Reviewing EMDR

Eye Movement Desensitization and Reprocessing (EMDR) is a therapy originally developed to treat post- traumatic stress disorder (PTSD). It was developed by Dr. Francine Shapiro, who made the observation that when upsetting thoughts came to her mind, her eyes began moving rapidly. She theorized that it was the brain’s mechanism for dealing with unwelcome memories and noticed that when the memories were recalled later, they had lost a great deal of their power. Dr. Shapiro began studying the phenomenon, and in 1989, published a study of the successful use of EMDR on 22 trauma victims.

Although the mechanism of action of EMDR, like that of most psychological therapies, is unclear, it is thought to affect the way in which the brain processes information. It is believed that EMDR helps the brain process memories in the same way that rapid eye movements do during sleep. It may break the neurological bonds between memories and the trauma associated with them. After successful EMDR treatment, memories can still be recalled, but the emotions associated with them are no longer disturbing.

Phases of EMDR Treatment

There are eight phases of EMDR treatment, as follows:

  • Phase 1: The therapist asks for the patient’s history and develops a treatment plan. Memories and currently distressing situations are identified and targeted for EMDR therapy. The therapist and patient work together to determine if there are any skills that need to be strengthened or developed.
  • Phase 2: Skills for handling emotional distress are taught. These may include imagery-based protocols and stress reduction techniques.
  • Phases 3-6: The following phases involve helping patients to identify visual images associated with memories, negative beliefs about themselves, and emotions and body sensations associated with the beliefs and memories. Patients are also asked to develop positive beliefs and to rate the intensity of both the positive beliefs and the negative emotions.

The heart of the therapy involves patients focusing on negative images, thoughts, and sensations while undergoing EMDR processing. This most commonly consists of eye movements, but can also involve tapping or listening to tones. Eye movements are generally elicited by asking patients to track the therapist’s hand.

Patients are then instructed to notice whatever comes to mind. This will help focus the next round of treatment. Once patients no longer experience distress associated with targeted memories, they are asked to focus on the positive belief they identified earlier. A positive trauma-related belief may be something like, “I survived and am strong.”

  • Phase 7: During Phase 7, patients are asked to keep a written record of their trauma-related thoughts and the self-calming activities used when necessary.
  • Phase 8: The final phase is one of evaluating progress.

Clients are guided through these eight stages with a skilled clinician who can tailor each session to the client’s unique needs.

The Effectiveness of EMDR

Because it is a relatively new treatment modality, EMDR has not been studied as extensively as older therapies. It appears, however, to be effective for a wide range of issues. The medical website WebMD notes that it has been used to treat addiction, anxiety, eating disorders and panic attacks. The site notes that the therapy has no apparent negative side effects and that researchers have shown the treatment’s effectiveness in reports that consolidated data from multiple studies.[i] EMDR has been recognized as effective by organizations such as the American Psychiatric Association, the Department of Defense, and the World Health Organization.

EMDR and Addiction Treatment

EMDR is generally used as an adjunct therapy in combination with other treatments. It is becoming more widely used to treat addiction, partly because it is not uncommon for people with addiction issues to also have PTSD. A 2006 article in the journal Psychiatric Services reports that up to 80 percent of women seeking substance abuse treatment have a history of assault, and that rates of PTSD in the population range from 30 to 59 percent.[ii] Sometimes, people with addiction issues haven’t been diagnosed with PTSD, but simply have negative thoughts and memories that prompt them, consciously or subconsciously, to escape through substance use. EMDR can address these thoughts.

EMDR may also be helpful for reprocessing memories related to the addiction itself. These include memories related to preparing the drug, its effects, and loss of control. A 2008 article in the Journal of EMDR Practice and Research reported on a study involving patients with chronic alcohol dependency. Those who participated in two sessions of EMDR showed a significant reduction in craving for alcohol immediately and one month after treatment.[iii]

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[i] “EMDR: Eye Movement Desensitization and Reprocessing,” WebMD, (November 14, 2015).

[ii] “Treatment Outcomes for Women With Substance Abuse and PTSD Who Have Experienced Complex Trauma,” Lisa R. Cohen and Denise A. Hien, Psychiatric Services, January, 2006, (November 14, 2015).

[iii] “EMDR Reprocessing of the Addiction Memory: Pretreatment, Posttreatment, and 1-Month Follow-Up,” Michael Hase, Sabine Schallmayer, and Martin Sack, Journal of EMDR Practice and Research, 2008, (November 14, 2015).