Why Celebrities Are Turning to EMDR Therapy for Their Mental Health
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This season of the Real Housewives of Beverly Hills began with cast member Dorit Kemsley's shocking home invasion robbery, where she was held at gunpoint. Her subsequent journey with PTSD has been a key part of her storyline and, as she shared in one recent episode, one way she's coping with the trauma is with a form of therapy called EMDR, which stands for eye movement desensitization and reprocessing.
If you aren't a fan of RHOBH, perhaps you've heard of EMDR through Prince Harry. Last year, he and Oprah Winfrey co-produced The Me You Can't See, an Apple TV docuseries on mental health. In his own dedicated episode, the Duke of Sussex discusses the trauma of his mother, Princess Diana's, tragic death, sharing that he often feels "helpless" and "hunted."
To address these issues and his resulting anxiety, Harry turned to EMDR and even filmed a private session with his therapist to demonstrate how it's done for the documentary. In the session, he discusses his feelings and experiences, crosses his arms across his chest, and taps each shoulder in a steady rhythm. At the same time, the duke's eyes are closed, yet moving back and forth.
These movements are called bilateral stimulation (BLS), which is the linchpin of EMDR therapy, which other celebrities, including Sandra Bullock, Brie Larson, and Evan Rachel Wood, have tried. Along with following a therapist's moving finger or listening to repeated tones, BLS is meant to engage a person's eyes, ears, or body as they respond to the stimuli.
And it could be life-changing for the 15 million Americans diagnosed with PTSD per year, according to the National Center for PTSD, as EMDR may help reduce symptoms like anger; self-imposed isolation; fear; strong, dark thoughts; and flashbacks and nightmares of the trauma.
To learn more about EMDR therapy and how it helps those suffering from PTSD, we spoke with three experts in the field.
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What is EMDR therapy?
EMDR is a type of therapy developed 35 years ago by California psychologist Francine Shapiro to treat post-traumatic stress disorder (PTSD). "[Shapiro] stumbled into this practice while she was talking about her own childhood trauma," explains Ani Kalayjian, an EMDR practitioner and the president of Meaningful World, which focuses on trauma outreach and prevention, who has worked with Shapiro in the past. "When she started talking, her eyes started moving, and she kept on doing it consciously, and she noticed that her trauma is going down and down and down in severity."
Practitioners believe that remembering a traumatic event while engaging in BLS changes the way the patient processes and stores the memory. Some think it's related to REM (rapid eye movement), the deep state of sleep when we process our memories and experiences.
Marianne Silva, a clinical social worker at the Center for PTSD who offers EMDR therapy, says that the treatment is based on the fact that, when we process new information and experiences, we connect what's happening in the present to what has happened in the past.
"When, under normal circumstances, we have a new experience, we make sense of it. We process it. It kind of gets digested," she says. "But, when something traumatic happens, it overwhelms our natural information processing system. It gets kind of stuck with the feelings, the thoughts, the images — all of those sensations."
So, when something happens in the present that reminds us of that past trauma, it triggers those negative or distressing feelings or thoughts that were never fully processed, she says.
However, with EMDR therapy, focusing on that traumatic experience while being distracted by BLS calms the mind and body. "Because it's being distracted, it's able to make new associations and fully process and digest the memory," Silva says.
Any therapist who has undergone EMDR training can administer the treatment, which generally costs as much as a talk therapy session and lasts about 60 to 90 minutes. According to the American Psychological Association (APA), the standard course of treatment comprises two sessions a week for three to six weeks.
How effective is EMDR therapy?
Although it's been around for decades, the exact way EMDR physiologically affects the brain remains something of a mystery — which practitioners of the therapy will openly admit.
"We know it's effective, but we don't totally know why," says Sonya Norman, the PTSD consultation program director at the Center for PTSD at the U.S. Department of Veterans Affairs. The organization actively encourages service members with PTSD to undergo the treatment.
