Medically Reviewed By

Brittany Kowalski, LCSW, ACS, CCS

Clinical Director, Speranza Behavioral Health · Last clinically reviewed June 2026

EMDR Therapy for Addiction and Trauma: How It Works and What to Expect

Eye Movement Desensitization and Reprocessing — EMDR — is one of the most studied and most validated trauma treatments in the history of psychotherapy. If you've never heard of it, or if the name sounds intimidating, you're not alone. EMDR sounds unusual, works through mechanisms that aren't yet fully understood, and produces results that can seem remarkable — especially to people who have spent years in talk therapy addressing trauma that never seemed to fully resolve.

This guide explains what EMDR actually is, what the research shows, what happens in an EMDR session, who it's appropriate for, and how it's integrated into addiction treatment at Speranza Behavioral Health.

What Is EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) is a structured psychotherapy developed in the late 1980s by psychologist Dr. Francine Shapiro. It was originally developed for PTSD but has since been validated for a wide range of trauma-related and other conditions.

EMDR is based on the Adaptive Information Processing (AIP) model — the theory that the brain has a natural capacity to process and integrate disturbing experiences, but that traumatic memories can become "stuck" in memory networks in a way that preserves the original sensory, cognitive, and emotional content of the traumatic experience. When a stuck traumatic memory is later triggered, the person experiences distress as if the trauma is happening now — not as a memory.

EMDR uses bilateral stimulation (most commonly guided eye movements, but also auditory tones or taps) while the person holds aspects of a traumatic memory in awareness. This bilateral stimulation appears to facilitate the brain's natural processing of the stuck memory — integrating it into long-term memory in a way that preserves the factual content but removes the acute emotional charge.

What Does the Research Say?

The evidence base for EMDR is extensive and compelling:

• The World Health Organization (WHO) recommends EMDR as a first-line treatment for PTSD
• The American Psychological Association designates EMDR as "probably efficacious" for PTSD (its highest-evidence category)
• The Department of Veterans Affairs rates EMDR as a strongly recommended treatment for PTSD
• Multiple meta-analyses confirm EMDR's effectiveness for PTSD, often producing symptom remission in fewer sessions than other modalities
• Emerging research supports EMDR's effectiveness for co-occurring addiction, particularly when trauma is a primary driver of substance use

The 8 Phases of EMDR

EMDR is a structured, phase-based treatment:

Phase 1: History Taking — Comprehensive assessment of trauma history, current symptoms, and treatment readiness. Identifying target memories for processing.

Phase 2: Preparation — Building the client's capacity to tolerate trauma processing. Teaching stabilization skills — grounding techniques, a "safe place" visualization, and other coping tools. No trauma processing occurs until the client is prepared and stable.

Phase 3: Assessment — For the target traumatic memory, identifying the specific image, the negative belief associated with it, the desired positive belief, the emotional distress (SUDS scale), and the body location of physical sensation.

Phase 4: Desensitization — The core phase. The client holds the target memory in mind while following the therapist's moving fingers (or receiving bilateral taps or tones). After each set of bilateral stimulation, the client briefly reports what came up. The therapist guides the process across multiple sets until distress associated with the memory significantly reduces.

Phase 5: Installation — Strengthening the positive belief that emerged as the negative belief associated with the trauma was processed.

Phase 6: Body Scan — Scanning the body for any residual tension or distress related to the target memory.

Phase 7: Closure — Ensuring the client is stable and grounded at the end of each session.

Phase 8: Reevaluation — At the beginning of subsequent sessions, assessing the processing that occurred and the client's status since the last session.

What Does an EMDR Session Feel Like?

Most people's first concern about EMDR is whether it will feel overwhelming — whether confronting traumatic memories will be re-traumatizing. This is an understandable concern.

In practice, most EMDR clients describe the experience as:

• Less overwhelming than expected — the bilateral stimulation appears to create enough dual attention (between the memory and the present moment) to prevent complete reimmersion in the traumatic experience
• A sense of movement — many clients report that thoughts, feelings, images, and body sensations seem to shift and change during processing in ways that feel organic rather than forced
• Emotionally real — processing does involve genuine emotional experience; many clients cry, feel anger, or experience grief during sessions
• Relief — many clients report that traumatic memories that felt vivid and intrusive before EMDR feel "more distant" or "like it happened to someone else" after processing

EMDR sessions at Speranza are conducted by licensed therapists with specific EMDR training. Preparation (Phase 2) is thorough — no one enters trauma processing before they have the stabilization skills to manage it safely.

EMDR and Addiction: The Trauma-Addiction Connection

For people whose substance use is rooted in or sustained by unprocessed trauma, EMDR can be transformational in addiction treatment. When the traumatic memory driving the emotional pain that substances were medicating is processed and integrated, the compulsive need for that relief often diminishes significantly.

At Speranza Behavioral Health, EMDR is integrated into our PHP and IOP programs as part of our comprehensive dual diagnosis approach — delivered alongside CBT, DBT, MAT, and group therapy.

Call (866) 814-0126 for a free, confidential assessment. Explore all our therapies →

Related Reading:

• PTSD and Substance Abuse
• What Is CBT and How Does It Treat Addiction?
• What Is Dual Diagnosis?

About the Author

Brittany Kowalski

Brittany Kowalski is a licensed clinical social worker (LCSW) and behavioral health advocate at Speranza Behavioral Health in Woodbury, NJ. With over a decade of experience in addiction recovery and mental health treatment, she specializes in dual diagnosis care, trauma-informed therapy, and evidence-based outpatient programs serving South Jersey communities.