"The body keeps the score." Bessel van der Kolk's phrase has entered the cultural lexicon, but behind the memorable tagline lies decades of neuroscience, trauma research, and somatic therapy that reveal exactly how the body keeps the score — and why that matters for anyone who has ever experienced chronic stress, emotional overwhelm, or trauma.
Stress doesn't just happen in your mind. It happens in your muscles, your fascia, your viscera, your nervous system, and your immune system. And when stress becomes chronic or overwhelming, it doesn't just pass through the body — it takes up residence there, creating patterns of tension, restriction, and physiological dysregulation that persist long after the stressor is gone.
Understanding the science of somatic stress storage is essential to understanding why talk therapy alone isn't always enough — and why body-based approaches are increasingly recognized as necessary for complete healing.
The Stress Response: From Acute to Chronic
When you encounter a stressor — a near-miss on the highway, a confrontation at work, a startling noise — your hypothalamic-pituitary-adrenal (HPA) axis activates within milliseconds. The hypothalamus signals the pituitary gland, which signals the adrenal glands to release cortisol and adrenaline. Simultaneously, the sympathetic nervous system fires, producing the classic fight-or-flight response: elevated heart rate, rapid breathing, muscle tension, pupil dilation, and redirected blood flow from the digestive organs to the skeletal muscles.
In an acute stress response, this system activates, you respond to the threat, and the system deactivates. Cortisol levels return to baseline. Heart rate normalizes. Muscles relax. The parasympathetic nervous system re-engages, restoring rest-and-digest function. This is healthy stress physiology — a response that mobilizes resources and then resolves.
But when stress is chronic — sustained work pressure, ongoing relationship conflict, financial insecurity, or the cumulative weight of unresolved trauma — the HPA axis never fully deactivates. Cortisol remains elevated. Sympathetic tone stays high. And the body begins to adapt to a state of persistent mobilization, developing structural and physiological patterns that become self-reinforcing.
Muscle Armoring: Wilhelm Reich's Prophetic Insight
In the 1930s, psychoanalyst Wilhelm Reich observed a pattern in his patients that Freud had noticed but never fully explored: chronic muscular tension that corresponded to specific psychological defenses. Reich called this phenomenon "character armor" or "muscular armoring."
Reich proposed that when emotions are chronically suppressed — when rage can't be expressed, grief can't be released, fear can't be fled — the muscles that would execute those responses remain in a state of partial contraction. Over time, this chronic tension becomes structural: the muscles shorten, the fascia thickens, and the body adopts postural patterns that physically embody the suppressed emotion.
Reich identified seven segments of armoring, from the eyes to the pelvis:
- Ocular segment: Frozen forehead, restricted eye movement — associated with fear and hypervigilance
- Oral segment: Jaw clenching, compressed lips — associated with suppressed anger and grief
- Cervical segment: Neck tension, throat constriction — associated with blocked expression ("swallowing" words or emotions)
- Thoracic segment: Chest tightness, restricted breathing — associated with grief, heartbreak, and emotional guarding
- Diaphragmatic segment: Restricted diaphragm, shallow breathing — associated with anxiety and fear
- Abdominal segment: Core tension, gut holding — associated with vulnerability and control
- Pelvic segment: Pelvic floor tension, hip restriction — associated with sexual suppression and deep survival responses
While Reich's specific claims about "orgone energy" have been discredited, his core observation about muscular armoring has been validated by modern neuroscience. Chronic stress does produce persistent muscular tension patterns, and those patterns do correspond to emotional states and defensive strategies.
Key Insight
Wilhelm Reich's concept of "muscular armoring" — chronic tension that embodies suppressed emotions — has been validated by modern neuroscience. The body doesn't just express stress through tension; it stores stress patterns as structural changes in muscles and fascia.
The Psoas and Fight-or-Flight
The psoas major — a deep core muscle that connects the lumbar spine to the femur — has received particular attention in somatic therapy as a primary site of stress storage. The psoas is the body's primary hip flexor and is directly activated during the fight-or-flight response: flexing the hip to run, or curling the body into a protective fetal position.
When the fight-or-flight response activates but the action is never completed — you can't run from a stressful meeting, you can't physically fight an abusive boss — the psoas contracts but never releases. Over time, this chronic contraction can produce lower back pain, hip restriction, shallow breathing (the psoas shares fascial connections with the diaphragm), and a persistent sense of anxiety or readiness for threat.
Liz Koch, author of The Psoas Book, has described the psoas as a "muscle of the soul" — the site where fight-or-flight energy is stored when it can't be discharged. While the metaphorical language can be misleading, the physiological reality is clear: the psoas is directly innervated by the lumbar plexus, responds to sympathetic activation, and can maintain chronic contraction patterns that reflect unresolved stress responses.
Fascia as Stress Storage
The fascial system's role in stress storage extends beyond simple muscular tension. Research by Robert Schleip has demonstrated that fascia contains smooth muscle cells called myofibroblasts that contract independently of skeletal muscle — and they do so in response to sympathetic nervous system activation.
This means stress doesn't just tighten your muscles. It tightens your fascia — the continuous web of connective tissue that surrounds and penetrates every structure in the body. And because fascia is continuous (not segmental like muscles), fascial tension can propagate throughout the body, creating patterns of restriction that connect seemingly unrelated areas.
Fascia also has a property called thixotropy — it becomes more gel-like (viscous) with immobility and more fluid (sol-like) with movement. Chronic stress promotes both fascial contraction and immobility, creating a double mechanism for tissue stiffening. The result is fascia that becomes denser, less hydrated, and more restricted — physically encoding the stress pattern into the body's connective tissue architecture.
