EMDR, Addictions, and the Stages of Change: A Road Map for Intervention

The MET(T)A Protocol: Mindfulness and EMDR Treatment Template for Agencies

Evidence indicating the relationship between trauma and substance use disorders (SUDs), in addition to relapse and treatment retention rates for this population, suggests there is a need for a trauma-focused solution to treat SUDs. Eye movement desensitization and reprocessing (EMDR) therapy has been studied extensively as an effective approach for treating trauma and Posttraumatic Stress Disorder (PTSD). The research evaluating its treatment for other mental health disorders such as SUDs is promising. Merging mindfulness and ethical mindfulness practices with EMDR therapy lends additional evidence-based elements to make the case for this integrative system of treatment to be studied as a trauma-focused primary psychotherapy to treat SUDs. The resulting treatment, the MET(T)A Protocol (Mindfulness and EMDR Treatment Template for Agencies), has been created to address the need for a trauma-focused solution to treat SUDs. Procedures of the MET(T)A Protocol as applied in each of the 8 phases of EMDR therapy are described in detail. Clinical examples are provided to explain the application of the MET(T)A Protocol.

A Multicenter Phase II Rater-Blinded Randomized Controlled Trial to Compare the Effectiveness of Eye Movement Desensitization Reprocessing Therapy vs. Treatment as Usual in Patients With Substance Use Disorder and History of Psychological Trauma: A Study Design and Protocol

Background: Psychological trauma has a strong negative impact on the onset, course and prognosis of substance use disorders (SUD). Few trauma-oriented treatment approaches have been trialed, but preliminary evidence exists of the efficacy of Eye Movement Desensitization and Reprocessing (EMDR) therapy in improving clinical symptoms in SUD patients. Objective: To assess if EMDR therapy leads to: (1) reduced substance consumption; (2) an improvement in psychopathological and in trauma-related symptoms; and (3) an improvement in overall functioning. Our hypothesis is that the EMDR group will improve in all variables when compared to the treatment as usual (TAU) group at 6 and 12-months visits. Method: In this multicenter phase II rater-blinded randomized controlled trial, 142 SUD patients with a history of psychological trauma will be randomly assigned to EMDR (n = 71) or to TAU (n = 71). Patients in the EMDR group will receive 20 psychotherapeutic sessions of 60 min over 6 months. Substance use will be measured using the Timeline Followback Questionnaire, the Dependence Severity Scale and the Visual Analog Scale. Traumatic events will be measured by The Holmes-Rahe Life Stress Inventory, the Childhood Trauma Questionnaire Scale, the Global Assessment of Posttraumatic Stress Questionnaire, the Impact of Event Scale-Revised and the Dissociative Experiences Scale. Clinical symptomatology will be evaluated using the Hamilton Depression Rating Scale, the Young Mania Rating Scale and the Brief Psychiatric Rating Scale. Functionality will be assessed with the Functioning Assessment Short Test. All variables will be measured at baseline, post-treatment and 12 months as follow-up. Primary outcome: to test the efficacy of EMDR therapy in reducing the severity of substance use. The secondary outcomes: to test the efficacy in reducing trauma-related psychological symptoms and psychopathological symptoms and in improving overall functioning in patients with comorbid SUD and a history of psychological trauma. Conclusion: This study will provide evidence of whether EMDR therapy is effective in reducing addiction-related, trauma and clinical symptoms and in improving functionality in patients with SUD and a history of trauma. Clinical Trial Registration: The trial is registered at ClinicalTrials.gov, identifier: NCT03517592.

EMDR Therapy Reduces Intense Treatment-Resistant Cravings in a Case of Gamma-Hydroxybutyric Acid Addiction

This article presents the first experiences of using eye movement desensitization and reprocessing (EMDR) therapy to aid in the treatment of gamma-hydroxybutyric acid (GHB) dependency. A case presented itself as a result of intense, treatment-resistant cravings despite pharmacological treatment. The patient received 7 weekly sessions using a subset of the palette of EMDR interventions in addiction (PEIA; Markus & Hornsveld, 2017) targeting both negative and positive valenced addiction-related memory representations from the past, present, and future. Patient-reported GHB craving showed a gradual and prolonged reduction. Urine samples showed that the patient remained abstinent during and at least 6 months after EMDR therapy. Further research regarding the effectiveness of EMDR therapy in this particularly challenging group of substance users is warranted.

EMDR Interventions in Addiction

The use of tobacco, alcohol, and illicit drugs is widespread and has significant negative consequences for the individual, their families, and the communities to which they belong. A substantial number of users develop an addiction disorder. Cure-oriented addiction treatment is challenging regarding treatment retention and relapse rates. Here, we discuss the potential of eye movement desensitization and reprocessing (EMDR) therapy to aid addiction treatment. Two approaches are distinguished: trauma-focused and addiction-focused EMDR therapy. Existing adapted EMDR protocols and research on both approaches is critically reviewed. Despite 20 years of development and research, the feasibility and efficacy of addiction-focused EMDR therapy is still largely uninvestigated. Exciting new possibilities, offered by research on working memory theory, are discussed. An overview of all resourcing and EMDR therapy interventions in addiction is presented: the palette of EMDR interventions in addiction (PEIA). The article finishes with recommendations for further research in this field.

Single Case Study: Does EMDR Psychotherapy Work on Emotional Eating?

This article presents the methods and results of a single case study treating the effects of “emotional eating” (EE). It provides a comprehensive review of the literature related to obesity and emotional eating; explains childhood experiences, which may contribute to its development; and describes how emotional eating can become a default behavior for affect regulation. The background for the research is the worldwide epidemic of overeating and obesity. The study was designed to examine whether treating the symptoms of EE with selected protocols and methods within eye movement desensitization and reprocessing (EMDR) psychotherapy would have a positive effect, and the participant, a 55-year-old woman, was treated with an adjusted version of the desensitization of triggers and urge reprocessing (DeTUR) protocol, including resource installation, affect management, ego state work, and the standard EMDR protocol. The treatment consisted of 6 weekly meetings, each lasting 1.5 hours, and 2 follow-up meetings after 3 and 6 months. The measures, which were self-reported on a qualitative scale (0–10), included the experienced feeling of control in general (affect regulation) in specific eating behavior before and after the treatment, reduction of urge in triggering situations, number of situations with emotional eating per week, and body image before and after the treatment. The participant experienced an overall positive change in eating behavior, and the treatment could be one of the ways to reduce weight over time and to ensure better results in stabilizing weight after weight loss.