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

Summary

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The Diary Of A CEO – Most Replayed Moment: Can Eye Movements Heal Trauma? Bessel Van Der Kolk Explains EMDR Therapy!

Podcast Host: Steven Bartlett
Guest: Dr. Bessel van der Kolk
Date: September 19, 2025

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Overview

In this gripping highlight from "The Diary Of A CEO," Steven Bartlett sits down with renowned psychiatrist and trauma researcher Dr. Bessel van der Kolk. They dive into the mechanics of trauma in the brain, how it shapes our lives, and – most crucially – the revolutionary therapy known as EMDR (Eye Movement Desensitization and Reprocessing). The conversation unpacks how EMDR works, its effects on trauma survivors, and why, despite initial skepticism, it’s now a foundational treatment for PTSD.

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Key Discussion Points & Insights

1. The Prevalence of Trauma

[00:31-01:16]

• Trauma is not a binary experience; most people have it in some form.
• Dr. van der Kolk shares statistics:

  “A quarter of people get physically abused, one out of five people get sexually abused, one of eight kids witnesses violence, being their parents, et cetera...” (C, 00:43)

• At least half of any professional group viscerally understands trauma.

2. How Trauma Alters the Brain

[01:16-05:26]

• Brain scans can sometimes show activation patterns related to trauma, but these are complex and not always definitive.
• Trauma triggers the “cockroach center” of the brain (periaqueductal gray), beneath the amygdala, making people feel constant, vague danger.

  “When you’re traumatized...that little part of your brain way back in your brain stem is firing all the time. All the time.” (C, 02:22)

• Trauma can shut down parts of the insula (body awareness), leading to either hypervigilance or numbness.

3. The Trigger Mechanism and Dread

[05:26-07:14]

• Traumatized brains develop hyperactive “smoke detectors” (amygdala), causing overreactions to minor stimuli.

  “A minor thing that you may say to me I take as the most insulting thing in the world.” (C, 04:41)

• Triggers are not just sensitivity; they’re deeply tied to past trauma being relived as present reality.

4. Time and Cognition During Trauma

[07:14-09:21]

• Brain imaging of trauma recall shows the right side (emotional/sensory) highly active, while the left (cognitive/reasoning) and “timekeeper” (dorsolateral prefrontal cortex) go offline.

  “When you get traumatized, the timekeeper disappears...you don’t know the difference between the past and the present.” (C, 06:51)

• This leads to reliving trauma as if it is happening now, not as a distant memory.

5. Reliving vs. Remembering

[09:21-10:23]

• Trauma isn’t merely a memory but a reliving.
• Physiological responses (fight/flight) are rooted in past incidents, but felt in the 'now' without conscious realization.

  “It feels like you are beating me right now.” (C, 09:57)

6. Can This Cycle Ever Stop? Enter EMDR

[10:17-12:37]

• Yes, trauma triggers can be greatly diminished or eliminated.
• EMDR, originally dismissed as “crazy,” involves moving eyes side-to-side while recalling trauma – found to produce dramatic reductions in symptoms.

  “I go, that’s crazy...Then people start doing it and they showed me how it works. I go like, wow. ...after a few sessions of EMDR, [clients] go like, yeah, that really sucked. But it’s over. It belongs to the past.” (C, 11:28–12:15)

7. The Neurological Mechanism of EMDR

[12:37-13:54]

• Eye movement during recall activates neural pathways connecting self-perception and body awareness, allowing the brain to categorize trauma as “past.”

  “If you move your eyes back and forth...your brain is able to say, oh, yeah, this is what happened to me. But that happened to me in the past.” (C, 12:49)

8. EMDR’s Effectiveness and Limitations

[13:19-14:27]

• 78% of adults with single-incident trauma (e.g., assault, rape by stranger) were “completely cured” in their studies.
• More complex, early childhood trauma is harder to heal quickly, as these experiences become integral to identity.

  “...if you grow up in a certain family early on in your life, you actually become that. The imprint is very deep early on.” (C, 13:54)

9. Meta-Analysis and Clinical Evidence

[14:27-15:31]

• EMDR is recognized in multiple meta-analyses and has shown strong efficacy for PTSD, depression, and anxiety.