The ACE Studies: Childhood Stress and Lifelong Body Burden
The Adverse Childhood Experiences (ACE) studies, initiated by Vincent Felitti and Robert Anda in the 1990s at Kaiser Permanente, revealed a dose-response relationship between childhood adversity and adult disease. Children who experienced abuse, neglect, household dysfunction, or parental incarceration showed dramatically increased rates of heart disease, cancer, autoimmune disorders, chronic pain, depression, and substance abuse decades later.
The mechanism is somatic. Children exposed to chronic adversity develop a chronically activated HPA axis and sympathetic nervous system. Their cortisol rhythms become dysregulated — either chronically elevated or blunted (a sign of HPA axis exhaustion). Their inflammatory markers remain elevated. Their vagal tone is diminished. Their bodies develop in a state of perpetual stress mobilization that becomes their physiological baseline.
This means the body doesn't just "remember" childhood stress — it is physically shaped by it. The musculoskeletal system develops around chronic tension patterns. The nervous system calibrates to a threat-laden baseline. The immune system operates in a state of chronic low-grade inflammation. The stress isn't stored as a memory. It's stored as a body.
"Traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing awareness of what is played out inside." — Bessel van der Kolk, MD
Van der Kolk and the Neuroscience of Trauma Storage
Bessel van der Kolk's research at the Trauma Center at Brookline has provided the most comprehensive neuroscientific framework for understanding how trauma lives in the body. His key findings include:
- Traumatic memories are stored somatically: Unlike narrative memories (processed in the hippocampus and prefrontal cortex), traumatic memories are often stored as sensory fragments — body sensations, emotional states, and motor impulses — encoded in the amygdala, brainstem, and body without verbal narrative. This is why trauma survivors can re-experience the body sensations of a traumatic event without consciously remembering what happened.
- The body's alarm system becomes miscalibrated: After trauma, the amygdala becomes hypersensitive, triggering fight-flight-freeze responses to stimuli that resemble — even remotely — the original traumatic event. These triggers are often sensory (a smell, a sound, a body position) rather than cognitive.
- Dissociation disconnects mind from body: In severe trauma, the brain may disconnect awareness from body sensation as a protective mechanism. This dissociation can become chronic, producing a persistent sense of numbness, unreality, or disconnection from the body. fMRI studies show that dissociated individuals have reduced insular cortex activity — their brain is literally dampening interoceptive signals.
TRE and Somatic Release
Trauma Release Exercises (TRE), developed by David Berceli, are based on the observation that animals discharge stress through involuntary tremoring — the shaking that a gazelle exhibits after escaping a predator, or the trembling that follows a near-death experience. Berceli proposed that humans have the same neurogenic tremor mechanism but suppress it due to social conditioning.
TRE uses a series of exercises that fatigue the psoas and core muscles, inducing involuntary neurogenic tremors that originate deep in the body and propagate outward. The theory is that these tremors discharge stored muscular and fascial tension patterns associated with chronic stress and trauma.
While peer-reviewed research on TRE is still limited, preliminary studies have shown reductions in PTSD symptoms, anxiety, and chronic pain in military veterans and earthquake survivors. The mechanism appears to involve parasympathetic activation and motor pattern discharge — the body completing stress responses that were initiated but never resolved.
Why Talk Therapy Alone Isn't Enough
The somatic storage of stress has direct implications for treatment. If traumatic memories and chronic stress patterns are encoded in the amygdala, brainstem, and body — rather than in the narrative, language-based networks of the prefrontal cortex — then interventions that work exclusively through language and cognition (traditional talk therapy, CBT) may have limited access to the somatic substrate of the problem.
This is not to dismiss talk therapy — cognitive processing is essential for making sense of experience and developing new behavioral strategies. But the neuroscience suggests that effective treatment of chronic stress and trauma requires also addressing the body:
- EMDR (Eye Movement Desensitization and Reprocessing): Combines bilateral sensory stimulation with trauma recall, appearing to help integrate fragmented traumatic memories from somatic storage into narrative memory
- Somatic Experiencing (Peter Levine): Focuses on completing interrupted fight-or-flight responses by tracking body sensations and allowing the body to discharge stored survival energy
- Yoga: Van der Kolk's research has shown that trauma-sensitive yoga reduces PTSD symptoms and improves interoceptive awareness, allowing trauma survivors to re-establish a safe relationship with their body
- Breathwork: Conscious breathing directly modulates vagal tone, amygdala activity, and autonomic balance — addressing the physiological dysregulation that underlies somatic stress storage
- Myofascial release and bodywork: Manual therapy that addresses fascial restrictions can release chronic tension patterns that cognitive approaches cannot reach
Key Insight
Stress and trauma are stored in the body through muscular tension, fascial restriction, nervous system dysregulation, and somatic memory — not in cognitive or narrative brain regions. Effective treatment requires body-based approaches alongside talk therapy.
The Path Forward
The science of somatic stress storage tells us something both unsettling and empowering: your body carries the history of everything you've experienced — not as metaphor, but as physiology. Every unresolved stress response, every suppressed emotion, every traumatic event that was too overwhelming to process has left its mark in your muscles, your fascia, your nervous system, and your immune function.
But the same mechanisms that encode stress can also release it. The body's neuroplasticity extends to its stress patterns. Fascial tissue can be remodeled. Muscular armoring can be dissolved. Vagal tone can be restored. Interoceptive awareness can be rebuilt. The body keeps the score — but the score can be rewritten, through movement, breath, awareness, and the patient work of learning to inhabit your body again.
Key Takeaway
Stress and trauma are physically encoded in muscles, fascia, and the nervous system through muscular armoring, fascial contraction, HPA axis dysregulation, and somatic memory. The body keeps the score — but through somatic movement, breathwork, bodywork, and body-based therapies, the score can be rewritten.