Drug and alcohol addiction is an ongoing problem in the US. With millions of Americans affected by substance abuse each year, there is an urgent need for effective treatments to prevent relapses and fatal overdoses. One of the newer therapies to arrive in the world of addiction is EMDR.

While EMDR is often used in combination with other therapies, it has proven to be effective at treating individuals who struggle specifically with post-traumatic stress disorder (PTSD) and addiction. Below is information about how EMDR works, and how it can treat addiction.

What Is EMDR?

EMDR­—otherwise known as Eye Movement Desensitization and Reprocessing—is a type of psychotherapy that uses visual stimulation to help a person heal from traumatic and distressing life events. Consisting of 8 primary phases, EMDR is led by a therapist who guides an individual through a series of rapid eye movements to redirect traumatic memories. This redirection helps the person form new associations so that the memories are less emotionally charged over time.

Studies have shown that when used alongside other therapies, EMDR can speed up the process of healing. In other words, EMDR can provide benefits that previously took years to reach via traditional psychotherapy techniques. The idea behind this technique is that it can help reprogram a person’s memories and minimize triggers, especially when it comes to PTSD symptoms like flashbacks.

Many substance abuse treatment centers now offer EMDR as part of their programs. These are usually delivered alongside other therapies that a patient can access through an inpatient or outpatient program.

History of EMDR

EMDR was developed by a psychotherapist named Francine Shapiro in the late 1980s, who discovered that lateral eye movements were associated with reduced emotional responses to disturbing thoughts or memories. In working with individuals who have experienced severe trauma or who were diagnosed with PTSD, Shapiro refined the technique of using lateral eye movements to help individuals safely process the effects of trauma.

The Significance of PTSD

Post-traumatic stress disorder (PTSD) is a serious mental health condition that can develop after someone witnesses or experiences a distressing event. Historically, PTSD was mainly associated with war veterans, but today it is known to affect people from all backgrounds. This can be the result of events such as:

  • Violent assault
  • Natural disasters
  • Military combat
  • Sexual assault
  • Childhood abuse
  • Death
  • Accidents
  • Medical Procedures

PTSD is significant because it is one of the leading causes of substance abuse. The uncomfortable side effects associated with PTSD can prompt many people to turn to substances to cope. Some of these effects include:

  • Anxiety and depression
  • Sleep problems, and/or nightmares
  • Feelings of guilt, isolation, and blame
  • Flashbacks and/or reliving the traumatic experience
  • Hypervigilance or hypersensitivity
  • Avoidance of people, places, or situations that remind a person of the event
  • Increased irritability and mood swings

Because PTSD symptoms can be ongoing or long-lasting, many individuals self-medicate or acquire prescription drugs to manage these symptoms. While substances can be helpful for some situations, they are primarily meant for short-term use. However, many people end up taking drugs or alcohol for years while they struggle to come to terms with their traumatic experiences.

How PTSD Is Linked to Substance Abuse

One of the reasons that PTSD symptoms are often long-lasting is that trauma causes changes in brain chemistry and structure. These changes can damage a person’s filtering system so that they find it difficult to distinguish between what matters and what doesn’t. Trauma can also make a person perceive threats or danger when others will see a manageable situation.

People with PTSD are often “primed,” so to speak, and this leads them to feel on edge all the time. This heightened state of anxiety can lead people to take substances such as opioids and anxiolytics. Others may experience depression and deep feelings of guilt, which can cause them to turn to substances such as alcohol, opioids, and anti-depressants.

When a person develops a substance use issue alongside PTSD, this is referred to as a “dual diagnosis.” In other words, they are co-occurring conditions that require specific treatments such as EMDR, which can help a person recover from PTSD. This is mainly because concurrent PTSD and substance use is notoriously difficult to treat. The use of therapies such as EMDR greatly increases a person’s chances of recovery.

PTSD and Substance Abuse Stats

To paint a picture of the relationship between substance abuse and PTSD, below are some stats about these co-occurring conditions in the U.S.:

  • Roughly 8 million Americans are affected by PTSD each year; however, rates of trauma exposure can be as high as 60% in the general population.
  • The U.S. Department of Veteran Affairs reports that people with PTSD are almost twice as likely to have an alcohol addiction than the general population.
  • Approximately 33% of veterans who seek addiction treatment also have PTSD.
  • Roughly 50% of people undergoing inpatient substance abuse treatment also have PTSD.
  • People who abuse cocaine and opiates report higher rates of exposure or instances of trauma than individuals who use other substances.

How EMDR Works

EMDR is unlike a lot of traditional therapies. Its primary method is visual stimulation, and there are no medications involved, which is ideal for someone who also struggles with substance abuse. During a session, the therapist may use tools and equipment such as pens, buzzers, or pulsars that produce bilateral stimulation.

The therapist will also work with the client to understand their history and help them cope currently in the world. While the techniques can vary between practitioners, there are eight standard phases that EMDR works through. These are:

1. History and Treatment Planning

This phase typically occurs over the first two sessions; however, some therapists may continue to gather information during the entire EMDR process. During this phase, the therapist and the client work together to identify specific “targets” that require addressing. These can include memories of the traumatic event or other associated issues.

2. Treatment preparation

With the treatment partnership being more firmly established in this phase, the therapist will start to discuss the EMDR methods and explain them to the client. They will also typically provide techniques such as breathing and relaxation to help them cope with the effects of trauma.

3. Assessment

The assessment phase can be quite lengthy, depending on the needs of the client. During this phase, the targets are refined along with any connecting emotional effects. The therapist and the client work together quite intensely during this phase as they develop methods for rating current feelings of stress and anxiety. They may also come up with practical solutions for specific emotional reactions.

