Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based practice for treating trauma. Traumatic experiences can cause major changes in the brain. Such changes can impact how we perceive the world, others, and ourselves, as well as impact how we react to various situations and stressors. EMDR therapy targets those negative changes and helps to reprocess the traumatic event, often resulting in symptom improvement. Many individuals who struggle with substance abuse and dependence have a history of trauma. They have often used substances to cope with unpleasant symptoms stemming from traumatic experiences. Please read on to explore how this innovative approach can be used in treating substance abuse and addiction.
Self-Medicating to Cope With Trauma: How EMDR Therapy Can Help in Substance Abuse Treatment
The technique uses a client's own physiology to heal trauma.
By Paige Maurer | Contributor July 18, 2016, at 6:00 a.m.
Self-Medicating to Cope With Trauma: How EMDR Therapy Can Help in Substance Abuse Treatment
As a primary therapist at a substance abuse treatment center, I work with countless individuals who come to treatment with serious addictions to alcohol and/or drugs. Many of these individuals struggle with an inability to cope effectively with uncomfortable emotions, and drugs and alcohol become a means to “escape” from distress or discomfort. Unfortunately, many have also experienced one or more traumatic events in their lives – including childhood abuse and neglect, which they may not even realize is the basis of their constant discomfort and a contributing factor to their drug and alcohol use.
According to PTSD United, about 20 percent of individuals who have experienced a traumatic event end up developing post traumatic stress disorder. PTSD is a mental health disorder that occurs after witnessing or experiencing a traumatic event, which can include war/combat, physical/sexual assault, serious accidents, sudden emotional loss, natural disasters and emotional, physical and mental abuse. Symptoms of PTSD include flashbacks of the event; nightmares; feeling emotionally numb; angry outbursts; hyper-vigilance; avoiding thoughts, situations or people that are reminders of the trauma; panic attacks; and insomnia, among many others. Chronic emotional, physical and/or sexual abuse and/or neglect in childhood increase the chances of developing post-traumatic stress symptoms in adulthood. Childhood trauma may also be less obvious, like growing up in a chaotic home where one or both parents struggled with addiction themselves. Many clients fail to recognize that their unresolved trauma contributes to their chronic anxiety and depression, leading to the compulsion to use drugs and alcohol to self-medicate their distress.
Individuals who have experienced trauma in their lives are at a much higher risk of developing addictions. According to the EMDR Institute, EMDR – which stands for Eye Movement Desensitization and Reprocessing – is a specialized psychotherapy treatment technique that facilitates the reprocessing of traumatic memories using eye movements. The eye movements (or any bilateral stimulation like tapping or auditory tones) help to process disturbing information in a more normal process of memory. After successful processing, the disturbing thoughts, feelings and sensations that derived from the trauma are no longer relived when the event is brought to mind.
The idea behind EMDR is the notion that like the physical body, there is a natural movement in the direction of healing within the mind. A cut or wound will heal as long as there isn’t a disruption in the healing process (like debris stuck in the wound), which, if present, can lead to the wound becoming infected, painful and swollen, and it could spread to the rest of the body if not treated. The brain and emotional body appear to work in the same manner in that they have the same capacity to heal and give off warning signs of an infection.
When a person is unable to process trauma, it's usually because there is a block to his or her natural ability to fully process the situation and reach a state of health. EMDR seems to clear the “block” and rapid reprocessing occurs, bringing about mental and emotional relief and healing. In other words, when a person experiences a trauma, they get stuck in the images, thoughts, feelings, sensations and beliefs about the frightening situation and EMDR helps unstick it.
In my experience helping clients heal from trauma using EMDR therapy, most clients report positive responses to their once-disturbing memory – including the sensation of “relief” or feeling a new sense of perspective about the situation like, “I’m OK now.” The uncomfortable symptoms of post-traumatic stress diminish and the client has a greater, more positive outlook of their situation. They no longer feel like a victim and are able to move forward and focus on other important aspects of their substance abuse treatment.
Of course, not every individual coming in for substance abuse treatment is a candidate for EMDR. It's an intense therapy and what may take months or years to just “talk” through trauma with a therapist may take just three sessions to reach resolution with EMDR. It’s like taking the healing process 100 miles an hour. During the EMDR session, the client may experience physical sensations, retrieve images, thoughts and experience intense emotions, so individuals who participate in EMDR need to have some positive resources that can help in the healing process. With EMDR, each client participates in a calm/safe place exercise before he or she starts processing trauma, where slow eye movements bring clients to a calm, relaxed place. They can use their calm/safe place as a coping resource to work through any disturbances that may arise throughout their EMDR treatment.
A good candidate for EMDR, who is also participating in substance abuse treatment, is someone who is ready and willing to work through trauma, is committed to staying for the whole duration of his or her treatment (which can be anywhere from 28 to 45 days) and who is mentally and emotionally stable. The support of an inpatient treatment center makes it helpful to use EMDR because clients are monitored throughout the day and have staff nearby for support and extra TLC. EMDR is also meant to work in conjunction with traditional substance abuse treatment and should not be the main focus of treatment; it should be looked at as a supplemental treatment approach.
Clients who are attending substance abuse treatment in an outpatient setting may need to develop more resource-building exercises and establish a strong support network before participating in EMDR. Since these clients don’t have the safety of a residential treatment environment, it’s imperative that they have the support of a 12-step program, are working with a sponsor and have other positive resources and healthy coping mechanisms to process trauma. Processing trauma can be uncomfortable, and there’s a possibility that old coping mechanisms can arise – like increased cravings to use drugs.
With EMDR therapy, I have witnessed the amazing ability of the mind to heal and process information quickly. Clients come in to my office feeling depressed and anxious, often having nightmares or panic attacks, and through their sessions – although they may cry and feel uncomfortable emotions – experience rapid dissipation of their discomfort. I frequently see the amazing transformation into spontaneous insights and positive thinking. This therapy is more than education or teaching the client tools, it’s facilitating the client’s own physiology to heal trauma. After healing a traumatic wound, clients are better able to cope and respond more adaptively to their environment and the triggers that once led them to seek drugs for relief. Although there is no cure for addiction, EMDR seems to be a helpful catalyst in decreasing internal triggers and fostering progress in substance abuse treatment.
Paige Maurer, MA, LMHC at Delphi Behavioral Health.