Does the Body Really "Keep the Score"?
Trauma as a Disorder of Prediction and How Flexibility, Flow, and Connection Restore It
Some time ago, I started my Attachment Insights series, in which I aim to provide examples of the most prevalent discussions surrounding attachment theory and science (and, increasingly, trauma), together with the most accurate and up-to-date explanations.
In my thirty-eighth and most recent post, I would like to have a closer look at a thought-provoking new paper by Kotler, Mannino, Fox and Friston (2026) with the deliberately provocative title “The body does not keep the score: trauma, predictive coding, and the restoration of metastability.” One of its authors is Karl Friston, a leading figure in computational neuroscience and the originator of the free energy principle. Together, the authors revisit one of the most influential ideas in contemporary trauma discourse, Bessel van der Kolk’s The Body Keeps the Score (2014), as part of what they call an “updated reframing”.
I find this an especially valuable contribution because it does what I try to do throughout my Attachment Insights series: it takes a widely embraced idea seriously, acknowledges what is genuinely useful about it, and only then carefully updates the underlying neurobiology in light of current science.
Let’s have a closer look!
Summary
For nearly a decade, the phrase “the body keeps the score” has shaped how the public and many clinicians understand trauma. It is an emotionally compelling metaphor, and it carries some real and important truths. But recent work in computational and systems neuroscience suggests that, taken literally, the image is biologically inaccurate.
The body proper does not store trauma in its tissues. Instead, the brain dynamically re-enacts it through maladaptive prediction. What endures after trauma is not a memory locked in flesh, but a loss of flexibility. A collapse of metastability, the brain’s ability to fluidly switch among semi-stable network states.
In what follows, I first want to honour what van der Kolk and the “body keeps the score” framework get right. Only then will I turn to where the metaphor misleads, and how a predictive, and crucially also a social, account of trauma offers a subtler and, I believe, more hopeful story.
1. First, the Value: What “The Body Keeps the Score” Gets Right
Before challenging anything, it is only fair and scientifically accurate to recognise the genuine contributions of van der Kolk’s work. Kotler et al. (2026) are careful to do so, and so am I.
The book’s central and lasting achievement was to insist that trauma is deeply embodied and not merely “in the head”.
For many trauma survivors whose suffering had been dismissed as imaginary or purely psychological, this was validating and liberating. It brought concepts like interoception (our sense of the body’s internal state) and embodied cognition (a research program that emphasises the role of the body in cognitive processes) into mainstream clinical and public awareness, and it did so with compassion.
The framework also draws substantially on solid neuroscience. It discusses the dynamic interplay between neural networks and Antonio Damasio’s Somatic Marker Hypothesis (the well-supported idea that emotions are fundamentally tied to bodily states). And it rightly emphasises that traumatic memory is qualitatively different from ordinary memory, and that such memories can re-emerge after years of not being remembered.
In short, van der Kolk was right that the body is central to the traumatic process, that somatic states do matter, and that trauma cannot be reduced to a purely “cognitive” problem to be reasoned away. These insights remain valuable and should not be discarded.
The disagreement, as we will see, is not about whether the body matters, but about how and where trauma actually “resides”.
2. From Storage to Prediction: Where the Metaphor Misleads
The difficulty lies in the most memorable reading of the book: the notion that trauma “lives in the body” in a nearly literal sense. Inscribed in muscle, fascia, or other tissue apart from the brain’s neural innervation. This is a reading the metaphor strongly invites, even where the text itself is more careful.
To see why this is problematic, we need one central idea from modern neuroscience: our brain does not passively record the world, it actively predicts it.
According to the predictive coding and active inference framework (Friston, 2010), perception is not a camera faithfully registering reality. Instead, the brain is constantly generating predictions about the causes of its sensations and updating them only when prediction errors arise. Making sense of the world, and of our own bodies, is a process of continuous (Bayesian) belief updating that minimises “surprise”.
From this vantage point, trauma is not a thing that gets deposited somewhere. It is a disorder of prediction, not of storage. The body participates fully in trauma, but as a messenger relaying the brain’s current predictions, not as an archive holding the past.
