Eye Movement Desensitization and Reprocessing (EMDR) is a structured form of psychotherapy that helps people process distressing memories and experiences.
Originally developed to treat trauma and post-traumatic stress disorder (PTSD), EMDR is also used for anxiety, depression, addiction, and other emotional difficulties.
In addiction treatment, EMDR may help address past experiences, emotional triggers, and negative beliefs that contribute to substance use.
It can be particularly relevant when addiction and unresolved trauma are connected. Rather than focusing only on substance use itself, EMDR explores emotional experiences that may influence a person's behavior and recovery.
How Does EMDR Therapy Work?
EMDR is based on the idea that certain distressing experiences may not be fully processed, leaving memories associated with uncomfortable emotions, beliefs, or physical sensations.
During EMDR therapy, a person briefly focuses on a selected memory or experience while engaging in bilateral stimulation. This usually involves following a moving object from side to side with the eyes, although alternating sounds or gentle tapping may also be used.
The process is designed to help the person revisit the memory in a different way, so it becomes less emotionally distressing.
For example, someone who experienced a difficult event in childhood may continue to associate that memory with feelings of fear, shame, or helplessness.
EMDR may help reduce the emotional intensity connected to the experience and support a more balanced understanding of what happened.
Unlike traditional talk therapy, EMDR does not necessarily require someone to describe distressing experiences in extensive detail. Instead, it uses a structured process that combines attention to memories with bilateral stimulation.
The EMDR International Association explains that EMDR follows eight phases, including history-taking, preparation, assessment, memory processing, and reevaluation.
What Is the Connection Between Trauma and Addiction?
Trauma and addiction can sometimes be closely connected.
People who have experienced childhood neglect, abuse, violence, loss, or other distressing events may develop lasting emotional difficulties. For some, alcohol or drugs become a way to temporarily manage uncomfortable feelings or memories.
For example, someone experiencing anxiety or distress related to a past event might use alcohol to feel calmer. Although alcohol may provide temporary relief, repeated reliance on it can contribute to an unhealthy pattern of substance use.
Over time, substance use can become connected to certain emotions, situations, or memories. These connections may make it difficult to change established behaviors, even when someone wants to reduce or stop using substances.
However, not everyone with an addiction has experienced trauma, and trauma does not automatically lead to addiction. Substance use disorders develop through a combination of biological, psychological, social, and environmental factors.
Understanding these different influences is an important part of addiction treatment.
The U.S. Department of Veterans Affairs recognizes that PTSD and substance use disorders frequently occur together and that people experiencing both conditions can benefit from treatment addressing each concern.
How Is EMDR Used in Addiction Treatment?
EMDR may be incorporated into addiction treatment to address emotional experiences and patterns that contribute to substance use.
The specific focus depends on the person's history, current difficulties, and recovery goals.
1. Processing Past Traumatic Experiences
For people whose substance use is connected to past trauma, EMDR may help reduce the emotional distress associated with those experiences.
For example, someone who began drinking to cope with painful childhood memories may find that those memories become less upsetting through EMDR therapy.
Reducing trauma-related distress may make it easier to manage emotions without relying as heavily on substances for relief.
2. Addressing Emotional Triggers
An emotional trigger is a situation, memory, feeling, or experience that brings up distress or an urge to use substances.
Triggers vary widely. They may include arguments, relationship difficulties, feelings of rejection, stressful situations, or reminders of past experiences.
EMDR can be used to explore the memories and emotional associations connected to these triggers.
The goal is to reduce the distress they produce and help the person respond differently when similar situations arise.
3. Working With Negative Beliefs
People experiencing addiction may struggle with negative beliefs about themselves, particularly when their experiences involve shame, guilt, or past trauma.
These beliefs might include thoughts such as:
"I am not good enough."
"I cannot cope with difficult feelings."
"I will never be able to change."
"I am responsible for everything that happened to me."
EMDR may help people reconsider these beliefs as they process the experiences associated with them.
For example, someone who believes they are powerless may gradually develop a more balanced belief that they can make choices and influence their recovery.
4. Addressing Addiction-Related Cravings
Cravings are urges or desires to use a substance. They may be influenced by memories, emotions, environmental cues, or learned associations.
Some EMDR approaches focus on memories or situations connected to cravings rather than concentrating exclusively on traumatic experiences.
For example, someone may associate drinking with relief from stress. EMDR may be used to explore the memories and emotional responses that strengthen this association.
Researchers have examined whether EMDR can help reduce substance-related cravings. Some findings suggest that it may be useful, although results vary and reductions in cravings do not necessarily mean that long-term substance use will decrease.
What Does Research Say About EMDR for Addiction?
EMDR has a well-established research base for treating PTSD. Researchers have also examined its use in addiction treatment, including its effects on cravings, emotional distress, and substance use.
A 2025 meta-analysis published in Frontiers in Psychiatry examined 14 studies involving people with substance use disorders. The researchers found improvements in cravings, PTSD symptoms, depression, and anxiety following EMDR treatment.
