Traumatic experiences can affect mood, sleep, relationships, and responses to reminders of an event. Post-traumatic stress disorder (PTSD) can also occur alongside substance-use problems. EMDR is a structured psychological therapy used to treat PTSD and trauma-related symptoms.
People may consider EMDR therapy when trauma-related symptoms interfere with daily life or recovery. Treatment focuses on processing distressing memories and the thoughts, emotions, beliefs, and physical sensations associated with them. It does not necessarily require a detailed verbal account of every traumatic experience.
What EMDR Involves
EMDR stands for Eye Movement Desensitization and Reprocessing. During treatment, a trained therapist asks the client to focus on aspects of a distressing memory while engaging in bilateral stimulation, such as guided eye movements, alternating sounds, or taps.
The therapist guides the process with the aim of reducing distress associated with the memory and helping the client process it. Treatment may also address negative trauma-related beliefs and promote more adaptive beliefs about the self.
The Eight Treatment Phases
EMDR commonly follows an eight-phase protocol, although treatment is adapted to the individual’s circumstances and needs.
- History taking: The therapist gathers relevant information and identifies potential treatment targets.
- Preparation: The client learns about the process and may practise grounding or self-calming techniques.
- Assessment: A target memory and associated beliefs, emotions, and physical sensations are identified.
- Desensitization: Bilateral stimulation is used while the client focuses on aspects of the memory, with the aim of reducing associated distress.
- Installation: Treatment focuses on strengthening an appropriate positive belief.
- Body scan: The client notices whether physical discomfort or tension remains.
- Closure: The therapist helps the client manage any remaining distress and prepare for the period between sessions.
- Reevaluation: Progress and the need for further processing are reviewed.
Not every session involves processing a traumatic memory, and the amount of time spent in each phase varies.
Why EMDR Is Used in Trauma Care
Unresolved trauma can be associated with distressing reactions to reminders of previous experiences. Sounds, places, conversations, or physical sensations may trigger fear, shame, intrusive memories, or other trauma-related responses.
EMDR aims to reduce the distress associated with traumatic memories and their reminders. Physical responses are considered too, with the body-scan phase helping identify whether sensations such as tension or discomfort remain when thinking about a target memory.
EMDR is an evidence-based treatment for PTSD and is recommended in clinical guidelines for certain people with PTSD or clinically important PTSD symptoms. It is not appropriate for every person or situation, however, and individual outcomes vary.
EMDR and Substance Use Recovery
PTSD and substance-use problems can occur together. Some people use alcohol or drugs in an attempt to manage distressing memories, anxiety, sleep problems, or difficult emotions.
For people with co-occurring PTSD and substance-use problems, EMDR may form part of a broader treatment plan. It can address traumatic memories and PTSD symptoms while substance-use problems are treated through appropriate addiction services, medical care, and mental health support.
EMDR should not be regarded as a standalone treatment for substance dependence or a substitute for appropriate addiction treatment.
What Clients Can Expect
Some EMDR sessions focus on assessment, preparation, coping strategies, or reviewing progress. Others involve bilateral stimulation while the client focuses on a selected memory.
Clients can tell their therapist if distress becomes difficult to manage or they need to pause. Grounding and self-calming techniques may be used to help manage distress during and between sessions.
The length and course of treatment vary according to individual circumstances, symptoms, and response to therapy. No particular outcome can be guaranteed.
Conclusion
EMDR provides a structured approach to treating PTSD and trauma-related symptoms by addressing distressing memories and associated beliefs, emotions, and physical responses. For people who also experience substance-use problems, it may form part of broader care alongside appropriate addiction, medical, and mental-health treatment.
Anyone considering EMDR should speak with a suitably qualified professional who can assess whether the treatment is appropriate for their circumstances.
