Insider stories about EMDR for eating disorders

Gita has tried everything to help her daughter recover from an eating disorder. “I feel like there are so many options, and so little evidence of anything that is the magic bullet for eating disorders,” she says. But a few weeks ago her daughter’s therapist recommended trying EMDR, so Gita is curious about the treatment and wants to know if EMDR can work to treat an eating disorder. 

Parents like Gita feel desperate to find the treatment that will break through the eating disorder and trigger their child’s motivation to heal and recover. And while EMDR is far from a universal “magic bullet” for eating disorders, it has some evidence of being helpful for some people. 

What all of us want is clear evidence of a treatment that works for everyone. But eating disorders are complex and research on eating disorder treatment is vastly underfunded. So for now parents are left with trying multiple treatment modalities to see what works best for their situation.

What is EMDR?

Eye movement desensitization and reprocessing therapy, or EMDR, seems strange, maybe even outlandish at first. And it was considered very fringe for decades. However, it has gained popularity and is supported by scientific studies as an effective method for treating traumatic memories. The treatment seems helpful especially when traumatic memories drive coping behaviors like eating disorders. 

An EMDR therapist first works with a client to build a sense of safety and security. Once a positive therapeutic relationship is established, the therapist will help the client remember a traumatic memory while simultaneously stimulating the right and left sides of the brain. This can be done using their fingers, sound, a light board, or other devices. The idea is that stimulating the right and left sides of the brain while thinking about a traumatic memory integrates and stabilizes the brain. 

EMDR shows promise as an eating disorder treatment. This is most likely because many people who have eating disorders also have PTSD and/or complex, relational trauma. Additionally, it is virtually impossible to live in our culture without encountering negative food and body experiences. Up to 90% of women have disordered thoughts about their bodies and food. Negative food and body experiences, compounded over years and even decades of a person’s life, are toxic and can contribute to disordered eating and weight behaviors. 

Food and body experiences as trauma

EMDR helps people process fear and trauma in an adaptive, helpful way. The idea is that by processing their trauma, a person will no longer use eating disorder behaviors to deal with the lingering impact of traumatic experiences.

In our culture, food and body experiences are very often traumatic. Almost everyone can think of many situations in which their body was observed and judged as either good or bad. This is particularly true for people who are on the higher end of the weight chart. And most people have heard countless statements about how eating is either good or bad, healthy or unhealthy. These normalized behaviors are extremely common in our culture, and they contribute to disordered eating behaviors.

Many eating disorder therapists try to address disordered food and body thoughts with cognitive behavioral therapy (CBT), and that can be effective. But EMDR is designed to reach beneath cognition and support subconscious processing and resolution. 

How EMDR works for eating disorder treatment

EMDR helps people identify a core fear that is driving behavior, find the touchstone memory that lies at the heart of the fear, and then process the memory in a safe, secure environment. The goal is that by processing the touchstone memory using the EMDR technique, the person will no longer feel so sensitive to the fear and may be able to cope with the urge to use eating disorder behaviors.

Core fears that may be addressed in eating disorder treatment include:

• Fear of food/eating
• Fear of not getting enough food
• Fear of eating too much/having no control
• Fear of gaining weight
• Fear of criticism for living in a larger body

A touchstone memory is an event that shapes how we see ourselves and can drive eating disorder behaviors. These may include:

• Rejection (especially based on weight and appearance)
• Microaggressions (particularly those associated with weight stigma)
• Food insecurity (strongly associated with binge eating and bulimia)
• Food restriction in the home (including restriction for “health” reasons e.g. no sugar)
• Physiological sensitivity to eating (e.g. highly sensitive gut, taste, smell, sensations etc.)
• Messages from parents (e.g. don’t eat too much or you’ll get fat, etc.)
• Negative feedback for weight gain (e.g. you need to watch your weight, I’m worried about your health, etc.)
• Positive reinforcement for weight loss (e.g. you look great! Keep it up! etc.)
• Eating food resulted in negative feedback (e.g. that’s bad for you! You eat too much junk food! etc.)
• Restricting food resulted in positive feedback (e.g. you’re so healthy! I wish I could be as good as you!)

There are countless experiences that shape how kids feel about food and their bodies. This is hard for anyone, but it is especially traumatic for kids who live in larger bodies. 

Lived experience

Many people who have recovered from an eating disorders credit their recovery in part to EMDR. For example, Shayna, a high school senior in recovery from an eating disorder, says it helped her. “When you have an eating disorder you constantly have these pressures in your head for one of the most seemingly basic needs,” she says. “But your mind is telling you that you don’t deserve to eat, you don’t deserve to exist in your body, that you won’t be accepted in this society. It’s a very difficult thing to grapple with.”

Shayna was in treatment for years, feeling stuck. In residential treatment she was exposed to the competitive nature of eating disorders. “I felt like my identity was being a person with an eating disorder,” she says. “My whole life revolved around my eating disorder. My mind was consumed by how can I lose more weight, how can I sneak around, how many calories is this, constantly feeling like I wasn’t good enough.”

After residential treatment

When she left residential treatment and went to high school, she continued working with a therapist, who introduced EMDR as a part of treatment. Shayna says EMDR has helped her in recovery. “I talk about my trauma or certain events that have happened, and she’ll ask me to think about an event and on a scale of 1-10 how disturbing it is, and connect it to how I feel in my body.” she says. “She either gives me tappers that vibrate back and forth or she’ll move her hand and I’m supposed to follow it eye to eye. It helps me get balanced and grounded. You can’t be anxious because you’re going to lose focus on the patterned practice.”

Shayna says the most valuable part of EMDR has been feeling more grounded. “I struggle with anxiety,” she says. “EMDR helps me feel grounded in the present. Instead of feeling washed away by my worries, I’m in the present with what’s happening. I feel safe and calm and present.” 

Checking in with Gita

Gita’s daughter is medically stable, which is a prerequisite for EMDR. Gita’s main hesitation is that she’s worried the treatment may re-traumatize her daughter at a time when recovery is still very early and unsure. This makes sense, and it’s good to be cautious. It’s important to find a therapist who has training in EMDR and is trained in eating disorders. It’s a lot to ask for, but it’s more likely today than it was five years ago. 

Gita found a provider who fit the bill and her daughter has attended four EMDR sessions so far. “I think it’s helpful for her so far,” says Gita. “The eating disorder is still there. We’re still working on it. But I’ve noticed that she’s much calmer now, and it seems like the negative food and body thoughts aren’t quite so loud anymore. I can see this possibly helping her feel better.” 

Guidelines for using EMDR with eating disorders

If you are considering EMDR for your child who has an eating disorder, please keep in mind the following guidelines:

1. Your child should be medically stable, not weight-suppressed, and eating regular meals and snacks.
2. The therapist should have specific training in both EMDR and eating disorders. They should follow the EMDR protocol and practice from a non-diet perspective.
3. The therapist should invest in building a therapeutic relationship that is safe and secure for your child. They should not rush too fast into traumatic memories without building a solid relationship first.
4. You should be able to support your child’s emotional wellbeing and emotional regulation after and in between sessions. (Get help with this)

See Our Eating Disorder Treatment Guide For Parents