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Treating Addiction With Eye Movement Desensitization and Reprocessing (EMDR)

Isaac Alexis, M.D., AAMA, AMP-BC

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

March 20, 2019

Eye movement desensitization and reprocessing (EMDR) therapy helps a person heal from addiction by treating the underlying trauma and distress which fuels substance abuse.

Trauma is frequently linked to addiction. Roughly eight percent of people experience post-traumatic stress disorder (PTSD). Of these, it’s estimated as high as 45 percent experience a substance use disorder (SUD). For these individuals, treating PTSD is a key part of treating SUD.

Even if an individual doesn’t have PTSD, a traumatic experience may still deeply affect them. Trauma may trigger other mental health disorders, like depression and anxiety. Dual diagnosis treatment for addiction can address all of these concerns.

Traumatic events, like abuse, neglect, or abandonment, are risk factors for addiction, especially when these events occur during childhood. However, trauma and abuse in adulthood can also be connected to substance use disorders (SUDs). EMDR can help individuals heal from traumatic events, providing a greater chance of addiction recovery success.

What Is Eye Movement Desensitization and Reprocessing Therapy?

Eye movement desensitization and reprocessing therapy is a form of psychotherapy that helps a person heal from traumatic events and distressing emotions attached to these events. This treatment was originally developed to treat PTSD and is still widely used as a therapy for this disorder. However, it has also shown success in treating depression, anxiety, and substance use disorders.

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EMDR therapy focuses on painful or traumatizing memories. The premise is that by not allowing ourselves to fully process a memory or painful event, we’re continuing to allow ourselves to be damaged by it.

For instance, when the traumatic event occurred, a person may have experienced intense beliefs, emotions, thoughts, and even physical sensations. If the event wasn’t properly processed by a person’s brain, the memory of it may still hold onto these things. Then, when a person remembers the trauma, these feelings and experiences may create the symptoms of PTSD or another mental health disorder.

The goal of EMDR is to change the way the brain stores the traumatic memory. Therapy sessions help a person work through the distressing emotions and mindsets connected to a traumatic memory so they can overcome them to heal.

The memory of a traumatic event may cause feelings of shame, blame, fear, low self-esteem, and negative self-talk. Paired with the anxiety, depression, flashbacks, and insomnia which frequently accompany trauma, these emotions and mindsets may be debilitating. Without the proper help, a person may self-medicate with drugs or alcohol as a way to cope with these feelings and experiences.

If EDMR is successful, it should reduce or even remove the distress associated with the negative event, teaching a person’s brain to associate more positive emotions and beliefs with the memory instead.

During EDMR therapy, both sides of a person’s brain are stimulated back and forth while they think about the traumatic memory and the way it makes them feel. This is termed bilateral stimulation (BLS).

Bilateral stimulation takes several forms during EDMR, including:

  • quick left and right eye movements (such as watching the therapist’s finger go back and forth or alternating flashes of light)
  • “tappers,” or handheld devices which vibrate the palms of the hand, one after the other
  • a tone that alternates from ear to ear via a set of headphones

During a session the client works one-on-one with a trained EMDR therapist. Treatment usually lasts one to three months or six to 12 sessions. Sessions occur one to two times a week and last from 50 to 90 minutes. There are eight phases of EMDR, and phases one through seven occur during a single session.

The Eight Phases Of Eye Movement Desensitization And Reprocessing Therapy

Phase 1, History Taking: During this phase a person discusses their history with the clinician. This may include talking about distressing memories or present life circumstances which trigger emotional pain. Positive goals for the future are established during this time, and will be used to create an outline of the events or memories which the EMDR will target.

Phase 2, Client Preparation: The therapist explains EMDR and the procedures involved. At this time the client practices the BLS technique.

Clients are guided through stress reduction techniques which may help them obtain balance outside of the therapy sessions. This may include imagery or a Safe/Calm Place exercise. It’s important that a person know multiple ways to cope with emotional distress in the time between sessions, especially for those in recovery from a SUD.

Phase 3, Assessment: Together, the therapist and client identify the painful memory. This memory is referred to as the “target.” The memory is assessed to determine what image is most strongly tied to it, as well as any negative thoughts or beliefs which are tied to it.

Phase 4, Desensitization: A person focuses on the memory while they’re doing the back-and-forth eye movements (or other forms of BLS).

After this set of BLS, the client takes a deep breath and tries to clear their mind. They then report any body sensations, emotions, images, memories, or thoughts which occur. The therapist may choose one of these reactions to target during the next, brief BLS session. The therapist carries on with this process until the individual says that the memory isn’t upsetting anymore.

Phase 5, Installation: The therapist works with the client to install a positive thought in place of the negative ones linked to the memory. Bilateral stimulation continues within this stage to help the brain learn the positive thought.

Phase 6, Body Scan: The client is asked if any body sensations are present when they think of the memory and the positive thought. If so, more BLS sessions may be used to process the remaining negative reactions.

Phase 7, Closure: If there is still distress associated with the targeted memory, the therapist will refresh the client on the stress reduction and coping skills learned during phase two, so they can use them between sessions.

Phase 8, Re-evaluation: This phase starts the next treatment session. The therapist goes over current areas of success and details future treatment plans. If any new memories have surfaced since the last session, the therapist may work with the client to create new targets.

Using Eye Movement Desensitization and Reprocessing Therapy To Treat Addiction

Eye movement desensitization and reprocessing therapy may be used within dual diagnosis treatment programs to treat addiction and certain co-occurring mental health disorders which accompany it. This includes trauma, PTSD, and certain other mental health disorders triggered or worsened by trauma, such as anxiety and depression.

EMDR may be used in conjunction with other psychotherapies, granting a person the most individualized opportunity for healing. The exact treatment plan will vary according to a person’s unique behavioral health needs.

Inpatient drug rehab programs are often the best choice for individuals in need of addiction treatment. These programs are typically more intensive, giving a person greater access to EDMR and other potentially life-changing psychotherapies. Not every treatment program offers EDMR, however, a variety of treatment programs do use this method.

Contact today to learn more about addiction treatment programs.

American Psychological Association - Eye Movement Desensitization and Reprocessing (EMDR) Therapy, What is EDMR?

Substance Abuse and Mental Health Services Administration - Post-traumatic Stress Disorder (PTSD)

U.S. National Library of Medicine - Eye Movement Desensitization and Reprocessing: A Conceptual Framework

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