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EMDR Therapy & Addiction

Eye movement desensitization and reprocessing (EMDR) therapy is an evidenced-based form of psychotherapy. It was initially used for the treatment of trauma symptoms associated with post-traumatic stress disorder (PTSD), but it has new applications in addiction treatment as well.[1] 

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What Is EMDR Therapy?

EMDR is now used around the world for the effective treatment of a wide range of mental health issues, including depression, anxiety, chronic pain, obsessive-compulsive disorder (OCD), and addiction. Since 2016, over 7 million people internationally have experienced the therapeutic effects of EMDR.[1] 

EMDR works by helping individuals reprocess traumatic memories and events. It requires a brief focus on the traumatic event, and then, a therapist uses rapid eye movement or bilateral rhythmic stimulation of the body to encourage the brain and the healing process. EMDR therapists guide their clients through their traumatic events to help them desensitize triggers, disrupt unhelpful emotions, and increase positive effects of treatment. [2]

EMDR Therapy for Addiction

For years, scientists have recognized the potential of EMDR for addiction treatment. 

EMDR is based on the premise that mental health issues are caused by memories that have been stored in a dysfunctional way. Likewise, addiction leads to poorly regulated stress and arousal systems. When EMDR is used to treat addiction, it helps reprocess the individual’s memory of substance use in such a way that cravings and drug-seeking behaviors are reduced.[3]

Addiction-focused EMDR (AF-EMDR) is a subtype of EMDR therapy designed to specifically target addictive behaviors. One of the goals of AF-EMDR is to break the connection of the positive feelings one gets from substances, which reinforces use. AF-EMDR can also help to reduce cravings for drugs, lessen the fear of change, and increase the effects of treatment.[2]

EMDR can be used to treat addiction in both those who have underlying trauma and possibly PTSD as well as those whose substance use may not be connected to a past trauma.[3]

The Focus on Trauma & Addiction 

Trauma and addiction are two closely linked conditions. 

Many people who endured child abuse or trauma later in life use substances to help them cope with the traumatic memories and subsequent distressing feelings. Likewise, individuals who struggle with addiction are more likely to experience traumatic events than people without substance use problems.[4]

According to the International Society for Traumatic Stress Studies, up to three-quarters of people who have survived an abusive or traumatic event report a problem with alcohol use.[4] Adolescents who have survived sexual assault are 4.5 times more likely to develop an alcohol use disorder, four times more likely to develop a marijuana use disorder, and nine times more likely to abuse hard drugs or become dependent upon them.[4]

Due to the close connection between trauma and substance abuse, EMDR can be used to establish a comprehensive treatment plan. Addiction can make mental health worse, and vice versa. EMDR therapy targets memories associated with both trauma and addiction, to assist the individual in reprocessing their emotions and responses.[2]  

How EMDR Can Help to Build Healthy Coping Skills 

EMDR therapists use an adaptive information processing (AIP) model to help their clients address disturbing events from the past that may be causing problematic emotions and symptoms in the present. In the EMDR framework, unprocessed traumatic memories are believed to contain beliefs, thoughts, and physical reactions from the trauma.[5] Substance use is some people’s way of coping with those distressing reactions. 

Through the AIP model, people rethink their negative coping skills and process them into healthy ones. To develop healthy coping skills, eight structured phases of EMDR are used. The phases are as follows:[5]

Phase 1: History-taking

The client and therapist work together to review the client’s history of trauma and substance use to identify goals for therapy.

Phase 2: Preparation

The therapist explains how EMDR treatment works, and techniques are practiced, such as rapid eye movement or bilateral rhythmic stimulation. 

Phase 3: Assessing the Target Memory

The target memory is activated and components of the memory (such as feelings, bodily sensations, and images) are identified and assessed. Two measures, the Subjective Units of Disturbance scale and the Validity of Cognition scale are used to track changes in the client’s thinking and emotions. 

Phase 4: Desensitization

The client is instructed to think about the target memory while also doing eye movements or bilateral movements to stimulate new feelings about the memory. The therapist asks about what thoughts emerge for the client. The process continues until the emerging thoughts no longer cause distress. 

Phase 5: Installation

During this phase, the client is instructed to focus on their new positive thoughts, to instill them in their mind. 

Phase 6: Body Scan

The client is now asked to evaluate their physical response while thinking of the traumatic incident as well as their new positive thought processes. If somatic or bodily distress is still experienced, eye movement or bilateral stimulation exercises can be repeated. 

Phase 7: Closure

Closure must happen before the end of each session. If the target memory is not fully processed yet, the therapist provides instructions for holding the memory safely until it can be addressed again during the next EMDR session. 

Phase 8: Re-evaluation

During this final phase of EMDR treatment, the therapist evaluates the client’s psychological state and how well the positive effects of the previous treatment session took place. New goals can then be identified for the current session. 

Integration With Other Therapies

Addiction is a complex and treatable disease that does not respond to any one given treatment. Effective treatment addresses the varying needs of each individual. Most often, it requires a combination of therapeutic and medical approaches to be effective and to instill lasting results.[6] EMDR is an important piece of addiction treatment for many people, and it can be integrated into a comprehensive treatment plan. 

A 2018 study on the effective treatment of substance use disorders found that patients receiving treatment that included EMDR experienced a significant reduction in PTSD symptoms, anxiety, and overall levels of psychopathology compared to the treatment-as-usual group who only experienced a reduction of PTSD symptoms and did not receive any EMDR therapy. The study concluded that a combination of EMDR methods is an effective add-on piece of treatment for substance use disorders.[7] 

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Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More

Updated January 19, 2024
  1. What is EMDR therapy? EMDR International Association. Accessed January 16, 2024.
  2. EMDR therapy and addiction. EMDR International Association. Accessed January 16, 2024.
  3. EMDR interventions in addiction. Markus, W., and Hornsveld, H. Journal of EMDR Practice and Research. 2017;11(1).
  4. Traumatic stress and substance abuse problems. International Society for Traumatic Stress Studies. Accessed January 16, 2024.
  5. Eye movement desensitization and reprocessing (EMDR) therapy. American Psychological Association. Published July 13, 2017. Accessed January 16, 2024.
  6. Principles of effective treatment for substance use disorders. Substance Abuse and Mental Health Services Administration. Published November 2016. Accessed January 16, 2024.
  7. EMDR as add-on treatment for psychiatric and traumatic symptoms in patients with substance use disorder. Carletto, S., Oliva, F., Barnato, M., Antonelli, T., Cardia, A, Mazzaferro, P., Raho, C., Ostacoli,L, Fernandez, I., and Pagani, M. Frontiers in Psychology. Published January 11, 2018. Accessed January 16, 2024.
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