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

By Steven Bartlett

In this episode of The Diary Of A CEO, Bessel van der Kolk explores the neurological effects of trauma on the brain. The discussion details how trauma alters specific brain regions, including the periaqueductal gray and amygdala, leading to heightened feelings of danger and increased sensitivity to triggers. Van der Kolk explains how trauma can disrupt body awareness and make it difficult for survivors to distinguish between past traumatic events and the present moment.

The conversation then turns to Eye Movement Desensitization and Reprocessing (EMDR) therapy as a treatment for trauma-related disorders. Van der Kolk describes how EMDR helps process traumatic memories through eye movements, making them feel more like past events rather than ongoing experiences. He presents evidence of its effectiveness, particularly in treating adult-onset trauma, while noting its limitations in addressing childhood trauma.

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

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

1-Page Summary

The Neurological Impact of Trauma

According to Bessel van der Kolk, trauma significantly alters key regions of the brain. He explains that the periaqueductal gray, often called the "cockroach center," becomes hyperactive in trauma survivors, causing constant feelings of danger and dread. Similarly, the amygdala becomes hypersensitive, making individuals easily triggered by minor stimuli.

Van der Kolk notes that trauma can also affect the insula, leading to decreased body awareness and emotional disconnection. Additionally, trauma disrupts the dorsolateral prefrontal cortex, the brain's "timekeeper," making it difficult for survivors to distinguish between past traumatic events and the present moment.

The Psychological Experience of Trauma and Being "Triggered"

Van der Kolk and Steven Bartlett discuss how trauma triggers can provoke intense emotional and physiological responses long after the original event. When triggered, survivors experience a fight-or-flight response even without immediate threat. Van der Kolk emphasizes that these reactions aren't simply memories but visceral experiences where the body responds as if the trauma is happening in real-time.

Eye Movement Desensitization and Reprocessing (EMDR) therapy has shown significant success in treating PTSD and trauma-related disorders. Van der Kolk demonstrates how EMDR helps process traumatic memories through eye movements, making them feel more like past events rather than ongoing experiences. He shares an example of a car crash survivor who, after just three EMDR sessions, could discuss the accident without distress and resume driving.

While EMDR proves particularly effective for adult-onset trauma, helping to reduce symptoms of PTSD, depression, and anxiety, van der Kolk notes that it may be less effective for early childhood trauma.

1-Page Summary

Additional Materials

Clarifications

  • The periaqueductal gray (PAG) is a region in the brainstem involved in pain modulation and defensive behaviors. In the context of trauma, the PAG can become hyperactive, contributing to heightened feelings of fear and vigilance in trauma survivors. This hyperactivity in the PAG may lead to an exaggerated response to perceived threats, even in non-threatening situations. The PAG's involvement in trauma responses underscores its role in processing and reacting to stress and danger.
  • The insula is a brain region involved in processing emotions and bodily sensations. In trauma, the insula can be affected, leading to decreased body awareness and emotional disconnection. This disruption can contribute to difficulties in recognizing and regulating emotions in trauma survivors. The insula's involvement highlights how trauma can impact both emotional and physical experiences.
  • The dorsolateral prefrontal cortex is responsible for executive functions like decision-making and emotional regulation. In trauma survivors, this brain region can be disrupted, affecting their ability to differentiate past traumatic events from the present. This disruption can lead to difficulties in managing emotions and processing memories effectively. The impaired function of the dorsolateral prefrontal cortex can contribute to ongoing distress and challenges in coping with the aftermath of trauma.
  • In response to trauma triggers, the fight-or-flight response is activated, a primal reaction preparing the body to confront or flee from perceived danger. This response involves a surge of stress hormones like adrenaline, increasing heart rate and blood pressure, and redirecting blood flow to essential muscles for quick action. It can lead to intense emotional and physiological reactions, even in situations where there is no immediate physical threat present. The fight-or-flight response is a survival mechanism that evolved to help individuals respond rapidly to potential harm, but in the context of trauma triggers, it can be triggered inappropriately, causing distress and anxiety.
  • Eye Movement Desensitization and Reprocessing (EMDR) therapy is a psychotherapy approach that helps individuals process traumatic memories. During EMDR sessions, the therapist guides the patient through sets of bilateral stimulation, such as side-to-side eye movements or taps, while focusing on the traumatic memory. This bilateral stimulation is believed to help the brain reprocess the memory, reducing its emotional intensity and allowing the individual to integrate it more adaptively. EMDR aims to transform the distressing memory into a more neutral or positive state, enabling the individual to alleviate the emotional distress associated with the trauma.

