EMDR for Substance Use Disorders

Traditional EMDR:The purpose of EMDR (Eye Movement Desensitization and Reprocessing) is to use bilateral stimulation (tapping, eye movements, etc.) to facilitate communication between the right and left hemispheres of the brain. In traditional EMDR, you work with a therapist to identify trauma-related memories to process. For example, these could be memories of being hit by a parent or being in a car accident.

EMDR for Substance Use::EMDR has been adapted to cover a wider scope beyond just traumatic memories. It is now used to address substance use. However, the protocol for substance use is slightly different. Instead of beginning with a search for a traumatic memory, the focus is on navigating triggers. This is done by pairing the triggering moment with a "beneficial network."

Beneficial Networks:A beneficial network is any internal resource that provides relief from emotional pain, such as thoughts of a caring friend or a fond memory of a relaxing beach vacation. In EMDR, positive imagery and association are used frequently. The idea is that the brain cannot differentiate between imagination and reality, so imagining something positive actually elicits a positive internal response.

EMDR Protocol for Substance Use:When an individual with a substance use problem feels triggered to use, the goal is to connect that triggering moment with a positive association. For example, if your client recently engaged in binge eating, take them back to the moment before they binged and identify the trigger. They might say they had a fight with their boss. Rather than tracing this back to a core memory, simply ask the client to bring in a positive association. Ask, "What would have helped you in that moment?" They may respond that they needed to feel safe and secure, or loved and reassured. Once you've identified the positive resource, have them "tap it in" using bilateral stimulation.

Why is this Useful?Traditional substance use treatment focuses heavily on cognitive insight and behavioral change. However, after working in substance use treatment for some time, it becomes clear that most people rationally understand that they shouldn’t re-engage in substance use. Yet, when they feel triggered, this rationale often goes out the window. Laurel Parnell, who developed this technique, theorizes that relapse prevention wisdom is stored in a different part of the brain than the area that gets triggered. As a result, it's a tool we can’t access when we need it. If you’re struggling with a substance use problem and haven’t made progress using traditional treatment methods, consider trying EMDR.

You can learn more about EMDR therapy here.