The topic discussion of medication and Medicaid is something that really stood out to me in chapter 2. While there was much more to chapter two, I was drawn to this discussion as I thought about the families I work with daily. This section of the book was frustrating, and I have a lot of questions as to why - why as Van Der Kolk states, " children from low-incomes families are four times as likely as privately insured children to receive antipsychotic medicines. These medications often are used to make abused and neglected children more tractable" (pg. 37). What? Did that anger anyone else? I was angered more as I read that " 19,045 children age five and under were prescribed antipsychotics through Medicaid" (p. 37). As I read through that again and again, the faces of my clients continued to pop up in my head and they are SO much more than the behaviors they present and the medication they are prescribed. Is an antipsychotic worth the interference of lack of motivation, play and curiosity? 

 


Comments

  1. freebirdJanuary 26, 2021 at 11:34 AM

    For part of my job now, any child that is in an out of home placement and is on psychotropic medications has to be tracked. So every month I have to ask certain questions to those children to ensure that the medications are taken appropriately and if they are working for that child. It is sad to read that so many children on Medicaid are on psychotropic medications. It is society and agencies attempting to get control over the children instead of getting to the root of the trauma that these children and families have to go through. I also love this book and want to know more about Van Der Kolk. I can't wait until we keep reading.

    ReplyDelete
  2. Tanya TrimbleJanuary 27, 2021 at 4:32 PM

    Something to keep in mind with the insurance part is that Medicaid (though you would not think) it is able to prove more of the medications and families are able to get the covered medication easier for the child. Part of that is do to the behavior and wanting to get a quick fix. I have noticed with private insurance there seems to be more hoops to jump through, it costs more and there is fee to the person that has to be covered it is usually not all covered. I think therapy costs in general not covered by insurance creates a barrier to private insured children that need the medication.

    ReplyDelete
  3. Tara BoerFebruary 17, 2021 at 10:54 AM

    Yes the medication component of treatment is certainly difficult to grasp and work with. One could also wonder if everyone would be that heavily medicated if they had access to free medication (as children do when on medicaid). I'm glad you're able to apply the themes of the book and content to your work experiences--this is where good learning takes place!

    ReplyDelete

Post a Comment

Popular posts from this blog

Chapters 19 & 20

 Van Der Kolks discussion and research on neuroscience was incredibly interesting, but I must admit that I got lost throughout this chapter. The medical abbreviations, methods, and research frequently went above my head. I did find his discussion on sleep at the beginning of this chapter more understandable and how even when we sleep, our internal communication is still wide awake. I wondered how those patients felt about having to wake up post REM sleep and if being startled could have changed any remembrance of the dream. While I understand that they knew about the research and therefore knew they would be awakened, I still wonder if it was shocking to suddenly be pulled from your sleep - especially if the dream that had occurred was pleasant. The entire concept of the brain and what it tells us is amazing to me. From discoveries like epilepsy and other mental activities to understanding how EEG patterns can be a biomarker for ADHD.  To sum up this section, Van Der Kolk stat...
2 comments
Read more

Chapters 9 & 10

       These chapters, yet again, have reinforced why the work we do is important. Page 138 stated, " such patients typically receive five or six different unrelated diagnoses in the course of their psychiatric treatment" and page 139 further expands by stating that " none of these diagnoses will be completely off the mark, and none of them will begin to meaningfully describe who these patients are and what they suffer from". Children with a mental diagnosis are much more than a statistic.      I both enjoyed reading about and was taken aback by the formation of the DSM and how that diagnostical instrument came into 'power'. How what once was used for insurance companies is now the means of creating a lifelong label on someone. The stigma of having a diagnosis is something that one may carry with them all through life - from childhood to adulthood. Some may even identify as their diagnoses as the book describes a patient describing themselves as bipola...
2 comments
Read more

Chapters 11 & 12

     These chapters were heavy as they discussed components of sexual abuse and trauma, particularly how it can affect memory. The story of Julian is something that I can't imagine going through - the idea of hearing about a story and having startling memories of the same thing happening to you must be hard. Even harder yet, trying to have an intimate moment with a girlfriend and suddenly experiencing a flashback must also be hard as feelings of shame, fear, or even guilt may begin to creep in. Later in the chapter, Van Der Kolk states that due to traumatic experiences, narratives are not always organized in a coherent way.      I did find it interesting to read about memories and just how greatly trauma can affect those memories - both good and bad. Van Der Kolk states, "whether we remember a particular event at all, and how accurate our memories of it are, largely depends on how personally meaningful it was and how emotional we felt about it at the...
3 comments
Read more