The Body Does Not Keep the Score, So Why Does the Body Still Matter?

Abby standing in Athena pose from Hypopressives Level 1

What a new trauma paper could teach us about Hypopressives, TRE® and the nervous system

I read a really interesting study this week that came out very recently and it shed new light on our interpretation of the now popular phrases that many of us have used like the body stores trauma or the body keeps the score, a phrase introduced in some part to popular culture through the book 0f the same title by Bessel van der Kolk.

And I understand why we originally hooked onto them.

For so many people, that language has offered relief. It has given words to something they already knew in their bones. That stress is not just a thought. Trauma is not just a memory. Overwhelm is not just “in your head”.

It can feel like a jaw that never softens.
A rib cage that barely moves.
A pelvic floor that grips when you do not even realise you are holding.
A bladder that panics before it is full.
A back that braces before you lift, bend, run or even breathe.
A body that feels as though it is constantly preparing for something.

So when people heard the phrase the body keeps the score, it actually made sense.

It helped explain why the past can show up physically. Why something that happened months, years or even decades ago can still seem to echo through breath, posture, pain, tension, digestion, pelvic floor symptoms and the nervous system.

But it has also been criticised by some in the scientific and trauma-informed communities. Critics have argued that the book and the wider “body keeps the score” conversation can overreach around neuroplasticity and polyvagal theory, while sometimes underplaying resilience, structural factors such as racism and poverty, intersectionality, and the fact that trauma does not affect every person in the same way. We will come back to some of this in more depth a little later.

But a recent neuroscience paper has offered a more precise, and perhaps a more hopeful, reframe.

The paper is called The body does not keep the score: trauma, predictive coding, and the restoration of metastability. It was published in Frontiers in Systems Neuroscience in 2026, and its central argument creates a useful pivot: trauma may not be literally stored in the body like a file in a cabinet. Instead, trauma may be better understood as a problem of prediction. The authors summarise this beautifully: “The body does not keep the score; the brain keeps predicting it.”

And I think this matters.

We do not need to suddenly dismiss the body and focus only on the brain. People are definitely not imagining their symptoms, and the work we do around embodiment has not suddenly become irrelevant.

But this new approach may help us speak about the body in a way that is more accurate, less frightening and more full of possibility.

The body is not a storage cupboard

When we say trauma is “stored in the body”, it can be helpful at first.

It validates people who feel their experiences physically. It acknowledges that our bodies adapt to stress, shock, pain, grief, fear and chronic overwhelm.

But the phrase can also become heavy.

It can make people feel as though their body is carrying a permanent record. As though trauma is trapped inside the tissues waiting to be dug out. As though healing means finding every hidden pocket of pain and forcing it to release.

And that can become frightening, especially for people who already feel unsafe in their bodies.

The newer predictive coding model gives us a slightly different lens.

It says the body is not necessarily holding the past like a locked box.

Instead, the brain and nervous system are constantly using past experience to predict what might happen next.

That is what brains do. They are prediction machines. They are always asking:

Is this safe?
Is this familiar?
Have we been here before?
Do I need to protect you?
What is the most likely thing to happen next?

Most of the time, this is incredibly useful. It helps us move through the world without having to consciously analyse every single sensation, sound, movement or breath.

But after trauma, chronic stress, pain, surgery, birth injury, medical trauma, pelvic floor symptoms or long-term nervous system overload, those predictions can become less flexible.

The system can begin to predict danger even when danger is not present.

And when the brain predicts threat, the body prepares in the all to familiar patterns.

The jaw tightens.
The breath becomes shallow.
The pelvic floor grips.
The shoulders lift.
The belly braces.
The hips protect.
The bladder becomes more urgent.
The nervous system becomes less able to settle.

So the body is absolutely involved.

But perhaps not because it is storing a score.

Perhaps because it is participating in a prediction loop.

Why this is actually hopeful

This is the part I find exciting.

If trauma is not a fixed score written into the tissues, then the body is not broken.

If the nervous system is predicting danger, then healing may involve helping the system update its predictions.

That is a very different feeling.

Instead of asking, “Where is the trauma stored and how do I get it out?”
We might ask, “What is my system predicting, and what new experience could help it feel safe enough to change?”

That is much gentler, and less forceful.

It respects the body without making the body the villain.

It also fits beautifully with the way I work with Hypopressives, TRE®, breath, posture, release work and pelvic floor symptoms.

Because so much of this work is not about forcing the body into a new shape.

It is about giving the brain-body system new information.

A slower breath.
A different rib movement.
A tremor that starts and stops safely.
A pelvic floor that does not have to grip to protect you.
A spine that can move without bracing.
A body that can feel sensation without interpreting it as danger.

Tiny experiences, repeated gently, can begin to change the map.

