Eye Movement Desensitization and Reprocessing therapy (EMDR) is a treatment method used to address mental health disorders related to traumatic events.
The treatment involves the client processing trauma while focusing on an alternative stimulus. We call this treatment method bilateral stimulation. It allows the client to work through their responses to trauma without becoming overly distressed or repressing their reactions.
EMDR is often used to treat clients coping with anxiety disorder or post-traumatic stress disorder. As addiction is often rooted in mental health disorders, EMDR can be a useful treatment method for clients struggling with addiction. The process can help clients to address the underlying causes of their addictions and to identify healthy coping mechanisms in place of self-medication.
How EMDR Works
At the outset of the EMDR process, the client and their therapist discuss the traumatic events in focus and the client’s emotional and psychological responses to them. Less detail about these events is required than in other treatment methods such as individual therapy or cognitive behavioural therapy. EMDR focuses more on the client’s response to the events than the events themselves. Methods such as individual therapy and cognitive behavioural therapy can be highly complementary to the EMDR process, however.
New Responses
By analyzing the client’s emotional and psychological responses to traumatic events, the therapist will help the client to identify which responses are useful and which are damaging. The EMDR process aims to replace negative responses with positive ones, which are discussed and developed during the treatment process. By altering their response to traumatic events, EMDR can help clients to process these events without becoming overly distressed or repressing their responses.
Bilateral Stimulation
The EMDR process is based on bilateral stimulation. The patient focuses on the events in focus while following another stimulus, usually the therapist’s hand or an object moving from side to side. Some therapists also use hand-tapping or auditory stimulation for the process. By dividing the client’s attention, the process allows them to focus on the traumatic events without becoming overwhelmed or intensely distressed by them.
EMDR and Addiction
EMDR can be very useful in treating addiction. As addiction is usually related to underlying mental health disorders, EMDR can help a person coping with addiction to get to the root causes of their condition. Many people coping with addiction use addictive substances to cope with the symptoms of trauma. This is a highly addictive and dangerous pattern. It also prevents the addicted person from truly coping with the causes of their trauma or anxiety. EMDR can help them to process traumatic events and their responses to them in a progressive manner. This removes the need to self-medicate by replacing this behaviour with progressive, healthy coping mechanisms.
Controversy
EMDR is a controversial treatment method, as it is unclear precisely how the treatment achieves its objectives. Evidence of its effects is still emerging. However, there is a large body of evidence supporting its efficacy in treating certain mental health disorders. It has proven particularly effective in treating PTSD. EMDR treatment can significantly reduce symptoms of PTSD such as delusions, intense anxiety, hallucinations and depression. EMDR can also treat disorders such as anxiety and depression effectively.
Beginning
At the outset of the process, the client and therapist discuss the traumatic events in focus and the feelings associated with them. They then develop a treatment plan with specific and measurable objectives. While the traumatic events in focus are discussed throughout, less detail is required from the client than in individual therapy or cognitive behavioural therapy. The process focuses more on the feelings and responses associated with the events than the events themselves. The client is instructed to recall all of their sensory responses to events, rather than simply replaying the events in their mind.
Bilateral Sensory Input
The therapist and client agree on a form of bilateral sensory input to adopt for the process. Therapists usually use side-to-side movement or hand tapping. When using hand movements, the therapist will use their hand or an object to guide the client’s movements from side to side while focusing on the traumatic event and associated feelings and responses. In this way, the client is exposed to the traumatic events while focusing on the alternative stimulus. This allows them to process memories of the events and their responses without being fully exposed to them. Some experts believe that EMDR replicates the Rapid Eye Movement pattern of sleep, helping the subconscious mind to process events and emotions without becoming overly distressed or repressing negative responses.
Processing Trauma
The client and therapist identify and address the client’s responses to memories of traumatic events. They work to understand which negative feelings are not useful and are holding the client back. Clients also work with their therapists to develop more positive, progressive feelings and responses to their memories. Ultimately, EMDR can help clients to consider and recall events without experiencing the related trauma and distress they have previously elicited. This allows clients to process these events properly rather than repressing them or experiencing trauma each time they attempt to confront them.
