Most Replayed Moment: Can Eye Movements Heal Trauma? Bessel Van Der Kolk Explains EMDR Therapy!

Bessel van der Kolk is a psychiatrist and best-selling author best known for his groundbreaking book The Body Keeps the Score. A pioneer in the study of trauma, he explores how trauma reshapes both mind and body, and how people can find pathways to healing through therapies that go beyond talk alone. In today's Moments episode, Bessel explains why simply reliving a traumatic memory isn’t enough to heal, and dives into EMDR - how it works, why it’s effective, and guides Steven through a live demonstration. Listen to the full episode here! Spotify: https://g2ul0.app.link/IlUlTu5jLWb Apple: https://g2ul0.app.link/t1VI0Z9jLWb Watch the episodes on YouTube: ⁠https://www.youtube.com/c/%20TheDiaryOfACEO/videos⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:03Steven Bartlett?

  How many people do you think, I mean, this is maybe a ridiculous question, but how many people, what percentage of people do you think have trauma in some form? How you define it?

• 0:14Speaker 01

  You know, the figures are a quarter of people get physically abused, one in five people get sexually abused, one of eight kids witnesses violence being their parents,

• 0:27Speaker 01

  etc., etc. So, you know, if I sit in a room, you know, it's not a binary issue. It's not either you were traumatized, you didn't get traumatized. But when I talk to a room of professionals, which I do a lot, I assume that at least half the group viscerally knows what trauma means.

• 0:48Steven Bartlett?

  And what is trauma doing to my brain? You said you've done a lot of neuroimaging scans. If I was traumatized and you scanned my brain, is there something you could see?

• 0:57Speaker 01

  Not necessarily. I can see how your brain may be different from other people's brains. I may take a particular population, you can average it out and you can say, are there a little more activation of the parietal gray, a little bit less of the white insulin? So you see certain patterns of connectivity in the brain. But to some degree, you know, I think we learn a lot about the brain, but we don't know much about the brain. And I think people tend to overstate how much the brain pictures can teach us. You know, it's, I love the Hubble's telescope or the Webb telescope.

• 1:38Speaker 01

  You know, it's, our brain is like a universe and our technology is very inadequate to really know about all the unbelievably complex connections in the brain is. But we have learned a few things in the last 20 years.

• 1:50Steven Bartlett?

  So how does trauma affect the brain?

• 1:52Speaker 01

  It affects the brain that you tend to, you know, there's, there's one part of your brain that I call the cockroach center of your brain, the parietal gray that lights up. It's sort of underneath the amygdala. Everybody knows the word amygdala these days.

• 2:09Speaker 01

  The part of your brain that tells you that you're in danger. When you're traumatized, you're likely that that little part of your brain, way back in the, your brain stem is firing all the time. All the time you go like, I'm in danger, I'm in danger, I'm in danger. And that's where it starts, in a very elementary sensory level. You don't know what the danger is, but you just feel that you should be scared. And then there's certain parts, other parts of your brain, for example, your insula, which makes the connection with your physical sensations and your body awareness, that for many people get shut down.

• 2:52Speaker 01

  Because trauma, basically, the experience of trauma is a visceral experience of heartbreak and gut wrench. And if you have a law of that, you can learn to shut that part of your brain down, so you don't feel your body so much anymore. You don't feel your body so much, you don't feel very alive either. You don't feel so scared all the time. But it's likely that you will want to take some drugs to make yourself feel alive sometimes. Stuff like that.

• 3:22Steven Bartlett?

  So the part of my brain, you said just under the, around the amygdala?

• 3:25Speaker 01

  Below them.

• 3:26Steven Bartlett?

  Below the amygdala. People that are traumatised, they have some kind of dysfunction in that typically?

• 3:31Speaker 01

  The dysfunction is that it keeps firing.

• 3:33Steven Bartlett?

  Keeps firing. And how does that make you feel?

• 3:35Speaker 01

  And on the amygdala, so there's a constant sense of subliminal dread.

• 3:40Steven Bartlett?

  Is that anxiety?

• 3:43Speaker 01

  Anxiety is already too high of a mental function.

• 3:47Steven Bartlett?

  Okay.

• 3:47Speaker 01

  It's more elementary, it's like your dog shaking, like. Yeah, my daughter has adopted a dog, she was a trauma. And two years later, the dog still walks through my house.

• 4:00Steven Bartlett?

  You've adopted a dog and it shakes in your house still?

• 4:02Speaker 01

  Yeah, yeah, but still, never quite comfortable. And that's how many traumatisers you meet, never quite comfortable.

• 4:10Steven Bartlett?

  So when someone says they're triggered?