Why “The Body Keeps the Score” Is Not Quite Enough

The phrase the body keeps the score has been incredibly helpful for many people.

It gave language to something so many trauma survivors already knew: that trauma does not only live in the mind. It can show up in breath, posture, pain, digestion, pelvic floor symptoms, jaw tension, hypervigilance, exhaustion, shame and the feeling that the body is always preparing for something.

But I think we have to be careful.

Because trauma is not a neat, one-size-fits-all experience.

A global crisis, birth trauma, assault, racism, poverty, medical trauma, domestic abuse or police brutality may all affect the nervous system, but they do not land in every body in the same way. The body may respond, but the body is not separate from the world it lives in.

An immigrant woman experiencing domestic abuse, for example, may not only be dealing with fear inside her body. She may also be facing legal uncertainty, language barriers, financial dependence, racism, isolation, fear of authorities, child contact issues, housing insecurity and cultural pressure. Research into trauma-informed care for forced migrant women highlights how gender-based violence, abuse and patriarchal structures can shape women’s experience and access to support.

So when we say “the body keeps the score”, we risk making trauma sound too individual.

As if the whole story is happening inside one person’s muscles, fascia, brain or nervous system.

But often, the “score” is not just personal.

It is relational.
It is social.
It is cultural.
It is systemic.
It is historical.

This is where the newer paper The body does not keep the score: trauma, predictive coding, and the restoration of metastability becomes interesting. It argues that trauma is better understood through prediction rather than storage. In other words, the body is not simply an archive where trauma is kept; the brain-body system continues to predict danger based on what has been learned. The authors write that “the body participates in trauma, but as messenger, not archive.”

That distinction is super important.

Because if trauma is only framed as something “stored in the body”, we can accidentally place the burden of healing entirely on the individual.

Breathe better.
Move better.
Release more.
Shake it out.
Regulate yourself.
Heal your nervous system.

And while those tools can be powerful, they are not the whole picture.

A nervous system cannot fully settle if someone is still unsafe.
A body cannot simply “release” its way out of poverty.
A pelvic floor cannot relax if the person is living in ongoing fear.
A breath practice cannot undo systemic oppression.
A TRE® session cannot replace housing, justice, community, protection or belonging.

This does not mean body-based work is irrelevant. Far from it.

It means body-based work needs to be honest.

The body may not hold trauma like a storage cupboard, but it does carry the effects of living in a world that may or may not have been safe. It carries patterns of protection. It carries learned predictions. It carries the way a person has had to survive.

So effective trauma-informed work cannot just ask, “What is happening in this body?”

It also needs to ask:

What has this person had to adapt to?
What systems have shaped their safety?
What choices were available to them?
What support was missing?
What identities made them more vulnerable?
What communities helped them survive?
What strengths have they built because of what they have lived through?

That is a much more valuable and respectful conversation. And is exactly what I dive into with all my pelvic floor clients.

Because the goal is not to tell someone their body is holding trauma and then make them responsible for releasing it.

The goal is to understand the whole person.

Their body.
Their story.
Their relationships.
Their environment.
Their access to safety.
Their history.
Their resilience.

For one of my clients we had ticked off everything.

Her breath. Her postural awareness. Her diet. Her exercise level. Her nervous system. Things shifted but not to where we wanted them to. So, we looked at her life, everything was great, except her job - her work made her feel unsafe- so, she created an exit strategy. And this along with all the other skills she now had was the key. Not everyone can do this create an exit strategy. And if she had been unable to we would have developed coping strategies instead to build her mind/body resilience.

For me, this is where Hypopressives and TRE® can sit beautifully.

Not as tools that magically remove trauma from the tissues.

But as practices that may help the nervous system experience something different: breath without bracing, movement without fear, tremor without overwhelm, stillness without collapse, pressure without panic, and choice where there may once have been none.

The body does not keep the whole score.

The body is part of the score.

And if we are going to work with the body, we also have to respect the world that body has been living in.

What is predictive coding?

Predictive coding sounds complicated, but the basic idea is simple.

Your brain is not just reacting to the world. It is constantly predicting the world.

It uses your past experiences, body sensations, beliefs, environment and nervous system state to guess what is happening and what is likely to happen next.

If you have had pain with movement, your brain may predict pain before you even move.

If you have leaked when jumping, your body may brace before impact.

If you have experienced pelvic pain, your pelvic floor may tighten before touch, intimacy, exercise or even the thought of being assessed.

If your body has spent years under stress, stillness might not feel restful. It might feel unsafe.

If you have learned to hold everything together, softening may feel like losing control.

This is not in any way shape or form weakness.

It is protection.

The problem is not that the body is stupid. The problem is that the body may be working from old information.

The system is trying to keep you safe, but its predictions may be outdated.

