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EMDR Therapy for Trauma and Substance Use Disorder



EMDR shows promise as a treatment for substance use disorder, but the research highlights its effectiveness for psychological trauma. Eye movement desensitization and reprocessing (EMDR) therapy is often introduced in the context of drug and alcohol rehabilitation programs. As a unique type of psychotherapy, EMDR aims to help you reprocess traumatic memories through a series of steps guided by a mental health professional. Traumatic memories and conditions, like post-traumatic stress disorder (PTSD), are strongly associated with substance use disorder (SUD). The potential benefits of EMDR for SUD and addiction are still being investigated, but research supports its effectiveness for trauma symptoms. EMDR therapy is utilized for SUD because it targets the underlying trauma symptoms that can contribute to the urge for substances like alcohol, tobacco, cannabis, etc. Through an 8-step process, you can start working toward resolving painful memories and potentially recovering from trauma.


Is EMDR effective for substance use disorder?


Conclusions about the effectiveness of EMDR for substance misuse have yet to be determined. A comprehensive 2017 research review examined existing studies on EMDR for SUD and addiction.

More research is needed, but findings indicate that EMDR can improve the following addictions:

  • alcohol

  • gambling

  • gamma-hydroxybutyric acid

  • internet

  • sex

  • opioids

  • tobacco


Better quality research on EMDR is generally confined to its effectiveness for trauma symptoms and PTSD. EMDR therapy is employed in drug and alcohol rehabilitation facilities alongside other therapies, partly because trauma plays a role in substance use.

Despite scant data, researchers are hopeful about the potential value of EMDR for substance misuse and SUD because they often co-occurTrusted Source with trauma symptoms and PTSD.


The link between trauma and substance use


Trauma can take many forms and can influence your behavior. Persistent memories of traumatic experiences from childhood and adolescence, in particular, have an important relationship to substance misuse.

According to the CDCTrusted Source, these traumas can include:

  • violence, abuse, or neglect

  • when a family member attempts or dies by suicide

  • exposure to violence at home or in the community

  • incarcerated family members

  • divorced or separated parents


Through the years, research has demonstrated that trauma increases the likelihood of substance misuse and SUD. A 2015 studyTrusted Source noted that more traumatic experiences in childhood contribute to a greater likelihood of heavy drinking and smoking.

Similarly, a 2017 reviewTrusted Source noted that traumas experienced in childhood increased the rate of lifetime dependence on substances like:

  • cocaine

  • cannabis

  • alcohol


Aside from childhood experiences, traumas in adulthood such as those experienced by military personnel can also contribute to substance misuse. According to the US Department of Veterans Affairs, between 12% to 30% of combat veterans reported PTSD after serving, and 27% of veterans living with PTSD have SUD.


Benefits of EMDR


EMDR therapy primarily aims to address the causative factors of trauma symptoms. Factors like intrusive memories are associated with symptoms, such as anxiety and physical pain. EMDR can address many of these symptoms with EMDR.


Improves overall psychological symptoms in PTSD


According to a small 2017 studyTrusted Source, an EMDR intervention significantly reduced the severity of intrusive memories, avoidance behavior, and hyperarousal in PTSD.

Furthermore, EMDR lessened the frequency of dissociative experiences, e.g., disconnecting from particular thoughts, feelings, or self-identity, common in PTSD.


May improve anxiety symptoms


Research from 2017Trusted Source broadly noted that EMDR might be effective for anxiety symptoms.

While more research is needed, the EMDR International Association also mentioned that it could address panic attacks and performance anxiety.


May reduce alcohol cravings


A 2017 literature reviewTrusted Source identified that EMDR decreases craving intensity and improves drinking behavior. But more research is needed to confirm these findings.


May reduce physical pain


This 2021 reviewTrusted Source noted the positive effects of EMDR on the following disorders:

  • phantom limb pain

  • chronic pain

  • fibromyalgia

  • acute pain intensity


In the examined studies, EMDR effectively reduced pain in people living with these disorders. Research suggested that EMDR plays an important role in pain perception and, more specifically, that it may modulate pain responses.


What to know before trying EMDR therapy


If you’re interested in trying EMDR therapy, here are some of the basics about what you can expect:

  • Attend one or two 60-90 minute sessions every week.

  • The number of sessions you attend depends on your history and response to treatment.

  • EMDR therapy is considered safe, and there are no dangerous side effects.

  • The therapist will take you through an 8-step process during each session.


8 Steps of EMDR therapy


  • History: a discussion of your history with a focus on traumatic events, followed by the development of a treatment plan

  • Preparation: the therapist will then explain EMDR therapy, what you can expect, and provide techniques for coping with disturbing emotions that can come up during the session

  • Assessment: you’ll target various images, feelings, beliefs, or sensations associated with the traumatic event that needs to be reprocessed

  • Desensitization: the therapist will guide you through various eye movements, taps, or other stimulations while you think about the traumatic event and allow for new, positive associations to pair with the event

  • Installation: the therapist will help you strengthen the paired positive associations

  • Body scan: you’ll visualize the traumatic event again, and the therapist will ask you to note any remaining areas of tension or negative associations in your body

  • Closure: the therapist will help ground you back into the present, and you’ll incorporate some of the techniques from step 2 to facilitate this step

  • Reevaluation: in the next session, you’ll discuss how you’ve been feeling since the last session to determine your response to the treatment


Side effects


While there are no inherent dangers to EMDR therapy, some reported side effects have been:

  • vivid dreams

  • re-emergence of distressing memories

  • feeling vulnerable

  • emotional fluctuations

  • nausea, headache, or lightheadedness.


Next steps


Unresolved traumas can greatly influence your behavior and improve your quality of life. Although it may seem like nothing can be done to address disturbing events of the past, EMDR offers hope.

If you’ve been living with PTSD and find yourself reaching for substances to cope, it may be worthwhile to consider trying EMDR therapy. Research demonstrates its effectiveness for PTSD in particular.

If you’re willing to spend some time revisiting troublesome memories with a professional, EMDR may help you cope with traumas and potentially improve substance use disorder.

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