What is EMDR Therapy? Is It Effective for Substance Abuse?

Last Updated: October 7, 2021

Authored by Dr. Ahmed Zayed

Reviewed by Michael Espelin APRN

EMDR therapy has gained ground as one of the treatment methods for trauma approved by the American Psychiatric Association (APA) and the World Health Organization (WHO). Its results have been observed to be quite effective and reliable for mental disease and substance abuse.

So, what is EMDR therapy? Does it have any side effects? Read further to find out its benefits for substance use disorder and other applications.

What Is EMDR Therapy?

Eye Movement Desensitization and Reprocessing, or EMDR, is an interactive medical therapy adopted to treat various mental disorders. EMDR treatment is often procedural for people who have experienced traumatic events that can cause the retention of the experience with disturbing mental images. This psychotherapeutic approach helps people heal from symptomatic psychological and emotional trauma. Studies have shown that EMDR trauma therapy reduces mental pain and emotional recession, paving the way for a healing course from substance abuse disorder.

Worried woman talking to EMDR therapist.

In the late 1980s, an American psychologist Dr. Francine Shapiro developed this interactive technique to treat mental trauma. Over time, this method became a part of the treatment of other mental disorders, such as depression, anxiety, chronic pain, phobias, post-traumatic stress disorder (PTSD), substance abuse, and other physically detectable disorders. Research studies have shown an impressive EMDR success rate where 84-90% of cases were diagnosed with a cured case of PTSD after some 90-minute therapy sessions. After many years of research, EMDR therapy has gained global recognition by renowned health-based organizations.

How Does EMDR Therapy Work?

EMDR therapy bridges the resources in the form of memories and events in different hemispheres of the brain. The brain compartmentalizes good memories and events in the left hemisphere and tragic and bad ones in the right. Every traumatic event is associated with the impaired neural network, and EMDR therapy re-activates these pathways, facilitating its repair and synchronizing it with other parts of the brain.

During the session, patients’ good and positive memories are jogged up, and positive resources are strengthened, which repairs and strengthens the dysfunctional neural network. In this way, patients become more resilient and tolerant during the desensitization part of the therapy. Dual Attention Stimulation (DAS) is used in the desensitization part by using bilateral eye movements or tones that alternate between both sides of the body. During DAS, memories from the traumatic events are recalled while maintaining the awareness of present surroundings.

Is It Effective?

This method provides an effective and efficient approach to resolve the psychological symptoms associated with traumatic events. Patients dealing with PTSD and other medical conditions such as burn victims have shown impressive responses to EMDR trauma therapy.

Positive effects are reported, including a significant decrease in distress level and the clarity of the traumatic and disturbing image by using desensitizing techniques. Furthermore, eye movement desensitization is reported to be successful in desensitizing the traumatic memories, followed by a decrease in the anxiety level.

EMDR Treatment For Addiction

Patients commonly suffer from co-occurring mental health disorders and addiction problems simultaneously. In 2019, 9.5 million adults in America were diagnosed with at least one co-occurring disease alongside a substance abuse disorder. Among this group, the majority belong to 18-25 years of age, and of these diagnosed people, only 742,000 people (7.8%) received treatment for mental health disorders and substance abuse.

Depresed man suffering from substance abuse and mental health disorder with a therapist near the window.

People who have PTSD are more vulnerable to addiction, and EMDR for PTSD can be effective. EMDR treatment can be utilized as an effective tool in managing addiction. EMDR for PTSD treats a past traumatic event and can eventually lead to decreased use of the abused substance and help with co-occurring mental disorders as well. It would help in maintaining sobriety and reducing symptoms due to mental disorders.

EMDR therapy also helps with addiction in other ways. For addiction, it is provided as Trauma-Focused EMDR in addicted patients with comorbid PTSD and without PTSD. This therapy reported a reduction in PTSD and depressive symptoms in patients with substance abuse disorder. Various research studies are in progress to determine the effectiveness of EMDR for PTSD as a comorbidity in substance abusers with the expected outcome as reduced PTSD symptoms compared to other approaches.

EMDR Reprocessing of the Addiction Memory

Not everyone becomes a substance abuser due to a traumatic event they have experienced in their lives. There are other contributing factors as well. For example, some might have experienced some physical injury, which led them to use potent opioid drugs and eventually led to addiction. While this therapy may not be helpful in providing them the treatment in this condition, these people can still get help from it if they are dealing with addiction memory.

An addiction memory is the overall memory of the loss of control which leads to a continuous behavior of drug abuse and prevents someone from recovering. EMDR intervention can be used in this case to desensitize the feeling that is associated with drug-taking. In addition, this therapy can be integrated with pharmacotherapy and other approaches to achieve efficient results in the long run.

Depressed anxious girl at home on the couch.

