Benzodiazapines like Xanax, Ativan, Klonopin, Valium, Antihistamines such as Hydroxyzine, Beta Blockers like Propranolol and Atenolol and even other non-Benzodiazapine sedatives like Ambien and Lunesta can be very useful for the treatment of anxiety as an adjunct to psychotherapy. While the antihistamines and beta blockers may be better and safer choices, the use of Benzodiapines is meant to be short term.
Unfortunately, these medications are generally not recommended during EMDR (Eye Movement Desensitization and Reprocessing) therapy because they can interfere with the therapeutic process.
Here's why:
1. Dampening Emotional Processing
EMDR relies on the client's ability to access and process distressing emotions and memories.
Benzodiazapines, which are sedatives, can dull emotional intensity, making it harder for clients to fully engage with the target memories and emotions necessary for reprocessing.
2. Impairing Memory Consolidation
Benzodiazepines like Xanax can impair memory formation and recall, which are critical components of EMDR therapy.
EMDR requires clients to connect past experiences with current emotions and beliefs, and this can be hindered if memory recall is affected.
3. Reducing Arousal Too Much
EMDR works best when clients are in a "window of tolerance"—not too distressed, but not too calm or sedated either.
The medications may overly suppress the arousal needed for effective processing, preventing the client from confronting and reprocessing trauma.
4. Masking Symptoms
These types of medications can temporarily alleviate anxiety, which may mask the symptoms EMDR is designed to address.
This can limit the therapy’s effectiveness, as the root causes of anxiety and trauma might not be fully addressed.
5. Dependence and Avoidance
Regular use of Benzodiazapines can create a reliance on the medication to manage distress, which may reinforce avoidance of emotional processing—contrary to the goals of EMDR.
This information is evidence based and the following studies below provide a deeper understanding of EMDR therapists' concerns of clients using these medications during the reprocessing phase of EMDR.
Potential Impacts of Benzodiazepines on EMDR Therapy:
Impaired Memory Processing: Benzodiazepines can affect memory formation and recall, which are crucial for therapies that involve processing traumatic memories. This impairment may hinder the effectiveness of treatments like EMDR that rely on accessing and reprocessing traumatic experiences.
U.S. Department of Veterans Affairs PTSD
Reduced Treatment Efficacy: Some studies indicate that benzodiazepine use may diminish the effectiveness of exposure-based therapies. For instance, research on exposure therapy for PTSD suggests that benzodiazepines might inhibit therapeutic response, potentially due to their anxiolytic effects reducing the necessary emotional engagement during sessions.
Symptom Suppression Without Resolution: While benzodiazepines can provide short-term relief from anxiety symptoms, they may not contribute to long-term resolution of underlying trauma. Their use could potentially interfere with the emotional processing required in therapies like EMDR, leading to symptom suppression rather than resolution.
If you're using one of these medications but would still like to participate in EMDR therapy, talk to your therapist and your medication provider. They should be able to talk with you about strategies that may include adjusting timing or switching you to a non-sedating medication for your anxiety.
Alternative Approaches
If anxiety is a significant barrier to participating in EMDR:
Grounding Techniques: Clients can use breathing exercises, mindfulness, and other grounding tools to manage distress.
Non-Sedating Medications: SSRIs or other non-sedating medications might be better options for managing underlying anxiety during EMDR therapy.
Psychoeducation: Learning about the nature of trauma and the temporary discomfort of processing can help clients feel more prepared to engage in EMDR without sedatives.
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