Is EMDR the Cure?
Is EMDR the Cure?
When Nicole, a 40-year-old teacher from Santa Barbara, began doing EMDR therapy, she had already been in regular old therapy since the age of 18. But despite years of cognitive behavioral work, she suffered an emotional breakdown at 38 and wound up at an inpatient treatment center. While being in treatment helped, what brought Nicole back to normalcy was a form of psychotherapy known as EMDR—which stands for Eye Movement Desensitization and Reprocessing and involves a therapist leading a patient through an eight-phase treatment, including a series of left-to-right and right-to-left eye movements, in a way that’s meant to process memories stored in the brain. Within a matter of weeks of once-a-week treatments, Nicole realized just how much her past experiences of bad romantic relationships were affecting her physically. “I realized that I was engaging in my addiction to avoid emotional pain,” she says. “When you don’t have a full self, you fill that emptiness with whatever substance you can get. Because EMDR is so focused on how trauma is stored in your body, it allowed me to experience the grieving process that I needed and let me release the negative emotions that were affecting me.”
First invented in 1987, EMDR addresses traumatic or distressing past memories that a person has often repressed in order to avoid dealing with. Over the course of a full treatment—which can range from a handful of sessions to years of therapy—patients will go through eight phases that include identifying significant life events, processing the traumatic memories and transforming them into a learning experience. Using a combination of methods—including eye movements, playing tones or tapping the patient’s hands—the treatment not only helps patients allow these unprocessed memories to surface but also addresses those memories in a way that drastically reduces their future impact. Psychotherapy research has proven that EMDR can be incredibly successful for addicts—particularly those who use drugs as a way to avoid dealing with traumatic incidents. “When I presented at conferences, people running drug programs wondered what they could do about meth addiction,” says Dr. Francine Shapiro, the founder of EMDR therapy. “But we found that when patients engaged in EMDR therapy, traumas of meth addicts were clearing up the same as all the other drugs. If the participants were able to stay straight for the duration of the program, that was typically all they needed.”
About 10 years into her studies, Shapiro noticed that disturbing thoughts that once upset her no longer did if she moved her eyes in a certain way.
The concept of EMDR was first brought to the attention of Dr. Shapiro in 1979, when she was enrolled in a Ph.D. program for English Literature at NYU. After being diagnosed with cancer, she began reading extensively on psychoneuroimmunology (the interaction between psychological processes and the nervous and immune systems of the human body) and the effects of stress on the human body. She found the work so fascinating that she ended up dropping out of her Ph.D. program and enrolling in a Ph.D program in Clinical Psychology. “We had been putting men on the moon but didn’t know how to deal with their minds and bodies, which was something that fascinated me,” she says. “I entered into every workshop and training program I could find.”
About 10 years into her studies, Shapiro noticed that disturbing thoughts that once upset her no longer did if she moved her eyes in a certain way. “When one of the upsetting thoughts came to mind, my eyes started moving rapidly as an internal brain mechanism to deal with the disturbance,” she recalls. “And when I brought those thoughts back, they didn’t have the same charge they once did.” She first began experimenting on her friends to see if they had similar eye movements when dealing with disturbing thoughts before moving onto a study on how these eye movements affected a pool of 70 volunteers. Her next study, which involved 22 trauma victims, was published in the Journal of Traumatic Stress Studies in 1989, and 40 randomized clinical trials and non-randomized studies have been published since then.
While the main focus of EMDR therapy is processing memories stored in the brain, Shapiro is quick to point out that EMDR is meant to be used in conjunction with other therapies—such as Dialectical Behavior Therapy (DBT)—and not as a replacement for them. She also says that traumatic memories aren’t necessarily a sign of post-traumatic stress disorder. “Something relatively small like being bullied at the age of five can cause even more symptoms of PTSD than a major trauma,” she says. “It’s often a wide variety of life experiences that lead to the memories, beliefs and doubts that set the foundation for addiction. When those things are triggered, feelings of negativity and self-doubt like “I’m not good enough” or “I’m not lovable” begin to surface. And when people can’t cope with these feelings, they turn to drugs to kill them.”
Craig Penner, a 58-year-old in Santa Barbara, believes that unprocessed memories led to his drug addiction in his late teens. Now a certified EMDR therapist and a member of the training staff at the EMDR Institute, a training center for future EMDR practitioners in Watsonville, California, Penner realized when he got sober in 1982 that he had been using drugs as a way to avoid dealing with feelings of anger and disappointment. He also found that EMDR therapy could help other people create a greater sense of comfort in addressing difficult topics like addiction. “We want to resolve issues like addiction but it’s in our nature to avoid and rationalize them or to view them in a certain way even if it’s not accurate.” he says. “EMDR often ends up becoming a spontaneous way for people to self-confront. I’ve had a lot of people come in for EMDR therapy who were not there for addiction issues but realized over the course of the treatment that this was also a problem.”
