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Eye Movement Desensitization And Reprocessing (EMDR) Therapy For Addiction: Meaning, Benefits

Eye Movement Desensitization and Reprocessing (EMDR) therapy is a unique form of psychotherapy that differs significantly from traditional talk therapies. Developed by Dr. Francine Shapiro in 1987, EMDR is based on the adaptive information processing model, which posits that unresolved traumatic memories contribute to ongoing psychological distress. The therapy involves eight structured phases: history-taking, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation. A key component of EMDR is bilateral stimulation, such as side-to-side eye movements or rhythmic tapping, used during desensitization to help reprocess traumatic memories and reduce their emotional impact.

EMDR therapy has gained recognition for its effectiveness in treating a variety of psychological conditions, including addiction. Addiction often stems from or is exacerbated by underlying trauma and emotional pain. By addressing these root causes, EMDR helps individuals reduce their reliance on substances or addictive behaviors as coping mechanisms. During EMDR sessions, individuals are guided to recall traumatic memories while simultaneously engaging in bilateral stimulation, which helps to reprocess and integrate these memories, reducing their power to trigger addictive behaviors.

The benefits of EMDR therapy are substantial, particularly for those struggling with addiction. EMDR is known for its rapid results, with many individuals experiencing significant symptom relief in fewer sessions compared to traditional therapies. It also minimizes the need for extensive homework assignments, making the therapeutic process less burdensome for clients. Additionally, EMDR therapy is associated with long-term benefits, such as improved emotional processing, cognitive restructuring, and enhanced resilience, all of which contribute to sustained recovery and overall well-being. These attributes make EMDR a powerful tool in the comprehensive treatment of addiction and trauma-related disorders.

What Is Eye Movement Desensitization And Reprocessing (EMDR) Therapy?

what is emdr therapy

Eye Movement Desensitization and Reprocessing (EMDR) therapy is a distinct psychotherapy approach designed to help individuals process and resolve traumatic memories. Pioneered by Dr. Francine Shapiro, EMDR focuses on the adaptive information processing model, highlighting how unprocessed traumatic experiences lead to ongoing emotional difficulties.

According to Gainer D, Alam S, Alam H, and Redding H. A et al. 2020, “FLASH OF HOPE: Eye Movement Desensitization and Reprocessing (EMDR) Therapy,” therapy involves bilateral stimulation, such as eye movements or rhythmic tapping, in conjunction with guided recall of distressing memories. This process aims to reprocess and integrate these memories, reducing symptoms and improving emotional health.

How Does EMDR Therapy Work?

The effectiveness of EMDR therapy lies in its ability to facilitate the reprocessing of traumatic memories through bilateral stimulation. While the exact mechanisms behind EMDR are still debated, several theories offer insights into its therapeutic effects. The working memory theory suggests that EMDR works by splitting the brain’s resources between memory recall and visual stimulation, thereby reducing the emotional intensity of traumatic memories. 

According to Sack, M., & Hofmann, A. et al. 2008, “Psychophysiological Changes During EMDR and Treatment Outcome,” the bilateral eye movements in EMDR induce relaxation responses, promoting nervous system regulation and desensitization to traumatic triggers.

What Are The Phases Of EMDR Therapy?

phases of EMDR therapy

EMDR therapy consists of a structured approach involving eight distinct phases, each designed to facilitate the processing and resolution of traumatic memories. The phases are discussed in detail by Menon SB, Jayan C., et al. 2010, “Eye movement desensitization and reprocessing: a conceptual framework.”

Phase 1: History Taking

The therapist comprehensively assesses the individual’s history, symptoms, and treatment goals.

Phase 2: Preparation

The therapist educates the individual about EMDR therapy, explains the therapeutic process, and establishes a therapeutic alliance.

Phase 3: Assessment

The therapist collaborates with the individual to identify target memories for reprocessing.

Phase 4: Desensitization

The individual focuses on the target memory while engaging in bilateral stimulation.

Phase 5: Installation

Positive beliefs or self-statements are reinforced to replace negative cognitions associated with the traumatic memory.

