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Updated on September 27, 2022

What is EMDR?

EMDR stands for Eye Movement Desensitization and Reprocessing. This psychotherapy is designed to help individuals deal with past trauma

Trauma is a form of associative learning. The most famous example of associative learning comes from the physiologist Ivan Pavlov’s dog studies. 

Every time Pavlov fed the dogs, he would ring a bell. He discovered that eventually, dogs would salivate when he rang it, even in the absence of food.

Like Pavlov’s dogs, traumatized people learn to associate feelings with certain thoughts or actions.8 

In this case, they’re negative feelings such as shame, anxiety, and fear. These feelings condition them to react negatively to anything related to the trauma.

Due to the stress it produces, they avoid thinking about their trauma and so never learn to overcome it.

EMDR therapists address this using a technique called bilateral stimulation

During an EMDR session, the patient thinks of a traumatic memory. While doing so, the therapist stimulates the senses of the patient in various ways. 

These include: 

  • Visual — The therapist waves their fingers from left to right in a back-and-forth motion as the patient watches. 
  • Audio — Patients wear headphones and listen to auditory tones in an alternating, rhythmic fashion. 
  • Kinesthetic — This involves tapping the patient on their knee, arm, or leg.

These actions engage patients in a way similar to meditation.

The visual component particularly has been found to reduce the intensity of disturbing thoughts. It’s thought this is related to how the patient’s eyes move back and forth rapidly, simulating REM sleep.

Multiple meta-analyses of scientific publications have reported EMDR as being an effective treatment for PTSD.

Various health authorities and governmental bodies recognize the effectiveness of EMDR treatment for PTSD.

These include:

  • American Psychiatric Association (APA)
  • The Substance Abuse and Mental Health Services Administration (SAMHSA)
  • The U.S. Dept. of Veterans Affairs/Department of Defense
  • The World Health Organization (WHO)

EMDR for Addiction Treatment

Like PTSD, researchers believe addiction is a form of associative learning. 

Drug users learn to associate drugs with good feelings like euphoria. This makes the addiction hard to break.

Researchers believe EMDR can reduce the intensity of those feelings, weakening the addiction.

One review of the literature found:

“In conclusion, both clinical and laboratory data suggest that EMDR can be useful to reduce intensity of substance-related imagery and craving and might be a valuable intervention in addiction treatment.”10

Two other reviews also found EMDR to be a potentially valuable treatment for addiction.11, 12

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How Does EMDR Work? 8 Phases of Treatment

EMDR is an eight-phase treatment. Individuals can receive sessions twice per week on a consecutive basis. 

The phases are as follows:

History-taking and treatment planning (phase 1)

The therapist gathers the patient's full history and works alongside the individual to define targets for therapy. 

 These targets comprise memories, present triggers, and prospective goals. 

Preparation (phase 2)

The therapist provides an overview of the treatment and its procedures. The patient will practice eye movement and/or other bilateral stimulation techniques. 

The therapist will also help the patient practice calming exercises. These are aimed at providing a temporary rest during sessions.   

Assessment (phase 3)

The therapist activates the target memory via identifying and evaluating each aspect of that memory, including image, cognition, affect, and physical sensations. 

Processing memories to potential closure (phases 4 to 7)

Processing memories may take one to three sessions depending on the patient. These phases comprise different components. 

In these sessions, the therapist will employ bilateral stimulation like rapid eye movement therapy while the patient focuses on the memory. This process continues until the patient no longer states feeling distraught by the memory. 

Then, in the “installation” phase, the therapist helps reinforce a positive thought. After this, the therapist will ask the individual to mentally scan their body from head to toe. 

Observing the physical sensations while thinking about the event and positive cognition help to resolve any residual distress in the body. 

Finally, the therapist will bring the session to an end.

Evaluating treatment results (phase 8)

The therapist will assess the individual’s current psychological state. They will look for any lasting treatment effects, as well as new memories since the prior session. 

The therapist will take the opportunity to work alongside the patient in defining new targets for the session. 

What is Attachment-Focused EMDR?

Attachment-focused EMDR (AF-EMDR) builds upon EMDR while offering techniques for those less responsive to conventional EMDR approaches.   

These three primary techniques include:

Resource Tapping™ 

This approach consists of two parts

  1. Resource This represents real or imagined people, locations, and memories that evoke a sense of security in the patient’s mind
  2. Tapping. This is an example of bilateral stimulation. It involves left-right tapping on the legs, shoulders, or knees of the patient. 