What does metastability mean?

The paper also talks about metastability, which is one of those words that sounds like it belongs in a neuroscience lab rather than a conversation about pelvic floors.

But it is actually a very useful idea.

I would describe metastability as the body’s ability to move between states.

To activate and settle.
To tense and release.
To focus and soften.
To respond and recover.
To be alert without becoming overwhelmed.
To rest without collapsing.
To feel sensation without panic.

A healthy system is not one that is relaxed all the time.

A healthy system is flexible.

It can move.

It has real options.

When we lose that flexibility, we get stuck. We may live in a state of guarding, bracing, gripping, scanning, collapsing or avoiding. The body has fewer choices.

And this is where practices like Hypopressives and TRE® become really interesting.

Not because they are magic.

Not because they promise to “release trauma”.

But because they help restore options.

They help most systems experience safe shifts between effort and rest, breath and pause, activation and settling, tremor and stillness.

That is the work.

Not forcing release.

Restoring the movement back into the system.

So why does trauma feel so physical?

This is the bit I think we need to be careful with.

Saying “the body does not keep the score” does not mean the body does not matter.

It does not mean trauma is imaginary.

It does not mean people’s symptoms are “just thoughts”.

It means the relationship between brain, body and experience is dynamic.

The body is constantly sending information to the brain. The brain is constantly interpreting that information. The nervous system is constantly adjusting tone, breath, posture, muscle tension, pressure, digestion, heart rate and readiness.

So if the brain predicts threat, the body may show it.

That might look like:

A pelvic floor that holds on for dear life.
A diaphragm that does not want to descend.
A rib cage that feels stiff and guarded.
A belly that grips during inhale.
A jaw that clamps shut.
A throat that tightens when you try to speak.
A bladder that urges you to go “just in case”.
A body that cannot quite exhale.
A back that creates stability by becoming rigid.

In pelvic health, this matters enormously.

Because so many women are told they are weak when actually they may be protective.

They are told to squeeze when they may need to soften.

They are told to strengthen when their system may first need safety, breath, rhythm and better information.

They are told their pelvic floor is the problem, when actually the pelvic floor may be responding beautifully to a nervous system that keeps predicting threat.

Where Hypopressives fit in

Hypopressives are often described as a method to reduce intra-abdominal pressure or create lift through the pelvic floor. We know from a previous blog that this is pretty far from the truth, you can read that blog here.

And yes, pressure matters. Posture matters.

But I think Hypopressives are far more interesting than that.

To me, Hypopressives are a way of reorganising the body’s internal support system.

We are not just training muscles. We are working with breath, posture, pressure, fascia, the diaphragm, the abdominal wall, the pelvic floor, the nervous system and the brain’s map of the body.

That is why I do not teach Hypopressives as “pull your belly in” or “suck everything up”.

That misses the point altogether.

Hypopressives are not about creating any sort of tightness.

They are about creating space, direction, tone, lift and coordination.

They help interrupt the old prediction that support must come from bracing.

So many women live in bodies that have learned:

To hold the belly in.
To grip the pelvic floor.
To clench the jaw.
To breathe high into the chest.
To brace before movement.
To keep going even when exhausted.

Hypopressives offer a different experience.

The ribs can widen.
The breath can move.
The spine can lengthen.
The pelvic floor can respond rather than be forced.
The abdominal wall can participate without gripping.
The body can feel supported without being squeezed.

That is a huge sensory update.

And if the brain is constantly predicting based on incoming information, then changing the information matters.

A Hypopressive posture is not just a shape.

It is a message.

A slow rib expansion is not just a breathing technique.

It is information.

An apnoea is not just a breath hold.

It is a chance to experience pressure, stillness and internal lift without panic, force or collapse.

This is where Hypopressives and the predictive coding model speak to each other beautifully.

We are not trying to drag the past out of the tissues.

We are helping the system experience a different present.

Where TRE® fits in

TRE® stands for Tension and Trauma Releasing Exercises.

And because of the name, people often assume that TRE® is about shaking trauma out of the body.

I understand why that language exists.

When people tremor, shake, yawn, sigh, cry, laugh or feel waves of sensation, it can absolutely feel like something is being released.

But I think this newer model gives us a more careful and more useful way to describe what may be happening.

TRE® may not be “trauma leaving the body”.

It may be a way of giving the nervous system a safe experience of activation, movement, tremor, pause and return.

That is powerful.

Because many people are frightened of body sensation.

They are frightened of shaking.

They are frightened of losing control.

They are frightened of feeling too much.

They are frightened that if they let go, they will fall apart.

In a well-held TRE® session, the person learns the opposite.

I can tremor and still be safe.
I can pause whenever I need to.
I can open my eyes.
I can stop.
I can change position.
I can use my hands, breath, voice or contact with the floor.
I can feel activation and come back down.
My body can move without me disappearing.