Counterarguments

  • While EMDR therapy is effective for many, some studies suggest that its efficacy is comparable to other trauma-focused therapies, and it may not be superior to all other forms of treatment.
  • The exact mechanisms by which EMDR works are still not fully understood, and some researchers argue that the eye movements may not be a necessary component of the therapy.
  • The long-term effectiveness of EMDR and its ability to prevent relapse of symptoms is an area that requires more research.
  • The idea that specific brain regions are uniformly affected by trauma may be an oversimplification, as individual responses to trauma can vary greatly.
  • The concept of the brain's "timekeeper" being disrupted by trauma is a metaphor that may not capture the complexity of how the brain processes time and traumatic memories.
  • Some critics argue that the term "triggered" is sometimes used too broadly in popular discourse, potentially minimizing the experiences of those with severe trauma responses.
  • There is ongoing debate about the pathologization of normal stress responses and where to draw the line between typical human reactions to adversity and clinical trauma responses.
  • The effectiveness of EMDR in treating early childhood trauma is an area that may benefit from more nuanced research, considering the complexity of developmental trauma and attachment issues.
  • The physiological responses described as being a result of trauma triggers can also be caused by other disorders, and it's important to differentiate between them for accurate diagnosis and treatment.
  • Some experts emphasize the importance of integrating EMDR with a broader therapeutic approach, rather than relying on it as a standalone treatment.

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

The Neurological Impact of Trauma

Bessel van der Kolk discusses how trauma fundamentally alters various regions of the brain that are involved in emotion, sensory processing, and temporal awareness.

Trauma Alters Brain Regions Involved In Emotion, Sensory Processing, and Temporal Awareness

Experts like Bessel van der Kolk provide insights into how the brain's function and structure are impacted by traumatic experiences.

"Smoke Detector" Brain Region, Periaqueductal Gray, Hyperactive in Trauma Survivors, Causing Subliminal Dread, Hypervigilance

According to van der Kolk, in traumatized individuals, a brain region called the periaqueductal gray becomes hyperactive. This area, located beneath the amygdala and often referred to as the "cockroach center" of the brain, causes a constant sense of danger and subliminal dread in those affected. This hyperactivity results in an ongoing state of hypervigilance. Similarly, the amygdala, known as the "smoke detector," becomes hypersensitive, causing trauma survivors to be easily triggered by seemingly small stimuli. This hypersensitivity contributes to a state of heightened alertness and an ever-present feeling of dread.

Trauma May Reduce Insula Activity, Affecting Body Awareness and Causing Disconnection

Van der Kolk points out that trauma can also disrupt the insula, which is responsible for connecting physical sensations to body awareness. In many trauma survivors, this area of the brain can shut down, leading to decreased body sensation and aliveness, which may paradoxically reduce the constant feeling of fear. However, a reduction in insula activity can cause individuals to feel ...

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The Neurological Impact of Trauma

Additional Materials

Clarifications

  • The periaqueductal gray (PAG) is a brain region involved in processing pain and defensive behaviors. It earned the nickname "cockroach center" due to its role in triggering survival responses like freezing or fleeing. In trauma survivors, hyperactivity in the PAG can lead to a constant sense of danger and hypervigilance. This heightened activity contributes to the ongoing feeling of dread experienced by individuals who have been through traumatic events.
  • The insula is a brain region responsible for integrating physical sensations with emotional and cognitive processes, contributing to one's sense of body awareness. It helps in recognizing and interpreting internal bodily signals, such as heartbeat, temperature, and pain, allowing individuals to understand their physical state and emotions. Disruption in insula activity, often seen in trauma survivors, can lead to a disconnect between physical sensations and emotional experiences, affecting how one perceives and responds to their body's signals. This disconnection may result in decreased awareness of bodily sensations and emotions, impacting overall well-being and self-regulation.
  • The dorsolateral prefrontal cortex is involved in executive functions like planning, decision-making, and working memory. It helps regulate attention and control impulses. In the context of trauma, it plays a role in distinguishing between past memories and present reality. When disrupted, it can make traumatic experiences feel like they are happening in the pre ...

