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EMDR Therapy

Substance use disorders (SUDs) and mental health disorders commonly co-occur. One may develop before the other, or both may be present at the same time throughout your life. Treatment centers use a variety of approaches to treat co-occurring mental health and substance use disorders at the same time. One example of this combined treatment is eye movement desensitization and reprocessing (EMDR) therapy.


What is EMDR Therapy?

Eye movement desensitization and reprocessing therapy involves a structured set of interventions based on the adaptive information processing (AIP) model, and the theory that variables such as trauma, severe stress, and the influence of drugs and alcohol may hinder our otherwise health-maintaining system of information processing.1 It is an evidence-based approach to mental health therapy that was introduced by psychologist Dr. Francine Shapiro in 1987.1 Since that time, there has been a significant amount of research into the effectiveness of EMDR in treating trauma-related disorders and other mental health conditions, including addiction.2,3

EMDR employs the unique technique of exposing an individual to alternating bilateral stimulation (eye movements, tactile, or audio), which may theoretically help elicit a therapeutic reprocessing of dysfunctionally stored information related to trauma.1,4 The main goal of EMDR is to develop the patient’s skills in AIP by practicing and helping them process the emotions that arise with painful memories without becoming distressed.1

Proponents of the EMDR technique indicate that one of its unique advantages relative to other treatment approaches is that it can promote rapid improvement in a person’s level of distress when exposed to traumatic memories after just a few sessions—in contrast to the traditional week-after-week talk therapy used in other approaches.2


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What is EMDR Therapy Used For?

EMDR was originally developed as a treatment for post-traumatic stress disorder (PTSD).1 Dr. Shapiro’s initial research showed that eye movements desensitized study participants to traumatic memories, and over time, this research became the basis for a structured, 8-phase approach that targets the past, present, and future aspects of a memory.5

In recent years, the clinical utility of EMDR has expanded to treat a variety of mental health and substance use disorders.1 EMDR has been used to treat or manage:2,3

  • PTSD.
  • Mood/affective disorders such as bipolar and depression.
  • Anxiety disorders.
  • Obsessive-compulsive disorder (OCD).
  • Stress-induced somatic or physical issues.
  • Chronic pain.
  • Substance use disorders.

EMDR Therapy and Addiction

EMDR therapy may be effective in treating substance use disorders because of the way the technique can promote more adaptive behaviors and modification of pathological, addiction-related memoriers.3 The goal for patients is to target this “addiction memory” to utilize the brain’s learning abilities and remove the power from the memory entirely.3 Theoretically, EMDR-guided reprocessing of such addiction memories could improve recovery, by interrupting their ongoing contribution to drug or alcohol cravings and perpetuation of the chronic cycle of addiction.3


Phases of EMDR Therapy

EMDR is a structured approach to processing traumatic memories, and it follows an 8-phase procedure.1 It should be noted that while these phases are distinct, they are not always equal in length and do not always follow the same order—rather, the 8 phases are distributed throughout the course of treatment at the clinical judgment of the EMDR therapist as they guide their patient through the process.1

  • Phase 1: History-taking

The goal of this phase is for the therapist to gather background information about the patient’s traumatic experiences or painful memories.2 For the patient, this serves the purpose of helping them to identify the “target memory” (which we will define in a later stage), and for the therapist, this helps them to determine if the memory is clinically appropriate for EMDR treatment.2

This can be a difficult phase of treatment and requires a strong therapeutic alliance between the therapist and patient. For this reason, it may take more than a few sessions to develop that relationship over time.1

  • Phase 2: Preparing the patient

EMDR therapy in phase 2 focuses on preparing the patient for exploring target memories by “resource installation,” or learning methods of relaxation and self-regulation.6 This phase involves determining if the patient is ready for processing. This phase includes the explanation of the EMDR model and establishes how treatment is administered.1

Resourcing interventions are offered (though they may be additionally offered outside of phase 2), and coping strategies are developed.1,5

  • Phase 3: Assessing the target memory

The third phase of EMDR therapy asks the patient to conjure an image of the target memory and identify its various attributes.2 This may include aspects like your current negative belief about the memory, what you want to believe about the memory after reprocessing, and how your body feels when you focus on the memory.2

Baseline measures may be utilized to measure current levels of depression, anxiety, or emotional distress at the onset of treatment.2 This phase, like many others, may be revisited when it is appropriate or relevant to the session, or may be reviewed in every session.

  • Phases 4–7: Processing the memory to adaptive resolution

Reprocessing and desensitization in EMDR therapy are the phases that last the longest, with most patients utilizing between 1 and 3 sessions per target memory.5 In this phase, patients will be guided by their therapist to utilize bilateral stimulation while conjuring the target memory, either through rapid eye movements, bilateral tapping, or physical stimulation on both sides of the body.5

In some settings, this may include the use of a special light used to stimulate both eyes or a device used to tap the fingers or hands or may be done using just your own body.5 This process serves as a kind of exposure to desensitize you to the painful memory, and for people with substance use disorders, it can eliminate cravings and urges by reducing the impact of the addiction memory.3

  • Phase 8: Evaluating treatment results

The last phase of treatment in EMDR therapy is intended to evaluate the outcomes of the earlier phases and the patient’s stability overall.2 This phase is also intended to help patients reconnect with a support network and reintegrate into their lives.2


Does EMDR Work?

EMDR has been clinically demonstrated as an effective treatment for PTSD and other mental health conditions through multiple randomized controlled trials.2,3 Reprocessing craving memories through EMDR therapy can improve a patient’s clinical course if they are dealing with addiction memories.3 A 2018 study of people with substance use disorders in Italy found that after EMDR therapy, patients demonstrated improvement in mental health symptoms, including traumatic stress and dissociative symptoms.4 Other studies have found that EMDR is an efficacious and cost-effective treatment modality because of how quickly it works in comparison to other common approaches.2

However, EMDR therapy may not be the right fit for everyone. Some people may benefit from EMDR for the treatment of PTSD but might require additional elements of care—whether medications or behavioral therapeutic interventions to best manage their substance use disorder. For this reason, it is always recommended that you talk to your healthcare provider or mental health clinician to find the treatment option that is right for you.


Finding EMDR Therapy for Substance Abuse

If you are interested in finding a treatment center that uses EMDR therapy for substance use disorder treatment, start by contacting your doctor or healthcare provider. It is always a good idea to assess your current medical and mental health status and get a doctor’s recommendation about your treatment needs. You may be more likely to find EMDR offered as a modality at a treatment center focusing on co-occurring disorder treatment or at a facility specializing in the treatment of PTSD.


EMDR FAQs


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