Eye Movement Desensitization and Reprocessing
How EMDR Works
At its most basic explanation, EMDR helps clients process difficult or traumatic emotions while diverting their attention through eye movements. When a client’s attention is focused on something else, it may be easier for them to walk through painful or traumatic memories and process those emotions.
How Does it Work?
There are eight different phases of EMDR treatment. Multiple sessions, typically between 6 and 12, may be needed to complete these phases. Though that is the average number of sessions needed for most clients, there is no timeline on EMDR therapy. It can take as few or as many sessions as the client needs for EMDR to be effective.
Phase One: History and Treatment Planning
Clients are going to discuss with their therapist their treatment history, their trauma, and an evaluation is going to decide whether EMDR is the appropriate treatment plan. It is critical that clients remain honest with their therapist during this phase as they discuss:
- The specific problems or reasons why they came to therapy in the first place
- What those problems have caused (drug or alcohol abuse)
- Possible trauma or events from the past that led to the development of those specific problems
- Moments in the present that cause distress or bring up those distressing memories of the past (triggers)
- What behaviors the client wishes to develop and the necessary skills to get them to that desired state of mind
Phase Two: Preparation
Therapists work with their clients to discuss and develop stress management skills such as breathing and meditation to help them process and deal with difficult emotions. This phase is also important because, in order for EMDR to work, the client needs to have a strong, trusting relationship with their clinician.
Phase Three: Assessment
During this phase, therapists pinpoint which traumatic memories will be targeted. Questions are going to be asked, like:
- What incident caused the trauma?
- What image is associated in your mind with that event?
- Where do you feel that image in your body/what physical effect does it produce?
Clients will be instructed to decide which image best represents each of the targeted events discussed during the first phase. They will also choose a negative statement that fits that image and a positive statement they wish to replace it with.
Therapists use the Validity of Cognition (VOC) scale to evaluate how true each of those beliefs are in the present moment. They also use the Subjective Units of Disturbance (SUD) scale to rate physical and emotional disturbances caused by that image. Ideally, the VOC score should increase from 1 to 7 while the SUD score should decrease from 10 to 0 as treatment continues.
Phase Four-Seven: Desensitization, Installation, Body Scan, Closure
This is where the EMDR treatment really begins. Clients will be asked to think about one of the specific traumatic memories. At the same time, the client will be instructed to focus on specific eye movements, also known as bilateral stimulation (desensitization). Then, the client will be asked to think of a blank slate and assess the emotions they are feeling. Clients will then either be brought back to the present moment if the memory causes distress, or the client will move on to the next memory.
As the client and therapist move through the sequence of memories, they will work to replace the originally negative thought with something positive (installation). For instance, the original negative thought might be, “I am a bad person.” At the beginning of the session, that negative thought might be extremely powerful. But, through these bilateral stimulations, the therapist can help their client replace that original thought with something positive, such as “I am good.”
Once the installation has brought this more positive feeling to the front, clients will be asked to go back to that original memory and evaluate how it makes them feel (body scan). If they still feel distressed, more bilateral stimulation will be used. If not, they can move onto the next phase (closure). During phase seven, those previously learned stress reduction techniques will be used and emphasized once more.
Phase Eight: Reevaluation
After each session, both client and therapist will evaluate the progress. Follow-up sessions will be determined here.
Does EMDR Work?
EMDR is effective in treating trauma and PTSD. 77% of individuals who struggle with trauma see improvement in those symptoms after having completed EMDR therapy. Studies have also shown that these benefits last long-term. It has also been shown as an effective form of treatment for anxiety, depression, and panic disorders, especially when underlying trauma led to the development of those.
With regards to substance abuse and addiction treatment, EMDR helps improve symptoms and can help to treat the underlying trauma that led to substance abuse. When there is co-occurring mental illness, it is critical these are treated together; EMDR does this.
Benefits of EMDR
When eye movement desensitization and reprocessing are used in conjunction with other substance abuse therapies, it can:
- Reduce hallucinations, delusions, anxiety and depression
- Enhance motivation to remain in treatment
- Help clients maintain abstinence from drug or alcohol use
- Prevent relapse
- Enhance the outcome of recovery treatment programs
- Help clients access positive emotions and slip into positive states
Is EMDR Right For Me?
Though EMDR can be helpful, it is important that clients seek this treatment from a trained professional. It should not be used to treat someone that is not stable, especially if they are experiencing withdrawal symptoms. Speaking with your clinician about the possible benefits is the best way to know whether EMDR is right for it. You may benefit, however, if:
- You struggle with acute or severe PTSD or trauma
- You struggle with anxiety or depression
- You suffer from panic attacks
- You suffer from chronic pain or other severe medical issues
- Your addiction or substance use was caused by underlying trauma
- You have underlying mental illnesses such as dissociative disorders, eating disorders, or personality disorders
- You were a victim of sexual assault, violence or abuse
- You deal with sleep disturbances
In general, EMDR is a safe form of treatment and can be stopped at any time if it becomes too distressing. The important thing is to communicate with your therapist and be honest.
EMDR at Summit
If you are struggling with substance abuse, talking to your therapist about EMDR might be an important link currently missing in your treatment program. It is safe and has various benefits that last long term. Not only is it helpful in treating substance abuse, but it can help treat those underlying conditions that may have actually led to your addiction.
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