Eye movement desensitisation and reprocessing (EMDR): Mental health-substance use

Substance use disorders remain a persistent social and medical problem. According to a recent report,1 addiction is the number one health problem in the United States. The report notes that when one considers the direct costs of drug-induced health problems, deaths due to accidents, Human immunodeficiency virus (HIV), or drug-related acts of violent crime, there are ‘more deaths, illnesses and disabilities from substance abuse than from any other preventable health condition’.1 Most experts today agree that substance use disorders are a complex interaction between genetics, environment, and experience. ‘Substance dependence is not a failure of will or of strength of character, but a medical disorder that could affect any human being. Dependence is a chronic and relapsing disorder, often co-occurring with other physical and mental conditions’.2 The question remains - Why has it been that over the course of human history, where people and cultures have had access to alcohol and potent mind-altering substances, that only some become addicted while the rest are able to regulate their use? The drugs that people experiencing substance use disorders select are not chosen randomly, but are a result of an interaction between the psychopharmacologic action of the drug and the dominant painful feelings with which they struggle. Edward Khantzian, observed that opiates are often preferred because of their powerful numbing action on the affects of rage and aggression. Cocaine has its appeal because of its ability to relieve distress associated with depression. Although ill-fated, ‘addicts discover that the short-term effects of their drugs of choice help them cope with distressful subjective states and an external reality otherwise experienced as unmanageable or overwhelming’. Thus emerges a compelling hypothesis, which proposes that people use psychoactive substances in an attempt to control painful symptoms resulting from psychological trauma. This is referred to as ‘self-medication’. Some studies in the United States show that more than 50% of people with mental disorders also suffer from substance dependence compared to 6% of the general population.2 It is from our interest in providing integrated treatment for the complex interaction of genes, environment, trauma, and psychological pain as a driving force behind mental health-substance use disorders, that this chapter is written.

Book Section

English

Susan H. Brown
Julie E. Stowasser
Francine Shapiro

Brown, S. H., Stowasser, J. E., & Shapiro, F. (2011). Eye movement desensitisation and reprocessing (EMDR): Mental health-substance use. In D. B. Cooper (Ed.), Intervention in Mental Health-Substance Use (pp. 165-193). United Kingdom: Radcliffe Publishing Ltd