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Navigating EMDR and Benzodiazepines: Understanding the Risks and Strategies for Effective Trauma Therapy

In the realm of trauma therapy, the intersection of Eye Movement Desensitization and Reprocessing (EMDR) and benzodiazepines presents a nuanced landscape requiring careful navigation. Heather Bell, LCPC, RYT, a seasoned therapist, sheds light on this intricate terrain, emphasizing the importance of comprehending the associated risks and implementing effective strategies for trauma healing. In this blog post, Heather delves into the complexities surrounding the use of benzodiazepines during EMDR therapy, drawing from both empirical evidence and clinical insights to offer invaluable guidance to therapists and clients alike. Let’s embark on a journey to unravel the intricate dynamics of trauma therapy and pharmacological interventions, guided by Heather’s expertise and compassionate approach.

“Taking benzodiazepines during EMDR is not recommended. There isn’t research to show that benzodiazepines completely block processing, but there have been reports that it does reduce treatment efficacy. Other reports have been made that it slows down the processing quite a bit. While it is true that benzodiazepines are still prescribed by some clinicians to manage anxiety, irritability, and insomnia, related to PTSD, it’s important to know the rationale behind why they should be avoided in the context of EMDR. 

With EMDR, we are working to process the traumatic event by recalling the memory and connecting to it emotionally, cognitively, and somatically. Benzodiazepines can promote emotionally numbing emotions that are related to the trauma. In turn, this makes it difficult to truly confront the most difficult parts of the experience and can keep one in a state of avoidance. Research also shows that benzodiazepines impair episodic memory, which is responsible for recalling personally experienced events.  

If benzodiazepines cannot be avoided during the re-processing phase of EMDR, it might mean that more time needs to be spent on the ‘resourcing phase’. This is phase two of EMDR which focuses on developing skills and tools to manage any emotional distress or challenges that may come up as we begin to confront the memory. I usually explain this to my clients as the phase where we “pack your backpack” before we head out on the journey.

In the case that benzodiazepines still are unable to be avoided during the re-processing phase of EMDR, the presenting traumas that have been processed, should be processed again after the client is no longer taking the medication. The need for benzodiazepines should be assessed carefully with any trauma-therapy, understanding that it will likely increase the time required for successful treatment.”

Heather Bell, LCPC, RYT

Alternative strategies or medications that can help clients manage their distress and symptoms during EMDR therapy, such as mindfulness, relaxation, grounding, selective serotonin reuptake inhibitors (SSRIs), and novel treatment approaches that can help promote cognitive flexibility or neuroplasticity such as IV Ketamine therapy. 

 

References:  

Shapiro, F., Eye Movement Desensitization and Reprocessing Therapy Third Edition, 2018 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684331/

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Taylor Carter

Taylor Carter is a dynamic Senior Marketing Manager with a passion for crafting compelling narratives and driving impactful campaigns. She has been an integral part of the Hopemark Health team for the past two years. By combining industry insights and medical facts with a deep understanding of the patient experience, Taylor continuously seeks to uplift and empower individuals on their journey to well-being.

Article by: Taylor Carter