• 4:12Speaker 01

  Now, trigger isn't a higher level thing.

• 4:14Steven Bartlett?

  Okay.

• 4:15Speaker 01

  So then the next level is indeed the trigger, that is in part mediated by the amygdala. If you're amygdala, if you're smoke detector, that tends to become hypersensitive, so that minor things get blown up. And a minor thing that you may say to me, I take as the most insulting thing in the world. And so you're constantly triggered by things. And that makes you feel like you are doing terrible things to me. And it's not like I'm hypersensitive. And when you have an off day, that is your issue and not my issue, no. When you have an off day, I feel your off day. And then we start getting into trouble together.

• 4:58Steven Bartlett?

  I've got a picture here of what the brain looks like when the brain smoke detector goes off. Is that what it looks like on the brain?

• 5:05Speaker 01

  That is one particular guy. And nobody is exactly the same as everybody else.

• 5:10Steven Bartlett?

  Can you explain this to me?

• 5:11Speaker 01

  But basically, what you see here is,

• 5:15Speaker 01

  this is a guy who is reliving a terrible car accident. He was involved in. And what you see here is that the right posterior part of the brain, the temporal parietal junction, on the right side of the brain fires. And that's the feeling part of your brain. So you go, oh, my God, oh, my God, I'm terrified. But there's no cognition. Basically, the left side of the brain shuts down. So when you're in your trauma, you don't become, you're not a reasonable person. You actually become a little bit of a blubbering idiot. All of us, when we really are angry or upset, are not very articulate, but we have a lot of feelings. And then the piece that I showed is

• 5:59Speaker 01

  is that as he is, this guy is reliving his trauma, these two parts of your brain go offline. This is the dorsolateral prefrontal cortex. That's the part of the brain that's the timekeeper of your brain. And so if something unpleasant happens between us, let's say, I'll go, oh, it's not a half hour and I'll be OK. So let me just sort of put off of this. But when you get traumatized, the timekeeper disappears. And this is all there is. You lose your sense of perspective. And that is what happens when you're in your trauma. You don't know the difference between the past and the present because the timekeeper of your brain goes offline. And whatever is your feeling is real, as opposed to being feeling like a memory.

• 6:45Speaker 01

  Do you get it?

• 6:46Steven Bartlett?

  Yeah, so for people that can't see it in this brain scan, what I'm basically seeing is the right side is extremely activated. The left side looks like it's off.

• 6:55Speaker 01

  Off, yeah.

• 6:55Steven Bartlett?

  And then there's these two blanks, empty spaces that aren't activated called the durs.

• 7:01Speaker 01

  The dorsolateral prefrontal cortex.

• 7:02Steven Bartlett?

  Dorsolateral prefrontal cortex.

• 7:03Speaker 01

  That's part of the system in the brain that give you a sense of time.

• 7:07Steven Bartlett?

  Okay.

• 7:08Speaker 01

  And as long as you have a sense, it's like little babies always a sense of time, right? As like, whatever happens, happens totally. Then you see a child slowly grow and they get a sense of perspective. This is happening right now, but tomorrow it will be different.

• 7:23Steven Bartlett?

  Okay, so that's when, I mean presumably that's when you get anxiety, right? When you start thinking about the future.

• 7:27Speaker 01

  It is about having a perspective of this is happening right now. Right now, I'm really scared, but the moment I go home, the moment I call my friend, I'll feel better. So that, that you need to have the capacity for perspective. And the perspective goes offline when you're in your trauma and you become a traumatized person.

• 7:49Steven Bartlett?

  So this particular person, this brain scan that I have here, this guy was in a car accident. And the, the triggered brain that I'm looking at here is, he was basically put in a, an M, F M R I scanner. And he was intentionally triggered to see what would happen in his brain.

• 8:07Speaker 01

  Exactly.

• 8:07Steven Bartlett?

  So he was shown maybe a car accident or something.

• 8:09Speaker 01

  No, no, we specifically his car accident.

• 8:12Steven Bartlett?

  Oh, you showed him a picture of his.

• 8:12Speaker 01

  What did you see? What did you hear? What did you smell? What were you thinking? Very specific sensory details.

• 8:19Steven Bartlett?

  Okay, so you're.

• 8:20Speaker 01

  Not somebody else's sensory, your sensory details.

• 8:22Steven Bartlett?

  And the right side of his brain was illuminated.

• 8:25Speaker 01

  Yeah, lighter being became very active.

• 8:28Steven Bartlett?

  Yeah.

• 8:28Speaker 01

  But, but got inactivated was the timekeeper of his brain. So he could not lie there and say, oh, I'm remembering what happened to me yesterday. He's reliving what happened yesterday.

• 8:44Steven Bartlett?

