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The Diary Of A CEO with Steven Bartlett

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

Published September 19, 2025
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About This Episode

The conversation explores how common trauma is, how it affects brain function, and how eye movement desensitization and reprocessing (EMDR) can change traumatic responses. The guest explains specific brain regions involved in danger signaling, body awareness, and time perception, showing how trauma leads to chronic fear, loss of perspective, and reliving rather than remembering events. They then discuss EMDR's mechanisms, research evidence, and demonstrate a brief EMDR-style exercise that quickly reduces the host's emotional activation around a recent unpleasant experience.

Topics Covered

Trauma Therapy Neuroscience Mental health Anxiety Depression Neuroplasticity Fear conditioning Perception Visual system

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Quick Takeaways

  • Trauma is widespread and exists on a spectrum rather than as a simple yes-or-no condition.
  • Traumatic stress can cause primitive danger circuits in the brain to fire constantly, producing a chronic sense of unsafety.
  • During traumatic reliving, emotional and sensory brain regions become highly active while language and time-keeping areas go offline.
  • A key feature of trauma is that experiences are relived in the present, not simply remembered as past events.
  • EMDR uses side-to-side eye movements while recalling traumatic events to help the brain reprocess them as something that happened in the past.
  • Research shows EMDR can substantially reduce PTSD, depression, and anxiety symptoms, especially in adult-onset trauma.
  • Childhood trauma is more resistant to brief treatments because early experiences are deeply woven into identity and development.
  • A brief EMDR-like intervention in the episode quickly reduced the host's distress and made the upsetting memory harder to access.
  • EMDR intentionally bypasses verbal storytelling to avoid distortion and instead targets core perceptual and emotional patterns.
  • Despite strong clinical effects, EMDR research has faced significant funding barriers.

Podcast Notes

Prevalence and non-binary nature of trauma

How common traumatic experiences are in the general population

Quoted statistics on abuse and witnessing violence[0:14]
• About a quarter of people are said to experience physical abuse.
• Roughly one out of five people experience sexual abuse.
• Approximately one out of eight children witness violence between their parents.
Trauma as a spectrum rather than a binary condition[0:31]
• The guest emphasizes that trauma is not simply an either-or phenomenon (traumatized vs. not traumatized).
• In groups of professionals the guest speaks to, he assumes at least half viscerally know what trauma means from personal experience.

Limits and insights of neuroimaging in understanding trauma

What brain scans can and cannot show about trauma

Comparing brains of traumatized vs. non-traumatized groups[0:50]
• The guest explains that you may not see trauma clearly in one individual's scan.
• By averaging across specific populations, patterns of connectivity differences can be detected.
• He mentions seeing slightly more activation in the periaqueductal gray and less in the insula in some traumatized groups.
Caution about overstating what brain images can tell us[2:07]
• The guest believes people tend to overstate how much brain pictures can teach us.
• He likens the brain to a universe and current technology (like telescopes for the cosmos) as inadequate to fully capture its complexity.
• Despite limitations, he says a few important things have been learned about the brain in the last 20 years.

How trauma affects brain circuitry and body awareness

The "cockroach center" and chronic danger signaling

Periaqueductal gray as primitive danger center[1:57]
• He refers to part of the brain as the "cockroach center" - the periaqueductal gray beneath the amygdala.
• This area signals danger at a very primitive, sensory level.
• In traumatized people, this region tends to fire constantly, creating a sense of perpetual danger.
Chronic subliminal dread vs. higher-level anxiety[3:34]
• The guest clarifies that anxiety is already a higher mental function.
• The periaqueductal overactivation is more basic: like a body-level sense of dread or a dog shaking.
• He gives an example of his daughter's adopted dog that still shakes in his house years later, never quite comfortable.

