How EMDR Therapy Works for OCD, Anxiety, and Intrusive Thoughts

If you are living with obsessive compulsive disorder, you probably spend a lot of time in “what if” mode. Maybe you have already tried CBT or ERP. Maybe you are up late googling “EMDR Therapy for OCD” and wondering if it could help you feel more like yourself again.

This post walks through OCD, the basics of EMDR, what the research actually says, and how we at Emberly Counseling think about treatment for teens and adults in Pennsylvania. The goal is simple. Clear information, no scare tactics, and practical next steps.

Obsessive-Compulsive Disorder

OCD is more than being neat or “a little particular.” It usually shows up as two parts that feed each other:

• Obsessions
  Unwanted thoughts, images, or urges that feel sticky and upsetting.

• Compulsions
  Things you do to try to feel safer or less guilty, either on the outside (washing, checking, repeating) or on the inside (mental checking, replaying memories, praying in a specific way, counting).

These cycles can take hours, drain energy, and pull you away from school, work, parenting, and relationships. OCD is one of the more disabling mental health conditions globally, not because people are weak, but because the doubt and fear are intense and constant.

OCD can also be linked with:

• childhood experiences of bullying, neglect, or abuse

• medical or birth trauma

• big life changes like pregnancy, parenting, or grief

There is growing research that people with OCD often report higher rates of childhood trauma compared to people without OCD.

So if your symptoms feel “bigger than habits” and wrapped up with old painful memories, you are not imagining it.

Cognitive Behavioral Treatments for OCD

The first line treatments with the strongest research are cognitive behavioral therapies.

The two big ones are:

• CBT (Cognitive Behavioral Therapy)
  Helps you notice patterns between thoughts, feelings, and behaviors, then test them out in real life.

• ERP (Exposure and Response Prevention)
  A specific form of CBT for OCD. You slowly face triggers on purpose (the “exposure”) while not doing compulsions (the “response prevention”), with support and pacing. Over time, your brain learns “this is uncomfortable, but I can handle it, and the bad thing does not actually happen.”

Medication, usually SSRIs, can also help many people by lowering the intensity of anxiety and obsessions so therapy feels more doable.

At Emberly Counseling, we treat ERP and CBT as core tools for OCD. EMDR therapy for OCD is something we may add, not something we use instead of these well-researched approaches.

EMDR Therapy

EMDR stands for Eye Movement Desensitization and Reprocessing. It was first developed to treat trauma and post-traumatic stress disorder (PTSD) and is now considered an evidence based treatment for PTSD in adults and children.

In simple terms, EMDR:

• focuses on memories and experiences that “got stuck” in the nervous system

• uses bilateral stimulation (for example, moving your eyes side to side, tapping your hands, or using vibrating buzzers) while you bring up parts of a memory

• helps the brain refile that memory so it feels more distant and less intense

When EMDR is done well, people usually stay grounded in the room while touching into hard material in small, manageable doses.

EMDR Therapy in the Treatment of OCD

So where does EMDR therapy for OCD fit in?

Clinicians and researchers have started adapting EMDR for OCD in a few different ways:

• targeting traumatic memories that seem connected to OCD starting or spiking

• targeting the first time OCD really disrupted life (for example, missing school, getting in trouble at work)

• working with “flash-forward” scenes, such as the worst case scenario you fear if you do not do your compulsions

• combining EMDR procedures with exposure ideas from ERP

Some EMDR therapists have developed full treatment models specifically for OCD. One example is the Distancing Approach, which uses:

• the EMDR phobia protocol

• a “distancing” technique to help you see OCD thoughts from a little more space

• future rehearsal that blends EMDR and ERP ideas to practice facing triggers without compulsions

Treatment Conceptualization

At Emberly Counseling, we like to be transparent about how we think about treatment so you know there is a plan.

When someone comes in asking about EMDR therapy for OCD, we look at a few layers:

1. OCD symptoms right now

   • What obsessions are showing up?

   • What compulsions or avoidance are taking time and energy?

   • How is this affecting school, work, parenting, and relationships?

2. History of OCD and anxiety

   • When did OCD first start to get in the way?

   • Were there specific events that seemed to “flip a switch”?

3. Trauma and attachment history

   • Past experiences of abuse, bullying, medical trauma, birth trauma, or chaotic homes

   • Messages you got about feelings, mistakes, and being “good”

4. Core beliefs and inner critic
   Many people with OCD carry painful beliefs like “I am a bad person,” “I am dangerous,” or “I am disgusting,” especially when obsessions are about harm, sex, or religion.

From there, we decide together:

• what makes sense to address with CBT or ERP first

• where EMDR might help process past experiences that keep OCD “fired up”

• how to pace the work so you feel safe, seen, and supported, not flooded

We do not force a one-size-fits-all protocol. Your pace with a plan matters.

EMDR Therapy and OCD

When EMDR is added for OCD, sessions might include:

• mapping out your OCD cycle so we can see how obsessions, compulsions, and avoidance fit together

• building grounding skills and inner resources first (this is non-negotiable if you have a trauma history)

• choosing target memories or worst case images that connect to your OCD

• using bilateral stimulation while you hold pieces of these experiences in mind

• pausing often to check in with your body, your emotions, and your sense of safety

Over time, many people report:

• less emotional charge around triggers

• less shame about their thoughts

• more ability to use ERP skills in daily life

The research so far is hopeful but still early. Small studies and one randomized controlled trial suggest EMDR may reduce OCD symptoms and sometimes works about as well as CBT for people who complete treatment. In some studies, EMDR plus ERP outperformed ERP alone, especially when trauma was part of the picture.