This is not a merely semantic quibble. As I have discussed elsewhere in relation to the Polyvagal Theory and the idea of “Getting stuck in certain brain or nervous system states”, where we locate a problem strongly shapes how we try to solve it.
3. Trauma as Over-Weighted Danger Priors
So what actually “goes wrong” after trauma? In computational terms, trauma over-weights the precision of danger priors. “Precision” here simply means confidence: the brain assigns excessive certainty to its threat predictions, and then constrains all subsequent inference on the premise of enduring danger.
Kotler et al. offer an elegant image for this. Picture belief as a landscape with hills and valleys (i.e., a free energy landscape) where every possible interpretation of the world has an elevation reflecting its (im)plausibility. A healthy mind moves fluidly across this terrain. Trauma, by contrast, carves out a deep, steep-sided ravine: a local minimum that becomes so precisely and rigidly engrained that one can no longer climb out of it.
Hypervigilance, flashbacks, and avoidance are then best understood not as fragments of stored experience resurfacing, but as the symptoms of a system trapped in self-confirming predictions.
Functional imaging is consistent with this picture. The dominant neuroimaging finding in PTSD is a dissociation between amygdala hyperactivation (i.e., heightened threat detection as part of the larger salience network) and medial prefrontal hypoactivation (i.e., weakened top-down regulation as part of the larger executive functioning network), with less prefrontal engagement associated with more severe symptoms (Shin et al., 2006). The net effect is a reduction in the brain’s dynamic repertoire: connectivity shifts toward defensive configurations, and the capacity for flexible reconfiguration is diminished.
4. The “Score” as Circular Inference
If trauma is not stored in the body, why does it feel so bodily? Why the racing heart, the tight chest, the sense that the body itself remembers?
The answer lies in a mechanism called sensory attenuation. Normally, the brain can resolve prediction errors not only by acting or by updating its internal model, but also by simply assigning less precision to certain signals (i.e., dampening down bodily sensations it deems predictable or irrelevant). In trauma, this capacity to attenuate is reduced, and internal signals are mis-weighted.
Unattenuated interoceptive signals (e.g., a pounding heart, a clenched stomach) are then interpreted as confirmation of danger rather than as imprecise noise. The result is a vicious loop of circular inference: the brain predicts pain, senses arousal, and takes that arousal as proof that the pain persists.
This is the real origin of the “score” the body appears to keep. It is not an inscription in tissue but an artefact of a self-reinforcing inferential loop.
Damasio’s own work makes the same point at the level of neural architecture. His convergence–divergence zones (CDZs) are neural hubs that store the parameters for a memory and its associated emotion and then coordinate the flexible, context-dependent reactivation of those patterns. They do not encode raw sensory activations “in the body”.
In PTSD, one can hypothesise that CDZs become overly primed to a wide range of cues, so that even a distantly related trigger (e.g., the classic example of a car backfiring) can unleash the full cascade of a flashback. Emotions and their bodily correlates are, in this view, modifiable and adaptive, without any need for hidden storage in non-innervated tissue.
5. The Real Casualty: A Loss of Metastability
We can now name what trauma actually erodes. A healthy brain is metastable: its networks continually integrate and segregate, assembling into transient coalitions and dissolving again, allowing the system to explore multiple interpretations of the world. Hellyer and colleagues (2015) showed that this metastability is a hallmark of cognitive flexibility, and that its reduction is associated with impaired information processing.
Trauma erodes precisely this fluidity. It traps the brain in narrow basins of fear and defensive salience, collapsing the graceful movement across a landscape of beliefs, commitments and intentions that characterises mental health.
Seen this way, restoring wellbeing is not about “releasing” stored emotion but about re-establishing dynamic equilibrium, expanding the brain’s repertoire of viable states. Health, in a single word, equals flexibility.
6. Why Most People Recover: Resilience Favours the Inference Model
One of the most compelling pieces of indirect evidence comes from resilience research. Across large longitudinal cohorts, George Bonanno and colleagues have repeatedly shown that the majority of trauma-exposed individuals do not develop chronic PTSD (Bonanno, 2004). A systematic review of 54 studies furthermore identified a resilient trajectory in roughly 65.7% of cases across populations (Bonanno et al., 2015). Most people, in other words, adapt.