Insula shutdown and loss of body awareness

Trauma as visceral heartbreak and gut wrenching[2:50]
• He describes trauma as a visceral experience of heartbreak and gut-wrenching sensations.
• Repeated experiences of such intense feelings can lead people to shut down that part of the brain.
Shutdown of insula and its consequences[2:35]
• The insula connects physical sensations to body awareness.
• In many traumatized individuals, the insula's activity is diminished, so they stop feeling their bodies as much.
• Not feeling the body reduces fear, but also leaves people feeling less alive.
• He notes that people may turn to drugs to feel alive again when their internal sensations are numbed.

Triggers, amygdala hypersensitivity, and interpersonal conflict

From primitive threat responses to triggers

Difference between primitive danger firing and triggers[3:29]
• The ongoing firing of the brainstem threat center creates a baseline sense of unsafety.
• Triggers are described as a higher-level phenomenon, connected to the amygdala's function.
Amygdala as a hypersensitive smoke detector[4:14]
• The amygdala is likened to a smoke detector that becomes hypersensitive after trauma.
• Minor comments or actions from others are perceived as extremely insulting or dangerous.
• This leads to constant triggering and the feeling that others are doing terrible things to you.
How trauma-driven sensitivity affects relationships[5:38]
• The guest points out that people often perceive the problem as the other person's "off day" rather than their own hypersensitivity.
• When someone else has an off day, the traumatized person feels it acutely and interpersonal conflict escalates.

Brain scan example: reliving a car accident and loss of time perspective

Description of the trauma-activated brain scan

Right temporal-parietal activation and emotional reliving[5:20]
• The scan shows a person reliving a terrible car accident while in an fMRI.
• The right posterior part of the brain (temporal-parietal junction) lights up strongly.
• This region is described as the feeling part of the brain where the person experiences terror and emotional intensity.
Left-brain shutdown and reduced cognition[5:33]
• The left side of the brain is largely inactive in the scan during trauma reliving.
• The guest notes that the person is not reasonable or articulate in that state but is full of feelings.

Dorsolateral prefrontal cortex as the brain's timekeeper

Timekeeping and perspective under normal conditions[6:25]
• The dorsolateral prefrontal cortex is referred to as the timekeeper of the brain.
• Normally, when something unpleasant happens, you can think, "In half an hour I'll be okay" and maintain perspective.
Timekeeper going offline during trauma[6:30]
• In the trauma state, the dorsolateral prefrontal cortex goes offline.
• The person loses the sense of past vs. present; whatever is felt becomes the only reality.
• This loss of time perspective is described as a core feature of being in one's trauma.

Development of time perspective in children

From timelessness in babies to perspective in older children[7:07]
• Babies lack a sense of time; whatever happens is total and present for them.
• As children grow, they develop perspective: understanding that something may be happening now but will be over later.
• The guest compares this developmental gain in perspective to what is lost temporarily during trauma reliving.

Trauma as reliving the past in the present

Design of the car accident fMRI experiment

Triggering the specific trauma in the scanner[7:56]
• The man in the scanner was asked about specific sensory details of his own car accident.
• Questions included what he saw, heard, smelled, and thought at the time.
• They did not show him generic car accidents but focused on his personal sensory experience.
Reliving vs. remembering[8:28]
• The right side of his brain becomes very active, but the timekeeper goes offline.
• He is not lying there thinking, "I'm remembering yesterday"; instead he relives it as if happening right now.
• The guest defines trauma as reliving, not merely recalling, an event.

How bodily responses make past trauma feel present

Host's experience of being triggered[9:13]
• The host shares having felt instantaneous fight-or-flight responses when triggered in the past.
• He notes that his body feels like it is back at the original event, even if his mind does not explicitly think that.
Why people are not aware they are reliving old events[9:25]
• The guest says people do not usually think, "This reminds me of when my dad beat me" in conscious terms.
• Instead, the current person or situation feels like the original perpetrator in the present.
• Because the timekeeper is offline, the feelings are experienced as current reality, not as memories.

Introduction to EMDR and dramatic clinical improvements

Outcomes for the man with the car accident trauma

Use of EMDR in his treatment[9:49]
• The guest says the man did EMDR (eye movement desensitization and reprocessing).
• He reports that the man is now functioning well and is no longer a traumatized person.