  “A 2014 meta-analysis of 26 randomized controlled trials found that EMDR significantly reduced PTSD symptoms with a large effect size...” (B, 14:27)

10. Experiencing EMDR Live (Demo On-Air)

[15:31-17:36]

• Dr. van der Kolk leads Steven through a mini-EMDR session around a recent unpleasant memory.
  • Steven rates the distress about 6–7/10 before; after a round of guided eye movement he reports:

  “It’s hard to recall why I was bothered...That is the weird stuff.” (B, 17:30; C, 17:36)

• Dr. van der Kolk notes EMDR works by bypassing language and directly reorganizing how the brain processes and stores trauma.

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Notable Quotes & Memorable Moments (with Timestamps)

• On the persistence of trauma:

  “The experience of trauma is a visceral experience of heartbreak and gut wrench... 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 because you don’t feel so scared all the time.”
  – Bessel van der Kolk (C, 02:22)

• On the limitations of brain scans:

  “To some degree I think we learn a lot about the brain, but we don’t know much about the brain…our technology is very inadequate to really know about all the unbelievably complex connections to brainness.”
  – Bessel van der Kolk (C, 01:35)

• On the immediate effect of EMDR:

  “It’s hard to recall why I was bothered. It’s the best way to describe it.”
  – Steven Bartlett (B, 17:30)

• On EMDR’s surprising effectiveness:

  “Everybody who hears it, that’s crazy. And then people start doing it...and people, 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.”
  – Bessel van der Kolk (C, 12:09)

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Timestamps for Important Segments

• Prevalence of trauma: 00:31–01:16
• How trauma changes the brain: 01:16–05:26
• Triggering and misfiring of the amygdala: 04:38–05:26
• Time perception and brain imaging: 07:14–09:21
• Reliving trauma, not remembering: 09:21–10:23
• Introduction to EMDR: 10:26–12:37
• How EMDR works neurologically: 12:37–13:54
• EMDR clinical results: 13:19–14:27
• Host tries EMDR: 15:31–17:36

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Final Takeaway

This episode’s most replayed moment compellingly explains both the agony and hope in treating trauma. Dr. van der Kolk demystifies EMDR as a technique rooted in real neurobiological change, demonstrating—in real time—how even simple eye movements can allow trauma to be processed and left in the past.

To hear the full story and more life lessons, listen to the complete episode via the links shared by Steven Bartlett.

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Transcript

[A]

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[B]

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.

[C]

Figures are a quarter of people get physically abused, one out of five people get sexually abused, one of eight kids witnesses violence, being their parents, et cetera, et cetera. So you know, if I sit in a room, it's not a binary issue. It's not either you got 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 of the group viscerally knows what trauma means.

[B]

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?

[C]

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 bariac are too gray, a little bit less of the bright insulin. So you see certain patterns of connectivity in the brain. But to some degree 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. I love the Hubble's telescope or the Webb telescope. Our brain is like a universe. And our technology is very inadequate to really know about all the unbelievably complex connections to brainness. But we have learned a few things in the last 20 years.

[B]

So how does trauma affect the brain?

[C]

It affects the brain that you tend to. There's one part of your brain that I call the cockroach center of your brain, the periacular gray that lights up, it's sort of underneath the amygdala. Everybody knows the word amygdala these days. So 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 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 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, other parts of your brain, for example, your insula, which makes the connection between 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 wrench. 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 because 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. Yeah.

[B]

So the part of my brain you said just under the amig, around the amygdala, below the, below the amygdala. People that are traumatized, they have some kind of dysfunction in that.

[C]

Typically dysfunction is that it keeps firing, keeps firing. And how does that feel? And then the amygdala. So there's a constant sense of, of subliminal dread.

[B]

Is that anxiety?

[C]

Anxiety is already too high mental functioning.

[B]

Okay.

[C]

It's more elementary. It's like your dog shaking, like. Yeah, my daughter has adopted a dog three years at times, and two years later the dog still walks to my house.

[B]

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

[C]

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

[B]

So when someone says they're triggered.

[C]

Now, trigger isn't a higher level thing. Okay, so then the next level is indeed the trigger that is in part mediated by the amygdala is your amygdala. If you 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, 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.

[B]

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?

[C]

That is One particular guy, nobody is exactly the same as everybody else.

[B]

Can you explain this to me?