Despite the somewhat mysterious way in which it works (which has led to some calling EMDR pseudoscience), research has shown that it's very effective in treating PTSD — even more so than traditional methods. A 2014 study published in The Permanente Journal found that participants with PTSD who underwent EMDR therapy "noted rapid decreases in negative emotions and/or vividness of disturbing images" and that these results were "more rapid and/or more effective than trauma-focused cognitive behavioral therapy."
Another study, conducted in 2018 and published in Frontiers in Psychology, yielded a similar conclusion. "EMDR therapy improved PTSD diagnosis, reduced PTSD symptoms, and reduced other trauma-related symptoms," the authors wrote. "EMDR therapy was evidenced as being more effective than other trauma treatments."
What happens in a typical EMDR session?
There are eight phases in EMDR treatment, per the APA.
The first is history-taking and treatment planning, which is "similar to any kind of therapy," says Silva. "We want to have a solid assessment of the trauma, the symptoms, and other things that might be happening in somebody's life."
Next, in the preparation phase, the therapist explains how EMDR works and what it will entail.
During the assessment phase, the patient identifies the memory they want to focus on, known as the "target," says Silva. "We identify a target, which includes the image of the memory, the negative belief the client holds about themselves now, the feelings, and the body sensations associated with it."
Then, in the desensitization phase, the patient focuses on that target while engaging in BLS for 30 to 60 seconds at a time. "Then the therapist asks the client what they're noticing, and there can be a change in really anything," she says. "It could be a shift in the image that they were noticing, their feelings. They might notice a change in the body sensation or belief. A new memory might pop up."
The BLS would then continue for several rounds, known as the installation phase, "until they start noticing that the distress related to the original target memory is down and that the negative belief that they were telling themselves starts to shift to a more positive belief about the self," she says.
Near the end, the patient observes how they physically feel during the body scan phase, and, finally, closure is when the therapist wraps things up, perhaps giving the patient EMDR exercises to do at home.
Kalayjian ends her EMDR sessions with a short meditation so the client is relaxed and not "hyper-aroused in a trauma situation," she says. "I make sure they're down to their normal emotional state."
The last of the eight phases, re-evaluation, actually takes place at the start of the next treatment session. The therapist and patient discuss how the previous session went and what can be improved moving forward.
How does EMDR compare to other methods of treating PTSD?
"It's one of the more effective therapies," says Norman, pointing out that EMDR is part of the trauma-focused category of therapy. Along with EMDR, prolonged exposure therapy and cognitive processing therapy are some of the most effective methods in this category, she says, compared to other treatments like traditional talk therapy or medication (Zoloft and Paxil are the only drugs FDA-approved to treat PTSD).
"We've had some comparative effectiveness trials but not really enough yet to say that this one is better for this person or this one is better overall," she says about EMDR and other trauma-focused therapies. "They're all really effective."
Are there any side effects or risks involved with EMDR?
Not really, which is why there isn't much controversy surrounding it (unlike say, MDMA therapy for PTSD). While some might consider the distressful experience of revisiting trauma a negative side effect, it's part of the healing process. Norman compares it to physical therapy: You may feel worse before you feel better.
That said, not everyone is a good candidate for EMDR therapy. Kalayjian notes that the treatment would likely not be effective for those with personality dissociative disorder (aka multiple personality disorder) or borderline personality disorder because they may dissociate, mentally and emotionally distancing themselves from both the past and present. Patients need to deeply focus on their traumatic memories in order for EMDR to work.
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Where can you find an EMDR therapist?
While EMDR therapy may not necessarily be well known, it's not difficult to find. The EMDR International Association runs a directory of trained EMDR therapists worldwide, and it currently has 12,000 practitioners listed. For example, I looked up EMDR practitioners within 25 miles of my South Florida home, and there were 73 results. So, if you're suffering from the nightmare that is PTSD, know that help just might be closer than you think.
The good news is, more and more providers within the Veterans Administration have been getting trained in EMDR, Silva says, and more organizations, like the APA and International Society of Traumatic Stress, are recommending it as a first-line treatment for PTSD.
Kalayjian agrees that EMDR is clearly becoming more popular right now — and she hopes it becomes even more so in the future. "It's really effective, and I don't think it's utilized enough."