EMDR for Substance Abuse Disorders

Many people use substances as a direct result of trauma or emotional distress and EMDR is a form of therapy that can help you to work through these issues so that you can cope with triggers and cravings and stay clean and sober.

EMDR or Eye Movement Desensitization and Reprocessing Therapy was originally developed to treat patients of trauma. It was later modified to help patients who suffer from substance abuse disorders including addiction. Today, EMDR is used to help people to recognize and move past trauma associated with addiction, the emotional and social aspects of substance use, and the direct triggers that cause substance use.

While EMDR has been the subject of controversy since its founding in the late 1980s, it has been shown to be effective for treating both trauma and substance abuse.

What is EMDR?

EMDR was developed during the late 1980s by Dr. Francine Shapiro, a psychotherapist. She noticed that eye movement changed her mood, and through a variety of experiments, was able to determine that lateral eye movement directly affected emotional responses. She developed lateral eye movement techniques combined with existing therapy techniques to create a new form of therapy, similar to cognitive behavioral therapy, but with a strong focus on desensitization and focusing on a physical movement (through the eyes).During a session, you are asked to focus on a specific instance such as a traumatic experience, an emotion experienced before using, or a trigger for substance use. At the same time, the therapist asks you to follow a guide with your eyes, to create quick jerky movements of the eye, which force your brain to disassociate the emotion you are thinking of.

This means that you are constantly exposed to triggers and desensitized to them, making it less likely for you to relapse when exposed on your own. EMDR also includes strong components of behavioral therapy and cognitive therapy, for learning coping skills, processing emotions, and developing mindfulness.

EMDR and Substance Abuse

EMDR is used to successfully treat substance abuse and prevent relapse by treating the underlying symptoms of trauma, depression, stress and anxiety.

Treating Trauma in Substance Abuse – EMDR was designed to treat trauma through desensitization and exposure. This enables you to move past the trauma by recognizing it, it’s impact, and desensitizing yourself to the impact of that trauma. Because as many as 70% of all people with a substance use disorder suffer from trauma as a result of or as a cause of their addiction, this type of approach is extremely helpful in treating addiction and preventing relapse. EMDR has been shown to be highly effective at treating trauma and the symptoms of trauma in addiction.


EMDR uses a structured process designed to start with your current situation and moving through your history and everything behind your current situation. This process is divided into 8 phases.

Phase 1

The therapist learns your history and prepares a personalized treatment plan over the first two to five sessions. Here, you and the therapist will define your goals and targets, what you want to address, and what is causing your problems. This can include drug or alcohol use, trauma, emotional problems, stress, anxiety, PTSD, and many other issues.

Phase 2

The therapist helps you to understand what EMDR is and what you should expect, while you learn new skills to help with relaxation and stress management. These can include mindfulness, breathing exercises, and other relaxation techniques.

Phase 3

You work together with your therapist to build an assessment of your needs and to develop a bond with your therapist. You identify goals and work to assess and evaluate emotions and how strongly you feel them, as well as to provide additional forms of stress release and management.

Phase 4

This is where the actual ‘EMDR” begins. Here, the therapist works to desensitize you to past trauma and negative emotions through reevaluation, exposure, and eye movement desensitization.

Phase 5

The therapist walks you through reprocessing to create positive feelings, build your ability to handle stressful experiences in everyday life, and desensitize you to stressful triggers.

Phase 6

You go through your history to evaluate anything you still have to do to meet your goals from the initial sessions.

Phase 7

You go through an assessment to ensure that you have met your goals and that you feel better able to cope with potential triggers.

Phase 8

Your therapist reevaluates your progress and the process to ensure that everything has been met and that you are capable of living on your own, finding happiness, and remaining drug or alcohol free.


EMDR uses multiple components in addition to eye movement desensitization and reprocessing. These include multiple evidence-backed therapies that are each effective on their own.


Like CBT, EMDR uses exposure therapy, or facing your triggers, past trauma, and stress points to desensitize yourself. This allows you to develop the ability to ignore these triggers and traumas when they occur again, so that they don’t prompt a relapse.

Cognitive Restructuring

Cognitive restructuring was directly adapted from CBT and is one of the most popular therapeutic techniques used to treat substance use disorders. This technique involves approaching your thought patterns and belief systems and restructuring them to be positive and to help you move away from drug use. For example, constant negative thinking (“Everyone hates me,” “I’m unlucky,” “Everything is always bad,” “I’m an addict so I’ll always be an addict,” “I’ll just relapse again,” etc.) is one type of destructive behavior tackled by cognitive restructuring.


Like most other types of cognitive and behavioral therapy, EMDR requires that you complete assignments and practice during and after therapy sessions and in groups. This allows you to develop skills and work on your mental health using your own motivation, so that you build self-reliance alongside your skills. This is especially important for people recovering from addiction who typically have problems with ego and self-dependence.

Therapist Relationship

EMDR focuses on building a strong relationship with your therapist, which allows you to develop friendship and trust. Because the first half of the EMDR is about building a relationship and trust, EMDR is highly successful at getting you to open up and participate in the therapy once it begins. This is sometimes attributed as one of the main contributors to the success of EMDR.EMDR also specifically taxes working memory, which helps with desensitization.

Criticism of EMDR

EMDR has faced consistent criticism since it’s founding, which is largely focused on using eye movement as part of therapy. However, multiple studies show that EMDR is effective without eye movement included, thanks to its usage of highly effective therapy techniques including exposure cognitive reprogramming, assignments, building strong relationships between the patient and therapist, and building skills to handle stress, life problems and cravings.

Benefits of EMDR for Substance Abuse Treatment

EMDR offers several advantages for substance abuse treatment:

  • Trauma and emotional response approach
  • You learn to tackle stress and emotional disturbances
  • EMDR focuses on exposure not avoidance
  • It is nonjudgmental
  • You develop a strong relationship with your therapist
  • Long training process for therapists
  • The treatment includes multiple stages of review to ensure that you have met your goals
  • EMDR uses evidence-based techniques to treat substance abuse, trauma, and stress
  • You learn multiple stress reduction strategies throughout the therapy to improve your coping skills. EMDR is a very popular therapy used to treat substance abuse while tackling recurring issues of stress, emotional disturbance, trauma, and destructive behavior. If you think that EMDR may be right for you, contact us to discuss your needs and our addiction treatment team will help you to choose a program solution that best suits your circumstances.