Since its recognition as a chronic disorder, the world of addiction treatment has changed for the better. Nowadays, victims of Substance Use Disorder are offered a plethora of therapies, from traditional methods like CBT to Holistic Therapies that cultivate mindfulness.
And then we have one of the newer kids on the therapeutic block: Eye Movement Desensitization and Reprocessing (EMDR) [1]. We know, it’s a bit of a mouthful, but the concept is (mercifully) a lot easier to grasp than it sounds.
EMDR reduces the mental impact of past trauma and is an effective treatment for patients battling PTSD from combat, sexual abuse, and car accidents.
Patients trying EMDR are trained to move their eyes a specific way while they process traumatic memories. This includes rapid eye movements, bilateral stimulation (alternating your eye movements), and using sound or sensory stimulation.
So how can rhythmic eye movements [2] help people recover from a traumatic incident? It all comes down to how our brains process difficult memories and the uncomfortable sensations that accompany these attempts to heal.
Although some people can recover from a horrific event or experience within a few months, others battle a prolonged stress response known as PTSD.
In cases of Posttraumatic stress, difficult memories have been partially processed, and the brain is still trying to get over the specific images, thoughts, and emotions surrounding the event.
This half-completed processing and storage of traumatic memories lead to some distressing symptoms. When these partial memories are triggered, victims may feel as though they’re re-experiencing the event, leading to tremendous feelings of anxiety.
While EMDR doesn’t exactly eliminate these memories, it helps ease the distress surrounding them. While practising rapid eye movements [3], many patients can stay grounded in the present, allowing them to process their trauma in an emotionally safe way.
Practising these eye movements during a PTSD episode is known as a dual attention stimulant. Individuals are encouraged to perform these movements while also holding a traumatic memory or flashback.
This allows them to process painful memories and can help them with future triggers.
What Is The Link Between Trauma and Addiction?
EMDR is becoming more common in addiction treatment plans, and a large part of this is because trauma plays a role in substance abuse [4].
Numerous studies have shown that the stress caused by a traumatic event makes people more vulnerable to addictive behaviours, especially if these events occur earlier in life.
Over the years, scientific literature has been published uncovering the link between Adverse Childhood Experiences (ACEs) and addiction in later life. ACEs describe psychological trauma that occurs in the first 18 years of someone’s life, such as physical, emotional, or sexual abuse.
It was discovered that adults who experienced ACEs are three times more likely to fall victim to alcohol use disorders in their adult years. If they never received formal treatment to help them process these negative memories, the risk of addiction grows.
This is because the perceived threat from their traumatic experiences was never resolved, leading to chronic stress as their fight or flight response becomes hyperactive.
As the years go by, these individuals attempt to cope in any way that they can, even self-medicating with addictive substances [5].
While we all know drugs and alcohol aren’t healthy coping mechanisms, they produce feelings of pleasure that, if only for a little while, lessen PTSD symptoms.
Using substances regularly helps them quieten intrusive thoughts and quell negative emotions, but can lead to further problems in the long run.
Not only will their Post-Traumatic Stress Disorder get worse, but they’re also at risk of developing a chronic addiction, leading to more physical symptoms and mental problems. It’s also worth noting that those who have experienced childhood trauma aren’t the only ones at risk.
Take, for example, someone who has just returned home from active military service. They suffered immense trauma while they were away, but feel as though they can’t talk to anyone about it, and so receive little to no treatment.
To push down their negative emotions, they start drinking alcohol every night, and pretty soon they can’t imagine coping without alcohol.
With this in mind, treatment approaches [6] for both addiction and Acute Stress Disorder should take a personalised, integrated approach.
Methods like EMDR help people relieve the psychological stress that comes from trauma and active addiction: allowing them to tackle the root cause of their addictive behaviours.
How Does EMDR For Addiction Work?
So how is EMDR implemented in the treatment of substance abuse? [7] While in its infancy compared to other behavioural therapies, EMDR has a highly-structured set of protocols: eight to be exact.
To allow time for each step, sessions are usually held once or twice per week, totalling 6 to 12 sessions depending on the person’s severity.
The core EMDR steps are as follows:
1. Reviewing the Client’s History
During your first EMDR session [8], your therapist will gather some information relating to your trauma history: establishing a therapeutic alliance.
They’ll also take note of your specific (pre-diagnosed) Substance Use Disorder, and past medical treatments, and build an overall picture of your health.
Together, you’ll identify some targets for treatment, whether these are painful life events, current relapse triggers, or future goals.
Because trauma symptoms and addictive behaviours are interlinked, EMDR therapy will operate in a way that provides relief for both co-occurring disorders.
2. Preparing the Client
Before undertaking most forms of therapy, it’s important that patients understand the process they’ll undergo and the therapeutic techniques involved. EMDR is no different, and phase two of treatment is spent preparing you for treatment and explaining each procedure.
Because it’s such a new therapy, there’s a high chance that people trying it out won’t have heard of it before. Therefore, it’s necessary to briefly explain the EMDR practice and research explaining its efficacy.