Maria, a sober 42-year-old business owner in Los Angeles, credits EMDR with helping her to overcome her alcoholism. Now sober for nine years, she says the EMDR she did when she first got sober at age 33 helped her to address sexual abuse she suffered as a child to such a degree that it made drinking to avoid the issue no longer necessary. Maria engaged in weekly sessions for a month while at a treatment facility in Tucson and then another five sessions with her therapist upon returning to Los Angeles. “I don’t think the sexual abuse specifically made me an alcoholic but the feelings of insecurity, shame and fear from it were things that I drank over,” she says. “I had blocked out certain parts and the therapy not only helped me go in and see the whole thing but also to go in as an adult and view it differently.”
From 2004-2007, Susan Brown and Sara Gilman conducted a 36-month study involving the Thurston County Drug Court Program—a court-supervised drug treatment in Washington that is offered to eligible non-violent drug offenders in lieu of jail time—and compared the effects of EMDR to Seeking Safety, a psychotherapy program for those suffering from both PTSD and addiction. The initial plan was to give half the sample pool SS therapy and the other half a combination of SS and EMDR but, according to Shapiro, “They had to drop the randomized part after the first few months because the people who weren’t getting EMDR were upset since the people who received it were doing so well in moving forward with their recovery.” Their findings showed that 91 percent of those who received EMDR graduated from the 12-month drug court program compared to 62 percent who did not.
While moving your eyes back and forth to cure drug addiction may sound simplistic to some, those who have engaged in EMDR describe it as difficult and emotionally exhausting. “In the sessions, you’re processing feelings of fear around your traumatic experiences,” says Nicole, the Santa Barbara teacher. “The experience naturally loses its charge after a while but the sessions are emotionally draining: not only do they deal with how the trauma is stored in your body but also involves the release of sadness and other emotions associated with those experiences.”
Although dealing with difficult memories can oftentimes make an addict want to go out and use, Penner said that even patients who are in the infancy stages of their sobriety can absolutely still engage in EMDR sessions. (Many rehabs offer EMDR for inpatients and there’s no set amount of sober time that experts recommend addicts should have since it varies from person to person.) “People can work on addressing memories very early on and if often helps them gain resiliency that will be needed later on in their early recovery,” says Penner. “Because early recovery is a very vulnerable time, the therapist needs to pace the work being done in order to let the patient build up resources.” Penner adds that 12-step programs in conjunction with EMDR therapy “can be helpful since a program creates the structure and sober environment that a recovering addict might need while the EMDR can be used to help unearth issues for addicts to process with 12-step work.”
Despite the psychological outcome studies that have come out in favor of EMDR as a method for treating addiction and addressing traumatic experiences, the therapy still has its share of critics who argue that it remains unclear how the therapy works—and that it may not be more effective than other exposure-based treatments. “There’s no peer reviewed evidence that EMDR works for drug addiction and most studies clearly show that EMDR doesn’t work better than other exposure-based treatments,” says Dr. Scott Lillenfeld, a Professor of Psychology at Emory University. “That being said, there is pretty good evidence that it works better than no treatment for PTSD. It might be helpful in some way if the addiction is centered around those anxieties but I’d feel very comfortable in stating that it’s premature to say this can be used to treat drug addiction.”
Penner himself even acknowledges that the concept of EMDR can be difficult for many to recognize as legitimate. “When I read an article on this 20 years ago, I laughed and threw it out,” he admits. “Who wouldn’t be skeptical? But there’s something about this therapy that allowed me to tolerate difficult emotions in a way that I simply wasn’t able to even when I was using to escape them.”
Shapiro still continues to expand the therapy through the EMDR Humanitarian Assistance Program, which started in 1995 after the Oklahoma City bombings and provides free treatments and clinical training to countries suffering from natural disasters and political violence. The therapists are all volunteers who work in exchange for travel and modest lodging and they’ve been on-site to help deal with events such as the conflict in Northern Ireland and the Israeli-Palestinian conflicts as well as 9/11 in New York, Hurricane Katrina in New Orleans and Turkey for the 2011 earthquake.
But regardless of where the sessions are being conducted, there are plenty of advocates for the treatment who believe that EMDR drastically improved the quality of their life. “It felt like my traumatic experiences had been filed away in a cabinet, only sideways,” Maria concludes. “Going through EMDR therapy helped place it right side up.”
McCarton Ackerman is a freelance writer currently residing in Portland, Oregon. His work has appeared in Time Out New York, The Huffington Post, abcnews.com and usopen.org, among others. He has also written about Carré Otis and Celebrity Rehab, among many other topics, for The Fix.