It is common for those who have experienced trauma to turn to drugs or alcohol to numb the emotional pain. But while substance use may provide some temporary relief, addiction ultimately destroys their lives even further.
Addiction treatment for those with trauma needs to not only addresses the addiction, but also can help resolve underlying trauma. Without addressing the root cause of the addiction, relapse is likely to happen after treatment.
Eye movement desensitization and reprocessing (EMDR) is one of the tools we use, as part of comprehensive holistic treatment, to help clients reprogram their brains after trauma, without having to go through years of talk therapy.
What Is EMDR and Why Is It Used in Addiction Treatment?
EMDR was originally developed by Francine Shapiro, Ph.D., in the 1980s to treat people with post-traumatic stress disorder (PTSD). As additional research has proven its effectiveness, EMDR has become a well-respected course of treatment for emotionally debilitating conditions and mental disorders.
One of the challenges in overcoming trauma is that reasoning logic and emotional logic work separately. For example, a person may be able to logically understand that they are no longer in danger, but on an emotional level they are not able to move on and still experience the fear of being in imminent danger.
EMDR works by isolating a harmful emotion in the brain and reprocessing it to create a more neutral feeling about the traumatic event, alleviating the extreme emotions that can lead to panic attacks, feelings of hopelessness, depression, etc.
How Is EMDR Different?
In traditional talk therapy, a client has to discuss his or her traumatic experience with a therapist, which brings the painful emotions to the surface. However, talk therapy can only apply logical reasoning to the problem, and it can take months or years to be fully effective.
EMDR therapy has three advantages over talk therapy:
- The client doesn’t have to discuss the traumatic experience; they only have to bring the event to mind.
- EMDR bypasses logical thinking and addresses the emotion itself.
- Recovery occurs much more quickly.
What Happens in an EMDR Session?
The goal of EMDR therapy is to reprocess past experiences in order to properly store memories of the event so that the client can retain any useful knowledge and emotions from the experience and discard painful or unhealthy feelings and beliefs.
It also involves teaching techniques that calm the person whenever an emotional disturbance is experienced.
There are eight phases of EMDR treatment that happen over a series of sessions. How many sessions are required, and how quickly the client moves through treatment, varies for each individual.
The EMDR process works to address:
- Past memories
- Present disturbances
- Future actions
Phase 1 – History and Treatment Planning
The therapist asks the client about the traumatic event that is the source of their symptoms. The client can choose to go into detail if they wish to, or give a more general answer such as, “It’s because of an incident with my father when I was a child.” This gives the therapist enough information to develop a customized treatment plan for that individual.
Phase 2 – Preparation and Trust Building
In this phase, the clinician teaches the client specific techniques they can use to deal with painful emotions as they arise outside of treatment. This is useful because even EMDR treatment takes several sessions to complete, and this provides valuable coping tools in the meantime.
This phase also helps build trust between the therapist and the client. In later phases, the client will be asked to rate how they feel and what they believe to be true. In order for EMDR to be effective, the client must feel comfortable giving completely honest answers to those questions.
Phase 3 – Assessment
In this phase, the client identifies a negative belief that stemmed from the traumatic event, such as “I am powerless.” Even if the client knows intellectually that this is no longer to be true, the objective is to target the emotions holding that belief in place.
Then the client chooses a positive belief that he would like to replace the negative belief, such as, “I am in control.” Using a scale of 1 to 7, the client then rates how true they feel (not thinks) the positive belief is at the moment.
During this phase, the client also describes any negative emotions (fear, anger, helplessness, etc.) and physical sensations (fast heartbeat, sweaty palms, stomach tightening, etc.) that they associates with the traumatic event. They then rate the intensity of these emotions and sensations on a scale of 1 to 10.
This sets a baseline from which the therapist and client can see the progress as the sessions progress.
Phase 4 – Desensitization
Now that the groundwork has been laid, the clinician leads the client through sets of eye movements to reprocess the emotions. The client is asked to watch the therapist’s fingers move in front of them, darting their eyes side to side without moving their head. Sometimes other bilateral stimulation is used, such as hand taps or audio tones.
Simultaneously, the client holds in their mind an image of the past trauma, the surrounding feelings they have about it, and any physical sensations in the body that go along with the memory.
This process helps the client move the traumatic memory from an improperly stored part of the brain to a short-term memory position where they can be reprocessed. While the thoughts reside in short-term memory, the bilateral eye movements allow the client’s brain to reprocess the information surrounding the event.
Periodically, the therapist will ask the client to rate their level of disturbance on the 1-to-10 scale again, with the goal of getting the response down to 0, which means that the negative emotion or sensation is no longer triggered by the memory of the traumatic experience.
This phase typically takes three sessions, sometimes longer, depending on the number of traumatic events and emotions to be processed.
Phase 5 – Installation
The objective of this phase is to focus on reinforcing the positive belief statement identified in Phase 3. Progress is measured by the 1-to-7 Validity of Cognition (VOC) scale, with the goal of getting to a level 7 – completely believing, on an emotional level, the truth of the statement.
In some cases, it may be necessary for additional education or action to take place in order for the client to fully believe the statement. For example, if the positive statement is, “I am in control,” and the person is under the influence of an addiction, this may not be entirely true yet. That’s why the detox process occurs at the beginning of addiction treatment in order to clear the way for therapy to be more effective.
This client might also want to take self-defense classes, engage in exercise that strengthens his body and take responsibility for aspects of their life that they had previously neglected. These actions will reinforce their feelings of being in control and supplement the work done in therapy.
Phase 6 – Body Scan
Once the client fully believes the positive statement, the therapist will ask them to bring the traumatic event to mind once again, and scan their body for any residual negative emotions or reactions. If any come up, then those sensations are targeted for additional reprocessing.
The ultimate goal is for the client to be able to recall the memory of the traumatic event without experiencing any tension in his body. The previous phases can be repeated as necessary until this goal is reached.
Phase 7 – Closure
At the end of every session, the therapist reviews the improvement the client has made, so that the client feels that progress is happening within each session. This is also a good time to review what to do if emotional disturbances happen in between sessions, and how to record any additional thoughts, feelings or sensations that come up so that they can be addressed in a future session.
Phase 8 – Re-evaluation
At the beginning of each session, the therapist will check to make sure that the client has maintained the level of progress from the last session, and then talk to the client about what needs to be addressed next. Then, additional processing will occur as is appropriate to that client’s circumstances.
Continuously re-evaluating a client’s progress is important in order to make sure that the positive improvements are permanent. Similar to taking antibiotics for a cold, a client may feel much better right away with EMDR, but it’s important to complete the full course of treatment in order ensure that the effects don’t wear off.
EMDR Treatment for Long-Term Addiction Recovery
Because many people who suffer from addiction use their substance abuse to cope with negative emotions and beliefs stemming from trauma, they are reluctant to commit to sobriety because they don’t have another way of dealing with these intense feelings.
By healing the emotional aspects of trauma, clients can confidently commit to addiction recovery and a life free from the shadow of past events. EMDR is one of the many clinical and holistic therapies we use at Reflections to treat trauma and several other symptoms and disorders that accompany addiction in our clientele.