Dr. Stephen Dansiger is the Clinical Director of Refuge Recovery Centers (RRC). He is an EMDRIA Approved Consultant and Training Faculty for the Institute for Creative Mindfulness. He is the author of Clinical Dharma: A Path for Healers and Helpers and co-author of EMDR Therapy and Mindfulness for Trauma Focused Care, coming November 2017 on Springer Books.
Like many of the doctors, therapists, and educators that have gravitated to Refuge Recovery Centers, Dr. Steve started out in rock n’ roll. After getting sober in the 1980s and being in the two NYC-based art bands Pianosaurus and King Missile, Dr. Steve eventually focused on how to use the emerging practice of EMDR therapy to treat trauma and drug addiction. Below is a conversation that discovers the distinct benefits of working with EMDR, mindfulness, and Buddhism to treat drug and alcohol addiction. Dr. Steve is one of the foremost authorities regarding EMDR therapy and sobriety in the United States.
How and when did you get involved with Refuge Recovery Centers?
Noah and I have known each other for over 20 years. In 2013, I had left the treatment world and was hoping to put together a center that was more trauma-focused and had mindfulness at the core. So we started having breakfast together and mapped it out.
I’m not familiar with the term “EMDR” – how does it work?
One of the easiest ways to understand EMDR (Eye Movement Desensitization Reprocessing) therapy is with the World Health Organization’s definition: This therapy is based on the idea that negative thoughts, feelings, and behaviors are the result of unprocessed memories. The treatment involves standardized procedures that include focusing simultaneously on (a) spontaneous associations of traumatic images, thoughts, emotions and bodily sensations and (b) bilateral stimulation that is most commonly in the form of repeated eye movements. Like CBT (Cognitive Behavioral Therapy) with a trauma focus, EMDR aims to reduce subjective distress and strengthen adaptive beliefs related to the traumatic event. Unlike CBT with a trauma focus, EMDR does not involve (a) detailed descriptions of the event, (b) direct challenging of beliefs, (c) extended exposure, or (d) homework.
How does EMDR compare to other modalities being used by addiction recovery centers?
EMDR therapy is used as an adjunctive therapy at many centers with varying degrees of effectiveness. What we are doing at Refuge Recovery Centers that is different is we are using EMDR therapy and mindfulness as the organizing principles through which we develop our program and treatment planning. In this way, EMDR therapy takes both a therapeutic and a structuring role at the center, which we believe in conjunction with mindfulness, provides the best structure for trauma resolution and long-term sustainable recovery. It is less about how EMDR therapy compares and more about how our model, the MET(T)A Method (Mindfulness and EMDR Treatment Template for Addictions) compares… it provides a structure and a treatment for the underlying issues of the addict, while also addressing urges, triggers, and other difficulties.
What is the role of trauma in addiction?
I had a mentor who once said, “Addiction: genetics, trauma, or both.” In a sense, trauma has a giant role in addiction. Whatever the genetic predisposition toward using is the events in a life (including the addictive behavior itself) can help lead to addiction, exacerbate it, and maintain it. Many in the field, including Gabor Mate and others, have noted that untreated trauma is a major factor in relapse. It is not true for all those suffering from addiction, but a vast majority are self-medicating their unresolved trauma and subsequent adverse life events that they were not able to tolerate without substances or addictive behaviors.
How do I know if I am ready for addiction recovery?
As one marker, one could use the World Health Organization definition of addiction: The compulsive, repetitive use of a substance despite negative consequences. For some a slightly strained relationship can meet the criteria, for others, it’s a near death experience. Is the use compulsive? Repetitive? Is it having a negative impact on their life? Consider how that could change with treatment.
What does successful completion of Refuge Recovery Centers programs look like?
The client takes away a solid training in mindfulness, some healing of their trauma, and a readiness to go back into life while continuing using the tools they learned in treatment.
What tools does Refuge Recovery Centers give/teach clients?
Buddhist philosophy – the Four Noble Truths, the Eight-Fold Path, the Refuge Recovery program, insight meditation and heart practices, trauma informed and trauma-focused abilities, Refuge inventories, a client’s one-on-one relationships with their therapists, group, and sangha/community.
When you say EMDR is evidence-based, what does that mean? Where can I find studies about how this works?
The World Health Organization, both the American Psychological Association and the American Psychiatric Association, all the branches of the military, and numerous other institutions say that EMDR therapy is evidence based specifically for PTSD. Evidence is building for other dilemmas, including addiction. One can go to emdria.org to find the research and more information on EMDR therapy.
Are there other addiction facilities that are based on EMDR, or is Refuge Recovery Centers unique?
Other facilities utilize EMDR therapy as an adjunctive (ie. added) modality. At this time, Refuge Recovery Centers is unique in using it as an organizing principle, the theoretical orientation, and the primary clinical practice.