Counterarguments

  • The extent of the changes in brain regions can vary significantly from person to person, and not all individuals with trauma will exhibit the same neurological patterns.
  • Some research suggests that neuroplasticity can lead to recovery of function in some of the affected brain regions with appropriate therapy and interventions.
  • The relationship between trauma and brain changes is complex, and there may be other contributing factors such as genetics, pre-existing mental health conditions, and social support systems that also play a significant role.
  • The idea that the periaqueductal gray causes a constant sense of danger might be an oversimplification, as this brain region is involved in a variety of functions, and its role in trauma response may be more nuanced.
  • While the amygdala's hypersensitivity is well-documented, some individuals may develop coping mechanisms that mitigate this response, suggesting that the brain's reaction to trauma is not uniform.
  • The reduction in insula activity and its effects on body awareness and disconnection might not be a universal response to trauma, and some indi ...

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

The Psychological Experience of Trauma and Being "Triggered"

The discussions with Bessel van der Kolk and Steven Bartlett delve into the sensitive and complex nature of trauma triggers, which can incite significant emotional and physiological responses in individuals long after the traumatic event has passed.

Trauma Can "Trigger" a Fight-Or-flight Response Without Immediate Threat

An act as simple as perceiving a minor trigger can instantaneously evoke a fight-or-flight response in a trauma survivor as Bessel van der Kolk describes. Although there might be no immediate threat, the individual undergoes a reaction as if they were in an intense and dangerous situation. This hyperaroused state is a testament to the enduring impact of trauma on the human body and mind.

Triggering Is a Visceral, Present Emotional Reaction, Indistinguishable From the Original Traumatic Event

According to van der Kolk, when a person is "triggered," it is not a cognitive or rational process but rather an emotional and visceral experience. In these moments, emotions surge as if terrible things are currently being inflicted upon them, making the past trauma feel real and ongoing. This reaction blurs the lines between past and present, creating a moment where the trauma is relived emotionally.

Triggers: Sensory Cues Reminding an Individual of Trauma, Causing Reactions as if It Is Happening Again

Van der Kolk emphasizes that triggers are often sensory cues that remind an individual of their trauma, causing reactions as if the traumatic event is happening once again. These triggers provoke the amygdala, the part of the brain that is connected ...

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The Psychological Experience of Trauma and Being "Triggered"

Additional Materials

Clarifications

  • Trauma triggers are stimuli that remind individuals of past traumatic experiences, causing intense emotional and physiological reactions. These triggers can lead to a fight-or-flight response, even in situations where there is no immediate danger present. When triggered, individuals may feel as though the traumatic event is happening again, blurring the lines between past and present experiences. Understanding triggers is crucial in supporting individuals who have experienced trauma, as they can profoundly impact mental and emotional well-being.
  • The physiological and emotional responses triggered by trauma involve the body's fight-or-flight response, where individuals can react as if in immediate danger even when there is none. These responses are often intense and can be triggered by sensory cues that remind the individual of the traumatic event. The amygdala, a part of the brain linked to emotional processing and threat detection, plays a significant role in these reactions. Trauma triggers can lead to a heightened state of alertness and emotional turmoil, blurring the lines between past and present experiences.
  • The amygdala is a key part of the brain involved in processing emotions, particularly fear and threat detection. It plays a crucial role in the body's fight-or-flight response, triggering physiological reactions in response to perceived danger. The amygdala's activation can lead to heightened emotional responses and increased alertness when faced with potential threats. This brain region helps link sensory information to emotional responses, influencing how we react to situations based on past experiences.
  • When someone is triggered, the emotional reaction is immediate and intense, driven by past trauma. This emotional response can feel as if the traumatic event is happening again in the present moment. In ...

