EMDR Therapy for Addiction and Trauma

Medically reviewed by Dr. Eric Chegouri, MD, Medical Director · Last reviewed November 7, 2026

For many people in addiction treatment, substance use began as a way to survive something. A memory that would not stop replaying. A body that stayed braced for danger long after the danger was gone. Alcohol or drugs quieted it for a while. Eye movement desensitization and reprocessing, or EMDR, is a therapy designed to work on those memories directly, so they no longer carry the same emotional force.

EMDR does not erase what happened, and it does not require you to tell every detail of your story out loud. Instead, it helps your brain finish processing an experience that got "stuck," so you can remember it without being pulled back into it. For people whose trauma and substance use are tangled together, that can change the whole picture of recovery.

What is EMDR therapy?

EMDR was developed by psychologist Francine Shapiro in the late 1980s. She observed that certain eye movements seemed to reduce the distress of disturbing thoughts, and went on to build and study a structured protocol around that observation. Over the following decades EMDR grew into a full, eight-phase psychotherapy used around the world for posttraumatic stress disorder (PTSD) and other trauma-related problems.

The theory behind EMDR is called the adaptive information processing model. In simple terms, it suggests that overwhelming experiences can be stored in the brain without being fully processed, along with the images, beliefs, emotions and body sensations of that moment. When something in the present resembles the original event, those stored pieces can fire as if the event were happening again. EMDR aims to help the brain process the memory so it is stored more like an ordinary, if painful, past event.

Researchers are still studying exactly why EMDR works. What is well established is that, for PTSD, it is supported by a substantial body of research.

Why does trauma matter in addiction treatment?

Trauma and substance use disorders frequently occur together. SAMHSA and NIDA both describe trauma as a significant risk factor for substance use problems, and people with PTSD are more likely to develop a substance use disorder. The connection often runs both ways: substances numb trauma symptoms in the short term, while substance use can also increase exposure to new dangerous or traumatic situations.

When the trauma underneath is left untreated, the urge to self-medicate tends to stay. Nightmares, flashbacks, hypervigilance and shame do not disappear just because the substance has stopped, and in early sobriety they can feel louder than ever. Treating trauma as part of addiction care, rather than "later," is one reason integrated dual-diagnosis treatment matters.

What are the eight phases of EMDR?

EMDR follows a standard eight-phase structure. The eye movements people hear about are only one part of it; much of the work happens before and after.

1. Phase 1History and treatment planning

   Your therapist learns about your history, current symptoms and goals, and identifies memories and present-day triggers that may become targets.

2. Phase 2Preparation

   You learn what to expect and build calming and grounding skills, such as a "calm place" exercise, so you can settle yourself during and between sessions.

3. Phase 3Assessment

   For a chosen memory, you identify an image, the negative belief attached to it ("I'm powerless"), a preferred belief ("I'm safe now"), and the emotions and body sensations involved, with simple ratings of distress.

4. Phase 4Desensitization

   While briefly holding the memory in mind, you follow sets of bilateral stimulation. Between sets you notice whatever comes up and report it in a few words. This continues until distress drops.

5. Phase 5Installation

   The preferred, more adaptive belief is strengthened and linked with the memory.

6. Phase 6Body scan

   You notice any remaining tension or discomfort in your body connected to the memory, which is then processed as well.

7. Phase 7Closure

   Every session ends with you returning to a calm, settled state, whether or not the memory is fully processed.

8. Phase 8Reevaluation

   At the next session, you and your therapist check what has changed and decide what to work on next.

What does an EMDR session feel like?

People are often surprised by how structured and contained EMDR feels. You stay awake, aware and in control the whole time; it is not hypnosis. During processing, your therapist might move their fingers or a light bar from side to side for you to follow, or use alternating taps or tones. Sets usually last less than a minute, followed by a short check-in.

You do not have to describe the memory in detail. Many people say only a few words between sets, such as "it's getting further away" or "now I'm thinking about my brother." Thoughts, feelings and images can shift quickly. Some sessions are emotional; others feel surprisingly calm. It is common to feel tired afterward or to notice vivid dreams for a day or two, and your therapist will help you plan for that.

Is EMDR effective?

For PTSD, EMDR is supported by a substantial body of research and appears in major clinical practice guidelines. The American Psychological Association's PTSD guideline includes EMDR among its recommended treatments, the U.S. Department of Veterans Affairs and Department of Defense guideline recommends it as a trauma-focused psychotherapy, and the World Health Organization has recommended it for PTSD as well.

The evidence for EMDR as a treatment for substance use disorders specifically is newer and more limited. It is best understood as a way to treat the trauma that so often drives substance use, used alongside proven addiction treatments rather than instead of them. That is how it is typically used in integrated programs.

Who does EMDR help?

EMDR may be a good fit if you:

• Have PTSD or ongoing trauma symptoms such as flashbacks, nightmares, avoidance or feeling constantly on guard.
• Notice that cravings spike when something reminds you of a painful experience.
• Carry strong negative beliefs about yourself rooted in past events ("it was my fault," "I'm not safe anywhere").
• Find it very hard to talk through trauma in detail, but want to work on it.
• Have used alcohol, opioids, benzodiazepines or other substances to numb trauma symptoms.

How is EMDR used at Reggie's?

At Reggie's Recovery Center, EMDR is part of our approach to trauma and is introduced when you are stable enough to benefit. In practice, that means stabilization comes first. If you are arriving from medical detox, still in acute withdrawal or in crisis, the early focus is on safety, sleep, medical stability and building coping skills.

Once you are ready, trauma processing can become part of your individual therapy, with the rest of your plan supporting it. All staff at Reggie's are trained in trauma-informed care, which shapes how everyone you meet works with you, not only your therapist. Your plan may also include psychiatric care and medication management if trauma symptoms, mood or sleep need medical support.

Many people begin trauma work during residential treatment at our Sun Valley campus, where 24/7 support and a calm, structured day make it easier to process difficult material. Your care team will help plan how that work continues as you step down to PHP or IOP.

How does EMDR fit with other therapies?

• DBT skills such as distress tolerance and grounding help build the stability EMDR needs.
• CBT helps with the everyday thoughts and habits that keep substance use going.
• Group therapy reduces isolation and shame, even though trauma processing itself happens individually.
• Holistic therapies like yoga, meditation and breathwork help regulate the nervous system between sessions.
• Relapse prevention plans account for trauma reminders as triggers.

What EMDR is not (and when to wait)

EMDR is not hypnosis, and it is not a technique you do to yourself from a video. It is a full psychotherapy delivered by a trained clinician, and the preparation phase is as important as the eye movements. It is also not a substitute for addiction treatment: processing trauma does not on its own manage withdrawal, cravings or relapse risk.

There are times when trauma processing is usually postponed: during acute withdrawal or intoxication, in a mental health crisis, when you do not yet have reliable ways to calm yourself, or when you are not currently safe. Some people prefer other evidence-based trauma therapies, and that is a valid conversation to have with your clinical team.

How do you start?

Call (818) 355-1200 any time to speak with admissions. You can share as much or as little about your history as you like on the first call. A free, confidential insurance check usually takes 15 to 30 minutes, and most major PPO plans cover treatment at least in part, depending on your plan. See our admissions page for the three steps and what to bring.