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

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?

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

etc., etc.

So, you know,

if I sit in a room, you know, it's not a binary issue.

It's not either you got traumatized or 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.

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?

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, oh, there's a little more activation of the periac

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, I love the Hubble's telescope or the Webb telescope.

You know, our brain is like a universe, and our technology is very inadequate to really know about all the unbelievably complex connections in the brain.

But we have learned a few things in the last 20 years.

So how does trauma affect the brain?

It affects the brain that you tend to

there's there's one part of your brain that I call the cockroach center of your brain, the periaque gray, that

lights up itself underneath the amygdala.

Everybody knows the word amygdala these days.

So the part of your brain that tells you that you're in danger.

But you're traumatized, you're likely that that little part of your brain way back in your brainstem is firing all the time.

All the time you go, like, I'm in danger, I'm in danger, I'm in danger.

And so 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 of the other part 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.

because trauma basically the experience of trauma is a visceral experience of heartbreak and gut venge and if you have a lot of that you can learn to shut that part of your brain down so you don't feel your body so much anymore or you don't feel your body so much you don't feel very alive either but 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 um stuff like that yeah

so the part of my brain you said just under the amig around the amygdala below them below the amygdala people that are traumatized they have some kind of dysfunction in that typically well the dysfunction is that it keeps firing keeps firing and how is that and so and then the amygdala so so there's a constant sense of of subliminal dread is that anxiety

anxiety is already too high of mental functioning okay it's more elementary it's like your dog shaking like

yeah my daughter has a adopted dog two years at times and two years later the dog still walks to my house you've adopted the dog and it shakes in your house still yeah yeah but still never quite comfortable um and that's how many times you meet are never quite comfortable so when someone says they're triggered no trigger isn't the higher level thing okay

so then the next level is indeed the trigger that is in part mediated by the amygdala is your amygdala is your 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 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 we start getting into trouble together.

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 when it comes to the business?

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

Can you explain this to me?

But basically,

what you see here is

this is a guy who is reliving

a terrible car accident he was involved with.

And what you see here is that the right posterior part of the brain, the temporal parasital junction, on the right side of the brain, fires, and that's the feeling part of the brain.

So you go, oh my god, oh my god, I'm terrified.

But there's no cognition and 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

that as he is with 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.

So if something unpleasant happens between us, let's say,

I'll go, oh, it's another half hour and I'll be okay.

So let me just sort of put up with 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 you're feeling is real as opposed to feeling like a memory.

So if you get it?

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.

Off, yeah.

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

The lateral prefrontal cortex.

So this is the

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

Okay.

And as long as you have a sense of, it's like little babies don't have a sense of time either.

So like whatever happens, happens totally.

You see a child slowly grow and they get a sense of perspective.

It's happening right now, but tomorrow it will be different.

Okay, so that's when, I mean, because you're that's when you get anxiety, right?

When you start thinking about the future.

It is about

having a 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

you need to have that capacity for perspective, and that perspective goes offline when you're in your trauma and you become a traumatized person.

So, this particular person, this brain scan that I have here, this guy was in a car accident, and the triggered brain that I'm looking at here is he was basically put in

an M F M R I scanner, and he was intentionally triggered to see what would happen in his brain.

Exactly.

So he was shown maybe a car accident or something.

No, no, we specifically his car accident.

Oh, you showed him a picture of his what did you see?

What did you hear?

What did you smell?

What were you thinking?

Very specific sensory details.

Okay, so you're not somebody else's sensory details.

Your sensory details.

And the right side of his brain was illuminated.

Yeah, his right side of the brain became very active.

Yeah.

But what got inactivated

was that timekeeper of his brain.

So he could not

lie there and say, oh, I'm remembering what happened to me yesterday.

He is reliving what happened yesterday.

Instantly.

You feel like it's happening right now.

And that's the nature of trauma.

Trauma is not a memory.

It's a reliving.

Are you consciously reliving it or is your subconsciously reliving it?

You feel like it's happening right now.

With all forms of trauma.

but not

it's happening right now but my feeling is happening right now and my body 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

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 it can and it's instantaneous

so although i don't feel like i'm back there my body does feel like it's back there And so, people are confused about it.

They say, Oh, you relived 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.

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

Yeah, he's done quite well.

He's done quite well.

He did EMDR, actually yeah the eye movement desensitization and what was his results he is an all right guy he's he's he's functioning he's fine he's no longer a traumatized person what's the most radical improvement you've seen in your clinical practice oh really people really coming to life people just saying it's over give me the the the most

uh best example uh the good example is the videotape i showed you 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 was jolted for it and my head was full.

And boy, that was terrible back then.

But

now I have a granddaughter and I drive my car to my granddaughter.

I'm fine.

Three sessions it took.

Three sessions, yeah.

And we saw it in psychedelic therapy all the time.

What did you do in those three sessions?

Wiggle your fingers in front of people's eyes.

I mean, for me, for me, EMDR was really the gateway at work.

Like,

sorry,

you know, I've written three books about PTSD.

I actually wrote the very first book in which the word PTSD exists in 84 or something.

But they 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 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, That's crazy.

Everybody who 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.

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

Well, and then of course we had to do a little research, which took us 15 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 temporoparietal junction, which gets your sense of self and your insulin, your sense of your body.

So your brain is able to say,

oh yeah, this is what happened to me, but it happened to me in the past.

So these are pathways that makes it possible for your brain to

make that distinction.

And in the research that's been done on this,

what did the outcome, what was the conclusion in terms of its efficacy?

Oh, in terms of uh in our research

um

78 of the people who had adult onset trauma so so uh being assaulted or raped uh by a stranger 78 of them were completely cured

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

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

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

So if you go to

a fancy college when you're 18, you do become identified with that college, but it doesn't matter 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.

And

the imprint is very deep early on.

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 2020, a 2014 meta-analysis of 26 randomized controlled 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 a a thousand 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.

And finally, a 2024 systemic review and individual participation data meta-analysis concluded that EMDR is an effective, 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?

I could.

Can I move my chair?

Of course, you can.

You're going to come closer.

So, can you bring to mind an really

rather unpleasant experience you have had not too long ago?

Yeah.

And

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

Yeah.

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

Or whatever it was?

Any sounds come to mind?

Yeah.

Do you remember what your body felt like back then?

Yeah.

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

Yeah.

Okay.

So So, how vivid is your feeling right now of

recollecting it?

Make a six, seven out of ten.

Okay, so stay there.

Now, follow my finger with your eyes.

So, look at my look at me right now.

Take a deep breath.

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

I feel calm.

Yeah, I just don't feel calm.

Okay.

So, when you go back to what you were just feeling,

what's it like now?

It's hard to recall why I was bothered.

It's the best way to describe it.

That is the weird stuff.

Why is that?

Is that just because...

Why is that?

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.

And, you know, of course, if you

bring up something much worse than what you had going through, it takes it much longer and a lot of other stuff comes up.

But what somehow EMDR seems to do, it creates new associative processes in the brain.

So let's say,

first people did EMDR on 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 that happened to you, I had images of sitting in my dining room table as a kid.

And I had images of playing in a playground in primary school.

Sounds already, don't come to my mind.

And then we stopped it.

And indeed, so

yeah, that really sucks.

Time to go on.

An important part is you did not tell me what you were going through.

Because I'm suspicious of language, because language is always an interactive process.

And if I 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 we circumvent this whole verbal process of your making meaning out of it and we reorganize some core

ways in which your brain is perceiving this so

so you saw a little bit of this very in minor way 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 got funded for

EMDR.

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.