Using Eye Movement Desensitization and Reprocessing (EMDR) in the Treatment of Addiction: An Introduction to EMDR Therapy Applications and Effectiveness in Addictions Recovery Presented by: Sandra Derks, LPC, CSAC, QUEST Counseling and Consultation Center, LLC Madison, WI Agenda Types of therapy Brain function and memory storage Introduction to EMDR EMDR with Addictions Case examples Practice Talk therapy Types of Therapy Experiential therapy EMDR 1
Brain Hand Model Brain Anatomy Limbic System When in a situation that is threatening, our primitive survival skills kick in. The limbic system churns out a series of chemicals that prepare us for fight, flight, or freeze. The limbic system holds very important brain structures: Everything that has ever happened to you, even before birth is stored here; Holds body memories, and regulates arousal and controls autonomic responses; Coordinates sensory input with your emotions. What Happens When Trauma Occurs? Natural coping mechanisms become overloaded. The experience becomes frozen remaining unprocessed. The unprocessed memories and feelings are stored in the limbic system in a raw and emotional form. Remain disconnected from the frontal cortex where we store memories as language. 2
Memory Resolution Highly Negative information is often: 1) Held dysfunctionally in an excitatory state, and consequently is more likely to be activated than other associations. 2) Dissociation information that is unavailable to awareness because it is stored in state dependent form in an isolated network. What does EMDR do? Utilizes the natural healing power of your body. Simulates the way REM or dream sleep works. Unlocks the negative memories and emotions stored in the nervous system. Helps the brain to successfully process the experience. How it Works EMDR works to remove blocks and resolve the excitatory state in information processing; processing resumes and moves toward resolution. Targets pathways or channels wherein memories, thoughts, images, emotions and sensations are stored and linked together. Sets of bilateral stimulation are utilized. With each set of stimulation, we move disturbing information along the neuro physiological pathway until it is adaptively resolved. 3
Adaptive Information Processing (AIP) Realistic Adult Perspective Defenses Trauma reliving parts Brain Anatomy Information Processing with EMDR The information is then able to When we focus on a particular move from the limbic system to part of an experience while Things that are stuck in the the prefrontal cortex. It shifts doing bilateral stimulation, the limbic system are able to be from a primitive emotional neurons in the limbic system reprocessed and desensitized. experience to a logical rewire themselves. experience. Applications of EMDR Big T trauma Complex trauma Small t trauma Anxiety Depression Anger Phobias Sleep Problems Grief/loss Pain including phantom pain Performance anxiety/enhancement Feeling States/addictive behaviors 4
8Stages of EMDR Therapy 1. History taking and treatment planning 2. Preparation 3. Assessment 4. Desensitization 5. Installation 6. Body scan 7. Closure 8. Re evaluation Components of EMDR Desensitization and Installation Procedure The image Negative and positive cognitions The emotions The physical sensations SUD (subjective scale of disturbance) VOC (Validity of Cognition) Addiction Definitions ASAM Primary, chronic, disease of the brain reward, motivation, and memory leading to characteristic biological, psychological, social and spiritual manifestations of impairment. AIP (Adaptive Information Processing) a genetically influenced neurodevelopmental disorder of memory, learning and chronic affect dysregulation associated with maladaptive neuroplasticity. (S. Brown) 5
Addiction Link to Trauma Most often, beginning with adolescence, addictions are strongly correlated with early Childhood trauma/neglect and disordered attachments. (Felitti et al, 1998) Begins as a solution to otherwise unmanageable internal states and/or external conditions due to unprocessed trauma and/or developmental deficits, which impact the ability to self regulate (shore, 1994) Over time develops into a rigid, maladaptive pattern of response. Addictive Behaviors Escape from distress or escape to a positive reward state. Leads to functional and structural brain changes which narrow the focus of interest, motivation, and behavior solely toward the pursuit of the desired substances or behaviors. Once cycle is established, addictive behavior is habituated, and control is lost. Addiction Originating as a Defense Against Posttraumatic Disturbance Wishing to appear normal 6
EMDR with Addictions EMDR focuses on desensitizing and reprocessing dysfunctional memory networks associated with the use of substances and/or behaviors. EMDR can target past, present and future: Reprocessing past traumas, Desensitizing current triggers and cravings, Installing positive future feeling states. Targeting Maladaptive Patterns (adapted from Knipe, 2005) Targeting Compulsions Urges (LOU) Urge to avoid (LOUA) Targeting Maladaptive Positive Affect (LOPA) Underlying Trauma Assess what is worst Assessment of Readiness for Change Assessing Stage of Change (adapted from H. Payson and A.K.Becker, 2018) How Important? How Confident? How Commited? 7
EMDR and Future Positive States Choosing and Enhancing the Positive Treatment Goal Identifying and Enhancing Internal Resources Anchoring the Positive State (adapted from H. Payson and A.K.Becker, 2018) Sandra Derks, LPC, CSAC QUEST Counseling and Consultation Center, LLC 700 Regent Street, Suite 300 Madison, WI 53715 608 567 4465 Sandra.derks@questmadison.com 8