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How to try the therapy style that Miley Cyrus says saved her life

Celebs talking about mental health therapy is nothing new, but what is new is how many celebrities are coming out as fans of a specific style of therapy called EMDR (short for eye movement desensitization reprocessing, though it has evolved far beyond that name). Most recently, Miley Cyrus that she loves EMDR, and that it “saved my life.”

Now that EMDR therapy is available online, this unique type of therapy is more accessible than ever, reports . Keep reading if you’re interested in virtual EMDR and are curious about how it works to help you decide if online EMDR is right for you.

What is EMDR and why is it getting so popular?

Eye movement desensitization reprocessing (EMDR) is an extensively researched, and highly effective psychotherapy method that’s proven to help people recover from trauma and manage a wide range of problematic symptoms.

Despite the name, EMDR doesn’t always incorporate eye movements. But the use of bilateral stimulation (BLS) — utilizing sounds or sensations to stimulate both sides of the brain to reprocess information — is the key component. A therapist might snap their fingers in a client's left ear, then their right, or they may place paddles in each of a client’s hands that vibrate at alternate intervals.

EMDR has a quickly growing fanbase. Some clients seek EMDR to get , sometimes in less than 12 weeks. Others prefer EMDR because they don’t want to rehash their trauma narrative. EMDR can be done with .

People are also learning that EMDR is not just for , but can now effectively treat many such as addiction, anxiety, chronic pain, depression, grief, OCD, phobias, and relational stressors.

What is virtual EMDR therapy, and how does it work?

Virtual EMDR implements the same methods of bilateral stimulation, including eye movements, auditory tones, or buzzer options, but may adjust them to fit whatever is available—and whatever works best—for the client.

At first, EMDR may elicit some big emotional responses, sensations, or fears. Because of this, it’s good to talk about expectations before you begin. Many don’t know there are actually of EMDR, and the first few phases involve history taking and building resources. Working through these phases together may take weeks, months, or even longer before the “reprocessing” part begins.

Is virtual EMDR effective?

Online EMDR sessions make this type of therapy more accessible, and the good news is that they can be just as effective as in-person.

published in the journal BMC Psychiatry collected efficacy data on a total of 93 patients receiving EMDR therapy online, and found that patients achieved statistically significant and clinically meaningful reductions in symptoms — and that results on par with those achieved with in-person therapy.

Some EMDR therapists use online tools to support BLS, such as those provided by , , , and .

Are there downsides to virtual EMDR?

The pros of virtual EMDR seem simple, such as the reality of having easier access (especially for those in remote places or with travel limitations). Virtual EMDR can help save on gas or childcare and may be a fit for anyone wishing to enjoy therapy from the comfort of home or a favorite space.

That said, there can be the same blockers and downsides that come with any kind of online therapy. You might have unreliable internet service or distractions in your home that could interrupt your sessions.

Some clients also struggle to connect and trust a therapist online (consider young children, for example). A strong relationship with trust is crucial in helping a client avoid overly intense emotional or physical reactions (known in EMDR as ) that can reduce the efficacy of treatment.

Online, it can also be more difficult for therapists to observe the more subtle signals and state changes, such as voice volume or body language. That said, an experienced online EMDR practitioner will reduce the likelihood of this happening by ensuring that they can see and hear you clearly at the start of every session.

What exactly happens in EMDR therapy?

After defining a positive goal, your EMDR therapist will prompt you to recall a specific memory, feeling, and belief (such as “I’m bad or not safe/lovable/capable”). Your therapist will then use a combination of personalized cues, support, and BLS to support your brain in reprocessing the memory.

You may quickly begin to integrate new ideas and feelings (such as “I’m able to learn/I’m safe/lovable/capable, etc.). In subsequent sessions, the therapist will help you reassess a memory or concern until it no longer has the same negative impact.

Over time the impact of — and your responses to — previously traumatic memories are often reduced or resolved. Through adaptive information processing, you can gain greater calm and functioning in your mind, body, and world.

What does it mean to process a memory adaptively?

Imagine that when you were little, someone told you not to touch a hot stove (or perhaps you did and you quickly learned that it led to pain). Information about “hot stoves” was likely stored adaptively, meaning appropriately and helpfully. In other words, your automatic thoughts and feelings about stoves succeeded in keeping you safe.

That’s how (AIP) is supposed to work. On the other hand, sometimes information gets stored in less helpful ways, leading to less helpful automatic thoughts and feelings.

For example, imagine someone has crashed a motorcycle into a bakery. For months or years afterward, this person may become terrified at the smell of bread.

That fear is the result of automatic thoughts and feelings that come up in response to stored information about the smell of bread (it’s dangerous!). In situations like this, it's in a person’s best interest to reprocess information so they don’t have that unhelpful, subconscious response.

How do I get the most out of virtual EMDR?

The EMDR International Association and other offer many tips to help people get the most out of virtual EMDR. Therapists and clients should work to discuss or resolve any safety, stability, or crisis concerns, including risk behaviors or suicidality, substance abuse, and any recent or upcoming changes to medications or life circumstances.

Clients with specialized or higher acuity concerns (such as co-occurring conditions, complex PTSD, erectile dysfunction, dissociative identity disorder, or severe and persistent mental illness) should work with someone familiar with those conditions.

Before beginning virtual EMDR online, clients can ask:

• How were you trained (EMDRIA, EMDR Institute, or another credible organization)?
• How long have you been doing EMDR?
• How have you helped people with similar concerns and conditions?
• How or when do we know if I’m a good candidate for EMDR?
• What happens if we get disconnected during a session?
• Do you accept my insurance?
• How does scheduling (and late cancellations) work?
• Is there anything else I should know?

To get the most out of virtual EMDR, clients can try:

• Securing a quiet and private space.
• Having a chair that’s comfortable enough to sit in for an hour or more.
• Establishing a strong, secure internet connection.
• Using a big screen (and any tools or platforms suggested by your therapist).
• Having a reliable camera and audio for video conferencing.
• Checking for adequate lighting (no back-lit windows or dark basements).
• Gathering comfort items (support animals, blankets, tissues, water, etc.).
• Limiting distractions (less supportive pets, people, children, phones, etc.).
• Leaving time after sessions to relax.

Can anyone get great results from EMDR?

Is it reasonable to expect that anyone can experience lasting changes with EMDR?

In , symptoms and conditions once considered “permanent” really can and do change. Even subconsciously, if you once “learned” unhelpful ways of doing things (like fearing the smell of bread), then in theory you can learn to “unlearn it.”

Many people can get great results with EMDR. Anyone feeling stuck or “out of balance” with their symptoms or condition should consider seeking support — whether that ends up being through EMDR therapy or otherwise, it may be time to take the next step.

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