As part of this, therapists will explain and may demonstrate the different eye movements and Bi-Lateral Stimulation.
In the early days of EMDR, eye movement components were simpler, with therapists holding up their hands with two fingers extended and having you follow their fingers from side to side with your eyes.
These days, newer methods involving light devices are available that have a moving light that you follow with your eyes in place of your therapist’s hand. In addition, sound therapy may be used whereby speakers on either side of your body play tunes to help with trauma symptoms.
Phase two of EMDR explains all of these relaxation techniques [9] and more to ensure you’re feeling comfortable and safe.
3. Choosing Specific Memories to Target
Next, you and your therapist will hone in on a specific memory or memory network to target. This should be one that triggers a negative or stressful response and that has led you to use substances in the past.
To really get to the core of this memory, you’ll work with your therapist to identify its different components: the images conjured, the bodily sensations, and the emotional effects.
During this phase, your therapist will introduce two assessment methods used to evaluate cognitive and emotional changes. These are the Validity of Cognition (VOC) scale and the Subjective Units of Disturbance (SUD) scale.
Both of these methods involve your therapist asking questions to which you’ll respond with a number that corresponds to how you’re feeling.
During the VOC assessment, the therapist will ask “When you think of the incident, how true do those words (repeat the positive reframing) feel to you now on a scale of 1-7, with 1 feeling completely false and 7 feeling true?”.
Once you’ve named the emotion that you’re feeling, your therapist will use the SUD scale. They’ll ask “On a scale of 0-10, where 0 represents neutral and 10 is highly disturbed, how disturbing does it feel now?”.
4. Eye Movement Desensitisation
Now we get to the crux of the EMDR process: engaging in rapid or alternating eye movements. During this phase, also referred to as “Desensitization”, you’ll focus on the target memory while practising these eye movements (which you’ll be coached on how to perform beforehand).
After each set of eye movements, you’ll report back to your therapist and explain which, if any, new emotions are presenting themselves. Depending on how you’re feeling after each session, the type of eye movements can be tweaked and adjusted.
Typically, the eye movement component of EMDR will continue until you report a shift away from negative feelings.
Remember, the goal of these exercises is to establish feelings of emotional safety and reduce the effects of trauma, rather than remove these memories. It’s all about cultivating a coping mechanism to steer you away from substance abuse [10] and its negative consequences.
5. Strengthening Positive Thoughts
Also called “Installation”, this term describes the process of strengthening the positive thinking you will (hopefully) have fostered by this point. During this phase, your therapist will have you focus on the positive beliefs you wish to build when confronted with a painful memory or relapse trigger.
These beliefs should have positive associations and can be something you said during the previous phase, or something new that comes to mind.
Whatever they are, these positive or even neutral feelings can help you unlock a more helpful response to the target memory.
6. Body Scan
While a key part of EMDR, the body scan method isn’t a new concept in the treatment of addicted patients [11]. Nor is it a new concept in the clinical realm; body scans have been a part of mindfulness practices for many years now and are a profound relaxation technique.
Once you’ve completed the installation process of EMDR and have worked on your feelings surrounding a particular memory, your therapist will talk you through how to perform a body scan.
This means observing your physical response to the traumatic memory, without judgement or prejudice.
Typically, you’ll be asked to close your eyes and hone in on one body part at a time: starting with your toes and moving towards your head, and noticing how they feel.
This allows you to identify lingering feelings of tension or stress, both of which are normal and not a sign that you’ve “failed” EMDR.
Your therapist will note your symptoms and use them to gauge the progress you’ve made during sessions while noting if there’s a need for further work. As you work through subsequent sessions, you’ll return to the body scan method as a way of assessing the therapy’s positive associations.
7. Closure
To end the session, your therapist will reflect on your progress during the other phases and decide how to proceed. In this way, the closing phase serves as a bridge between the current session and later EMDR workshops.
You’ll discuss the focus of future sessions with your therapist, as well as what you’ve already learnt in terms of coping mechanisms. Your counsellor may also teach you how to stabilise yourself if negative feelings occur between sessions.
This might also involve setting basic homework tasks, such as writing down any trauma-related thoughts you have, or any relapse triggers. You can discuss this in the following session and use this as a foundation for future workshops.
Most importantly, your EMDR therapist will only end the session once any residual feelings of stress have passed. Drug or alcohol-dependent patients may already be in a rehab facility: an optimal environment for trauma recovery.
8. Follow-Up
This final step provides aftercare for EMDR patients, allowing them to reflect on the positive emotions they’ve experienced, and how this has contributed to their drug or alcohol treatment outcome [12].
Your therapist will ask you how you doing now, and help you to decide whether any further sessions are necessary.
You’ll also be able to discuss what you’ve learnt about your trauma, how your body reacts to these memories, and how you can cope best in the future.
The Benefits of EMDR
When it comes to explaining the advantages of EMDR, there are a lot of “may benefit [insert symptom]” and “could benefit [insert another symptom]”.