The combination of tapping while thinking deeper about the resource helps rebalance the nervous system. This strengthens patients prior to undergoing EMDR. 

EMDR 

This is more emotionally intensive and aims to help patients face traumas more adequately.

Talk therapy

This consolidates information from EMDR sessions and supports the healing process. 

AF-EMDR differs from EMDR, taking into account acute or chronic relational trauma and attachment deficits. It aims to heal early attachment wounds.

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Who Benefits From EMDR Therapy?

Both children and adults can benefit from EMDR therapy, including those with:

  • Post-traumatic stress disorder
  • Anxiety, depressions, or other negative thoughts
  • Personality disorders
  • Eating disorders
  • History of substance use and addiction
  • Traumatic experiences due to sexual assault or rape
  • Traumatic experiences due to violence and abuse
  • Sleep disorders
  • Chronic illnesses
  • Dissociative disorders

How Effective Is EMDR Therapy?

Various studies have demonstrated that EMDR therapy is an effective treatment for trauma. The Department of Veterans Affairs strongly recommends it for PTSD.7

Some small studies have also discovered that EMDR therapy is successful in both the short and long term.

One study from 2004 assessed people several months after they were either provided with ‘standard care treatment for PTSD or EMDR therapy.9 

The study noticed during and immediately after treatment that EMDR was more successful in reducing symptoms of PTSD.

During the three- and six-month follow-ups, it also noticed these benefits lasted long after the program ended.9 

Another small study of 32 people found that EMDR shows promise in treating depression.6

The study discovered that 68 percent of the people in the EMDR group showed complete remission following treatment.6 

However, more research is required due to the small sample size of the group.

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EMDR At Home: Is It Possible?

As with any type of mental health intervention, it's best to undergo EMDR sessions with a trained professional.  

Self-administered without medical guidance may cause further problems and worsen symptoms associated with the condition in question. 

In AD-EMDR, your therapist may show you how to use resource tapping™ outside of sessions in moments of distress caused by specific memories. 

However, it is essential always to consult your nearest mental health professional if you are interested in pursuing any treatment.

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Resources

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  1. About EMDR Therapy.” EMDR International Association, 15 July 2020.
  2. Ehlers, Anke, et al. “Do All Psychological Treatments Really Work the Same in Posttraumatic Stress Disorder?” Clinical Psychology Review, Elsevier Science, Mar. 2010.
  3. “EMDR Institute – EYE MOVEMENT DESENSITIZATION AND REPROCESSING THERAPY.” Emdr Institute Inc.
  4. Eye Movement Desensitization and Reprocessing (EMDR) Therapy.” American Psychological Association, American Psychological Association, 31 July 2017.
  5. What Are EMDR and AF-EMDR.” Parnell Institute, 9 Aug. 2016.
  6. Hase, Michael et al. “Eye movement desensitization and reprocessing (EMDR) therapy in the treatment of depression: a matched pairs study in an inpatient setting.” Brain and behavior vol. 5,6 2015.
  7. VA/DOD “Clinical Practice Guideline for Management of Post-Traumatic Stress.” Department of Veterans Affairs, 2010.
  8. VanElzakker, Michael B et al. “From Pavlov to PTSD: the extinction of conditioned fear in rodents, humans, and anxiety disorders.Neurobiology of learning and memory vol. 113 : 3-18. 
  9. Marcus, S., Marquis, P., & Sakai, C. . “Three- and 6-Month Follow-Up of EMDR Treatment of PTSD in an HMO Setting.” International Journal of Stress Management. 11, 195–208.
  10. Markus, Wiebren, and Hellen K. Hornsveld. “EMDR Interventions in Addiction.Journal of EMDR Practice and Research, vol. 11, no. 1, 2017, pp. 3–29.
  11. Markus, Wiebren et al. “Addiction-Focused Eye Movement Desensitization and Reprocessing Therapy as an Adjunct to Regular Outpatient Treatment for Alcohol Use Disorder: Results From a Randomized Clinical Trial.Alcoholism, clinical and experimental research vol. 44,1 : 272-283.
  12. Pilz, René et al. “Die Rolle des Eye Movement Desensitization and Reprocessing (EMDR) bei Substanzgebrauchsstörungen: Ein systematischer Überblick” [The role of eye movement desensitization and reprocessing (EMDR) in substance use disorders: A systematic review]. Fortschritte der Neurologie-Psychiatrie vol. 85,10 : 584-591.

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