Example of rapid change in another patient

Woman with a terrible car accident[10:19]
• He references a videotape of a woman who had a terrible car accident and initially appeared frozen, upset, and freaked out.
• After three EMDR sessions, she could describe it as a "shitty thing" that happened but clearly positioned it in the past.
• She mentions having a granddaughter and driving her car to see her without fear, illustrating restored functioning.
Three-session timeframe for change[10:25]
• The guest explicitly notes that it took three sessions for this transformation.
Similar patterns seen in psychedelic therapy[10:49]
• He says they saw comparable dramatic improvements in psychedelic therapy as well.

EMDR origins, skepticism, and mechanism hypothesis

The guest's background in PTSD and early skepticism about EMDR

Being an early PTSD expert without effective treatments[11:14]
• He states he wrote three books about PTSD, including the first book to include the term PTSD around 1984.
• Despite expertise, he says he had no idea how to treat it effectively because people kept reliving trauma without knowing how to stop.
Initial reaction to EMDR technique[11:49]
• He describes EMDR as involving moving the eyes side to side while reliving the trauma.
• His first response was that the idea sounded crazy, and he notes that most people who hear about it initially think the same.
• However, as clinicians began doing it and showing results, his view began to change.

Proposed neural pathways engaged by EMDR

Research on eye movements during trauma recall[12:19]
• It took about 15 years to secure enough funding to research what happens when the eyes move back and forth during trauma recall.
• They found that recalling trauma with eye movements activates pathways between the temporal-parietal junction (sense of self) and the insula (sense of the body).
• This allows the brain to say, "This is what happened to me, but it happened in the past."
• These pathways appear to help the brain distinguish past from present in relation to the traumatic event.

Evidence base for EMDR and differences between adult and childhood trauma

Clinical outcomes from the guest's research

High success rates for adult-onset trauma[12:55]
• In his research, 78% of people with adult-onset trauma (e.g., being assaulted or raped by a stranger) were completely cured by EMDR.
Childhood trauma as more complex and resistant[13:19]
• He points out that most patients they see have early childhood trauma, which is more difficult to treat.
• Early experiences shape who a person is; they form deep imprints that become part of identity.
• Attending a prestigious college at 18 may change identity somewhat but doesn't radically remake the person, whereas early family environment does.

Meta-analytic evidence on EMDR for PTSD, depression, and anxiety

Findings for PTSD symptom reduction[14:30]
• The host cites a 2014 meta-analysis of 26 randomized controlled trials showing EMDR significantly reduced PTSD symptoms with a large effect size.
Effects on depression and anxiety[14:09]
• A 2024 systematic review and meta-analysis of 25 studies with more than 1,000 participants found EMDR alleviated depressive symptoms.
• The same 2014 meta-analysis showed EMDR produced significant reductions in anxiety symptoms among PTSD patients with a large effect.
Comparative effectiveness versus other psychological treatments[14:42]
• A 2024 systematic review and individual participant data meta-analysis concluded EMDR is as effective as other psychological treatments for PTSD.
• It achieved comparable symptom reduction and remission rates to other established therapies.

Live EMDR demonstration and nonverbal processing

Setting up the EMDR exercise

Recalling a recent unpleasant experience[15:05]
• The guest asks the host to bring to mind an unpleasant experience from not too long ago.
• He guides the host to recall what he saw, the sounds, body sensations, and thoughts at that time.
• The host reports being able to recall sensory and bodily aspects of the event.
Initial intensity of the distress[15:43]
• When asked to rate how vivid the feeling is, the host says it is about 6-7 out of 10.

Performing the eye movement component

Guided eye tracking[15:55]
• The guest asks the host to follow his finger with his eyes while holding the memory in mind.
• He briefly instructs the host to look at him and take a deep breath during the process.
Immediate change in emotional state[16:33]
• When asked what comes to mind, the host says he feels calm.
• Upon returning to the memory, the host finds it hard to recall why it bothered him or to describe it clearly.

