EMDR: Bilateral Eye Movement Reprocessing
Move your eyes side to side while recalling the trauma, and the brain files it as past instead of present.
- Difficulty
- Easy
- Time to result
- ~weeks to results
- Steps
- 4
- Confidence
- 95%
EMDR is the intervention van der Kolk calls his gateway drug. He had written three books on PTSD, including the first book in which the term appears, and was a world-renowned expert with no idea how to treat it, because people kept reliving the trauma and nobody could stop it. When EMDR was described to him he did not believe a word of it — you move your fingers in front of people's eyes — and says everybody who hears it thinks it is crazy. He then watched it work. It took fifteen years to raise funding to study the mechanism. The finding was that moving the eyes back and forth while recalling a traumatic experience activates pathways between the temporo-parietal junction, which carries your sense of self, and the insula, which carries body awareness — pathways that let the brain make the distinction that this happened to me, but in the past. In his research 78% of people with adult-onset trauma such as assault or rape by a stranger were completely cured. Early childhood trauma is much more stubborn and resistant, because early imprints form who you are rather than being added to who you already were.
Origin
Van der Kolk was a leading PTSD researcher without a treatment. Someone told him about EMDR and he dismissed it. After seeing practitioners demonstrate it, he pursued funding for fifteen years, and his NIH-funded study became the main trial cited for the method. He notes it was also the last time anyone got NIH funding for EMDR.
Core principles
- 01Bilateral eye movement while recalling the event does the work; the recall alone does not.
- 02The mechanism is associative reorganisation, not linear insight.
- 03The therapist does not need to know what happened to you.
- 04Adult-onset trauma responds far better than early childhood trauma.
- 05Early imprints form identity, which is why they resist.
How to run it
- 1
Bring the experience to mind through the senses
Van der Kolk's live demonstration on Bartlett proceeds sensory channel by sensory channel: what you saw, what the voice sounded like, what your body felt like, what you were thinking.
Pro tip Sensory specificity is what makes the material live rather than narrated.
Watch out A summarised account of the event is not the same input.
- 2
Rate the vividness
He asks how vivid the feeling of recollecting it is right now. Bartlett rates it six or seven out of ten. The rating gives a before-measure for the same question afterwards.
Pro tip The number is the outcome measure — without it, change is unverifiable.
Watch out Starting with something overwhelming rather than moderately unpleasant makes the session much longer and surfaces a great deal else.
- 3
Track the moving finger while holding the material
The person stays with the recalled experience and follows the therapist's finger with their eyes, breathing. This is the whole intervention.
Pro tip Van der Kolk's own experience was that unrelated images surfaced — his childhood dining table, a primary-school playground — which he takes as evidence of new associative processes forming.
Watch out He is candid that nobody knows the linearity or where the emotional imprint goes.
- 4
Re-check the material
Return to the memory and see what remains. Bartlett reports feeling calm and says it is hard to recall why he was bothered.
Pro tip The target result is a felt shift in charge, not a changed account of the facts.
Watch out Genuinely severe material takes far longer and pulls a great deal of other material with it.
In the wild
Van der Kolk moved his chair closer and ran the full protocol on Bartlett in the studio using an unpleasant recent experience Bartlett never described aloud, rated six or seven out of ten for vividness.
→ Bartlett reported feeling calm and that it had become hard to recall why he was bothered. He called it weird; van der Kolk agreed nobody knows where the imprint went.
In van der Kolk's NIH-funded research, participants with adult trauma — assaulted or raped by a stranger — were treated with EMDR.
→ 78% were completely cured. He is careful that this is not the majority of the people he sees, most of whom have early childhood trauma that is much more resistant.
Common mistakes
Requiring the patient to narrate the trauma
Van der Kolk deliberately did not ask Bartlett what he was going through. He is suspicious of language because it is always interactive — you filter yourself over what is embarrassing or what you do not want the therapist to know. Circumventing the verbal process is part of the design.
Expecting the same results for childhood trauma
The 78% figure is for adult-onset trauma. Early childhood experiences create who you are — the imprint is far deeper — and are much more stubborn and resistant.
Dismissing it because the mechanism sounds absurd
Van der Kolk did exactly this and lost time. He notes people are so conformist about being approved of by teachers and peers that anything innovative is quickly labelled kooky.
Is it for you?
Best for
People with a discrete adult traumatic event that keeps intruding, and clinicians evaluating evidence-based options.
Not ideal for
Complex developmental trauma, where van der Kolk says results are far weaker and other routes come first.
From the transcript
“if you move your eyes back and forth as you recall a traumatic experience you activate certain pathways between the temporo-parietal junction which is your…”
“78% of them were completely cured”
“I'm suspicious of language because language is always an interactive process”
From the episode
The Body Trauma Expert: Medicating Kids Can Harm Brain Development! Eye Movement Trick That Fixes Trauma! The Secret To EMDR Therapy! - Bessel van Der Kolk
Bessel van der Kolk