This Protocol is a Powerful EMDR-based Approach for Addictions and Compulsions
(research published R. Miller, 2010)
Author: Susan Brown, LCSW, BCD, San Diego, CA
What addictions respond to the FSAP?
Substance and behavioral addictions and compulsions (alcohol and drugs, including nicotine), gambling, pornography, compulsive eating, shopping, self-harm (cutting, hair pulling, skin-picking), sex addiction, and “love addiction” (the addiction to a person), can be treated with a modified EMDR protocol called the “Feeling-State Addictions Protocol (FSAP), developed by Dr. Robert Miller, from the EMDR treatment approach.
Intense Desired Feeling connected to a Behavior or Substance can create an Addiction
In a nutshell, the Feeling State Theory of Addictions and Compulsions proposes that addictions are created when a desired feeling and a behavior get “fixated” together. For example, a social gambler who hits a big win can experience such an intense feeling of being a “winner”, that the behavior and the feeling become fixated together, later becoming a compulsion (addiction). The person’s desire for that feeling is an important part of the creation of an addiction. If that person spent their early life being told what a “loser” they were and really believed it, they would be more vulnerable to an extreme “connection” to feeling like a winner, than someone who did not have that longing.
Pornography Addiction Example
In the case of pornography, a person’s pre-existing loneliness and sense of disconnection with others can leave them vulnerable to “feeling connected” to another when looking at pornography. In addition, the intense feelings associated with sexual images and behaviors themselves are extremely stimulating and compelling in their own right. But of course compulsive viewing of pornography is not true intimacy, just a fantasy….but one with a great deal of sensory power, easily fixated given the right conditions and the right “neediness” inside oneself.
Chemical or Substance Addiction Examples
With chemical addictions, the substances themselves are capable of creating a “feeling-state”: the “high” that is experienced when alcohol or other drugs are ingested. Other feelings can be generated as well, such as “I’m popular”, “I’m powerful”, “I can do anything”, etc. Any feeling can be connected to any behavior…there is no one formula for what feeling-states will be connected with which behavior for each individual person. A sex addict can feel both “powerful” and “desirable”, but those feelings can also be associated with gambling, or love addiction.
How Addictions Progress to “Out of Control”
Once the addictive process sets in, the person’s life begins to spin completely out of control. Even in the face of disastrous relationship, legal, professional, and financial consequences, the person persists in the behavior, which appears completely irrational. The problem is that addictions (all of them) do defy rationality. Dishonesty about one’s behavior and complete loss of control, despite severe adverse life consequences are two hallmarks of addictions and compulsions. Food compulsions are particularly insidious because we have to eat…..we don’t have to gamble, drink, or do drugs. But in terms of their origin and continuation, all of these behaviors are considered more alike than they are different.
Addictions may be self-medication for early negative experiences: Leads to vulnerability to seek out intense positive experiences
The concept of a “fixated memory” in addictions comes from the trauma literature. As described in EMDR, when someone experiences a traumatic event (which is in the ‘perception of the experiencer’, not the event itself), the brain can “fixate” on the disturbing event with all the sights, sounds, smells, emotions, thoughts, and body sensations contained within it. If overwhelming enough, the brain cannot “digest” it and the memory becomes “fixed” in time, un-integrated with the more adaptive networks of the brain, leading to symptoms such as anxiety, depression, nightmares, and substance abuse (to medicate the symptoms).
Later, when a reminder of the event occurs, the memory is “triggered” bringing with it all the associated elements of the previous experience, but it is not within the person’s conscious control….it just pops up and intrudes. For example, a person was assaulted near a bakery and months later sat down at a table in a restaurant serving fresh baked bread. Suddenly the person became overwhelmed with anxiety and panic. Why? The smell of fresh bread was a trigger for the stored memory of the assault. If the person doesn’t make the conscious connection, they can feel a bit crazy, but you can see, they are not. That is simply how memory works, through “associated networks” in the brain.
How EMDR and FSAP help the brain regain balance and health
Vulnerability to over-reactivity or over-identification with an intense positive event is pre-dated by an emotional deficit or need for a particular feeling. In the example of the gambler, believing he was a “loser” (resulting from a childhood fraught with chronic criticism), led him to long for the feeling of “being a winner” much more than someone who had experienced a kind parent who nurtured self-worth. EMDR breaks the connections between negative traumatic memories and present day “triggers”, allowing the person to be totally calm when thinking about the memory, knowing it is in the past. The FSAP breaks the fixation between the intensely positive feelings and the behavior, just as EMDR breaks the connection between negativetraumatic memories. With the modified EMDR protocol used in the FSAP, after processing the fixated feelings and behavior, the person no longer has to try to manage or control the behavior, they actually no longer “want” to do the behavior or engage in the substance. The fixation is simply broken and the person regains their “rational” state. The early negative memories are then processed with standard EMDR, followed by processing of the negative beliefs the person has about him or herself as a result of becoming addicted (such as “I can’t do anything right”). In combination, EMDR and FSAP is a very powerful, comprehensive treatment approach for addictions and compulsions.
To link to Susan Brown’s website, click here: www.susanbrownlcsw.com