Interpreting the rapid shift and unknown mechanisms

Acknowledging the mystery of how EMDR works[16:49]
• The host remarks on how strange it is that the distress has become hard to access so quickly.
• The guest agrees and says this is the "weird stuff" of EMDR-we do not know the linear chain of where the emotional imprint goes.
• He notes that for more severe experiences, the process would take longer and involve more material surfacing.
EMDR as creating new associative processes[16:49]
• He describes EMDR as creating new associative processes in the brain.
• He gives an example where, during EMDR for something very nasty, a person might suddenly think of sitting at a childhood dining table or playing in a primary school playground.
• After EMDR, such a person can say, "That really sucked. Time to go on," indicating integration of the trauma as past.

Why EMDR minimizes verbal storytelling

Suspicion of language and filtering[17:34]
• The guest intentionally did not ask the host to describe the event.
• He is suspicious of language because it is interactive and filtered; people omit embarrassing details or things they don't want the therapist to know.
• By bypassing extensive verbalization, EMDR reorganizes core perceptual patterns in the brain without relying on narrative meaning-making.

Research funding and the guest's role

NIH-funded EMDR study[18:08]
• He says the main EMDR study was done by him and funded by NIH.
• He adds that his study was the last time someone received NIH funding specifically for EMDR.

Episode context as a replayed highlight

Identification of the clip as a most replayed moment

Host explains this segment is from a previous full episode[18:25]
• At the end, the host notes that what was just heard is a "most replayed moment" from a previous episode and mentions that the full episode is linked in the description.

Lessons Learned

Actionable insights and wisdom you can apply to your business, career, and personal life.

1

Trauma is not a binary label but a spectrum of experiences that can deeply shape how your brain perceives danger, time, and relationships.

Reflection Questions:

  • • What past experiences in my life might still be subtly influencing how I react to stress or conflict today?
  • • How do my body and emotions respond in situations that feel threatening, even when there's no clear external danger?
  • • What would it look like to treat my reactions with curiosity instead of judgment, assuming they might be linked to older experiences?
2

A key feature of unresolved trauma is that the brain relives events as if they are happening now, because the systems that keep track of time and context go offline under stress.

Reflection Questions:

  • • When I feel disproportionately upset, how often do I experience it as "this is happening to me right now" rather than "this reminds me of something"?
  • • How could noticing the difference between what is actually happening and what my body is reliving change my responses in heated moments?
  • • What simple grounding practices (like checking the date, looking around the room, or naming where I am) could I use when I feel overwhelmed?
3

Effective trauma work often requires engaging nonverbal brain systems-sensations, movements, and images-rather than relying solely on talking and rational explanation.

Reflection Questions:

  • • In what situations do I notice that talking about a problem doesn't change how I feel in my body?
  • • How might I incorporate more body-based or sensory practices (e.g., movement, breath, noticing sensations) into how I process difficult experiences?
  • • Where in my life could I experiment with paying attention to images and bodily feelings, not just thoughts, when I'm working through something hard?
4

Methods like EMDR suggest that brief, targeted interventions can help the brain form new associations so that painful events are recognized as past instead of constantly replayed in the present.

Reflection Questions:

  • • What recurring memories or emotional reactions in my life seem "stuck" and feel like they keep happening again?
  • • How open am I to structured approaches (whether EMDR or other evidence-based methods) that aim to change how my brain links memories and feelings?
  • • What is one step I could take this month to explore or learn more about trauma-focused treatments that might fit my needs?
5

Early life experiences create deep imprints on identity, so patterns rooted in childhood may require more patience and nuanced approaches than single-event, adult-onset traumas.

Reflection Questions:

  • • Which of my recurring emotional patterns feel like they've been with me for as long as I can remember?
  • • How might recognizing the depth and age of these patterns change my expectations about how quickly they should change?
  • • What supportive structures (therapeutic, relational, or self-practices) could I put in place to work with long-standing patterns over time rather than seeking quick fixes?

Episode Summary - Notes by Drew

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