To be clear, this does not logically disprove a storage account. A storage model could, in principle, accommodate individual differences in vulnerability. But the sheer prevalence of spontaneous recovery is much more parsimoniously explained by an inference model.
Under typical conditions, the brain simply rebalances its own predictive architecture, restoring metastability and flexibility without any therapeutic intervention. Pathology arises not from the permanence of what was stored, but from the failure of that recalibration process.
This resonates strongly with a theme I return to again and again in my Attachment Insights series: insecure attachment patterns and post-traumatic responses are, in the first instance, meaningful, adaptive and often necessary reactions to overwhelming circumstances, and resilience is the norm rather than the exception (see also the integrative definition of attachment trauma by Zagaria et al., 2024, in my Attachment Insights post #26 “What is Attachment Trauma? A New Integrative Definition”). Reframing trauma this way guards against pathologising what is, for most people, a recoverable disruption.
7. Restoring Flexibility: Flow, Cognitive Control and Co-Regulation
If flexibility is what trauma steals, how do we give it back? Kotler et al. propose a fascinating candidate: flow states. The experience of complete absorption in a meaningful, high-challenge activity.
During flow, the brain appears to undergo transient, localised quieting of self-referential processing alongside rapid, adaptive reconfiguration of sensory-motor and attentional networks. Theoretical models predict surges in neuromodulators such as dopamine, norepinephrine and anandamide (Kotler et al., 2022), and a shift from avoidance to approach dynamics that converts arousal into focused action rather than defensive freezing.
In this sense, trauma and flow can be seen as divergent responses to the same physiological stress signal. One collapses movement, the other restores it. Early clinical signals are encouraging: in a randomised controlled trial, surf and hike therapy both improved depression in active-duty service members, with some advantage for surfing at follow-up (Walter et al., 2023); though, as the authors honestly note, generic factors like exercise, nature and social connection are hard to disentangle here.
This is a genuinely useful reframing, and it dovetails with evidence that training cognitive control (e.g., through mindfulness, working-memory practice, or executive-function exercises) reduces intrusive symptoms (Bomyea & Amir, 2011). The unifying idea is that many diverse therapies work not through any specific content, but by restoring flexible coupling between large-scale networks.
Here, though, I would like to add a dimension that the paper (understandably focused on individual dynamics) leaves largely implicit. The most fundamental route to restoring predictive flexibility is not solitary. It is social.
Recent work reframes the brain’s primary job as allostasis: the predictive regulation of the body’s energy budget (Theriault et al., 2025). And because all prediction and regulation are metabolically costly, our brains evolved to share those costs with others.
This is the core insight of Social Baseline Theory (Coan & Sbarra, 2015): the human brain treats the presence of trusted others as its expected baseline condition, using risk distribution and load sharing to conserve metabolic resources. Through social allostasis, a reliable companion literally does some of our predictive and regulatory work for us (see, e.g., Saxbe et al., 2020). This is also why, as I discussed in my Substack post on the “Bioenergetic Map of Social Connection”, a hill looks less steep when a good friend stands beside us.
From an attachment perspective, this matters enormously for trauma. Secure attachment is, in predictive-processing terms, an internal working model that others are reliably available for co-regulation (White, Kungl & Vrticka, 2023). Such a model provides exactly the bioenergetic safety a traumatised brain needs in order to loosen its over-precise danger priors, re-open its dynamic repertoire, and re-learn that arousal and safety can coexist.
Indeed, an active-inference account of allostasis (co-authored by Friston himself) links precisely these predictive-regulatory mechanisms to distinct resilience phenotypes (Harrison et al., 2025), building a direct bridge between the paper’s framework and the social neuroscience of connection (see my Substack post on the “Bioenergetic Map of Social Connection”).
In other words: flow restores metastability from the inside, through challenge and absorption. Secure co-regulation restores it from the outside, by lending us social resources to help carry the predictive and allostatic load. Tellingly, the flow-inducing activities in the surf-and-hike trial were also deeply relational and communal. A reminder that these two routes are not rivals but partners.