Phase 6: Body Scan

The individual monitors changes in physical sensations and emotional responses.

Phase 7: Closure

Ensures the individual feels grounded and safe before concluding each session.

Phase 8: Reevaluation

The therapist assesses the individual’s progress and identifies any remaining target memories or symptoms requiring further treatment.

What Is The Role Of EMDR In Treating Addiction?

EMDR therapy plays a crucial role in treating addiction by addressing the underlying traumatic experiences and psychological factors that contribute to addictive behaviors. 

1. Trauma Resolution

EMDR targets traumatic memories associated with addiction, such as childhood abuse or neglect, and helps individuals process and release the emotional distress linked to these experiences.

2. Bilateral Stimulation

During EMDR sessions, bilateral stimulation techniques, such as eye movements or tapping, are used to facilitate the reprocessing of traumatic memories, reducing their emotional intensity and power to trigger addictive behaviors.

3. Healthy Coping Mechanisms

EMDR helps individuals develop healthier coping mechanisms and emotional regulation skills, which are essential for maintaining sobriety and preventing relapse.

4. Comprehensive Treatment

EMDR therapy offers a holistic approach to addiction treatment, addressing the root causes of addiction like PTSD and empowering individuals to break free from the cycle of substance use. According to Schubert, S., & Lee, C. W. et al. 2009, “Adult PTSD and Its Treatment With EMDR: A Review of Controversies, Evidence, and Theoretical Knowledge,” EMDR helps n reducing symptoms of PTSD and facilitating recovery among trauma survivors. 

5. Research-backed Effectiveness

According to Shapiro, F. (2014, “The Role of Eye Movement Desensitization and Reprocessing (EMDR) Therapy in Medicine: Addressing the Psychological and Physical Symptoms Stemming from Adverse Life Experiences,” EMDR is effective in reducing addictive behaviors, cravings, and relapse rates, highlighting its potential as a valuable intervention for addiction recovery.

What Are The Benefits Of EMDR Therapy For Addiction?

benefits of EMDR therapy for addiction

EMDR therapy presents a multitude of advantages for individuals coping with addiction, particularly those with underlying post-traumatic stress disorder (PTSD) and related trauma responses. By addressing the root causes of trauma, EMDR significantly improves the overall well-being of individuals struggling with addiction. 

According to the findings of Ostacoli, L. & Carletto S. et al. 2018, “Comparison of Eye Movement Desensitization Reprocessing and Cognitive Behavioral Therapy as Adjunctive Treatments for Recurrent Depression: The European Depression EMDR Network (EDEN) Randomized Controlled Trial,” EMDR therapy exhibits a distinct advantage over certain medications. Unlike some pharmaceutical interventions, EMDR demonstrates sustained effectiveness even beyond the duration of treatment, providing individuals with enduring and long-lasting benefits for managing recurrent depression.

1. Alleviating PTSD and Addiction Symptoms

One of the primary benefits of EMDR therapy is its ability to reduce symptoms associated with PTSD, which often co-occur with addiction. EMDR interventions lead to significant decreases in intrusive memories, flashbacks, nightmares, and hyperarousal symptoms. For individuals battling addiction, these symptoms are often triggers for substance use or other addictive behaviors. 

According to Jeffries FW, Davis P. et al. 2013, “What is the Role of Eye Movements in Eye Movement Desensitization and Reprocessing (EMDR) for Post-Traumatic Stress Disorder (PTSD)? A Review,” by mitigating these symptoms, EMDR reduces the emotional distress that fuels the addiction cycle. This alleviation of PTSD symptoms allows individuals to experience a calmer, more stable state of mind, making it easier to focus on recovery and reducing the likelihood of relapse.

2. Transforming Emotional Responses

EMDR therapy promotes the desensitization of distressing memories, helping individuals process these experiences more adaptively. During EMDR sessions, bilateral stimulation (such as eye movements or tapping) supports the brain’s reprocessing of traumatic memories, reducing their emotional impact. This enhanced emotional processing allows individuals to integrate traumatic experiences into their life narratives without being overwhelmed by them. As a result, individuals develop healthier emotional responses and adaptive coping strategies, enabling them to handle stress and emotional triggers without resorting to addictive behaviors. This improvement in emotional regulation is critical for long-term recovery and resilience.

