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Eye Movement Desensitization and Reprocessing (EMDR) therapy is a type of therapy focused on treating core traumatic memories through a different approach than traditional talk therapy. A unique element of EMDR is a scripted procedure that includes analyzing eye movements to help the brain heal. Research has found a relationship between the rhythm of someone’s eye movements, similar to REM sleep, and the association of stressful and traumatic memories.
EMDR, at its most basic, works by having patients talk about their memories while stimulating their vision. This can help therapists process how that memory is stored and reduce intense feelings associated with that memory and other memories discovered throughout the process. EMDR has proven to be an effective treatment to help patients heal traumatic events, adverse reactions, and other triggers often experienced in substance use disorders.
EMDR generally consists of 8-12 structured sessions focused on systematically helping someone work through unresolved traumas. These sessions utilize a system called the three-pronged approach, which includes focusing on a patient’s past, present, and future concerning certain targeted, traumatic events.
Today, many treatment centers provide EMDR to help with co-occurring substance use disorders and mental illness. However, because EMDR is considered an advanced specialty training, only certain professionals can become trained in it, meaning not all rehab centers can offer this service. If you believe EMDR is a treatment that may help you or someone you love, make sure to ask specifically if the program or professionals are trained in it.
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Scientists are still trying to figure out how exactly EMDR interacts with the brain. With that said, there is evidence that reinforces its effectiveness. The eye movements and other strategies used, referred to as bilateral stimulation, lets both hemispheres of the brain to communicate with each other, allowing for effective emotional processing of traumatic events. This has shown positive signs in people who suffer from abusive relationships and PTSD.
As research has shown, traumatic experiences are one of the most common root causes of substance use disorders and mental illnesses. While this is not new information for those who work in the field of substance use, growing research into this relationship has helped direct treatment centers to invest more in treating a patient’s co-occurring disorder than ever before.
EMDR therapy does not utilize medication management in its treatment approach; however, some may benefit from collaborating with psychiatric medical providers to ensure they’re ready for EMDR. Because EMDR is a powerful trauma treatment approach, this often means that before starting, one may want work with their therapist for a period to make sure a plan that includes healthy coping strategies is in place.
While eye movement is the primary method of bilateral stimulation, equipment has been specially designed for this therapy, including light bars, vibrating hand stimulators, and even simple tapping mechanisms that have been found effective. However, there is no concrete evidence that one method is better than the other, and it seems to be a case of individual preference often determined in the beginning stages of EMDR.
While this therapy may seem simple, it is not something to try and do on your own. Proper use of this treatment means taking necessary safety steps with the patient. Not only can this be a painful emotional process, it can also trigger intense feelings and erratic behavior as they relive those moments.
The use of EMDR in co-occurring substance use and addiction treatment finds root in the fact that trauma is a common experience when in active addiction. Addiction is often tied to a past trauma that resulted in the substance misuse starting. This theory also believes that by treating the core reason for the substance use, trauma, the need for the substance will be reduced in severity and intensity. Since EMDR is a structured treatment modality, there are 8 phases of treatment:
Includes a review of the concerns involved and how EMDR may help. This often includes asking about additional history (non-trauma related) and developing a treatment plan for the next steps.
Focuses on preparation for EMDR by ensuring the process is understood, and expectations are reviewed. This phase also provides healthy coping skills, such as stress reduction techniques, are in place before moving forward to the next phase.
Focuses on assessing the core traumatic memory, often called the touchstone. This is done through a structured series of questions that helps the brain reconnect with the memory.
Helps to desensitize the memory from uncomfortable emotions using bilateral stimulation following a structured script. Eye movements, sounds, tapping, or other measures may be used to achieve this.
Begins associating positive emotions and beliefs about themself with the target memory to change how the brain associates with the memory.
Involves the body being brought into the process to review for body sensations that may need additional focus.
Focuses on closure and reevaluation of the process. It ensures no lingering discomfort is felt and that the target memory no longer causes a disturbance, which is recorded on a system called Subjective Units of Distress, or SUDS. A SUD of 0 is the goal.
Therapists using EMDR therapy to treat addiction will often use other treatment approaches called protocols. This allows them to examine each case as an individual and look at the contributing memories associated with cravings, triggers, and the need to escape.
Many people who struggle with substance use disorders often have diagnosable trauma disorders, like PTSD. This makes EMDR as a front-line therapy a logical choice that can significantly help patients and reduce their risk of relapse.
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If you or someone you love struggle with a traumatic history, a substance use disorder, or addiction, you may find benefit from EMDR. More and more treatment centers are offering EMDR to treat the underlying causes of addiction. If this is something that you think you may benefit from or you are unsure about, contact a treatment provider. They can discuss available treatment options with you.
Travis Pantiel, LMHC, MCAP
Travis Pantiel is a Licensed Mental Health Counselor and a National Board-Certified Counselor with specialized expertise in the co-occurring disorder treatment field.
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