What Is EMDR—the Form of Therapy That Miley Cyrus Says ‘Saved My Life’?

Miley Cyrus has a history of performing in front of massive crowds, both as Miley and as Hannah Montana. But, she started opening up about having anxiety around large performances during the pandemic. Now, the 32-year-old is speaking out about what helped her move past that fear: A form of psychotherapy called eye movement desensitization and reprocessing, more commonly known as EMDR.

“Love it, saved my life,” the Grammy winner told The New York Times in a new interview. Cyrus shared a lot of details about her experience, noting that she was encouraged to “seat” herself on a train during her therapy session. “It’s so weird, because it’s like watching a movie in your mind, but it’s different than dreaming,” she said. “You’re kind of more in yourself but still in another place of consciousness that’s hard to describe unless you’ve been in that hypnotic state.”

Cyrus said that her therapist encouraged her to watch her life like a movie. “I see all these times, just frames of these moments like a film, and he goes, 'What’s the feeling of anxiety that comes up for you when you’re performing?’ And I never even thought about it before, but in my hypnotic place, I said, ‘I just want them to love me so bad,’” she said. 

But after her therapist asked her the first time she felt that way, Cyrus said, “The train stopped moving forward, and it started going backward…it sounds so trippy, but this is medical. This is real.”

Cyrus' thoughts about performing in front of fans mirrored some of her mother's experiences, too. She described her mother's experience with adoption, explaining that her mom thought, "I just want them to want me. I want them to love me so bad.”

From there, Cyrus said her therapist nudged her to think about when she actually felt loved. She said she saw her mom being handed over to Cyrus’ grandmother, who adopted her. “I see myself being handed to my grandmother too as a baby,” she said. “My mom had a very intense, very dangerous pregnancy with me, so I wasn’t actually handed to my mom. I was handed to my grandma. So I saw myself being handed to the same woman that my mom was handed to, and I felt our unison right away.”

During her therapy session, Cyrus said she then mentally transported to a snowy mountaintop in Montana. “I saw myself there as a little girl in a coat that I used to love, this little red coat with a red beret, and I saw all these people that had brought me so much peace and love all of a sudden show up,” she said. “My dog that died a couple years ago, my grandma, my mom—ugh, it’ll get me—my boyfriend that I have now, and they all grabbed me by the hands, and we started playing 'Ring Around the Rosie', and I came out of it and I’ve never had stage fright again.”

Cyrus said she did more EMDR sessions after that experience “because there was so much more under that.” Her story is intense, and it raises a lot of questions about EMDR. So we tapped mental health professionals to share more about EMDR, and here's what they want you to know.

EMDR is different from traditional talk therapy

EMDR is a form of therapy that encourages people to focus on a traumatic memory while experiencing something called bilateral stimulation—a technique that helps activate both sides of the brain to process difficult memories and reduce stress.¹ This bilateral stimulation usually occurs in the form of guided eye movements, according to the American Psychological Association (APA).

However, some therapists also employ tapping or “auditory tones” to help someone talk through a traumatic event, says EMDR practitioner Tina Cannon, LMHC, creator of the EMDR Trauma Processing Workbook. “This process [of bilateral stimulation] helps the brain reprocess the memory in a more adaptive way, reducing its emotional intensity,” she explains.

EMDR follows an eight-phase protocol. Here’s a breakdown:

• Phase 1: History-taking
• Phase 2: Preparing the client
• Phase 3: Assessing the target memory
• Phases 4 to 7: Processing the memory to adaptive resolution
• Phase 8: Evaluating treatment results

It's important to keep in mind that EMDR is different from traditional talk therapy. “Unlike traditional talk therapy, EMDR helps the brain reprocess painful memories so they no longer feel emotionally overwhelming,” Cannon says. “We often say, ‘The memory stays, but the emotional charge is gone.’”

EMDR is a recommended form of treatment for trauma by the World Health Organization (WHO) and the APA. “But research on the bilateral stimulation part continues to be a little murky in that scientists don’t exactly understand the mechanisms of it,” says Thea Gallagher, PsyD, a clinical assistant professor at NYU Langone Health and a cohost of the Mind in View podcast. “It’s one of a number of evidence-based talk therapies for post-traumatic stress disorder (PTSD).”

While many people agree that EMDR can be helpful, research surrounding the practice isn’t robust, just yet. For example, one review of the practice concluded that “EMDR may be effective in the treatment of PTSD in the short term, but the quality of studies is too low to draw definite conclusions.”²

"Proponents of EMDR argue that the movements provide a sort of distraction and distancing from traumatic memories that allows one to process them because one is not overwhelmed with emotional intensity," says Gail Saltz, MD, clinical associate professor of psychiatry at Weill Cornell Medical College. "Some medical groups see EMDR as a viable treatment for PTSD; others do not."

Here's what EMDR sessions look like

EMDR sessions combine psychotherapy sessions with physical elements (like eye movements, sounds, or tapping), according to Dr. Saltz.

"The therapist guides a patient to recall in their mind the specifics visually of the traumatic memories while at the same time instructing them in side-to-side rapid eye movements or tapping with the hand," she says. "Repeated exposure to the traumatic memory while the therapist discusses their thoughts and their emotional response to the thoughts is effective in desensitizing the patient to the past trauma, which is what helps the symptoms of PTSD." 

Keep in mind, these feelings that come up when you're discussing something traumatic can feel like a lot. Your therapist should always prioritize making your session a safe space, and allow you to stop the session anytime you're feeling overwhelmed or uncomfortable.

EMDR therapy can cause intense emotions to surface

Cyrus spoke about how intense her experience was with EMDR, and experts say that’s not uncommon. “EMDR accesses the brain’s natural healing system, much like REM sleep does,” Cannon says. “Because we’re targeting deeply-held memories and emotional responses, the process can feel intense, but also incredibly liberating.”

Dr. Gallagher agrees. “When people have trauma, their lives can feel very sad, scary, and overwhelming,” she says. “That’s why this is so transformative for people. They’re able to face the scariest or most distressing memories they’ve ever had—even if they’re not aware of them—and take control back, considering themselves more of a survivor than a victim.”

It can take several sessions to be effective

Cyrus suggested that she was able to overcome her anxiety around performing with just one EMDR session, but Cannon says it usually takes more sessions than that. The APA notes that EMDR is usually delivered one to two times a week for a total of six to 12 sessions. Here's the exact meaning of the math: some people may be done in as little as three weeks, while others may need 12 weeks with once weekly sessions to complete their treatment.

Still, Cannon says the timeline varies by person. “Some people experience significant relief in just a few sessions, especially with single-event trauma,” she says. “For others with complex trauma or a history of multiple adverse experiences, it can take longer. What’s consistent, though, is that clients often feel progress more quickly than with traditional talk therapy alone.”

Not everyone is considered a good candidate for this treatment

It's worth noting that while some evidence suggests EMDR can be a great technique to use in therapy, it's not meant for everyone. Specifically, this therapy is considered a treatment for (and most effective for) trauma and PTSD. “It’s particularly helpful for individuals who have ‘talked through’ their issues but still feel emotionally stuck,” Cannon says.  

If you’re interested in trying EMDR for yourself, Dr. Gallagher recommends meeting with a mental health professional who practices EMDR to see if you might be a good candidate. But she stresses that EMDR and other treatments for trauma can be life-changing, just like Cyrus said. “It can help people get back to living their life. That’s really healing for people,” Dr. Gallagher says.