If you or someone you love is in addiction treatment, you’ve probably heard EMDR mentioned. It sounds strange the first time it’s described — following a therapist’s fingers with your eyes to treat a drinking problem? Here’s what it actually is, what the evidence does and doesn’t say, and when it makes sense.
What EMDR is
EMDR (Eye Movement Desensitization and Reprocessing) is a structured, eight-phase psychotherapy developed by Francine Shapiro in the late 1980s. It was designed for trauma, and that’s where its evidence base is strongest — it’s recommended for PTSD by the World Health Organization and the American Psychological Association.
The mechanism, in plain terms: traumatic memories can get stored in a raw, unprocessed form. They don’t feel like the past. They intrude, they carry their original emotional charge, and the body reacts as though the event is happening now. EMDR asks you to hold a piece of that memory in mind while engaging in bilateral stimulation — usually guided eye movements, sometimes alternating taps or tones. Over repeated sets, the memory tends to lose its charge. It becomes something that happened, rather than something happening.
You are not hypnotized. You don’t lose awareness. You don’t have to narrate the memory in detail out loud, which is part of why some people tolerate EMDR when they can’t face traditional talk therapy.
What does eye movement have to do with addiction?
The link is trauma. A large share of people with substance use disorders have significant trauma histories, and the substance is frequently doing a job — shutting off intrusive memories, numbing hyperarousal, making it possible to sleep. If that’s what’s happening, then getting someone sober without touching the trauma removes the coping mechanism and leaves the injury.
That’s the clinical logic for EMDR in addiction treatment: it isn’t aimed at the drinking or the using directly. It’s aimed at what the drinking or using is managing.
Being honest about the evidence
We’d rather tell you this than have you discover it later:
- For PTSD, the evidence is strong. EMDR is a well-established, guideline-recommended trauma treatment.
- For addiction specifically, the evidence is promising but thinner. Studies on EMDR as a standalone addiction treatment are smaller and more mixed than the PTSD literature. The strongest support is for EMDR treating trauma in people who also have a substance use disorder — and for the downstream effect that has on cravings and relapse risk.
- It is not a replacement for addiction treatment. Any program presenting EMDR as a cure for addiction is overselling it.
The accurate framing: EMDR is a powerful component of a comprehensive treatment plan for people whose substance use is entangled with trauma. It is not the plan by itself.
Who EMDR tends to help most
In our clinical experience, the people who benefit most from EMDR in an addiction program are those who:
- Have a clear trauma history — childhood adversity, assault, combat, a serious accident, medical trauma, or sustained emotional abuse.
- Relapse in response to emotional triggers rather than social or situational ones.
- Have intrusive memories, nightmares, or flashbacks that get worse in early sobriety, once the substance stops suppressing them.
- Have done talk therapy, understand their patterns intellectually, and still feel the same in their body.
- Struggle to talk about what happened — EMDR requires far less verbal disclosure than most trauma therapies.
When EMDR should wait
Timing matters, and a responsible clinician will sometimes tell you not yet:
- During active withdrawal or acute intoxication. Trauma processing requires a regulated nervous system. Medical stabilization comes first.
- Before there’s stability and coping capacity. Opening trauma material in someone with no sober coping skills and no support structure can precipitate relapse. Phases 1 and 2 of the EMDR protocol exist for exactly this reason — history-taking and resourcing come before any reprocessing.
- Without adequate support between sessions. Processing continues after you leave the room. That’s an argument for doing EMDR inside a structured program rather than as an isolated weekly appointment.
What a session is actually like
The first sessions involve no reprocessing at all. Your therapist takes a history, identifies target memories, and — importantly — builds your capacity to self-regulate, often through exercises like establishing a “calm place” you can return to.
When reprocessing begins, you’ll be asked to hold a specific image, the negative belief attached to it (“I’m not safe,” “it was my fault”), the emotion, and where you feel it in your body. Then come sets of bilateral stimulation, typically 30 seconds or so, with brief check-ins between. You report whatever came up — an image, a thought, a sensation — and continue. The disturbance is rated periodically on a 0–10 scale, and the session works toward bringing it down and installing a more accurate belief in its place.
Sessions usually run 60–90 minutes. Some people notice shifts within a handful of sessions; others need considerably more, particularly with complex or repeated trauma.
How to vet an EMDR therapist
“EMDR-informed” is not a credential. Ask directly:
- Are you EMDR-trained or EMDR-certified? Certification through EMDRIA requires training, consultation hours, and ongoing education beyond a basic weekend course.
- Do you have experience with addiction specifically? Sequencing trauma work alongside early recovery is a distinct skill.
- How do you decide when I’m ready to reprocess? A good answer involves stabilization and resourcing, not a start date.
- What happens between sessions? You want a plan, not a shrug.
EMDR at Totality Treatment Center
At Totality Treatment Center in West Los Angeles, EMDR is delivered by certified clinicians as part of our outpatient programs rather than as a standalone service — which means the trauma work is coordinated with your group therapy, psychiatric medication management, and family work, and there’s clinical support in place between sessions.
That coordination is built into how our programs run. We operate five groups concurrently from 9:30am to 3:30pm — three in person at our Olympic Blvd office, two by telehealth — organized around three clinical tracks: substance abuse, mental health, and dual diagnosis. Those tracks subdivide by specialty, and trauma is one of the main reasons they do: someone doing active EMDR work often belongs in a different room from someone whose primary need is psychiatric stabilization, even when both sit under the same track. Running the groups at the same time lets us place people by clinical need rather than by whichever group has space.
EMDR is available within our Partial Hospitalization Program (PHP), our Intensive Outpatient Program (IOP) — including the evening telehealth track for people who can’t attend a full day — and most intensively within our Individualized Intensive Program (IIP), where clients receive up to 8–10 private clinical sessions per week. Sessions can be delivered in person or via telehealth across California.
We’re in-network with Optum, Blue Shield, Anthem, and Health Net, and we work with most major PPO plans.
To ask whether EMDR is appropriate for your situation, speak with our clinical team confidentially: (855) 619-5383
Common questions
Does EMDR work for addiction?
The evidence is strongest for EMDR treating trauma in people who also have a substance use disorder, with meaningful downstream effects on cravings and relapse risk. It is not established as a standalone addiction treatment and should be one component of a comprehensive plan.
How many EMDR sessions will I need?
Single-incident trauma sometimes resolves in 6–12 sessions. Complex or repeated trauma — the more common picture in addiction — typically takes longer, and the work is usually paced alongside the rest of treatment.
Is EMDR safe in early recovery?
It can be, with proper sequencing. Medical stabilization and coping-skill development come first; reprocessing begins once you can regulate between sessions. This is why EMDR inside a structured program is generally safer than EMDR as an isolated weekly appointment.
Can EMDR be done over telehealth?
Yes. EMDR is routinely delivered via telehealth using on-screen bilateral stimulation or self-administered tapping, and we offer it that way across California — including within our evening track. Whether it’s the right format for you depends on your stability and home environment, which we’ll assess together.
Will I have to describe what happened in detail?
No. Far less verbal disclosure is required than in most trauma therapies, which is one reason it’s tolerable for people who freeze up in traditional talk therapy.
Does insurance cover EMDR?
Generally yes, when delivered by a licensed clinician as part of medically necessary treatment. We’re in-network with Optum, Blue Shield, Anthem, and Health Net and can verify your specific benefits.