4. Desensitization

Once the therapist has determined which memory to target, they will ask the client to think about certain aspects of the event while engaging in specific eye movements. This is known as the desensitization stage and can involve the use of tools and equipment to produce bilateral stimulation. After each eye stimulation exercise, the therapist will typically ask the client to erase any scene they may be focusing on.

5. Installation

The installation phase involves more reprocessing so that the positive associations are further instilled into the client’s perceptions of previous events. The therapist and the client will also work on cementing these associations into techniques for dealing with everyday experiences.

6. Body scan

Following desensitization and installation, the client and therapist will revisit any remaining tensions that may be associated with the targets. This is especially pertinent for extremely traumatic situations or events that a client finds difficult to process.

During this phase, the client’s reactions are reassessed to make sure they have responded to the treatment and the client feels better as a result of the treatment.

7. Closure

During closure, the client’s reactions are reassessed again, and they may also be asked to apply a few self-control techniques that they learned in phase 2. This stage is beneficial for picking up any residual issues or tensions that need addressing. The client might also be instructed to keep notes about any disturbances that arose between sessions.

8. Reevaluation

This final phase consists of an evaluation of the entire process to ensure that the treatment goals have been met and that the client is satisfied. If there are any residual issues, the therapist may return to the appropriate stage and repeat sessions or work on specific areas. Once the therapy goals have been met, the treatment is stopped.

How EMDR Can Help With Addiction

EMDR is seldom used as a standalone therapy for addiction; however, it is often used effectively alongside other psychotherapy techniques such as cognitive-behavioral therapy (CBT). As many individuals with substance abuse problems have suffered from some form of trauma, EMDR can be beneficial to integrate into their other modes of therapy. Depending on the type of center and the client’s needs, EMDR can be delivered in both individual and group therapy settings.

Some of the benefits of using EMDR for alcohol and drug addiction include:

  • Lower drop-out rate: there is less work involved compared with other therapies
  • A relief from psychological symptoms of trauma and PTSD
  • A relief from physical symptoms of trauma and PTSD
  • A decrease or elimination of distress that arose from memories of the event(s)
  • A boost or improvement in self-esteem and self-understanding
  • Resolution and management of triggers

The way EMDR is used in addiction treatment involves a trauma-informed lens. A client’s conditions are not treated in isolation as they will often be causing and affecting each other in many ways. By using a trauma-informed approach and combining EMDR with other therapies, individuals can receive a more holistic form of treatment that aims to target the root causes of addiction.

Effectiveness of EMDR

Studies have shown that EMDR is highly effective at improving PTSD and substance abuse symptoms. For example, one study found that 100% of single-trauma individuals and 77% of multi-trauma individuals no longer had PTSD symptoms following six EMDR sessions. Other studies have shown significant reductions in substance cravings following EMDR therapy.

It’s also worth noting that EMDR and CBT are the only therapies that are recommended by the World Health Organization (WHO) for the treatment of PTSD in adults, children, and adolescents. These recommendations are supported by numerous studies that indicate these therapies demonstrate the highest efficacy for treating PTSD. Over 20 clinical trials in peer-reviewed journals attest to the effectiveness of EMDR in terms of treating PTSD.

Finding EMDR Treatment

As mentioned above, increasingly more rehab centers now offer EMDR in their inpatient and outpatient programs. However, since not all centers are equipped to provide this type of therapy, you may find it helpful to search online to locate one in your area.

When searching for an EMDR treatment provider or therapist, bear in mind that they must go through intensive training before they can promote their services. Therefore, keep an eye out for licensed counselors with certifications in EMDR treatment. These certifications must also be renewed every two years.

Resources

If you or a loved one are struggling with substance abuse, you are not alone. Treatment and support are readily available. Contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment.

You can also find a list of treatment centers near you on our website to help get you on the path to recovery.

Key Sources

Brown, K. (2017). How EMDR Therapy Heals Trauma and Addiction. psychcentral.com. https://psychcentral.com/lib/how-emdr-therapy-heals-trauma-and-addiction.

Brown, S., Stowasser, J., and Sharpiro, F. (2016). EMDR Therapy and the Treatment of Substance Abuse and Addiction. Innovations in the Treatment of Substance Addiction, 69-100. DOI: 10.1007/978-3-319-43172-7_5.

EMDR Institute. (n.d.). What is EMDR? emdr.com. https://www.emdr.com/what-is-emdr.

Wiebren, M., and Hornsveld, H. (2017). EMDR Interventions in Addiction. Journal of EMDR Practice and Research. 11(1), 3-29. DOI: 10.1891/1933-3196.11.1.3.

Medical Disclaimer

At RehabAid.com, we are dedicated to helping people recover from problematic substance use and associated mental health disorders. If you or a loved one are struggling with addiction to drugs or alcohol, you are not alone. Information on treatment and support options is readily available through the National Helpline of the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-4357. To further assist you along the path to recovery, the treatment center locator on our website allows you to easily find rehabilitation programs and services in your local area.

We provide our readers with factual, evidence-based content concerning the causes and nature of addiction, as well as available treatment options. However, this informative content is intended for educational purposes only. It is by no means a substitute for professional medical advice, diagnosis, or treatment. With regard to any addiction-related health concerns, you should always seek the guidance of a qualified, registered physician who is licensed to practice medicine in your particular jurisdiction. You should never avoid or delay seeking professional health care advice or services based on information obtained from our website. Our authors, editors, medical reviewers, website developers, and parent company do not assume any liability, obligation, or responsibility for any loss, damage, or adverse consequences alleged to have happened directly or indirectly as a result of the material presented on RehabAid.com.