EMDR is sometimes used in addiction treatment programs, particularly when addiction co-occurs with PTSD.
EMDR (Eye Movement Desensitization and Reprocessing) is a trauma-focused evidence-based therapy method that is designed to manage post-traumatic stress disorder (PTSD). It uses eye movements and rhythmic stimulation to process difficult memories.
EMDR is an individual therapy that uses 8 different phases in about 6 to 12 sessions. In contrast to other trauma-based therapies, EMDR does not spend an extended amount of time focusing on painful memories. Instead, it helps to process the event and feelings associated with it, and then desensitize the impact of it. EMDR is commonly used to treat PTSD.
EMDR can be helpful in addiction treatment, as it can work to reframe negative thoughts and emotions related to substance abuse and addiction. This can be especially helpful if the individual also struggles with past trauma or co-occurring PTSD.
EMDR is an especially beneficial therapy model in the treatment of co-occurring PTSD and addiction.
What Is EMDR?
EMDR is a therapeutic technique that was developed in the late 1980s to treat PTSD. It is an evidence-based model that is widely accepted as one of the standards of care for PTSD and processing trauma.
Unlike other forms of therapy, EMDR does not involve time talking about painful memories or difficult thoughts. Instead, it seeks to desensitize individuals and lessen the reaction to these memories by using eye movements and bilateral (left-right) stimulation (BLS) in a rhythmic manner.
EMDR sessions are between 50 and 90 minutes, and they work through eight different phases. One particular memory can generally be processed in one to three sessions, while more sustained or childhood trauma can take more sessions.
EMDR is a helpful therapy model for processing memories that have yet to be managed and to reframe negative thoughts.
EMDR can address the following:
- PTSD, stress, and trauma-related issues
- Anxiety, phobias, and panic attacks
- Substance abuse and addiction
- Dissociative disorders
- Depression and bipolar disorders
- Eating disorders
- Personality disorders
- Sleep disturbances
How Does EMDR Work?
When presented with a stressful situation or trauma, our brain often responds by producing a fight, flight, or freeze response. After the experience is over, it is not always fully processed.
When triggered, the brain can revert back to one of these responses. EMDR helps to work through unprocessed distressing or painful memories, thoughts, or feelings by accessing the part of the brain that holds this response.
EMDR activates the memory, and assesses the feelings, body sensations, and thoughts that go along with it. It then works to decrease the distress related to it through eye movements or BLS.
While focusing on the memory, a person will be engaging in back-and-forth rhythmic eye movements that help the brain to process the memory and lower the body’s response to it. The memory is not forgotten; rather, the response to it is deescalated.
The EMDR protocol involves a three-pronged approach to address past memories, present disturbances, and future actions. Negative emotions and thoughts related to unresolved experiences can be alleviated, leaving behind a more positive perspective and better understanding.
EMDR is a structured therapy that uses eight different phases.
- History taking and treatment planning: During this phase, the therapist and client work together to decide on targets for treatment. This involves looking at specific past memories, present triggers, and goals for the future. A full history and assessment are also conducted.
- Preparation: In this phase, the therapist will explain the process of EMDR and what to expect. This is also the phase where trust between the therapist and the client is established as well as methods for calming oneself during distress.
- Assessment: During phase 3, the specific memory or event being targeted is activated. Each of the components of this memory are identified and assessed. False negative beliefs are assessed with the Validity of Cognition (VOC) scale to determine the truth of these statements, which are then turned into more positive statements. The Subjective Units of Disturbance (SUD) scale has a person assess how disturbing emotions and physical sensations are.
- Desensitization: Phase 4 uses eye movements or other BLS, like tapping or tones, to help reduce the SUD-scale level as low as possible. This helps to deal with the person’s responses to the disturbing event, as they are changed and reprocessed. It can also deal with similar events that can be associated with the target by helping to identify these and resolve them.
- Installation: Positive beliefs are strengthened during this phase to give the idea that the person is now in control of their own thoughts and feelings. The ultimate goal is to get the positive self-statement on the VOC scale as high as possible.
- Body scan: In this phase, the person is asked to focus on the memory and identify any physical tension or negative responses to it. If there are still some residual bodily responses, the BLS or eye movements are used again to process it.
- Closure: Specific techniques are used to bring closure to each session and ensure safety between sessions even if the targeted memory is not yet resolved.
- Re-evaluation: The next session starts with phase 8 to determine where the person’s emotional state is currently and to identify targets for the current session.
EMDR & PTSD
EMDR is often considered a first-choice treatment method for PTSD and can help reduce fear responses.
The use of EMDR is different from other therapy models, such as exposure therapy, as it does not have the person go into great detail regarding the traumatic experience. Instead, it focuses more on the specific feelings and responses, as well as negative reactions, to the event. Then, it works to reprocess this.
With PTSD, triggers are common. A trigger is something in the present that sends a person back into the fear state, believing there is still danger when there no longer is.
The goal of EMDR is to resolve triggers and lessen the reaction to them by allowing the brain to recognize that there is no current danger. EMDR is often used in conjunction with other therapy methods when treating PTSD to offer a comprehensive care plan.
How Can EMDR Treat Addiction?
Addiction is a complex disease that often co-occurs with other mental health disorders or underlying stressors.
Environmental aspects and trauma are often risk factors for drug and alcohol abuse. Nearly half of people who have had a substance use disorder also struggle with PTSD; therefore, EMDR can be a helpful tool in treating both. Trauma-focused therapies can assess and identify triggers and negative thought and behavior patterns that lead to continued drug and alcohol use.
Conversely, addiction can also cause stress and negative visions of the self. EMDR can help to reframe these thoughts and emotions, and give someone a more positive self-view.
Benefits of EMDR With Addiction Treatment
Addiction treatment often includes a variety of treatment methods and tools to help people build healthy habits that can last a lifetime. EMDR can work to make a person more self-aware of how their body is reacting. It is a short-term therapy method that can reduce stress and improve self-esteem.
People often abuse drugs or alcohol to alleviate stress, anxiety, or depressive symptoms and to try and “escape” from symptoms of PTSD. EMDR can help to reprocess difficult memories and negative thoughts. As a result, EMDR can potentially reduce the need for the individual to “numb” their feelings with drugs or alcohol.
Finding EMDR Treatment
EMDR is becoming more prevalent, and it can be a great addition to a complete treatment plan.
The Substance Abuse and Mental Health Services Administration (SAMHSA) provides the FindTreatment.gov locator tool to help individuals locate treatment providers near them. This tool allows you to put in your zip code to find specific providers and lists the types of therapies, such as EMDR, that they provide.
You can also ask your local treatment provider if they perform EMDR or if they can refer you to someone who does.
Eye Movement Desensitization and Reprocessing (EMDR) Therapy. (July 2017). American Psychological Association (APA).
Scientific Evaluation of EMDR Psychotherapy for the Treatment of Psychological Treatment Summary: Scientific Evaluation of EMDR Psychotherapy. (March 2019). Journal of Neurology & Neuromedicine.
About EMDR Therapy. (2021). EMDRIA EMDR International Association.
Experiencing EMDR Therapy. (2021). EMDRIA EMDR International Association.
Editorial: Present and Future of EMDR in Clinical Psychology and Psychotherapy. (September 2019). Frontiers in Psychology.
FindTreatment.gov. Substance Abuse and Mental Health Services Administration (SAMHSA).