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Anxiety can hinder so much of everyday life, but there are many helpful and safe ways to cope. For Miley Cyrus, she credits a specific type of therapy for helping her overcome stage fright—and also saving her life: EMDR.
“It’s so weird because it’s like watching a movie in your mind, but it’s different than dreaming,” the 32-year-old singer recently said in an interview with The New York Times. “You’re kind of more in yourself but still in another place of consciousness that’s kind of hard to describe unless you’ve been in that hypnotic state.”
EMDR, more formally known as eye movement desensitization and reprocessing, is a psychotherapy technique that treats trauma-related stress and other mental health issues such as depression, anxiety, panic, grief, loss, and substance disorders. Developed by psychologist Francine Shapiro, PhD, in 1987, it has since been used to help adults (and even children).
Cyrus explains in the interview that her therapist encouraged her to explore different points in her life that matched the anxiety she felt when she sang on stage. She eventually envisioned herself on a mountaintop in a place where she experienced a lot of trauma but surrounded by nature and beings—her grandmother, mom, and current boyfriend, herself as a little child, even her dog—that have brought her peace and love. When they all grabbed her hands to play Ring Around the Rosie, she came out of that vision feeling renewed. “I’ve never had stage fright again,” she says.
How does it work?
EMDR involves reprocessing traumatic memories or stressful events using bilateral stimulation. Elizabeth Ochoa, PhD, chief psychologist at Mount Sinai-Behavioral Health Center, explains that you’ll be asked to recall an emotion, image, or word that is linked to that traumatic event while a clinician administers a form of bilateral stimulation. The stimulation can include rapid eye movements during which a person tracks the movements of a finger, ball, or some other stimulus with their eyes, as well as tapping or auditory cues. The goal, Ochoa says, is to reduce distress related to that painful memory.
Who is it for?
Ochoa says that EMDR is perfect for those who are experiencing depression, anxiety, panic, or other emotional distress whenever a traumatic memory is triggered. If this happens frequently enough over a long period and starts to hinder your day-to-day life, she says, this might be a treatment to consider.
The benefits of EMDR
Studies show that those who use EMDR can reap the same benefits as those who undergo years of psychotherapy, just in a shorter amount of time. The idea is that EMDR can help the mind recover from psychological trauma by removing mental blocks that stop the healing, similar to how the body recovers from physical trauma. “The brain’s information processing system naturally moves toward mental health,” according to the EMDR Institute website. “If the system is blocked or imbalanced by the impact of a disturbing event, the emotional wound festers and can cause intense suffering. Once the block is removed, healing resumes. Using the detailed protocols and procedures learned in EMDR training sessions, clinicians help clients activate their natural healing processes.”
The downsides of EMDR
EMDR can be quite triggering at first. Uncomfortable feelings, distressing thoughts, and even disturbing dreams may emerge as you reprocess these traumatic events, Ochoa says. Those who are not ready to face those painful feelings may want to look for a gentler treatment option.
EMDR is not for those who have personality disorders, diagnosed mental illnesses, or severe psychiatric disorders. She adds that this treatment is not suitable for ongoing trauma that is currently happening in your present life. “In a general sense, for EMDR to be safely utilized, the patient needs to have sufficient emotional coping skills, distress tolerance, and stability to manage safely the emotional distress that will emerge during treatment,” she says.
What to expect during a session
There are eight phases in a single EMDR session. The initial phase will focus on identifying the memory that is causing all the trauma, Ochoa explains. The following phase will try to desensitize that memory using the same bilateral stimulation techniques. Once that memory is neutralized, the focus will shift to instilling positive beliefs. The EMDR Institute breaks it down like this:
Phase 1: The history session. Here, a therapist will assess your readiness and develop a personalized treatment plan. Together, you will identify possible memories that are triggering the trauma and gain more insight.
Phase 2: Your therapist will teach you ways to reduce emotional distress during and between sessions.
Phases 3 to 6: This is where the target of your trauma is identified using EMDR therapy stimulation techniques. Your therapist will have you identify a vivid visual image associated with the memory, a negative belief about yourself, and the related emotions and body sensations tied to the memory.
After each set of stimulation, you’ll be asked not to think of anything and be encouraged to note what feeling, thought, memory, etc., pops up. From there, your therapist will decide what to focus on next. If you become more distressed, your therapist will help calm you down. If you are progressing and finding more neutral or positive feelings toward a targeted memory, your therapist will try to reinforce that belief during the next session.
Phase 7: Closure. Your therapist will ask you to keep a log for the week and document times when you’re feeling distressed. This will encourage you to practice what you’ve learned in previous sessions and focus on positive self-beliefs.
Phase 8: This begins at your next session to assess whether you’ve made any progress during the week. And then you go through all the phases again.
You can expect each session to last between an hour and 90 minutes, and it is typically held once a week. But the number of EMDR sessions a person has may vary; it’s all dependent on the type of trauma you want to address and how you progress during treatment.
And Cyrus says she isn’t done with EMDR: She and her therapist are now tackling other things. “I did more sessions,” she told The New York Times, “because there was so much more under that.”
