HOW DOES EMDR SUPPORT RECOVERY FROM SUBSTANCE USE?
When we experience trauma, it can reduce our capacity to tolerate emotional experiences. We call this capacity the window of tolerance. In this window, we have access to our frontal lobe. When we are bumped out of the window, we enter hyper-arousal (fight, flight, flee) or hypo-arousal (freeze, fawn, dissociate). The bump out happens in the brain stem (back part of the brain or reptilian brain) where shift into survival mode and decisions are reactions meant to keep us alive. We do not get to choose which trauma response we engage in, rather the body chooses what it feels is safest in the moment. It is a split-second decision; generally, the body prefers flight/flight but will shift to freeze/fawn/dissociate when the later feels more dangerous. These reactions do not include “thinking” about consequences to decisions because they bypass the frontal lobe.
We see consequential substance use as secondary to trauma and genetics. We can be predisposed to develop this, but in general the trauma is the “ON” switch; not all people who have this genetic predisposition go on to develop it. People can experience distance or dissociation from their emotional experiences by using substances. This is a form of self-soothing. Complex trauma survivors often did not have caregivers with regulated nervous systems, meaning they never learned to self sooth themselves. When trauma changes how we see ourselves, others and the world, we may reach for substances to belong when we otherwise do not feel safe.
People seeking recovery often must face, sometimes for the very first time, all the wreckage their trauma has caused without the safety blanket of their substance. Never having learned to cope and self sooth, they face steep learning curves while the brain is trying to heal. After the initial withdrawal from a substance, people often encounter a longer period of recalibration (post-acute withdrawal, PAWS) in the brain and body as it gets used to functioning without the substance. This can feel like a pendulum swinging from one extreme to the other. PAWS further impacts our ability to regulate our emotions, have critical thinking, handle impulses and rejection. This can last up to three years, depending on the amount, frequency and length of substances used.
People in early recovery often deal with a great deal of shame. Our society continues to stigmatize substance use (all while promoting it) and generally makes people feel that it is a personal failure, rather than a complex compilation of societal oppression, genetic predisposition, and history of personal and collective trauma. When we believe we are a bad person, this shame can drive future decisions and behaviors. Relationships often do not feel safe due to past betrayals, stoking the fire of isolation and making connecting with new people terrifying.
EMDR helps to calm the nervous system so we can access our frontal lobe, improving perception, insight, decision making (the ability to pause before we act) emotional regulation, and access to our coping tools. It can reduce the cravings we have for substances and our triggers from our past trauma. It increases the window of tolerance, allowing us to handle more frustration throughout the day without constantly shifting into a trauma response. EMDR can target the shame substance use inevitably brings so we can reframe these experiences as not dictating our worth and having compassion for ourselves with the understanding that we were suffering.
EMDR can increase our beliefs about what we are capable of and what is possible in this life. It can allow us to trust ourselves, our decisions, and believe we are worthy of love. It can heal betrayal, lack of trust in others, and help the brain better discern between those who have/will hurt us and those who want to support and love us. Healthy connections are significant protective factors in recovery. In the nine years I have been utilizing EMDR with people recovering from substance use, I have witnessed the significant advantages and strengths it brings, increasing the odds of long term success.