[C]

But basically, what you see here is this is a guy who is reliving a terrible car accident. He was involved. And what you see here is that the right posterior part of the brain, there's temporal parietal junction on the right side of the brain fires, and that's the feeding part of your 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 and not very articulate, but we have a lot of feelings. And then the piece that I showed us 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 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, 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 you're feeling is real, as opposed to be feeling like a memory. Did you get it?

[B]

Yeah. So 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.

[C]

Off? Yeah.

[B]

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

[C]

Dorsolateral prefrontal cortex. So there's part of the system in the brain that gives you a sense of time.

[B]

Okay.

[C]

And as long as you have a sense, it's like little babies only have a sense of time either. Absolutely. Whatever happens, happens. Totally. Then you see a child slowly grow, and they get a sense of perspective. It's happening right now, but tomorrow it will be different.

[B]

Okay. So that's when. I mean, presumably that's when you get anxiety, Right. When you start thinking about the future.

[C]

It is about having the 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 that capacity for perspective. And that perspective goes offline when you're in your trauma and you become a traumatized person.

[B]

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 FMRI scanner and he was intentionally triggered to see what would happen in his brain.

[C]

Exactly.

[B]

So he was shown maybe a car accident or something.

[C]

No, no, specifically his car accident.

[B]

Oh, you showed him a picture of his car.

[C]

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. Your sensory details.

[B]

And the right side of his brain was illuminated.

[C]

Yeah, his right side of brain became very active. 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's 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.

[B]

Are you consciously reliving it or is your subconscious?

[C]

I feel like it's happening right now.

[B]

With all forms of trauma, but not.

[C]

It'S happening right now, but my feeling is happening right now in 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.

[B]

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.

[C]

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 be beat me when I was four years old. No, it feels like you are beating me right now.

[B]

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

[C]

Yeah, he's done quite well.

[B]

He's done quite well.

[C]

He did emdr, actually, eye movement desensitization.

[B]

And what was his results?

[C]

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

[B]

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

[C]

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

[B]

Give me the most.

[C]

The best example, 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, it was terrible back then. But now I have a granddaughter and I drive my car to my granddaughter and I'm fine.

[B]

Three sessions. It took three sessions.

[C]

Yeah, and we saw it in psychedelic therapy all the time.

[B]

What did you do in those three sessions?

[C]

Wiggle your fingers in front of people's eyes? For me, EMDR was really the gateway drug. Sorry, I've written three books about ptsd. 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. 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, that's crazy. Everybody who hears it, that's crazy. And then people start doing it, and they showed me how it works. I go like, wow. And people, indeed had 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.

[B]

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

[C]

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 temporal parietal junction, which is your sense of self, and your insulin, which sense 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.

[B]

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

[C]

Oh, in terms of. In our research, 78% of the people who had adult onset trauma, so being assaulted or raped 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.

[B]

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

[C]

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 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.

[B]

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 1000 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 as effective as other psychological treatments for PTSD and achieving comparable symptom reduction and remission rates. So can you show me how it works? Can you do it on me?

[C]

I could. Can I move my chair?

[B]

Of course you can. You're going to come closer.

[C]

So can you bring to mind and really sort of rather unpleasant experience you have had not too long ago?

[B]

Yeah.

[C]

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

[B]

Yeah.

[C]

Can you remember what the voice sounded like at that point or whatever it was? Any sounds come to mind?

[B]

Yeah.

[C]

Do you remember what your body felt like back then?

[B]

Yeah.

[C]

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

[B]

Yeah.

[C]

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

[B]

Like a six, seven out of ten.

[C]

Okay, so stay there. Now follow my finger with your eyes. So look at me right now and take a deep breath. So what Comes to your mind right now as we're doing this?

[B]

I feel calm. Yeah. I just don't feel calm.

[C]

Okay, so when you go back to what you were just feeling, what's it like now?

[B]

It's hard to recall why I was bothered. It's the best way to describe it.

[C]

That is the weird stuff.

[B]

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

[C]

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 has gone now, but it is. And you know, of course, if we bring up something much worse than what you had gone to, it takes 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 for some people, did EMDR on me. Something really very, very nasty has 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 had images of playing in a playground in primary school. Something don't come in my mind. And then we stopped it. And indeed. So, yeah, that really sucked. Time to go on. An important part is 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 organize some core ways in which your brain is perceiving this. So you saw a little bit of this. Very 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 ni, for emdr.

[B]

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.