To reprocess the addiction memory using EMDR treatment, the most likely targets would be memories of craving and relapse. Craving reductions can be measured using Obsessive–Compulsive Drinking Scale (OCDS). This therapy intervention reported a significant decrease in alcoholic cravings, followed by a decrease in depressive symptoms.

8 Phases Of EMDR Trauma Therapy

The sessions of this therapy involve attention to memories, current disturbances, and future actions. This therapy aims to address the traumatic experiences that cause emotional problems and add new ones essential for well-being. Its processing stage is more like a setup point to break down saved energy channeled towards a feeling. Such interactions are helpful in directing different behavior.

The time this therapy takes isn’t fixed – it is given to ensure complete healing after participating in the therapy. There are eight phases of EMDR treatment, and the treatment may take up to twelve sessions. Some clients may pass through the first 5 phases very fast to untangle the most significant memory that needs a more thorough approach and may take more time than expected.

The Eight Phases of This Interactive Therapy Are as Follows:

Phase 1

This phase revolves around the client’s history and treatment planning. First, the therapist takes a comprehensive history of the client to identify the particular trauma, its intensity, and potential triggers. The duration of this phase is based on the number of traumas and the age at which the client started to experience negative changes in behavior or emotions. Generally, people with a single traumatic event can be successfully treated in a few hours, while others with multiple negative experiences may need a longer time to get treated.

Phase 2

This phase aims to reach emotional equilibrium and may take up to four sessions in standard cases. For this, the therapist teaches the patient some specific self-control techniques to handle emotional stress better. The therapist then creates scenarios that may trigger such emotions and show the client how to deal with them effectively. If a client can do this, they are generally able to proceed to the next phase.

Phase 3

It is an assessment phase in which the therapist and client jointly identifies a significantly negative memory and asserts a statement that counters self-belief to the memory. It is needed to voice out the real feelings towards that particular event. These are turned into more logical and positive statements, such as “I was weak,” becomes “I survived,” and then “I am a survivor.”

Phase 4

It is the desensitization phase that highlights sensations felt and every response to target memories. All responses are measured with the SUD scale. The process involves sets of eye movements, sounds, and taps. It enables the client to identify the events and related memories to reach and exceed objectives.

Phase 5

In the fifth installation phase, the addiction specialist attempts to increase the power of positive beliefs. During this stage, the client learns to replace negative beliefs associated with the incident with positive thoughts. It also comes with complete acceptance and belief in one’s self.

Patient lying on the couch during EMDR session.

Phase 6

The sixth stage is the body scan stage. Some memories are often associated with physical signs like scars, which may be emotional reminders of the event. These sessions for body scans enable the verbalization of body scars or sensations to reduce the feeling of painful body reminders.

Phase 7

This is the closure phase, in which the client is encouraged to document all the self-control techniques to maintain emotional balance. It helps the client in soothing feelings for long post-therapy sessions.

Phase 8

It is the reevaluation phase in which a review is conducted for the optimal treatment effect and to check out further targets.

EMDR Therapy Side Effects and Challenges

This therapy shares some of the side effects with other forms of psychotherapy. Unlike pharmacotherapy, EMDR therapy side effects are less severe. In addition, it can maintain its long-term effect even after the therapy ends.Its side effects are primarily negligible.

However, in Rare Cases, This Method, as Well as Other Trauma Treatment Methods, May Cause:

  • Lightheadedness
  • An increase in distressing memories
  • The surfacing of new painful memories
  • Heightened emotions
  • Auditory hallucinations
  • Vivid dreams

However, the EMDR therapy side effects are not as severe as those of medication and will be resolved as the therapy takes its course, e.g., patients reported that auditory hallucinations disappeared over time.

Even though EMDR therapy is effective, it has its challenges for both patient and therapist. The patient relieves every traumatic moment which one intends to overcome. However, this experience is excruciating in itself, and some patients cannot bear going through these events over again. It is indeed a challenge for the patients to put themselves through this again voluntarily to feel better. In most cases, it is emotionally stressful, but it is worth it in the long run.

Considering EMDR: What To Look Out For?

The primary step in getting help for substance abuse is to find professional medical personnel to get guidance through the process. One might search for a licensed EMDR therapist nearby to narrow down on location.

Finding an expert drug addiction psychiatrist nearby may depend on one’s location. One can seek recommendations from a healthcare professional on the best therapist or rehab facility to consider. This step holds great significance since both substance abuse disorders and mental health conditions have to be rightly diagnosed by professionals to provide the proper addiction treatment services.

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Page Sources

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Published on: November 5th, 2019

Updated on: October 7th, 2021

About Author

Dr. Ahmed Zayed

Dr. Ahmed Zayed is a Bachelor of Medicine and Surgery. He is graduated from the University of Alexandria, Egypt. Dr. Ahmed Zayed has a passion for writing medical and health care articles and focuses on providing engaging and trustworthy information to readers.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.