A Shorter Process
Clinicians usually use EMDR for a limited number of sessions to address specific challenges and traumas. It can therefore be a good option for clients who want to deal with specific problems within a set time frame. Therapists monitor the client’s progress and work towards clear, measurable objectives. If the treatment is successful, by the end of the process the client will have engaged with and processed the feelings and thoughts associated with traumatic events. They will be ready to move forward.
The Process
History & Treatment Planning
At the outset of the EMDR process, the client and therapist carry out a preliminary assessment. This involves discussing the client’s mental health history, the traumatic events in focus and their responses to them, and any other information that may be relevant. As mentioned previously, the EMDR process requires less detail in discussing traumatic events than other forms of therapy. If the client is coping with addiction, they will also discuss these issues.
This initial discussion will also establish the objectives for the treatment process and the strategy for working towards them. The therapist and client will also discuss the way in which the process works.
Preparation
The second phase of the process involves preparing the client for treatment. This involves a detailed description of the process and the effects it may have. The client and therapist can also agree on the specifics of the process and their objectives. This phase allows the client to develop a proper understanding of EMDR, to become comfortable with the process, and to raise any questions or concerns they may have.
Assessment
In this phase of the process, the therapist and client assess the client’s responses to traumatic memories. The therapist instructs the client to identify their sensory responses rather than to simply remember the events. The therapist can help the client to understand these responses, including which of them are useful and which are negative. The client and therapist can also begin to identify positive replacements for these responses that will help the client to process the events and memories without becoming as distressed.
After each use of the stimulus, the therapist guides the client through a deep breathing exercise. They then discuss their responses and any new thoughts or feelings they may have experienced. Client and therapist repeat this activity throughout the process.
Desensitization
After progressing through the initial phases, the therapist and client begin the desensitization process. This involves the client thinking about the traumatic events while focusing on the alternative stimulus- usually the therapist’s hand movements. The client describes their response and reports any new thoughts or feelings. Some clients report recalling new details of the events in question during this phase or gaining new perspective on them.
Therapist and client repeat this activity throughout the process with the intention of gradually reducing the client’s response to the traumatic memories until it is relatively neutral. The client works through the memories and associated psychological and emotional responses while their focusing on the stimulus. This enables them to process these responses without becoming overly distressed or repressing their reactions.
Installation
We refer to the next phase of the process as installation. This phase involves building associations between the traumatic memories and the more positive reactions previously discussed between client and therapist. This allows the client to continue processing traumatic memories in a more secure and positive state of mind. It can also help them to recall neglected details of events and their responses to them.
Body Scan
After processing events while focusing on the alternative stimulus, the therapist instructs the client to mentally “scan” their body to assess its response. If there are still points of tension or feelings of physical discomfort, this is instructive and can help to guide the process. The therapist helps the client to identify any new responses or sensations they have experienced. By the end of the process, the client should report feeling comfortable and relaxed at this stage, having processed their emotional and psychological reactions and reduced negative responses.
Closure
Each session ends with a closure process. This involves evaluating what has been achieved during the session. Client and therapist discuss how the session has moved them towards their objectives. In early sessions, the client’s responses to triggering memories may not yet have been substantially reduced. In this case, the therapist will guide them through containment exercises. This involves preparing the client to cope with triggering memories between this session and the next.
Re-evaluation
Each session begins with re-evaluation. This involves the client and therapist discussing the client’s mental state and assessing whether the effects of previous sessions have remained between sessions. It also involves identifying targets for the upcoming session and checking in on progress towards overall objectives.
Side Effects
The side effects associated with EMDR are relatively minor. Client’s may leave sessions in an emotionally heightened mindset. They may also experience invasive thoughts about the events they are focusing on during sessions between sessions. However, the closure process of each session helps to ensure that clients are not overly affected between sessions.
Results
Clients for whom the EMDR process proves effective experience reduced negative responses to traumatic events and can process associated thoughts and emotions in a progressive manner. They can then move forward without letting their previous negative responses inhibit them. For clients coping with addiction, this is vitally important. If EMDR enables them to process trauma or anxiety progressively, they will no longer require addictive substances in order to cope with their symptoms.
If you have any questions about EMDR, contact Trafalgar Addiction Treatment Centres for more information.
