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Eye Movement Desensitization and Reprocessing (EMDR) Therapy

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Eye movement desensitization and reprocessing (EMDR) therapy, originally approved for treating post-traumatic stress disorder (PTSD), has since also been found useful in addiction treatment. EMDR can be combined with other therapies and works best in processing past trauma or negative experiences.1 Using multiple therapies in substance use disorder treatment allows you to approach your condition from all sides, thus giving you the best chance of recovery.

On this page, you will read about what EMDR is, how it works, and its benefits.

What Is Eye Movement Desensitization and Reprocessing (EMDR)?

Eye movement desensitization and reprocessing (EMDR) is a type of psychotherapy that helps a person process trauma or other negative life experiences.1 EMDR is based on the Adaptive Information Processing model, which proposes that the traumatic symptoms of mental disorders like post-traumatic stress disorder come from unprocessed memories.2 In therapy, you revisit the memory in a controlled setting, while stimulating both sides of your brain with eye movement.2 This process encourages your brain to restore those memories without the negative emotions that were previously attached.2

Ultimately, the goal of EMDR is to transform your negative memories.3 By changing the emotions attached to it, a memory of being held at gunpoint can change from feeling shame and vulnerability into feeling empowered that you survived.3 So, by changing the root cause of an unprocessed negative memory, EMDR can eliminate anxiety, flashbacks, or other unwanted symptoms associated with PTSD.3

What Happens During EMDR?

EMDR therapy is done one-on-one with a therapist and can be completed in a standard office setting. The therapist guides you through the 8 phases of EMDR centered around a particular negative memory that may be causing you disturbing symptoms.4 These can include memories of the negative experience itself, recent events that trigger you, or imagined events that might have the same effect on you.4

During the discussion, the therapist provides dual attention stimuli.1 These dual attention stimuli come in the form of bilateral eye movements, taps, or tones that alternate from side to side.1

To get through all 8 phases and ensure that you are safe between sessions, EMDR appointments run longer than the usual 50 minutes for therapy.4 It is dangerous to leave a therapy session that revisits negative memories if you cannot finish processing them.4 So, sessions are usually about 2.5 hours or are given in a 50–minute session followed by a 90–minute session.4 However, for your safety, the length of time of a session is ultimately decided by your needs, and not the ‘ding’ of a timer.4

Several studies have reported that EMDR allows its participants to heal in just a few months from psychological trauma that used to take a year to overcome with traditional psychotherapy.3 The process typically requires 6–12 sessions with 1–2 meetings per week.2 While other therapy types can also revisit traumatic memories with the goal of healing, EMDR requires active participation of the other senses to accelerate the process of healing.2

The 8 Phases of EMDR

The 8 phases of EMDR allow you and your therapist to choose an experience, plan, and work through your negative experiences in a stepwise manner that helps process each aspect of an experience.4 Throughout the process of EMDR, you may go through the 8 phases several times. The following sections will provide a brief explanation of the 8 phases.

Phase 1—History Taking

Phase 1 allows your therapist to get to know you and your story.4 There may be multiple experiences to process throughout your story. So, hearing your full story and symptomatic experiences can help your therapist guide which might be the most helpful starting point.4 Then, together, you make a plan.4

Phase 2—Preparation

Phase 2 is a stage of preparation for the more intense steps to come. During this stage you are building a trusting relationship with your therapist, voicing any concerns you might have, and learning or reviewing skills that can help you relax and stay safe when you begin processing difficult memories.4 You need to trust your therapist, and for your therapist to know you well enough to determine whether you are emotionally disturbed either during or after EMDR sessions.4 That way, they know if you need help or more time before ending a session.

Phase 3—Assessment

Phase 3 is the time to establish your baseline response to a particular memory.4 You will choose an image that best represents that memory to you, and then verbally share a statement about yourself that is attached to the image.4

For example, perhaps someone who experienced childhood abuse remembers an image of their abuser and thinks “I am unlovable.” The therapist then takes your statement, turns it around, and asks you how true you think it is on a 7–point scale.4 They may say, “’I am loveable.’ How true is this statement for you?” Your response creates the baseline from which you will determine the efficacy of the memory processing.4

Phase 4—Desensitization

Phase 4 begins the main part of processing your negative memory. While you focus on your memory, the therapist engages you with eye movements or another form of bilateral stimulation (BLS).2 During this time, you communicate whatever new thoughts come to mind during the process.2 Periodically, your therapist might guide you through a new assessment or direct you to focus on a different aspect of your memory.2 This phase continues until you are no longer distressed by that memory.2

Phase 5—Installation

After you communicate “zero stress” associated with your memory, the goal is to “install” a positive belief in your mind to be associated with the memory.4 The therapist will periodically ask you to assess your earlier positive statement (ex: “I am loveable”), in between other thoughts and discussions about the memory with BLS.4 Again, you can report any new positive thoughts that surface during the process.4 Another example of a positive belief may be, “That was the past, now I am strong/safe/able to make my own decisions.”