  Instantly?

• 8:45Speaker 01

  You feel like it's happening right now. And that's the nature of trauma. Trauma is not a memory, it's a reliving.

• 8:53Steven Bartlett?

  Are you consciously reliving it, or is your subconscious reliving it?

• 8:56Speaker 01

  You feel like it's happening right now.

• 8:58Steven Bartlett?

  With all forms of trauma?

• 8:59Speaker 01

  But not, it's happening right now, but my feeling is happening right now.

• 9:04Steven Bartlett?

  And my body?

• 9:04Speaker 01

  You don't know that the feelings actually belong to the time that your dad used to beat you. It is now, I feel the same way because I disagree with you.

• 9:16Steven Bartlett?

  So I've been triggered in the past and I felt that sort of instant fight or flight response because something's happened or whatever. And it's instantaneous. So although I don't feel like I'm back there, my body does feel like it's back there.

• 9:29Speaker 01

  And so people are confused about it, they say, oh, you relive the past. No, actually, you're not aware that you relive the past because the past is the present. So you don't think, oh, this reminds me about the time that my dad used to beat me when I was four years old. No, it feels like you are beating me right now.

• 9:49Steven Bartlett?

  And is there a way for this particular gentleman here who's been through that car crash to ever stop this triggering?

• 9:56Speaker 01

  Yeah, he's done quite well.

• 9:57Steven Bartlett?

  He's done quite well?

• 9:58Speaker 01

  He did EMDR, actually, eye movement desensitization.

• 10:03Steven Bartlett?

  And what was his results?

• 10:04Speaker 01

  He's an all right guy, he's functioning, he's fine, he's no longer traumatized person.

• 10:11Steven Bartlett?

  What's the most radical improvement you've seen in your clinical practice?

• 10:17Speaker 01

  Oh, really, people really coming to life, people just saying it's over.

• 10:20Steven Bartlett?

  Give me the most, the best example.

• 10:24Speaker 01

  A good example is the videotape I showed people yesterday of a woman, again, terrible car accident, freezing, upset, freaked out. And then three sessions later, we go talk about it, she says, yeah, this shitty thing happened to me. I was in this car accident and I jolted for it and my head was full and, boy, that was terrible back then. But I'm, now I have a granddaughter and I drive my car to my granddaughter, I'm fine.

• 10:52Steven Bartlett?

  Three sessions it took?

• 10:53Speaker 01

  Three sessions, yeah. And we saw it in psychedelic therapy all the time.

• 10:58Steven Bartlett?

  What did you do in those three sessions?

• 11:00Speaker 01

  Wiggle your fingers in front of people's eyes. I mean, for me, for me, EMDR was really the gateway to work. I was like, sorry, you know, I've written three books about PTSD. I actually wrote the very first book in which it wrote PTSD exists in eighty-four or something. But I didn't know how to treat it. So I'm a world-renowned expert, but I have no idea how to treat it because people keep reliving their trauma and they don't know how to stop that. And then somebody starts telling me about EMDR and I don't believe a word of it. And they say, just you move your fingers in front of people's eyes. I mean, you move your eye from side to side as you relive the trauma. And I go,

• 11:42Speaker 01

  that's crazy. Everybody hears it. That's crazy. And then people start doing it. And they show me how it works. I go like, wow. And people indeed, a certain subsample of people we studied indeed, after a few sessions of EMDR, go like, yeah, that really sucked. But it's over. It belongs to the past. It's not happening right now.

• 12:09Steven Bartlett?

  You're telling me that wiggling your fingers in front of people's eyes can help heal their trauma?

• 12:12Speaker 01

  Well, then, of course, we had to do a little research, which took us fifteen years to get enough funding to do it, to see what happens when you move your eyes back and forth. And then we discovered that if you move your eyes back and forth, as you recall traumatic experiences, you activate certain pathways between the temporal parietal junction, which is your sense of self, and your insular, your sense of your body. So your brain is able to say, oh, yeah, this is what happened to me, but that happened to me in the past. So these are pathways that makes it possible for your brain to make that distinction.

• 12:51Steven Bartlett?

  And in the research that's been done on this, what does the, what did the outcome, what was the conclusion in terms of its efficacy?

• 12:58Speaker 01

  Oh, in terms of, in our research, seventy-eight percent of the people who had adult onset trauma, so being assaulted or raped by a stranger, seventy-eight percent of them were completely cured.

• 13:18Speaker 01

  But that's not the majority of people we see because most people we see have early childhood trauma, which is much more complicated.

• 13:25Steven Bartlett?

  Early childhood trauma is much more stubborn and resistant to this treatment.

