The 4-fields-technic in the traumatherapy of complex traumatized and drug-addicted people (in methadone-treatment)


Nowadays several international studies demonstrate that the problem of drug-addiction is very often found in combination with complex traumatization in early childhood and youth. (Felitti. 2903; Kufner et al. 2000; Langeland et al. 2006; Schmidt, 2000 etc.) As we all know PTSD and the other trauma symptoms cause a lot of psychophysical dysregulation. So the psychiatrist Khantrian postulated already 1985 the "self-medication hypothesis of addictive disorders". Janina Fisher, Trauma Center Boston, 2000, called this assumed combination of trauma-consequences and drug-addiction, "compensatory strategies aimed at self-regulation" In many years of working with drug-addicted people it became very obvious that a high percentage of this people are using drugs, for example to calm down after being aggressive, may be caused by an argue: or to reduce strong inner tensions; to sleep without nightmares, to alleviate the feeling of helplessness and fear etc. Drugs and alcohol do reduce all the mentioned symptoms for a while. To learn to cope in another, more adaptive way, the addicted people need to learn alternatives strategies for a good functioning self-regulation. After stabilization, the trauma therapy can start, so the patient can reduce some of the sources of psychophysiological dysregulation. Even when the addicted people still get methadone psychotherapy is possible. Practical experience over a long time. started 1990, did show a lot of successful treatments and that methadone does not interfere a traumatherapy. The 4-Fields-Technic is a special method of EMDR that was developed by Jarero et al. 1997 in Mexico after a hurricane disaster. Dorothee Lansch modified the group method into a therapy-setting for single persons. For complex traumatized and drug-addicted people this technic is very helpful. The focus is more easy to keep in mind, - in front of the eyes. In the 4-Fields-Technic the patient focuses on a self-painted picture, that represents the worst part of a trauma experience. The patient keeps his focus on this picture, combined with bilateral stimulation, till he feels the picture should be changed. And so the process is going on till finished. The participant will be able to learn: - about the correlation between complex trauma and drug-addiction - that drug-addicted people who get methadone are able to do trauma therapy -the 4-Fieids-Technic as a method to create resources. Psychotherapy and specially psychotraumatherapy with drug-addicted people who are as well in a methadone-treatment is for many therapists still controversial. This presentation will give you an idea how good it can work, based on various case series.






Angelika Koshal

Original Work Citation

Koshal, A. (2010, June). The 4-fields-technic in the traumatherapy of complex traumatized and drug-addicted people (in methadone-treatment). In Addictions. Symposium conducted at the 11th EMDR Europe Association Conference, Hamburg, Germany



“The 4-fields-technic in the traumatherapy of complex traumatized and drug-addicted people (in methadone-treatment),” Francine Shapiro Library, accessed November 26, 2020,

Output Formats