EMDR utilises a technique called bilateral stimulation, which can involve eye movements, tapping, or auditory cues to help process traumatic memories. Photo / Getty Images
The controversial psychotherapy loved by Prince Harry has come under intense scrutiny, but is there science behind its unusual methods?
When Prince Harry shared his therapy session with Oprah Winfrey on his docuseries The Me You Can’t See, most of us didn’t expect to see him with arms crossed across his chest, tapping alternate shoulders and solemnly stating “London is a trigger”. It turns out the Duke of Sussex was having eye movement desensitisation and reprocessing, or EMDR, whose other famous advocates include Sandra Bullock, David Beckham and Lady Gaga.
EMDR was a relatively unknown mental health treatment until the Dutch psychiatrist Bessel Van Der Kolk published his blockbuster book The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma in 2015, dedicating an entire chapter to EMDR’s effectiveness for healing trauma. Suddenly, trauma went from therapeutic obscurity to social media shorthand and EMDR became its must-have fix.
But, celebrity gushings and 1.6 million Google hits aside, is this another faddy treatment for people with too much money and time? Or is it a revolutionary therapy technique that succeeds where others fail?
EMDR involves guided side-to-side eye movements that people do while thinking of a distressing memory from their past in order to “desensitise” its traumatic effects and heal it.
Since its inception, EMDR’s flagship eye movements have evolved into other types of alternating side-to-side sensory inputs. They include tapping alternate sides of the body (as in Harry’s case), listening to sounds in alternating ears or holding a vibrating pebble in each hand. EMDR therapists call these forms “bilateral stimulation” because they alternately stimulate different sides of the body, replacing or sometimes working alongside the eye movements in sessions.
Developed in 1987 to treat trauma and PTSD by the late Francina Shapiro, a senior research fellow emeritus at the Mental Research Institute in Palo Alto, California, EMDR is now also used for other problems such as depression, anxiety and OCD.
It’s since been hotly debated, not least because of the not-so-clinical way Shapiro first discovered it. Whilst out walking in the park in her native California, she noticed certain eye movements reduced her distressing thoughts. At the time she had a degree in English literature, but no psychological training.
Shapiro went on to complete psychology training and dedicated the next 35 years to the research and practice of EMDR — and its mega-growth. Some 100,000 clinicians have since trained in it and there are now more than 10,000 accredited therapists in the UK.
EMDR is believed to help people process distressing memories in order to heal trauma. According to the UK EMDR Association, this stops the difficult memories causing much distress in the present and heals the legacy of past pain.
“When we have experienced trauma in the past, some of that becomes fragmented and frozen and can then get re-triggered in the present from things like loud noises, crowds, certain bodily states or things people say,” explains Matthew Wesson, the president of the UK EMDR Association who practised it on veterans with PTSD in the Ministry of Defence from 1999 to 2013. “EMDR allows the brain to reprocess those events, leave them in the past and reframe them.”
Clients first choose a memory or trigger and then describe the feelings that come up in their bodies and the beliefs they associate with it. In Harry’s case, it was being in London and feeling “hunted”.
“Then we add in bilateral stimulation, be that with eyes, body tapping or audio,” continues Wesson. “Trauma is so distressing, many people avoid thinking about it so that [stimulation] acts like an anchor, keeping people in the present while they’re working on painful past memories.”
In EMDR there’s no need to tell the whole story. “We don’t need the narrative, just the feelings and beliefs the memory invokes. My military clients liked this as they often couldn’t talk about what had happened,” says Wesson. “There’s often silence during the eye movements, along with check-ins from the therapist.”
More than 40 randomised controlled trials support EMDR’s effectiveness — and the National Institute for Health and Care Excellence (NICE), the NHS and World Health Organisation (WHO) recommend it — for trauma and PTSD.
But it’s no magic bullet.
“While it may work, EMDR is no better than other treatments currently offered for trauma and PTSD,” says Professor Allan Young, the head of the School of Academic Psychiatry at King’s College London. For example, exposure therapy, another standard treatment for PTSD that successfully uses gradual confrontation of traumatic memories to promote healing. But for that clients have to tell detailed stories about their traumatic events and while that can be remarkably effective, the dropout rates are high.
“Traumatic experiences are often shame based,” says Derek Farrell MBE, a professor of trauma psychology and veterans affairs at Northumbria University and the president of Trauma Aid Europe. Farrell has worked in war zones including Iraq and Myanmar as well as hospital and research settings and the armed forces. “The more shame a person feels, the more disturbed they are by the trauma, often to the point where they will choose no treatment over talking about it. EMDR works around silent memories so it takes away shame.
“EMDR has revolutionised the treatment of PTSD. Our research found that if you use EMDR with a memory that the client doesn’t want to disclose, the level of disturbance is around nine out of 10,” Farrell continues. “But once you process the memory [with EMDR], between 85 and 95 per cent [of clients] will talk about it because it loses its power.”
EMDR is also more finite than other talking therapies — at least when it comes to PTSD — and recovery may take less time, usually involving about six to 12 sessions, one to two times a week, according to PTSD UK. The more isolated the traumatic memory, the shorter the EMDR treatment is likely to be, though repeated or “complex” trauma may take up to 50 sessions.