• 13:30Speaker 01

  Yeah, because your early childhood experiences create who you are.

• 13:37Speaker 01

  So if you go to a fancy college when you're 18, you do become identified with a college, but it doesn't radically change you into a new person. It becomes part of your identity. But if you grow up in a certain family early on in your life, you actually become that. The imprint is very deep early on.

• 13:59Steven Bartlett?

  So it's called eye movement desensitation and reprocessing treatment. I was just looking up some stats about it. It says it's been extensively studied with evidence supporting its efficacy across various conditions. With PTSD, a 2014 meta-analysis of 26 randomized control trials found that EMDR significantly reduced PTSD symptoms with a large effect size. Depression, a 2024 systemic review and meta-analysis encompassing 25 studies and more than 1,000 participants reported that it alleviated depressive symptoms. The same 2014 meta-analysis noted that EMDR led to significant reductions in anxiety symptoms among PTSD patients with a large effect.

• 14:42Steven Bartlett?

  And finally, a 2024 systemic review and individual participation data meta-analysis concluded that EMDR is as effective as other psychological treatments for PTSD, achieving comparable symptom reduction and remission rates. So can you show me how it works? Can you do it on me?

• 15:03Speaker 01

  Good.

• 15:07Speaker 01

  Can I move my chair?

• 15:09Steven Bartlett?

  Of course you can.

• 15:11Steven Bartlett?

  Are you going to come closer?

• 15:12Speaker 01

  So can you bring to mind a really unpleasant experience you have had not too long ago?

• 15:19Steven Bartlett?

  Yeah.

• 15:20Speaker 01

  And can you bring to mind what you saw at that point?

• 15:27Steven Bartlett?

  Yeah.

• 15:28Speaker 01

  Can you remember what the voices sounded like at that point?

• 15:34Speaker 01

  Or whatever it was. Any sounds come to mind?

• 15:38Steven Bartlett?

  Yeah.

• 15:40Speaker 01

  Do you remember what your body felt like back then?

• 15:45Steven Bartlett?

  Yeah.

• 15:47Speaker 01

  Can you remember what you were thinking? Or bring to mind what you were thinking?

• 15:58Steven Bartlett?

  Yeah.

• 15:58Speaker 01

  Okay. So, how vivid is your feeling right now of recollecting it?

• 16:05Steven Bartlett?

  Make a six, seven out of 10.

• 16:07Speaker 01

  Okay. So stay there. Now, follow my finger with your eyes. So, look at me right now.

• 16:33Speaker 01

  Get deeper.

• 16:39Speaker 01

  So, what comes to your mind right now as we're doing this?

• 16:43Steven Bartlett?

  I feel calm.

• 16:47Steven Bartlett?

  Yeah, I just feel calm.

• 16:48Speaker 01

  Okay. So, when you go back to what we're just feeling,

• 16:55Speaker 01

  what's it like now?

• 16:57Steven Bartlett?

  It's...

• 17:02Steven Bartlett?

  It's hard to recall why I was bothered.

• 17:05Steven Bartlett?

  It's the best way to describe it.

• 17:07Speaker 01

  That is the weird stuff.

• 17:09Steven Bartlett?

  Why is that? Is that just because... Why is that?

• 17:11Speaker 01

  No, see, that is what's so great about his work. We don't know the linearity. And we don't know where the hell the emotional imprint is gone now. But it is.

• 17:26Speaker 01

  And, you know, of course, if you bring up something much worse than what you had going to, it takes it much longer and a lot of other stuff comes up. But somehow EMDR seems to do, it creates new associative processes in the brain. So let's say, first of all, people that EMDR are me. Something really very, very nasty had happened to me and I started off being very upset. And then during the EMDR, I don't know if this happened to you, I had images of sitting at my dining room table as a kid and I had images of playing in a playground in primary school. Sounds really, don't come in mind.

• 18:08Speaker 01

  And then we stopped it and indeed, so, yeah, that really sucked. Time to go on. An important part of this, you did not tell me what you were going through. No. Because I'm suspicious of language, because language is always an interactive process. And if I would ask you to tell me what happened, you will filter yourself because certain things may be embarrassing or you don't want me to know about it. And so we circumvent this whole verbal process of your making meaning out of it and we organise some core ways in which your brain is perceiving this. So you saw a little bit of this, very in minor way.

• 18:52Speaker 01

  For me, when I first saw this, I was blown away by it and thought, I need to study this. So when they quoted studies, the main study was done by me. NIH funded it, but I was also the last time that somebody could fund it for EMDR.

• 19:11Steven Bartlett?

  What you just listened to was a most replayed moment from a previous episode. If you want to listen to that full episode, I've linked it down below. Check the description. Thank you.