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

Effectiveness of Emdr Therapy In Treating Trauma-Related Disorders

Emdr Therapy Effectively Treats Ptsd and Trauma

Eye Movement Desensitization and Reprocessing (EMDR) therapy has been found to be an effective treatment for those suffering from PTSD and other trauma-related disorders.

Emdr Helps Process Trauma With Eye Movements, Making Memories Feel Like Past Events

EMDR therapy has proven successful in helping individuals, such as a car crash survivor, process their trauma in such a way that the memories become less distressing and feel more like past events than ongoing traumas. By doing so, individuals like the car crash survivor can function well after treatment.

Bessel van der Kolk demonstrated a brief EMDR exercise with Steven Bartlett, where Bartlett was asked to recall an unpleasant experience along with the associated feelings. As Bartlett followed van der Kolk's finger with his eyes, he reported a sense of calm. Furthermore, when asked to revisit the feelings connected to the memory, Bartlett had difficulty recalling why the memory bothered him.

Research: Emdr Therapy Significantly Reduces Ptsd, Depression, Anxiety Symptoms, With High Improvement and Remission Rates, Especially For Adult-Onset Trauma

Van der Kolk explains that through EMDR, new associative processes are created in the brain. While undergoing EMDR, unrelated and less distressing memories may also arise, and individuals often feel ready to move on from their traumas after sessions. An essential aspect of EMDR is the circumvention of language, allowing individuals to process traumas without verbal narratives' interference or the discomfort of sharing details due to embarrassment or unwillingness.

Van der Kolk provides ano ...

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Effectiveness of Emdr Therapy In Treating Trauma-Related Disorders

Additional Materials

Clarifications

  • Eye Movement Desensitization and Reprocessing (EMDR) therapy is a form of psychotherapy that helps individuals process traumatic memories by using bilateral stimulation, such as eye movements. EMDR aims to reduce the distress associated with traumatic memories and help individuals reprocess these memories in a less distressing way. The therapy involves a structured approach where the individual recalls distressing memories while focusing on external stimuli like the therapist's hand movements. EMDR has shown effectiveness in treating conditions like PTSD, anxiety, and depression by facilitating the reprocessing of traumatic experiences.
  • Post-Traumatic Stress Disorder (PTSD) is a mental health condition triggered by a terrifying event, either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event. PTSD can disrupt a person's daily life and is commonly associated with military combat, natural disasters, accidents, or violent personal assaults. Treatment often involves therapy, medication, or a combination of both to help manage symptoms and improve quality of life.
  • Trauma-related disorders encompass mental health conditions stemming from experiencing distressing events. These disorders can include PTSD, which arises from traumatic incidents, leading to various symptoms like anxiety and depression. Treatment approaches like EMDR therapy aim to alleviate the impact of trauma on individuals' mental well-being. Understanding trauma-related disorders involves recognizing the lasting effects of distressing experiences on an individual's mental health.
  • Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapy technique developed by Francine Shapiro in 1987 to treat PTSD and other psychological conditions. It involves recalling traumatic memories while undergoing bilateral stimulation, such as side-to-side eye movements, to help process and reduce the distress associated with these memories. EMDR is recognized by various medical bodies for its effectiveness in treating ...

Counterarguments

  • EMDR therapy, while effective for many, may not be universally effective for all individuals with PTSD or trauma-related disorders, as treatment efficacy can vary widely among individuals.
  • The mechanism by which EMDR helps process trauma is not fully understood, and some researchers argue that the eye movements may not be a necessary component of the therapy.
  • Some studies suggest that EMDR may not be significantly more effective than other trauma-focused therapies, and its purported rapid effects may be overstated.
  • The long-term effectiveness of EMDR therapy is not as well-documented as its short-term efficacy, and more research may be needed to understand its long-term benefits.
  • EMDR therapy's claim to bypass the need for verbal narrative could be seen as a limitation for those who find articulating their experience a crucial part of their heal ...

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