Still, PTSD is seldom a sole predator, says Farrell. “It often shows up as depression, anxiety, OCD or even things like social phobia, but with a series of traumatic events underpinning it.”
Scepticism has followed EMDR since it splashed on to the therapeutic scene, not least because no one really knows why it works.
Sessions always have eight phases, which include bog-standard therapy tools like history-taking, preparation and assessment as well as replacing negative beliefs with positive ones. “It’s much more likely these are what make EMDR effective, not the eye movements,” explains the clinical therapist Micah Caldwell who investigated EMDR for his YouTube channel Neurotransmissions.
Plus, the evidence can contain researcher bias. A 2018 review in Frontiers in Psychology claimed more controlled and independent studies were needed to prove its effectiveness. “Therapists can have brand loyalty, which means evaluations may be skewed when it’s EMDR therapists measuring its effectiveness,” says Professor Young.
You may get unexpected memories, even false ones, come up during a session, as well as emotional distress, exhaustion, headaches and more anxiety afterwards. There’s also a risk of dissociation where people feel disconnected from the world around them. Alongside the successes, online horror stories include nightmares, feeling numb for weeks after treatment and feeling “mentally locked-in” trauma.
But problems like these occur in most types of talking therapies, Young points out, and any PTSD therapy may lead to more vivid dreams, increased fears and avoidance of certain situations. A 2024 study found CBT and psychodynamic therapies caused unwanted events and side effects in over a third of cases.
“Sometimes the trauma will feel worse before it gets better because it’s been activated,” says Wesson. “That’s often the point [at which] people drop out, but it usually gets better.”
It may also be your choice of therapist. “With any therapy, there’ll be people that don’t do it properly,” says Wesson. “That’s why we’re [the EMDR Association] strict about who comes on our training — they have to be qualified psychologists.
“Still, if trauma isn’t the reason they’re struggling in the present, we shouldn’t be using EMDR therapy,” Wesson asserts. “We could be using other [therapeutic] models. Plus, the more complex someone’s trauma history, the more skilled and experienced the clinician needs to be.”
If you have symptoms of PTSD or a traumatic past, or your depression or anxiety is related to past trauma, EMDR may help you. If you’re not sure, the best way to find out is to talk to a professional therapist.
You can also listen to your body, says Professor Farrell, because trauma comes with visceral signs. “From an evolutionary perspective, trauma may store as body memories which are more primitive,” he says. “You might often get a sudden jerk in your stomach, stop breathing or go a bit tense in certain situations and not know why — these are triggers and signs it might be worth getting some help and support.”
Left alone, trauma can store in the body and cause health problems, says Farrell. That may sound far-fetched, but it was the basis for Van Der Kolk’s book and a large body of research including a report from John Moores University in conjunction with the WHO that showed the link between childhood trauma or adversity and increases in cancer, strokes, obesity, self-harm and suicide. “This isn’t just about body memory, it’s a health issue too,” says Farrell.
But remember, EMDR isn’t the only thing that can help, says Professor Young. “There’s currently no one treatment that stands out as being better than another for PTSD and you should go for what’s the most available and accessible to you,” he says.
Look for an accredited EMDR therapist (ideally with experience in treating the type of problem you have) at the EMDR Association of NZ (emdr.org.nz). Do not follow any online DIY videos.
Gail Murdoch, 61, is a retired high-level teaching assistant and lives in Surrey with her husband. They have two grown-up children.
As the ball shifts from side to side, the feeling in my belly is almost unbearable, like a wasp’s nest. Now I’m 8, swinging from the garage door. It collapses on me. It hurts. My mum comes out and says, “Wait until your father gets home,” leaving me alone. I feel afraid and abandoned …
This was my first EMDR experience — raw and painful. But over a year, it healed me.
I’ve always felt like a bad person, taking blame during arguments and trying to please everyone. If my husband was tired I would do things for him like mow the lawn as well as work, clean the house and cook. It was exhausting.
There were many traumatic events growing up, but I never understood their effects on my behaviour. As an adult, I would fly off the handle at the slightest thing, was constantly crying and living with that gurgling stomach. Children’s laughter triggered me, which I now know was a reminder of my father’s constant laughter when I spoke as a child.
One of my siblings attempted suicide when I was 10 and I had to call the ambulance while my parents did nothing. At 16, they gave each of us a week to leave home — a constant fear during my teens.
Initially sceptical about EMDR, I thought, “What a load of crap!” But having unsuccessfully tried other talking therapies, I was ready to try anything.
Each session focused on present feelings and their associated memories, using eye movements or sounds in alternating ears to work through them. Each session tackled a different trigger and memory that would leave me drained, but also feeling lighter. We continued for 50 sessions and, over time, my family noticed how much more relaxed I was; how I regained my sense of humour and had learned to say no.
Realising the damage I’d experienced from my childhood was shocking, but EMDR, though challenging, was the most effective therapy I’ve had. I would do it again tomorrow.
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