In the Westport House model, integrated services is a concept merging sober living, outpatient treatment, employment, academics, wellness, and life skills into a working whole – successfully launching clients into life with a solid foundation in recovery. We have created an environment that is both small and intimate to facilitate the variety of needs, goals, and expectations that the client, referring provider and family are searching for to increase the probability of long-term recovery from addiction and co-occurring disorders.
Each young man who walks through the doors of Westport House relies on the individualized treatment planning we offer based on the clinical needs that are assessed upon admission. When a client has been exposed to a traumatic experience, often they turn to drugs and alcohol to numb the pain or look to self-harming behaviors. Although this can be addressed in an inpatient facility, it is up to the aftercare provider to deliver a continuum of care that will facilitate the ongoing trauma treatment required for healthy change and freedom from the crippling emotions/events that bind them. Liz Modugno, trauma trained primary therapist, takes the time to describe the vital importance of trauma treatment in conjunction with treating substance use disorders.
TRAUMA, ADDICTION, AND EMDR THERAPY
What is trauma?
Addiction and psychological trauma go hand in hand. Trauma can come from any severely distressing event, such as a natural disaster, a severe accident, assault or any other perceived life threat. It can contribute to addiction, or addiction can be the trauma. Not everyone who struggles with an addiction has experienced a significant trauma, but often some experiences negatively shape the way individuals see and understand themselves and the world around them.
To better understand trauma, we can look at how traumatic experiences are stored differently in the brain than pleasant or neutral experiences. If I were to ask you to bring up a pleasant memory, maybe of an accomplishment in your life, you might remember a beautiful location, friendly company or the positive emotions your felt in some kind or organized and pleasing way. Unlike a pleasant memory, trauma doesn’t store itself in the same way. It is initially fragmented and then stored in a disorganized and often triggering way.
The traumatic experience can reappear consciously or subconsciously when provoked by similar stimuli and bring individuals back to physical feelings of distress, uneasy emotional states, and negative thoughts about self. An example of this could be a child struggling academically may identify as “a failure” or “not good enough.” These negative thoughts can make them feel anxious and distressed. Throughout their life, they may notice other ways they are “a failure” like when they don’t make a particular team or their significant other breaks up with them unexpectedly. Those life events can be difficult to handle and may contribute to why they search for drugs to self-soothe. Later, the negative thoughts may again emerge if the individual struggles to maintain sobriety (i.e. I am a failure because I can’t get sober, maybe I should just keep using).
What is EMDR?
Eye Movement Desensitization Reprocessing (EMDR) Therapy is an eight-phase protocol created by Francine Shapiro in the late 1980s. EMDR has been scientifically researched over the last 30 years becoming an evidenced-based treatment for Posttraumatic Stress Disorder (PTSD), Depression and a promising treatment for addiction disorders. The first stages of the therapy are used to stabilize the client and teach positive copings skills such as deep breathing, guided meditation, mindfulness and grounding skills. After the client can regulate their effect in a healthy way, negative cognitions are identified and linked to specific experiences in their lives. The overall process of EMDR therapy allows clients to desensitize to the adverse cognitions of self (i.e. “I’m a failure” or “I’m not good enough”) and create more positive cognitions in their place (“I did the best I could” or “I can succeed”).
EMDR Therapy and Addiction
There is an obvious link between substance abuse and trauma, but research continues to explore the comorbid correlation. Research has shown those with substance use disorders are between two to five times more likely to have a history of trauma compared to those without substance use disorders. EMDR therapy has specific protocols to target and treat a variety of disorders and addictions. Traumatic events that happened before or during addiction can be targeted, desensitized and reprocessed into memories that cause much less disturbance than initially felt.
EMDR can also target distress in recovery by using addiction-specific EMDR protocols that desensitize and reprocess triggers, urges, and cravings. Individuals can gain great insight and self-awareness into behaviors that cause and contribute addictions or relapses. EMDR can also be used to prepare people for a sober life by recognizing possible concerns about the future. They may be asked to imagine realistic situations that can become a trigger to relapse. Then, they can enhance refusal skills, create positive cognitions to combat cravings, identify and desensitize negative thought patterns, and identify positive cognitions that can empower them to make healthy choices in the future. In our experience, EMDR has been an effective therapy, and has shown to significantly change the experience for clients struggling with substance abuse and trauma.
Liz Modugno, LCSW, LADC