However, the analysis did not find a statistically significant overall improvement in addiction severity. The researchers also noted limitations in study quality and the availability of long-term follow-up data.
Other research has examined EMDR as part of treatment for people experiencing both PTSD and substance use disorders.
A randomized controlled trial published in Addiction in 2025 compared several trauma-focused therapies, including EMDR, in people receiving treatment for co-occurring PTSD and substance use disorders.
This research contributes to the evidence supporting trauma-focused treatment within addiction care.
Overall, the findings suggest that EMDR may be helpful in addressing trauma-related distress and certain addiction-related symptoms. Its effects on sustained abstinence, relapse prevention, and long-term addiction recovery require further research.
Can EMDR Be Combined With Other Addiction Treatments?
Yes. EMDR can be used alongside other approaches to addiction treatment.
Addiction recovery often involves addressing several different needs, including physical dependence, behavioral patterns, emotional well-being, and ongoing support.
Depending on the individual, treatment may involve counseling, cognitive behavioral therapy, medication, recovery support programs, or other services.
EMDR can complement these approaches by focusing on distressing memories, emotional triggers, and beliefs that may contribute to substance use.
For example, someone might use cognitive behavioral therapy to recognize patterns in their behavior while also using EMDR to address painful experiences connected to those patterns.
The U.S. Department of Veterans Affairs explains that evidence-based trauma-focused therapies can be provided alongside treatment for substance use disorders. Treating one condition does not necessarily require postponing treatment for the other.
EMDR does not replace medications or medical care that may be needed for substance dependence or withdrawal. Instead, it may address additional emotional and psychological aspects of recovery.
What Can Someone Expect From EMDR During Addiction Treatment?
EMDR typically begins with identifying the concerns a person wants to address and exploring whether past experiences may be connected to current difficulties.
A therapist trained in EMDR may work with the person to identify relevant memories, emotional triggers, or negative beliefs.
The process also includes preparation and techniques for managing emotional responses.
During the memory-processing phases, the person focuses briefly on a selected experience while engaging in bilateral stimulation. The process is repeated in sets, with opportunities to notice changes in emotions, thoughts, and physical sensations.
Some people notice that a memory gradually feels less upsetting or that they begin to view the experience differently.
The number of sessions varies depending on the person's needs and the issues being addressed.
EMDR is also available in online formats, and some structured programs offer self-guided exercises. However, self-guided EMDR programs are not identical to therapist-delivered EMDR, and research specifically examining their effectiveness for addiction remains limited.
Is EMDR Appropriate for Everyone Experiencing Addiction?
EMDR may be useful for people whose substance use is connected to trauma, distressing memories, or difficult emotional experiences.
However, addiction is different for everyone. Some people may find that trauma-related issues are a significant part of their substance use, while others may be more affected by physical dependence, environmental influences, or other factors.
The usefulness of EMDR depends partly on what the person hopes to address.
For someone experiencing both PTSD and addiction, EMDR may be a relevant option within a broader treatment approach.
For someone primarily concerned with physical dependence or withdrawal, other forms of care may be more immediately relevant.
There is no single treatment approach that works equally well for everyone.
The Bottom Line
EMDR is a structured therapy that helps people process distressing memories and experiences. In addiction treatment, it may be used to address trauma, emotional triggers, negative beliefs, and other psychological factors associated with substance use.
Research suggests that EMDR may help reduce cravings and trauma-related symptoms in some people with substance use disorders. However, evidence for its effects on long-term addiction outcomes is still developing.
For people whose addiction is connected to unresolved emotional experiences, EMDR can be a meaningful part of a broader recovery approach, alongside other treatments that address the behavioral, physical, and social aspects of addiction.
References
1. EMDR International Association. About EMDR Therapy. https://www.emdria.org/about-emdr-therapy/
2. American Psychological Association. Eye Movement Desensitization and Reprocessing (EMDR) Therapy. https://www.apa.org/ptsd-guideline/treatments/eye-movement-reprocessing
3. U.S. Department of Veterans Affairs, National Center for PTSD. Treatment of Co-Occurring PTSD and Substance Use Disorder in VA. https://www.ptsd.va.gov/professional/treat/cooccurring/tx_sud_va.asp
4. Seok, J.-W., Kim, K., & Kim, J. U. (2025). Therapeutic effects of eye movement desensitization and reprocessing for substance use disorders: A meta-analysis of addiction-related and emotional symptoms. Frontiers in Psychiatry, 16, 1660046. https://doi.org/10.3389/fpsyt.2025.1660046
5. Lortye, S., et al. (2025). Effectiveness of treating post-traumatic stress disorder in patients with co-occurring substance use disorder with prolonged exposure, eye movement desensitization and reprocessing or imagery rescripting: A randomized controlled trial. Addiction, 120(11), 2231–2244. https://doi.org/10.1111/add.70097
