EMDR and Addictions
EMDR helps many emotional and behavioral conditions including addictions. True, there are many psychological and behavioral residential treatment settings and everything else in-between. What does approaches that deal with addictions, from Twelve-Step groups to EMDR do that is different or even better?
First, let’s define addiction. Simply put, addiction is behavior that a person engages in that is not in their best interest and cannot stop doing. More complicated definitions include one from the American Society of Addiction Medicine:
“Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.”
The bottom line seems to be the negative effects that the compulsive behavior has on a person’s life and relationships. No one can really predict who will become addicted to a certain substance or behavior, but most would agree that addiction is multi-determined and complicated to treat.
Next, let’s describe the kinds of behaviors that people engage in that sometimes become addictive. 1) Substance addictions include alcohol, prescribed medications, street drugs, and tobacco. Marijuana, whether medically prescribed or bought legally, still can be addictive. Different categories of substances produce different effects mentally and physically. 2) Common behavioral addictions include gambling, sex, shopping, and food. Obsessive-Compulsive Disorder is not considered an addiction even though it has addictive-like components.
Two approaches using EMDR have been developed to deal with the strong urges and emotional states that are involved in the addictive process. Both approaches require a thorough bio/psycho/social history-taking and assessment of the addictive behavior(s) before any treatment is applied. The client’s social support network is extremely important for someone who wants to end an addiction. As with all therapy, the client needs to be motivated to change, which in the case of addictive behavior, means that the client has experienced severe negative consequences from their addiction and wants to avoid repetitions of those consequences. Adjunctive supports such as Twelve-Step groups, physical exercise, a healthy diet, and a generally stable social lifestyle is recommended for therapy to be successful.
The first approach is called the DeTur Model, developed by Dr. A.J. Popky. It focuses on the emotional and physical urges that take place before someone uses a substance or engages in an addictive behavior. The urges are categorized along with their internal and external triggers and processed with a specific EMDR protocol until the urge no longer exists. Positive experiences of the non-using lifestyle changes are installed as well so that the client has a strong belief in their ability to stay clean of their addiction. Clients are encouraged to maintain their social and physical supports to avoid any relapses.
The Feeling-State Addiction Protocol, developed by Dr. Robert Miller, is premised on the belief that addictions are caused by a fixated memory called a feeling state. This feeling state is created when someone uses a substance or engages in a behavior such as gambling while also experiencing an intensely positive (often social) event.
Feelings states are based on common human needs or desires such as needs for power or control, need for social status, acceptance or approval, importance or worth, nurturance or lovability, among many others. These needs or desires, if not met in other parts of a person’s life, can be the driving force beneath the creation of a feeling state that leads to a compulsion or addiction. The Feeling-State Theory of Addiction posits that once a person eliminates or processes the original feeling state, there is no more need to use the addictive substance or engage in the addictive behavior. Sometimes there can be more than one feeling state associated with an addictive behavior, so it is important to process all of them.
I am trained in both of these approaches and have seen positive results with substances and behavioral addictions. Feel free to call me to set up a consultation to see if these EMDR approaches could be helpful to you.