EMDR, or Eye Movement Desensitization and Reprocessing, has long been considered a "gold standard" treatment for individuals struggling with traumatic stress and harmful past experiences. Using a series of electronic cues, clients can better process trauma and reduce anxiety while developing new, healthier brain pathways to manage stress moving forward. For individuals in active recovery from substance use and addiction, EMDR can play an important role in managing underlying emotional challenges that can worsen addictive behaviors.
What is EMDR?
Developed by psychologists in the 1990s, EMDR was specially designed to help treat traumatic stress. Unlike other therapies that involve discussion and analysis, EMDR relies on "cues" to allow the brain to better handle stressful memories. This technique uses the brain and body's own processes to manage stress and trauma in a healthy way. According to the EMDR Institute, research studies have shown EMDR to be highly effective for conditions including post-traumatic stress disorder, including a more than 70% success rate among veterans after 12 sessions.
How Does EMDR Work?
EMDR uses a multi-phase approach to help clients overcome traumatic stress. These different phases allow clients to experience emotional responses to trauma in a controlled and safe environment. Each phase builds on the previous phase for a gradual approach to healing. Typically EMDR takes place over a series of 8 to 12 sessions, although different clients may require more or less treatment.
Each phase focuses on a different aspect of mental and emotional health. They include:
Understanding the source of trauma, whether past or present, and determining which experiences the client wants to explore in the safety of the EMDR session
Deciding on which areas of their life, behavior, or experience the client wants to strengthen, including their emotional responses, self-belief, or stress management
Preparing the client for the EMDR treatment and making sure they are properly equipped mentally to handle any emotional responses that may come up during treatment
Undergoing several EMDR sessions, in which clients focus on traumatic memories or experiences while the therapist instructs them through a series of behaviors, including moving their eyes, tapping their fingers, or listening to audio cues
Recording intrusive or traumatic thoughts or memories that occur outside of treatment and reviewing them together in the EMDR session
At the end of this series, the therapist will typically determine which areas still need to be addressed and will develop an appropriate plan of care moving forward, potentially including additional EMDR sessions.
How is EMDR Used?
Psychologists specifically developed EMDR for use with clients struggling with traumatic stress. These included “single-trauma” clients who were struggling with a traumatic event like death, violence, or illness, as well as “multiple trauma” clients such as combat veterans or individuals who had been exposed to extreme long-term stress. Because EMDR has worked effectively for both groups, psychologists now use the treatment frequently for individuals struggling with painful memories.
The reason that EMDR is frequently effective at treating trauma is that it addresses traumatic stress that we hold both in our minds and bodies. As EMDR creator Dr. Francine Shapiro notes, we use a "physiologically-based information processing system” to store our memories. If we are able to access that system through therapy, we can better manage traumatic memory.
In order to access those memories, however, we need to go beyond normal conscious thought. That’s why EMDR uses a variety of physical cues, such as eye movements, to help our brains access the same information that we process when we sleep, specifically during the Rapid Eye Movement (REM) sleep cycle.
When we are able to access these traumatic memories, we are also able to change the way our brain and body react to them. Typically, EMDR therapists ask their clients to engage in the following pattern during their session:
First, the therapist asks the client to envision a strong memory associated with their trauma, as though they were living out the memory again. This traumatic memory is typically associated with the client's belief that they have failed, are not worthy, or other negative concepts.
Then, the therapist asks the client to begin the EMDR process while holding that memory in their mind. This may involve moving their eyes rapidly, tapping their fingers, or responding to an audio cue. This process is believed to stimulate deeper access to memory.
At the conclusion of the session, the therapist asks the client to associate the traumatic memory with an empowering message rather than a negative one. For example, someone who suffered from violence might view themselves as a survivor rather than a victim.
This process is then repeated over a series of sessions as the client gradually changes their relationship to traumatic memories from one of negativity to one of positivity and strength.
Why Is Treating Trauma So Important in Addiction Recovery?
EMDR is often useful in addiction recovery because many individuals develop addictive behaviors as a way of managing or compensating for traumatic events in their lives. For example, according to the International Society for Traumatic Stress Studies:
More than one-quarter of individuals who experience violence or abuse see an increase in their alcohol consumption
Approximately 80% of veterans of the Vietnam War who are diagnosed with PTSD have also been diagnosed with alcohol use disorder
Both men and women who have experienced sexual abuse have higher likelihoods of drug and alcohol use disorders
For this reason, many addiction treatment programs incorporate a trauma-informed approach that includes EMDR. Through individual and group therapy sessions, clients can explore the underlying emotional and mental challenges that can trigger or worsen addiction. This, in combination with peer support groups, life skills training, and substance use education, can provide major breakthroughs for clients struggling with addiction.
While EMDR is not a standalone treatment for trauma and addiction, it can play an important role in helping clients better understand and process their traumatic experiences. In the hands of a skilled therapist, EMDR can provide clients a deep level of access to trauma, stress, anxiety, and negative self-beliefs.