3. Reframing Negative Beliefs

Addiction and trauma often lead to the development of negative self-beliefs and cognitive distortions. These dysfunctional thought patterns perpetuate feelings of helplessness, worthlessness, and hopelessness, making it difficult for individuals to break free from the cycle of addiction. EMDR therapy facilitates cognitive restructuring by addressing and modifying these negative beliefs. 

Griffioen, B. T., & van der Vegt, A. A. et al. 2017, “The Effect of EMDR and CBT on Low Self-esteem in a General Psychiatric Population: A Randomized Controlled Trial,” suggests that by reprocessing traumatic memories, individuals develop more positive and empowering perspectives about themselves and their abilities. This shift in core beliefs fosters a greater sense of self-efficacy and confidence, which is essential for maintaining sobriety and achieving personal goals.

4. Rapid Recovery and Symptom Relief

EMDR therapy is renowned for its ability to expedite the healing process compared to traditional talk therapies. Many individuals experience great improvements in PTSD symptoms after a relatively short course of EMDR treatment, often spanning only a few sessions. This accelerated healing trajectory not only reduces the duration of emotional distress and disability but also enhances overall treatment outcomes and client satisfaction. For individuals in addiction recovery, this means they achieve substantial therapeutic gains quickly, allowing them to progress through their recovery journey more efficiently. The rapid symptom relief EMDR provides enables individuals to focus on rebuilding their lives and pursuing meaningful activities with renewed vitality and purpose.

5. Building Long-Term Resilience

Beyond symptom reduction, EMDR therapy fosters long-term resilience and psychological well-being. By addressing the underlying trauma and its associated triggers, EMDR equips individuals with the skills and resources necessary to navigate future challenges and stressors effectively. 

The study conducted by Edmond, T., & Rubin, A. et al. “2004, “Assessing the Long-Term Effects of EMDR: Results from an 18-Month Follow-Up Study with Adult Female Survivors of CSA,” suggests that EMDR therapy offers long-term benefits. The findings indicate that the therapeutic advantages of EMDR are sustained over 18 months, with evidence suggesting that EMDR provides more efficient trauma resolution compared to routine individual therapy. 

What are the risks of EMDR therapy?

The risks of EMDR therapy are emotional response variability, initial discomfort amplification, physiological sensation, dream activity and intrusive nightmares, and disorientation or detachment.

1. Emotional Response Variability

While EMDR therapy is generally well-tolerated, individuals experience temporary emotional discomfort during or after treatment sessions. This discomfort manifests as feelings of sadness, anxiety, anger, or distress as traumatic memories are processed. While these emotions are a natural part of the therapeutic process, therapists provide support to help individuals navigate these challenging feelings safely.

2. Initial Discomfort Amplification

In some cases, individuals undergoing EMDR therapy experience an initial increase in distress or symptom intensity before experiencing symptom reduction. This phenomenon, known as discomfort amplification, occurs as suppressed emotions and memories resurface during therapy. While unsettling, this temporary increase in distress often precedes breakthroughs in the therapeutic process and indicates that significant emotional material is being addressed.

3. Dream Activity and Intrusive Nightmares

EMDR therapy triggers heightened dream activity or intrusive nightmares in some individuals, particularly following treatment sessions. As traumatic memories are accessed and processed during therapy, clients experience vivid dreams or nightmares related to their trauma. While distressing, these dreams are a natural part of the healing process and usually subside as therapy progresses.

4. Physiological Sensations

During EMDR therapy, individuals experience various physiological sensations, such as muscle tension, fatigue, dizziness, or lightheadedness. These sensations are typically transient and are attributed to the physiological arousal associated with trauma processing. Therapists monitor these sensations and guide them to help individuals manage any discomfort they experience during sessions.

