Eye Movement Desensitization and Reprocessing (EMDR) therapy is a treatment for symptoms of trauma. Some limited research suggests it could also help with obsessive compulsive disorder (OCD).
EMDR works by reducing the intensity of traumatic memories, making them less distressing and helping the brain process them.
OCD may have an association with traumatic experiences, which could explain why this therapy benefits some people with the condition. However, research into this connection is still ongoing.
Read on to learn whether EMDR for OCD works, what to expect, potential side effects, and more.
In 2017, a randomized controlled trial involving 55 participants found that EMDR worked as effectively as cognitive behavioral therapy (CBT), one of the most popular therapies for OCD.
Overall, 30.2% of participants reported a significant improvement in their symptoms during the treatment course, with similar results in both the EMDR and CBT groups.
However, similarly to other studies on EMDR and OCD so far, this trial had a small number of participants and did not last a long time.
A 2023 review of the research to date states there is not enough data to show that EMDR works reliably as a stand-alone treatment for OCD, but people may find it useful as an additional therapy.
EMDR may be especially useful for people with a history of trauma or OCD that has not responded to other treatments.
Studies on EMDR for OCD tend to focus generally on all the symptoms. So far, none have looked at EMDR for intrusive thoughts alone.
However, a few studies on EMDR for OCD have noted reductions in symptoms, which may include intrusive thoughts.
Because there is a lack of research on EMDR for OCD, there is no standardized protocol that all practitioners use. But EMDR generally involves eight stages:
- History taking: A qualified mental health professional takes the person’s history. They may ask the person which memories or triggers they want to target and their goals for treatment.
- Preparation: Next, the professional explains how EMDR works and what it can do. They may also provide techniques for managing symptoms during and after treatment, such as breathing techniques or imagining a safe, calm space. They will also tell the person how to signal that they want to stop if the EMDR becomes overwhelming.
- Target memory activation: This stage involves a series of questions that “activate” the target memory. This may only take 30 seconds.
- Desensitization: At this point, the main part of the treatment begins. The therapist asks the person to recall the traumatic memory while they perform bilateral stimulation. This could involve following a dot on a screen from left to right, sounds that occur on different sides of the head, or both. A person continues focusing on the memory until their distress disappears.
- Installation: When the desensitization portion is finished, the therapist uses further bilateral stimulation to help the person associate a new belief with the memory until they feel it is true. This could be a belief such as “I am safe.”
- Body scan: The practitioner may ask the person to scan their body for any continuing signs of discomfort or stress. If there are any, the practitioner will continue bilateral stimulation until it has gone.
- Closure: The practitioner helps the person return to the present moment, concluding the session.
- Evaluation: At the beginning of the next session, the practitioner will ask how the treatment is going and the effect on symptoms. If one memory is no longer distressing, they may suggest moving on to another.
For OCD specifically, some practitioners may focus more on current triggers or obsessions rather than memories, or address these first.
There is no consensus on how many sessions of EMDR are effective for OCD. Some people may notice significant improvements quickly, while others may require more sessions.
For PTSD, the U.S. Department of Veteran Affairs says it is typical to have weekly sessions for 1 to 3 months.
People can work with their practitioner to determine the right number of sessions for them.
No studies have shown that EMDR makes OCD worse long term, but EMDR can temporarily bring up distressing emotions and memories. Some people may find this difficult while it is happening.
According to the nonprofit PTSD UK, the distress upon recalling these memories should peak quickly before rapidly reducing. If it does not decrease on its own, the therapist will have techniques to help this process.
Some of the other potential side effects of EMDR include:
- big releases of emotion, such as crying
- physical sensations
- tiredness
- vivid dreams
- temporary increase in sensitivity to others, or to external stimuli, such as noise
- unexpected memories or emotions that emerge during, or outside of, sessions
A good EMDR practitioner will explain any potential side effects to the person before they begin and provide tools for managing them.
If OCD symptoms worsen outside of sessions, the person should tell the therapist about this. The therapist may decide to go more slowly, take more breaks, or make other adjustments to make treatment more comfortable.
EMDR may not be the right treatment approach for everyone. According to a 2022 research article, people with the following symptoms may need to address these first before they can consider EMDR:
- severe substance use
- psychosis
- self-harm
- suicidal thoughts or ideation
- a history of violence or violent urges
Note that violent urges are different from intrusive thoughts. While intrusive thoughts may sometimes contain upsetting content, they do not necessarily reflect a person’s actual desires, and so are not a barrier to EMDR.
EMDR may also not be suitable for people who experience dissociation and have no other means of managing difficult emotions.
If a person often experiences dissociation, a therapist may work with the person to first develop other coping skills. Once these are in place, EMDR may be appropriate.
Other potential concerns include:
- the use of certain medications, such as benzodiazepines, as these may slow EMDR progress
- epilepsy or psychogenic nonepileptic seizures
- visual impairments
- neurological impairments
- severe physical health problems
- a lack of social support during treatment
Additionally, while the risks of EMDR in pregnancy are likely low, there is a lack of evidence assessing its safety. Pregnant people may need to weigh the benefits and risks with their therapist.
Help is out there
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
- Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
- Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
- Call 911 or your local emergency services number if you feel safe to do so.
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you’re not in the same household, stay on the phone with them until help arrives.
Some research suggests that OCD may have a connection to traumatic experiences. EMDR, in its original form, is a trauma therapy. This has led some researchers to suggest EMDR could be useful for a range of conditions, in addition to PTSD.
Some small studies found benefits in using EMDR for OCD. However, scientists are still investigating this. At the moment, there is not enough evidence to confirm if EMDR works reliably for all people with OCD, but it could be useful for some.
People who are interested in EMDR can look for a qualified therapist with experience treating OCD. For severe symptoms or thoughts of self-harm, seek immediate help.
