EMDR or Eye Movement Desensitization and Reprocessing Therapy is a psychotherapy used to treat trauma, behavioral disorders, and emotional distress. The therapy was first created in the 1980s and is now one of the most common treatment options in the world. Rehab centers are increasingly utilizing EMDR to treat the underlying problems behind addiction, including PTSD, other trauma, distress, and social issues.
While EMDR is not available everywhere and is not the right choice for everyone, it is available in many rehab facilities. Understanding the treatment, how it works, and what to expect can help you to decide on taking a program, to get more from your program, or to choose a rehab facility that best suits your needs.
What is EMDR?
EMDR is a type of psychotherapy focused on treating the patients of trauma. The form found in most rehabilitation centers is modified EMDR, specifically designed to treat substance use disorders by helping individuals recognize and move past contributing trauma, social issues, behavioral issues, and social behaviors that might be triggering.
In most cases, EMDR functions by asking patients to move through memories and distressing imagery while taking part in bilateral sensory input such as hand tapping or side-to-side eye movement. The treatment was first developed by Dr. Francine Shapiro in the late 1980s. Here, Dr. Shapiro used research to determine a series of lateral eye movements that combined with cognitive behavioral therapy (CBT) to focus on desensitization and controlling emotional and behavioral responses.
This treatment is intensely different than CBT in that it focuses on emotional responses and triggers rather than on changing behavior. This works to reduce the likelihood of instances of stress or trauma to become triggering by desensitizing you to them. In most cases, EMDR will also incorporate elements of CBT by incorporating coping mechanisms, new behaviors to process and react to identified emotions, and sometimes focusing on mindfulness (the act of being mindful) as part of the treatment. It has been used to successfully treat substance use disorder, especially in tandem with other treatments including detox, CBT, counseling, and social support.
What is an EMDR Session Like?
EMDR evolves throughout the process so that treatment changes as you do. However, the typical EMDR session will consist of a series of interactions between you and a therapist.
- You talk with your therapist
- The therapist asks you to focus on an emotion, experience, trigger, etc.
- You follow bilateral sensory input, either following a guide to create quick eye movements or use hand-tapping. The intent is to force the brain to disassociate with what you are thinking about or discussing
- You review and repeat the process
- You review and work on coping mechanisms or alternatives
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How EMDR Approaches Substance Use Disorders
EMDR approaches substance use disorder from the angle of past trauma and emotional distress. It focuses on using desensitization and repeat exposure to attempt to reduce the risk of relapse and to help individuals cope. While not a viable solution for every individual, 60-70% of all individuals with a substance use disorder have experienced trauma. Many more use substances to self-medicate for stress, emotional distress, or acute stress relating to work, economic conditions, or social conditions. Substance use disorder is very much a complex disorder linked to an array of social, physical, psychological, and socio-economic problems which often result in trauma and emotional distress.
EMDR works to approach those elements of addiction, helping individuals to hopefully tackle root issues and problems contributing to a substance use disorder. This means that EMDR is not likely to be an effective treatment on its own because individuals still need behavioral therapy in addition to drug and alcohol detox to change seeking and self-medicating behaviors.
How Does EMDR Work in Addiction Treatment?
EMDR is divided into 8 phases, allowing each patient to follow a specific structured path that is dependent on them and their pace. In most cases, this includes a blend of CBT and other therapies, alongside EMDR-specific treatments.
- Phase one involves the therapist learning about you, your needs, and your goals. This typically requires 2-5 sessions and will focus on you, your past, and your needs. These sharing sessions allow the therapist to prepare a personalized treatment plan based on specific personal health and needs.
- In Phase two, your therapist works to educate you about EMDR, what you should expect, and how to properly utilize the therapy. In most cases, this will include introducing base skillsets such as breathing exercises and stress-relief techniques such as mindfulness treatment for addiction.
- Phase three is typically about getting to know your therapist and building a bond with them. EMDR focuses on creating friendship and trust between the therapist and patient, which is why this stage can take as much as half of the program. While controversial, many attribute EMDR’s focus on strong therapist/patient bonds to its success.
- EMDR treatment begins, with therapies and techniques including rapid eye movement, exposure treatment, cognitive restructuring, and assignments.
- Phase five focuses on using cognitive restructuring to create new coping mechanisms and positive feelings or reactions to events and triggers.
- Phase six helps you review progress to ensure that you have met goals and have the tools to move forward
- You complete assignments for yourself and the therapist
- In the final phase, your therapist reevaluates the entire process to ensure the success of the program.
This 8-phase structure moves along at a pace that works for the individual, allowing every patient to progress at their own pace.
How EMDR Aligns with CBT
EMDR has a lot in common with Cognitive Behavioral Therapy, simply because it was originally designed from CBT.
Assignments – Most types of behavioral therapy ask you to complete assignments. These help you to develop skills, ask you to show motivation, and allow you to prove that you can work on your own mental health. Most assignments are about taking initiative, developing discipline, and approaching your emotions and behavior as a changeable state. EMDR typically links these assignments to self-sufficiency, reducing negative emotions, and building a healthy ego or sense of self.
Cognitive Restructuring – Cognitive restructuring is the “behavior” therapy element of CBT, and one of the most popular and science-backed methods to treat substance use disorders. CR is about recognizing harmful thought patterns and behaviors, working to identify where they come from, and working to instill new and healthier thought patterns and behaviors. This typically involves a considerable amount of introspection, identifying emotions, and learning new skills to replace old behaviors.
Exposure Therapy – EMDR heavily relies on exposure therapy to desensitize patients from trauma and stress. In most cases, exposure therapy will be present in nearly every EMDR session you attend. This therapy works to reduce the likelihood that you will respond to a trigger or a behavior by immediately relapsing, simply because you have been desensitized and are therefore more accustomed to seeing it.
Is EMDR a Good Choice for Substance Use Disorder?
EMDR has pros and cons and it is always important to consult with a doctor, addiction specialist, and/or a counselor before moving forward with any therapy. However, EMDR is a very popular therapy with many potential advantages for individuals seeking addiction treatment.
EMDR focuses on responding to emotional trauma and trauma, creates outlets to learn how to manage and deal with triggers and problems. It also focuses on reduction strategies to reduce harm and potential problems, with the goal of increasing coping skills.
EMDR is just one of many behavioral therapy-based addiction treatment methods, but it is one that is increasingly popular. Consider talking to your doctor, counselor, or therapist for more advice or guidance to help you decide which treatment method is best for you.