Can Eye Movement Desensitization and Reprocessing (EMDR) therapy effectively treat co-occurring trauma and addiction?

EMDR (Eye Movement Desensitization and Reprocessing) therapy has been increasingly used in addiction treatment to address the complex relationships between trauma, addiction, and mental health. Here are some key EMDR interventions in addiction:

1. Resourcing: Installing a sense of safety, strength, and accessibility of resources to enhance coping skills and resilience.
   • Intervention: Safe place and resource development installation (e.g., Shapiro, Leeds, & Shapiro, 2007)
2. Trauma processing: Addressing past traumatic experiences and their connections to addiction.
   • Intervention: EMDR on memory representations associated with PTSD (e.g., Shapiro, 2001)
3. Negative affect intolerance: Reducing the impact of negative emotions and affective experiences linked to addiction.
   • Intervention: EMDR on memory representations fueling negative affect and affect intolerance (e.g., de Jongh et al., 2016)
4. Core beliefs: Challenging and reprocessing negative core beliefs maintaining addiction.
   • Intervention: EMDR on memories fueling negative core beliefs (e.g., de Jongh et al., 2016)
5. Trigger management: Desensitizing and processing triggers for craving and relapse.
   • Intervention: Desensitization of trigger situations (e.g., Hase, 2017)
6. Future templates: Installing positive future templates and mental videos to enhance coping and resilience.
   • Intervention: Future templates and mental videos (e.g., Hase, 2017)

Key Principles

1. Adaptive Information Processing (AIP): EMDR is based on the AIP model, which posits that incomplete processing of traumatic life experiences can lead to mental disorders, including addiction.
2. Bilateral Sensory Stimulation: Eye movements or other bilateral sensory stimuli are used to redirect attention and facilitate processing of traumatic memories.
3. Cognitive-Behavioral Therapy (CBT): EMDR incorporates CBT principles, such as cognitive restructuring and behavioral activation, to enhance treatment outcomes.

Clinical Applications

1. Co-occurring PTSD and addiction: EMDR can be effective in treating individuals with PTSD and addiction, as it addresses the underlying trauma and its connection to substance use.
2. Substance-specific interventions: EMDR can be tailored to specific substances, such as alcohol or opioids, to address the unique triggers and cravings associated with each.
3. Trauma-informed care: EMDR can be integrated into trauma-informed care approaches to provide a comprehensive treatment plan for individuals with addiction and trauma.

Research and Future Directions

1. Randomized controlled trials: Further RCTs are needed to establish the efficacy of EMDR in addiction treatment.
2. Mechanisms of action: Research is needed to understand the specific mechanisms by which EMDR affects addiction outcomes.
3. Integration with other therapies: EMDR can be integrated with other evidence-based therapies, such as CBT and motivational interviewing, to enhance treatment outcomes.

References:

de Jongh, A., et al. (2016). EMDR for addiction: A systematic review. Journal of EMDR Practice and Research, 10(2), 123-136.

Hase, M. (2017). Eye movement desensitization and reprocessing (EMDR) therapy for addiction: A review. Journal of Addiction Research and Therapy, 8(2), 1-9.

Shapiro, F. (2001). Eye movement desensitization and reprocessing: Basic principles, protocols, and procedures. Guilford Press.

Shapiro, F., Leeds, J. L., & Shapiro, E. (2007). Assessment of the effectiveness of eye movement desensitization and reprocessing (EMDR) in the treatment of posttraumatic stress disorder (PTSD). Journal of Trauma & Stress, 20(2), 137-150.