Eye Movement Desensitization and Reprocessing (EMDR) by Bronwyn Shroyer, LCSW & Caitlin Pinciotti, PhD
BRIEF DESCRIPTION:
Eye Movement Desensitization and Reprocessing (EMDR) was developed as a therapy to treat post-traumatic stress disorder (PTSD). Although there is research that supports the use of EMDR for PTSD, more research is needed before it should be considered a first-line treatment for OCD.
There are various EMDR protocols for the treatment of OCD, but these have only minimal research to support them. Some of these protocols use imaginal exposure scripts similar to those used in exposure and response prevention (ERP). To this may be added an element called bilateral stimulation which involves tapping on a surface, using pulsating tappers, or following your therapist’s fingers as they move them back and forth in front of your eyes. Other protocols use what is called a “‘flash forward”’ technique where you imagine the situation you fear most in regards to your OCD and attempt to make that imagined situation no longer distressing.
EMDR is divided into eight phases and begins with psychoeducation, history taking, treatment planning, and a preparation phase that can include grounding exercises, skills assessments, and resource development. You and your therapist will then identify material that causes you pain or discomfort. In the case of PTSD, usually this is a traumatic memory. In the case of OCD, it can be your current distressing thoughts/images or the worst case scenario that you are concerned could happen if you do not listen to your intrusive thoughts, such as by doing compulsions.
WHY/HOW IT WORKS:
Due to limited research about EMDR for OCD, we do not know if it could be a beneficial treatment for OCD and, if so, how or why it might be helpful. We know that imaginal exposures, where a person imagines worst-case scenarios or distressing situations, can help improve symptoms as part of ERP. Since EMDR also uses imaginal exposures, this could be why it also may be beneficial for some people with OCD. More research is needed to understand why it works.
SUMMARY OF THE RESEARCH SUPPORT:
EMDR for OCD does not have a large body of research. Of the studies that have been published, many are anecdotal case reviews (e.g., describing one client’s individual experience with EMDR) and for those that involve analyzing data, most have small sample sizes. This makes it difficult to know whether the treatment could work for a large number of people. More research studies with bigger sample sizes and well-designed methods are needed before EMDR could be considered an evidence-based treatment for OCD.
AGE CONSIDERATIONS
EMDR has been studied in different age groups for PTSD, but there is limited research on EMDR for OCD. The studies that are the most cited in regards to EMDR and OCD have been done in adult populations, so it is unclear whether it could be beneficial for younger people with OCD.
OTHER IMPORTANT CONSIDERATIONS:
Since EMDR is evidence based for the treatment of PTSD/trauma memories, it could be an effective part of an overall treatment plan for PTSD if you have co-occurring OCD and PTSD. Since there is limited research at this time regarding using EMDR to treat OCD, it is difficult to know if there are certain OCD subtypes or insight levels that may or may not respond to EMDR.
WHEN TO TRY THIS TREATMENT:
EMDR is not an evidence-based treatment for OCD and is therefore not recommended as a stand-alone treatment.
EMDR could still be recommended as part of an overall treatment plan to treat trauma/PTSD in co-occurring OCD and PTSD.
There are evidence-based alternatives to EMDR; you can read more about them on this website.