8. Why This Reframing Matters
Where does all of this leave us? Not, I want to stress, with any diminishment of how much trauma hurts. Framing trauma dynamically does not make the suffering less real. But it grounds that suffering in neurobiological mechanisms that can actually be addressed.
The practical shift is from a language of “excavation” to one of “exploration”. If trauma were buried injury, healing would mean finding and purging what was stored. If trauma is instead frozen inference, healing means introducing variability, recalibrating precision, and expanding the brain’s capacity for adaptive flexibility. Often, and most efficiently, in the company of trusted others.
This is also why expression, catharsis, or “somatic release” can genuinely help: not because they discharge buried energy, but because they introduce novel sensorimotor feedback that loosens a rigid model.
This perspective also dissolves a long-standing puzzle: why so many different treatments (e.g., exposure therapy, EMDR, mindfulness, exercise, psychedelics, secure relationships, flow-inducing pursuits) can all succeed. Each, in its own way, restores flexible coupling between networks and rebalances an over-confident predictive system. And it guards against a subtle harm in the literal “storage” reading: the risk of convincing people that their bodies are indelibly marked, when in fact most brains retain the very capacity for metastable inference that recovery requires.
If the old story was that “the body keeps the score”, the emerging narrative is subtler and more hopeful. The body does not keep the score; the brain keeps predicting it. When prediction becomes too rigid, experience repeats. Not because it is stored, but because it cannot yet be reinterpreted.
The above said, it’s time for an honest limitation, as I must add the same caution the authors themselves raise. The specific claim that PTSD involves reduced metastability has not yet been directly tested using established metastability metrics in PTSD populations. The Hellyer et al. (2015) findings concern traumatic brain injury (i.e., a neurologically distinct condition) and structural connectome damage should not be conflated with the functional dysregulation of PTSD. This framework is therefore best understood as a compelling, testable prediction rather than an established fact (Hancock et al., 2025). Future work should quantify metastability (i.e., signal variability, entropy, network switching) as a clinical biomarker before and after intervention.
And finally, a short take home message. Healing, in the end, is not the erasure of what happened, but the return of movement: within the mind, within its underlying brain networks, within our actions. And, I would add, within our secure relationships. Because for a fundamentally social species, the safest and most efficient place to rediscover flexibility is rarely alone.
Scientific References
Bomyea, J., & Amir, N. (2011). The effect of an executive functioning training program on working memory capacity and intrusive thoughts. Cognitive Therapy and Research, 35(6), 529–535. https://doi.org/10.1007/s10608-011-9369-8
Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59(1), 20–28. https://doi.org/10.1037/0003-066X.59.1.20
Bonanno, G. A., Romero, S. A., & Klein, S. I. (2015). The temporal elements of psychological resilience: An integrative framework for the study of individuals, families, and communities. Psychological Inquiry, 26(2), 139–169. https://doi.org/10.1080/1047840X.2015.992677
Coan, J. A., & Sbarra, D. A. (2015). Social Baseline Theory: The social regulation of risk and effort. Current Opinion in Psychology, 1, 87–91. https://doi.org/10.1016/j.copsyc.2014.12.021
Damasio, A. R. (1994). Descartes' error: Emotion, reason, and the human brain. G. P. Putnam's Sons
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Walter, K. H., Otis, N. P., Glassman, L. H., Ray, T. N., Michalewicz-Kragh, B., & Thomsen, C. J. (2023). A randomized controlled trial of surf and hike therapy for U.S. active duty service members with major depressive disorder. BMC Psychiatry, 23, 119. https://doi.org/10.1186/s12888-022-04452-7
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Zagaria, A., Fiori, F., Vacca, M., Lombardo, C., Pariante, C. M., & Ballesio, A. (2024). Toward a definition of attachment trauma: Integrating attachment and trauma studies. European Journal of Trauma & Dissociation, 8(3), Article 100416. https://doi.org/10.1016/j.ejtd.2024.100416
Genuinely the most meaningful read I’ve had in a long time. Thank you