EMDR Substance Abuse Therapy

Last Edited: October 5, 2020

Patricia Howard, LMFT, CADC

Clinically Reviewed

All of the information on this page has been reviewed and certified by an addiction professional.

What is EMDR?

EMDR Therapy is an abbreviation for Eye Movement Desensitization and Reprocessing Therapy. This treatment modality was developed by Francine Shapiro in 1987. While it was originally intended to be utilized in the remedying of memories of traumatic events, therapists have been finding more and more uses for this technique in areas such as treating depression, couple’s therapy, eating disorders, sports performance, and now substance abuse and addictive disorders. EMDR generally consists of the clients utilizing rapid eye movement or rhythmic tapping while imagining a troubling event. In addition, newer and more positive beliefs are substituted instead of the negative event, reducing the symptoms of unpleasant experiences, and increasing one’s quality of life.

However, today more than 20 scientifically controlled studies of EMDR have proven its effectiveness in the treatment of traumatic and other disturbing life experiences.

Concepts Behind EMDR

One unique trait that EMDR possess is the fact that it does not possess the extensive philosophies of human nature that are necessary for other treatment modalities to function. In addition, there are fewer concepts involved in this process. EMDR functions on a scale that is more physiological scale, and therefore utilizes some neurological factors of the brain, rather than emotional states.

The main factor that is at play during EMDR Therapy is the concept of dual attention in the human brain. By the action of pairing an experience with a physical activity (such as rapid eye movement or rhythmic tapping), the memories of the negative experiences become disrupted, dampening the effect on one’s emotional and psychological state. When the mind becomes more flexible due to these actions, other positive beliefs can be implemented and stored into the memory more receptively, further decreasing the negative effects of an unpleasant experience.

Francine Shapiro

Francine Shapiro is credited as the originator of of Eye-Movement Desensitization and Reprocessing Therapy. In the year 1987, Shapiro came to a realization regarding physical signs of remembering negative effects. She realized that her eyes would move rapidly back and forth when remembering past events that caused discomfort. From then on, Shapiro has utilized this knowledge to associate this physical signs of eye-movement or rapid tapping to alleviate the symptoms of trauma or bad habits.

While this therapy is not fully understood, research indicates that this process is effective in multiple treament settings.

The 8 Phases of EMDR: Therapeutic Techniques

Phase 1, Treatment Planning With Respect to Client History: This stage generally consists acquires an in-depth history of the client’s family relationships, work records, legal encounters, and physical and mental health. In addition, the counselor acquires knowledge regarding the event (or multiple events) that caused the client distress, as well as events that continue to trouble the client. While it is necessary to identify the problem, the issue does not need to be discussed in great depth.

Phase 2, Preparation: This stage generally consists of the counselor building a trusting relationship with the client, so that the actual process will be more effective. Since trust is a key factor in any treatment process, the client must be sure where he/she stands and be trusting of the therapist’s intentions as well. In addition,  The counselor also teaches the client multiple relaxation strategies, and other healthy mechanisms of coping with stress.

Phase 3, The Assessment:  This stage consists of the client identifying the negative thoughts and beliefs associated with a negative experience. Examples of these beliefs would be “I’m not lovable,” or “I am worthless.” After this identification, the client picks out numerous statements that directly contradict the current negative beliefs, such as “I am lovable” or “I am worthy.”

Phase 4, Desensitization: This Stage consists of the counselor presenting a series of upsetting images, negative beliefs or physical triggers of the unpleasant event. While this occurs, the client performs the physical action of rapid eye-movement or rhythmic tapping while mentally letting the negative feelings go.

Phase 5, Installation: This stage consists of the client now pairing the opposite beliefs held from Phase 3, and pairs these beliefs with the unpleasant event itself.  When the more positive beliefs are reinforced during this time, they become anchors that are associated with the event instead of the negative events.

Phase 6, The Body Scan: Once the session is completed, the client is asked to examine the physical tensions behind any thoughts regarding the unpleasant event; if there is noticeable tension, there may be more work to be done.

Phase 7, Acquiring Closure: This stage of treatment ensures that clients end each session in a better state than when they began. Clients are also encouraged to engage in relaxation exercises and stress management techniques that were learned in Phase 2.

Phase 8, Reevaluation: This is done on the therapists part in every session, examining any other possible issues that may arise or other potential complications in treatment, allowing the therapists to remain flexible with the client’s shifting needs.

Strengths in Treatment

  • EMDR has been shown to be just as effective (and even more effective) as medications regarding traumatic events and occurrences of PTSD.
  • While EMDR is based in alleviating trauma, it has been shown to be effective in treating addiction.
  • EMDR is less invasive than other therapies.
  • EMDR utilizes a comprehensive approach to treatment with neurological considerations.

Conflicts with Treatment

  • EMDR must be performed by trained professionals; inexperienced practitioners may otherwise induce serious mental damage in clients with PTSD.
  • Some clients may wish to deal with the core roots of issues, rather than the negative symptoms being alleviated.
  • Some people may not feel comfortable addressing a traumatic event, so trust may be more difficult to earn.

Neukrug, E. (2011). Counseling theory and practice. Australia: Brooks/Cole, Cengage Learning.