That is not forcing trauma out.

That is restoring choice.

And choice is enormous for the nervous system.

TRE® can become a way to teach the brain-body system that sensation does not automatically mean danger. Activation does not have to become overwhelm. Movement does not have to mean loss of control.

The tremor itself may be less important than the relationship we build with it.

Can I stay curious?
Can I pause?
Can I notice?
Can I settle?
Can I trust that my body has a rhythm?

That is where the work becomes deeply respectful.

Why this matters for pelvic floor symptoms

This conversation is especially important in pelvic floor work.

Because the pelvic floor is so often treated as a mechanical problem.

Too weak? Strengthen it.
Too loose? Squeeze it.
Leaking? Do more Kegels.
Prolapse? Brace harder.
Pain? Stretch it.

But pelvic floor symptoms rarely exist in isolation.

The pelvic floor lives inside a whole messy human.

It responds to breath, pressure, posture, pain, fear, shame, birth history, culture, beliefs, scar tissue, stress, movement habits, exercise choices and nervous system state.

So if someone leaks, feels heaviness, has pelvic pain, struggles with urgency or feels disconnected from their core, I do not just want to know how strong their pelvic floor is.

I want to know what their system is predicting.

Does the body predict pressure every time they lift?
Does the pelvic floor grip every time they inhale or exhale?
Does the bladder predict urgency when they leave the house?
Does the jaw tighten when they concentrate?
Does the breath disappear when they move?
Does the back brace because the body does not trust the front?
Does the belly grip because softening feels unsafe?

This is why I often say pelvic floor work is not just about the pelvic floor.

It is about the whole system.

And this paper gives us even stronger language for that.

We are not chasing symptoms around the body.

We are helping the system update.

A more careful way to talk about release

I still and will always use the word release.

I love the word release.

It makes sense to people.

It describes something many of us feel.

But I think we can be more precise with it.

Release does not have to mean trauma being squeezed out of the tissues.

Release might mean the nervous system no longer needs the same level of protection.

Release might mean the brain receives enough new information to soften an old prediction.

Release might mean the body has found another option.

Release might mean the pelvic floor no longer has to grip.

Release might mean the breath can finally move.

Release might mean the system trusts that it can come back.

That feels way more hopeful to me.

Because it means we do not have to hunt for what is wrong.

We can create the conditions for something new. And this is something so powerful.

The body still tells the story

So no, perhaps the body does not keep the score.

But the body does tell us something.

It tells us what the system has learned.
It tells us where protection has become habit.
It tells us where breath has become shallow.
It tells us where pressure has lost its rhythm.
It tells us where movement has become guarded.
It tells us where the nervous system may need more choice.

And when we listen well, the body also tells us when things are changing.

A fuller breath.
A softer jaw.
A steadier bladder.
A pelvic floor that feels less gripped.
A spine that moves with less fear.
A tremor that feels less alarming.
A body that can rest for five minutes without scanning the room.

These are not small things.

They are signs that the map may be updating.

What this means for healing

For me, this paper does not make body-based work less important.

It makes it more interesting.

It asks us to move away from simplistic claims.

Less “your trauma is stored in your hips”.
Less “we are releasing trauma from the fascia”.
Less “shake it out and it will be gone”.

And more:

Your body is responding intelligently.
Your nervous system is trying to protect you.
Your brain may be predicting danger based on old information.
Your symptoms are real, but they may not be fixed.
Your system can learn.
Your body can update.
You can build new experiences of safety, breath, movement and support.

That is where Hypopressives and TRE® sit for me.

Not as quick fixes.

Not as miracle cures.

But as intelligent, body-based practices that give the nervous system something new to work with.

A body that has learned to brace can learn support.
A body that has learned to grip can learn response.
A body that has learned to fear sensation can learn curiosity.
A body that has learned collapse can learn tone.
A body that has learned protection can learn choice.

Final thoughts

Maybe healing is not about getting the past out of the body.

Maybe it is about helping the body realise the present is different.

Maybe the body is not a vault where trauma is locked away.

Maybe it is a living, sensing, adapting system, constantly asking:

Am I safe now?

And maybe our work, through breath, movement, Hypopressives, TRE®, stillness, shaking, posture and support, is not to force an answer.

It is to offer enough safety, enough repetition and enough choice that the body can begin to answer differently.

Not all at once.

Not by pushing.

Not by performing healing.

But gently.

Through experience.

Through rhythm.

Through breath.

Through the slow return of trust.

References

Kotler, S., Mannino, M., Fox, G. and Friston, K. The body does not keep the score: trauma, predictive coding, and the restoration of metastability. Frontiers in Systems Neuroscience, 2026. (Frontiers)