Phase 6—Body scan

Phase 6 employs the technique of body scanning, which is commonly used in other forms of therapy and meditation. During this time, you hold the original memory and the new positive belief in mind and mentally scan your body from top to bottom.4 The purpose is to discover any leftover tension in any part of your body that is associated with the memory.4

For example, while holding the memory and positive thought in your head, you might also turn your mind to your head, then neck, facial muscles, then shoulders, and take notice of what you feel and if any of your muscles are tense.4 After going through your whole body, the body scan is complete. If you do have residual tension, you can then work through and process that with your therapist next.4

Phase 7—Closure

Revisiting traumatic memories can be a dangerous thing, and Phase 7 is responsible for closing out the session and ensuring you will be safe between sessions.4 If a memory is not completely processed, it is possible to have disturbing thoughts, images, or emotions between sessions.4 For some, these can lead to self-harm or regression in the therapy process if patients don’t know how to respond to them.4

The process of closure concludes the session by preparing you for what to do in case of disturbing symptoms.4 Its goal is to minimize the likelihood of those symptoms occurring.4

Phase 8—Reassessment

Even though it is the last phase, reassessment or reevaluation happens at the beginning of a new session.4 You typically review any thoughts (positive or negative) related to the previously targeted memory that occurred between sessions.4 The therapist will evaluate whether you need more processing for that memory or begin again with a new memory.4

Each targeted memory must get fully reintegrated with positive thoughts to overcome the symptoms that previously found root in the negative experience.4 Throughout EMDR therapy you can expect to cycle through the 8 phases multiple times.4

What Are the Benefits of EMDR?

EMDR is helpful because it works through the root of mental health symptoms to eliminate present-day disorders.3 While many factors can contribute to a mental disorder, past trauma or unresolved negative experiences can play a significant role.3

However, EMDR does not only address the past. It is also useful for current situations that cause distress and can develop skills and attitudes that help you react differently in future situations.3

One of the greatest benefits of EMDR therapy is how quickly it works. Multiple studies have found that people heal in a few months from conditions that would have previously taken years to overcome.3 With EMDR, your road to recovery could be given a head start.

EMDR for Drug and Alcohol Addiction

Childhood trauma is often found in the stories of people who suffer from substance use disorders.5 Studies show that people who suffer “adverse childhood events” (ex: violence, divorce, abuse, death of a loved one) are 2–4 times more likely to start using substances at an early age.5 And early substance use increases your risk for addiction.5 In fact, nearly two-thirds of people who use injection drugs suffered abusive or traumatic childhood events.5

Additionally, many individuals develop substance use disorders as a coping mechanism for mental illness, stress from other events, or other life problems.6 By healing from any co-occurring disorders that may contribute to your substance use at the same time you treat your substance use disorder, you can greatly increase your chance of long-term change.6

With such a close relationship between substance use and experiences of trauma or negative emotions, it is easy to see how addressing your past trauma might help in treating your substance use disorder. EMDR was made to help work through trauma.3 By working through your negative experiences, EMDR therapy can help address some of the reasons you may have started or continued your substance misuse. And, by resolving those reasons, you can loosen the bonds substance use disorder has around your life.

Find EMDR Treatment Near Me

If you are struggling with substance misuse but aren’t sure if you have a substance use disorder, it may be time to get help. Spending time in rehab can give you a diagnosis, a fresh start, and assistance toward stability. EMDR therapy could play a crucial role in recovering from addiction or any other mental health disorders you might have. Start looking for a rehab and easily verify your insurance now. Start on the path to recovery and find healing today. Call .

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Kristen Fuller, MD, enjoys writing about evidence-based topics in the cutting-edge world of mental health and addiction medicine and contributes to medicine board education. Her passion lies in educating the public on the stigma associated with mental health. Dr. Fuller is also an outdoor activist, an avid photographer, and is the founder of an outdoor women's blog titled, GoldenStateofMinds. In her free time, she enjoys hiking, backpacking, skiing, camping, and paddle boarding with her dogs in Mammoth Lakes, California, where she calls home.
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