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Q6: Why is EMDR an important protocol in treating addicts? - EMDR with Dr. Andrew M. Leeds Ph.D.

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Published on Sep 5, 2012

Dr. Andrew Leeds is talking about the EMDR: Eye Movement Desensitization and Reprocessing.

Q6: Why is EMDR an important protocol in treating addicts?

Well I think this is a really important question and first I want to say that it's really a privilege to be associated with the ONE80CENTER. I worked with you Steve and with Bernie even before you founded the ONE80CENTER and I've consulted on some of your other cases before.

It isn't just a feeling or a clinical observation that trauma is commonly involved with substance abuse problems. The SAMHSA, The Substance Abuse and Mental Health Services Administration research shows that the vast majority of people with alcohol and other substance abuse problems have co-occurring disorders.
Most commonly trauma related disorders. Trauma typically leads to symptoms of post traumatic stress disorder, but it can also cause other anxiety disorders and other depressive disorders.

The vast majority of people with these co-occurring disorders don not receive treatment for both their substance abuse problem and their other co-occurring conditions which is why most treatment programs have high relapse rates. If you don't treat the co-occurring condition then the person is going to continue to have a need to medicate.

If their prescription medications don't meet their needs adequately they are going to begin to self medicate again. So, relapse rates are very high if you can't resolve this. PTSD in particular has an episodic cycle. People alternate between phases of intrusion and phases of numbing. So people can have a quiescent phase where their intrusions are somewhat hidden and then as they get triggered their intrusions begin to get reactivated and then have urges to relapse again. It isn't just a chemical process of detoxification.

It's the condition association between a long established history of self medication in response to the cyclic turn of the trauma material. The trauma material as Bessel Van Der Kolk has pointed out is not that often in the form of disturbing images or nightmares in the kind of overt signs of PTSD that many clinicians may be looking for. The most common forms of the reoccurrence of trauma symptoms are body sensations and emotional states, that are the re experiencing of aspects of traumatic experiences.

So clinicians who don't have a strong background in psychotraumatology won't recognize that the cues that are triggering relapse are associated with traumatic experiences. They wouldn't have gone looking for the trauma history. They would be thinking that's too disruptive to the client who is in a recovery program to uncover that material and they won't even think about treating it. As a result these co-occurring conditions largely go untreated and so what you are doing here at the ONE80CENTER, I think is really pioneering work.
I think you're one of a handful of programs around the country that's even thinking about attempting to use a comprehensive approach. And I know you do more than just conventional recovery work and EMDR here. You use lens neural feedback and other innovative approaches to try to get at the source of what's going on behind the urge to use. EMDR is an essential part of a comprehensive treatment program for substance abuse programs. If you don't treat the trauma people will relapse. That's been demonstrated over and over again.

I think they're kind of a common myth that you have to wait until people have been stable in recovery for years before you think about treating the co-occurring conditions. That was a model that was promoted in the 1980s. Researchers now have demonstrated that that doesn't work. If you don't begin to treat the co-occurring conditions immediately people will fail. They'll go through a rehab program and then they'll relapse again. So it's essential. In EMDR compared with other approaches for treating the co-occurring PTSD or similar traumatic or depressive symptoms that patients may have, has a lot going for it.

As I think the first choice in ways of treating co-occurring disorders compared with prolonged exposure and cognitive processing therapy. The main thing it has going for it is it's efficiency. The research studies show again and again that the modal response is faster to EMDR that prolonged exposure and cognitive processing. PE and cognitive processing do catch up with enough sessions but for people who respond well to EMDR, they respond faster and they get symptom relief faster.

So I think when you're in a residential treatment or an aftercare program offering EMDR it's a much more attractive modality to be considering because it's going to produce faster symptom relief. When patients who have relapsed again and again start to experience substantial symptom relief of long existing symptoms in a few EMDR sessions they become believers. They go, I want more EMDR. Forget about that other stuff.

For more information, call 888.593.2301 or visit our website : http://www.one80center.com/

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