5. Disorientation and Detachment

In rare cases, EMDR therapy induces disorientation or dissociation in individuals, characterized by a sense of detachment from one’s thoughts, emotions, or surroundings. While mild dissociative experiences are relatively common during trauma processing, severe disorientation or dissociation interferes with therapy and necessitates modifications to treatment approaches. Therapists carefully monitor individuals for signs of disorientation and provide support to ensure their safety and well-being throughout the therapeutic process.

How To Compare EMDR With Other Therapies?

TherapyFocusApproachTargeted Issues
Cognitive Behavioral Therapy (CBT)Identify and modify maladaptive thoughts, beliefs, and behaviorsCognitive restructuring and behavior changeSubstance use triggers, coping skills
Dialectical Behavior Therapy (DBT)Regulate emotions, improve interpersonal relationships, and cope with distressing situationsMindfulness, acceptance, interpersonal effectivenessEmotion dysregulation, interpersonal conflicts
Acceptance and Commitment Therapy (ACT)Promote psychological flexibility and values-based behavior changeMindfulness, acceptance, values clarificationAcceptance of difficult thoughts/emotions, values alignment
Eye Movement Desensitization and Reprocessing (EMDR) TherapyProcess and release traumatic memories underlying addictionBilateral stimulation, trauma processingPTSD, trauma-related distress, addiction triggers

Can EMDR Help with Relapse Prevention in Addiction Recovery?

Yes, EMDR can be an effective tool for relapse prevention by addressing the underlying trauma that often triggers substance use, thereby reducing the risk of relapse.

Is EMDR Therapy Suitable for Treating Behavioral Addictions?

EMDR therapy is also beneficial for treating behavioral addictions like gambling or internet addiction by targeting the traumatic memories and emotional triggers associated with these behaviors.

What role does EMDR therapy play in enhancing the cognitive restructuring techniques used in Rational Emotive Behavior Therapy (REBT) for addiction?

EMDR therapy can play a significant role in enhancing the cognitive restructuring techniques used in Rational Emotive Behavior Therapy (REBT) for addiction by alleviating the emotional distress associated with traumatic memories. While REBT focuses on identifying and changing irrational beliefs and thought patterns that contribute to addictive behaviors, unresolved trauma can continue to trigger these negative thoughts. EMDR helps to process and desensitize these traumatic memories, reducing their influence on the individual’s cognitive processes.

How does the integration of EMDR therapy with ACT and REBT provide a more comprehensive treatment for addiction?

The integration of EMDR therapy with Acceptance and Commitment Therapy (ACT) and Rational Emotive Behavior Therapy (REBT) provides a more comprehensive treatment for addiction by addressing the multifaceted nature of substance use disorders. EMDR targets and processes traumatic memories that often underlie addiction, reducing their emotional impact and helping clients achieve emotional stability. ACT focuses on mindfulness, acceptance, and commitment to value-driven behaviors, helping individuals cope with cravings and emotional distress in the present moment. REBT addresses the cognitive aspects by identifying and restructuring irrational beliefs and thought patterns that contribute to addictive behaviors.

How Long Does It Take to See Results from EMDR Therapy?

Many individuals begin to notice improvements after just a few sessions, although the duration of treatment varies based on the complexity of the trauma and individual needs.

Can EMDR Therapy Be Used in Conjunction with Other Addiction Treatments?

Yes, EMDR therapy can complement other addiction treatments, such as cognitive-behavioral therapy (CBT) or medication-assisted treatment (MAT), to provide a holistic approach to recovery.

What Should I Expect During My First EMDR Session?

During your first EMDR session, your therapist will take a detailed history, explain the EMDR process, and help you develop coping strategies to ensure you feel safe and prepared for the therapy.

Ryan Wakim MD
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Dr. Wakim is a board-certified psychiatrist with a passion for and expertise in addiction, mood disorders, trauma-related disorders and the subspecialty of interventional psychiatry. He obtained his medical degree from West Virginia University where he also completed his residency training, finishing as chief resident. Dr. Wakim co-founded and served as the CEO of Transformations leading to a successful merger with Shore Capital in May 2021. He is purpose driven towards improving the standard of and removing stigma related to behavioral healthcare. Dr. Wakim enjoys golf, traveling and time spent with his two dogs, Lulu and Rayna.

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