While this might be frustrating, it’s not because the benefits haven’t yet become apparent, but because the scientific findings haven’t yet been published. After all, this therapy is still in its infancy.
Despite this, there are some clear benefits of EMDR [13] when compared to other therapies for addiction and trauma.
1. EMDR Takes a One-to-One Approach
Many people find that sitting down with their therapist without the presence of others is the best way for them to recover from trauma and addiction.
While group therapies are effective forms of treatment, individuals may feel uncomfortable sharing traumatic memories in a communal space.
In this way, EMDR is a great option for the treatment of substance abuse and complex trauma. You’ll build a strong rapport with your therapist in a safe, secluded environment.
2. It Involves Less Homework
Unlike other traditional therapy methods [14], EMDR seldom requires patients to complete homework outside of sessions. While treatments like Cognitive Behavioral Therapy often set journaling or other writing tasks as homework, EMDR is more relaxed in this sense.
Any homework that’s assigned will be simple, such as writing down any thoughts or feelings that crop up or that you’d like to focus on in future sessions. After all, the majority of the progress you’ll make in EMDR occurs during workshops.
3. It Minimises Stress
A common narrative in the addiction treatment world [15] is that patients with mental health disorders must relive their trauma to move past it. However, describing negative experiences in detail can be deeply distressing, and rarely achieves a positive treatment goal.
While the emphasis is placed on moving past your trauma in EMDR, its methods don’t involve reliving the event by describing it to your therapist.
Re-processing these memories works internally, rather than externally voicing them to others, as in group therapy workshops or 12-step meetings.
Finding an EMDR Therapist For Addiction
If after reading this blog post you’d like to give EMDR a try, the next step is to find a therapist in your local area. However, this is sometimes easier said than done.
Not only will you need to find a counsellor with experience performing EMDR, but they’ll also need to be qualified in addiction treatment.
Here at Ok Rehab, our experts have you covered [16]. By calling 0800 326 5559, you’ll be able to speak with a professional instantly and book one of our phone consultations.
During this phone call, we’ll discuss your reasons for reaching out and help you decide how to proceed with treatment, whether this is entering a local rehab clinic, starting outpatient care, or finding a therapist specifically for EMDR.
Don’t wait for a substance abuse problem to turn into an addiction, reach out now and begin your recovery today.
References
[1] A FLASH OF HOPE: Eye Movement Desensitization and Reprocessing (EMDR) Therapy A FLASH OF HOPE: Eye Movement Desensitization and Reprocessing (EMDR) Therapy – PMC (nih.gov)
[2] Eye Movement Desensitization and Reprocessing (EMDR), A Beginner’s 30-Minute Quick Start Guide and Overview of EMDR to Manage Stress, Anxiety, and Trauma Eye Movement Desensitization and Reprocessing (EMDR) – Google Books
[3] The Role of Alternating Bilateral Stimulation in Establishing Positive Cognition in EMDR Therapy: A Multi-Channel Near-Infrared Spectroscopy Study The Role of Alternating Bilateral Stimulation in Establishing Positive Cognition in EMDR Therapy: A Multi-Channel Near-Infrared Spectroscopy Study – PMC (nih.gov)
[4] Examining the Relationship Between Trauma and Addiction Examining the Relationship Between Trauma and Addiction – Google Books
[5] Posttraumatic Stress and Substance Use Disorders, A Comprehensive Clinical Handbook Posttraumatic Stress and Substance Use Disorders – Google Books
[6] Ok Rehab: Psychotherapy for Addiction Treatment Psychotherapy for Addiction Treatment | OK Rehab
[7] The Science of Addiction: From Neurobiology to Treatment The Science of Addiction: From Neurobiology to Treatment – Google Books
[8] Recovery from Trauma, Addiction, Or Both, Strategies for Finding Your Best Self Recovery from Trauma, Addiction, Or Both – Google Books
[9] The Mindfulness Workbook for Addiction, A Guide to Coping with the Grief, Stress, and Anger That Trigger Addictive Behaviors The Mindfulness Workbook for Addiction – Google Books
[10] Ok Rehab: Dual Diagnosis, PTSD Dual Diagnosis: PTSD – OK Rehab
[11] NHS: Addiction, What Is It? Addiction: what is it? – NHS (www.nhs.uk)
[12] Substance Use Disorder Treatment for People With Co-Occurring Disorders Substance Use Disorder Treatment for People With Co-Occurring Disorders (Tr… – Google Books
[13] Taming the Tiger, How to Heal Your Past with EMDR Therapy Taming the Tiger – Google Books
[14] Ok Rehab: Cognitive Behavioral Therapy (CBT) Cognitive Behavioural Therapy (CBT) for Addiction | OK Rehab
[15] Ok Rehab: Addiction Counselling Addiction Counselling – OK Rehab
[16] Ok Rehab: Help For Myself Addiction Help for Myself | OK Rehab
