By Lara Boerth-Dryden
What is OCD?
Obsessive-Compulsive Disorder is a disorder where individuals suffer from intrusive thoughts and unwanted obsessions and/or compulsions. Patients with OCD may also suffer from other disorders like depression or social anxiety. OCD is considered an anxiety disorder because the compulsions and obsessions are performed to reduce distress/anxiety; however, there are discussions about whether it should be classified within an Obsessive-Compulsive Spectrum instead.
EMDR + OCD
Many sources indicate that Shapiro’s protocol for treating OCD with EMDR therapy increases the rate of processing anxiety and reducing unintended responses. This is also apparent in the treatment of patients with PTSD and other disorders. A literature review of studies focusing on EMDR therapy and OCD concludes that “a large proportion of individuals suffering from an anxiety disorder may benefit from EMDR.” (De Jongh, 2009, p.137). Within the EMDR community, there has been a movement to learn more about how EMDR can help this population. The results have been very promising.
Promising Protocol Progressions:
In terms of protocols, there are multiple resources available to EMDR clinicians who wish to work more effectively with OCD. Since OCD presents specific challenges, many clinicians adopt the standard protocol to better fit a patient’s needs. Multiple studies have found positive results when adapting different phases of treatment for OCD, phobias, and other anxiety disorders.
For example, researchers have found that refocusing the history-taking phase around events surrounding the development of OCD and working to reprocess those events early in the treatment plan yielded improvement in patients with OCD. In a sampling of literature surrounding the efficacy of EMDR and OCD, Karsten Rüdiger Böhm identified studies done by “Keenan (2018), and Nazari (2011)” as examples of positive outcomes when using this type of adaptation (Böhm, 2019, p.334).
Marr describes OCD as “a self-maintaining disorder” (Marr, 2012, p.11). Mar says that “OCD is not one continuous event, but instead, it is a number of interlaced events that both support and re-indoctrinate each other.” Marr experimented with the present prong by zeroing in on current triggers and treated each trigger as a traumatic event.
Another creative and effective EMDR protocol developed for use with OCD, phobias, intrusive thoughts, and other anxiety disorders is Ad de Jongh’s “Flash-Forward Procedure.” This future prong procedure concentrates on identifying and desensitizing an individual’s mental representation of a future “worst-case scenario.” Flash-Forward is described almost like a flashback but is a fear of an imagined, catastrophic future event. For an individual with OCD, this could present as “What happens when I don’t complete my compulsion.” A study done by Paul Keenan used the Flash-Forward Procedure and found that “the use of EMDR Therapy, for those clients with OCD, can bring about some symptom reduction” (Keenan et al., 2018, p.87).
Conclusions
There is a growing body of research that suggests the efficacy of treating OCD with EMDR therapy. One study by David Potik finds that “EMDR therapy can be useful in both reducing OCD imagery and obsessive thoughts” in patients (Potik, 2020, p. 52). In this case study, a patient reported “relief in his mental distress,” after only receiving pharmacological interventions, but continued to struggle with intrusive thoughts and obsessions; however, after receiving EMDR therapy, the same patient-reported, “a sharp decrease in the severity and the disturbance level of his obsessive thoughts” (Potik, 2020, p. 52-53). Marr’s study, as mentioned above, says that applying EMDR therapy to OCD was “a very tolerable process and did not elicit extreme anxiety. Instead, the participants experienced rapid desensitization of the targets with subsequent relief and reprocessing of the related materials” (Marr, 2012,p.13).
Using EMDR therapy for patients with OCD seems to be a valuable tool to promote growth and healing; however, there is still a lot to learn, and a lot more research to be done on the subject.
Lara Boerth-Dryden is a Psychology Major at Florida Atlantic University
References
Cusimano, A. (2018). EMDR in the Treatment of Adolescent Obsessive-Compulsive Disorder: A Case Study. Journal of EMDR Practice and Research, 12, 242-254. http://dx.doi.org/10.1891/1933-3196.12.4.242
de Jongh, A., & ten Broeke, E. (2009). EMDR and the Anxiety Disorders: Exploring the Current Status. Journal of EMDR Practice and Research, 3, 133-140. https://doi.org/10.1891/1933-3196.3.3.133
Ebrahim Sarichloo, M., Taremian, F., Dolatshahee, B., & Alireza Haji Seyed Javad, S. (2020). Effectiveness of Exposure/Response Prevention plus Eye Movement Desensitization and Reprocessing in Reducing Anxiety and Obsessive-Compulsive Symptoms Associated with Stressful Life Experiences: A Randomized Controlled Trial. Iranian Journal of Psychiatry and Behavioral Sciences. https://doi.org/10.5812/ijpbs.101535
Keenan, P., Farrell, D., Keenan, L., & Ingham, C. (2018). Treating Obsessive Compulsive Disorder (OCD) using Eye Movement Desensitisation and Reprocessing (EMDR) Therapy: An Ethno-Phenomenological Case Series. International Journal of Psychotherapy, 22, 74-91. https://www.researchgate.net/profile/Derek-Farrell-3/publication/330093373_Treating_Obsessive_Compulsive_Disorder_OCD_using_Eye_Movement_Desensitisation_and_Reprocessing_EMDR_Therapy_An_Ethno-Phenomenological_Case_Series/links/5c2d0a58a6fdccfc707829f2/Treating-Obsessive-Compulsive-Disorder-OCD-using-Eye-Movement-Desensitisation-and-Reprocessing-EMDR-Therapy-An-Ethno-Phenomenological-Case-Series.pdf
Marr, J. (2012). EMDR Treatment of Obsessive-Compulsive Disorder: Preliminary Research. Journal of EMDR Practice and Research, 6, 2-15. http://dx.doi.org/10.1891/1933-3196.6.1.2
Potik, D. (2020). Case Report: Pharmacotherapy and EMDR Psychotherapy as an Effective Treatment for OCD Imagery in a Patient with a Psychotic Disorder. Israel Journal of Psychiatry, 57, 47-54.
RĂĽdiger Böhm, K. (2019). EMDR’s Efficacy for Obsessive Compulsive Disorder. Journal of EMDR Practice and Research, 13, 333-336. http://dx.doi.org/10.1891/1933-3196.13.4.333