At the same time, the International OCD Foundation is clear. EMDR is not yet considered a first line, stand alone treatment for OCD. The evidence base is modest and more high quality trials are needed.

At Emberly, we take that seriously. We stay grounded in CBT and ERP and use EMDR as part of a broader, evidence-based plan.

Resources on EMDR and OCD

If you like to read up on the science or hear different perspectives, these are good starting points:

• EMDR International Association blog on EMDR therapy and OCD

• The Distancing Approach summary on EMDRIA’s site

• International OCD Foundation page on EMDR for OCD

• Healthline’s guide, “EMDR for OCD: Evidence, Risks, Resources, and More

• Medical News Today and Psych Central articles reviewing EMDR for OCD

You do not need to read any of these to start therapy, but they can help if your brain likes data and detail.

Eye Movement Desensitization and Reprocessing (EMDR)

This section is more reflective. It speaks to what EMDR can mean when you are dealing with OCD, anxiety, and a tough inner critic.

OCD, anxiety, self-esteem. Reflections and the search for knowledge

Many people who find us have already been on a long search. You might have:

• taken online quizzes

• read countless articles

• watched TikToks about mental health labels

You might swing between “I definitely have OCD” and “Maybe I am just overreacting.”

EMDR can help you gently process experiences that shaped how you see yourself. Instead of only working at the level of thoughts, we also work with stored memories and body reactions that keep anxiety high and self-esteem low.

OCD & Inner Critic

OCD is sometimes called the “doubting disorder.” For many people, that doubt turns inward:

• “What kind of person has that thought?”

• “If I were a good parent/partner/Christian, I would not think that.”

In EMDR, we often target both the scary content of the obsessions and the harsh beliefs about self that ride along with them. The goal is not to prove you are perfect. It is to help your nervous system update from “I am a monster” to something closer to “I have scary thoughts because my brain is wired for anxiety, and I am still a caring person.”

I don't have OCD but...

Maybe you see pieces of this, but you are not sure it counts as OCD. You might say things like:

• “I do not have OCD, I just need everything done a certain way or I cannot calm down.”

• “I do not have OCD, I just get stuck replaying conversations and asking for reassurance.”

Labels can be helpful, but they are not the only reason to get support. If your thoughts, rituals, or checking behaviors are taking up more time and energy than you want, it is worth talking to someone. We can sort out together whether this is OCD, anxiety, trauma, or a mix.

What is EMDR therapy?

Here is a quick overview of what EMDR usually looks like in practice.

1. History and planning
   We talk through your story, symptoms, trauma history, and what you want from therapy. We make a plan for which memories or situations to target and which to leave alone for now.

2. Preparation and safety
   Before we touch any heavy material, we:

   • build grounding and emotion regulation skills

   • create a “safe place” or calm image together

   • practice bilateral stimulation with neutral material

3. Assessment
   For a chosen target (for example, a memory or worst case image), we identify:

   • the picture that represents the worst moment

   • the negative belief about yourself

   • the preferred, more balanced belief

   • where you feel it in your body

4. Desensitization (processing)
   You hold parts of the target in mind while following bilateral stimulation. Your mind may jump between images, thoughts, and body sensations. The therapist checks in often and keeps you within a safe range.

5. Installation and body scan
   We strengthen the more helpful belief and notice how your body feels when you hold that belief and the old memory together.

6. Closure and follow up
   Every session ends with you grounded. We check in at the next session to see what changed and what still needs work.

You stay in control and can stop, slow down, or come back to the present at any time.

Is EMDR effective with OCD?

Short answer: maybe helpful, especially when trauma and OCD overlap, but not a replacement for ERP yet.

Here is what current research and expert groups generally agree on:

• EMDR is a well supported treatment for PTSD.American Psychological Association+1

• For OCD, the research base is much smaller. Case reports, small studies, and one larger trial suggest EMDR can reduce OCD symptoms and sometimes works about as well as CBT for people who complete treatment.Healthline+1

• In one study, people who did ERP plus EMDR did better than people who did ERP alone, especially when their OCD was connected to stressful or traumatic experiences.Psych Central

• The International OCD Foundation says EMDR should not be considered a first line treatment for OCD at this time and should not replace ERP or CBT.International OCD Foundation+1

So if you are considering EMDR therapy for OCD, it can help to think of it as:

• one piece of a larger treatment plan

• especially useful when trauma is part of the story

• something to combine with ERP, not to use instead of it

At Emberly Counseling, we will be honest about what EMDR can likely help with and where ERP or medication might be more direct.

Are there potential risks of EMDR therapy for those with OCD?

Every effective therapy has some discomfort. EMDR is no different.

Common short term side effects can include:

• feeling emotionally raw or tired after sessions

• strong dreams or new memories coming up between sessions

• short term spikes in anxiety as you touch into charged material

Specific to OCD, EMDR can sometimes:

• stir up intrusive thoughts for a bit

• bring you into contact with feared images or worst case scenarios

This is why preparation and pacing matter so much, especially if you have a trauma history or very graphic harm or sexual obsessions.

How we reduce risk at Emberly Counseling:

• We never jump straight into your most disturbing memory in the first session.

• We build skills and a shared language for slowing down and grounding.

• We check for OCD themes that might need ERP alongside or before trauma work.

• We collaborate on targets so you are not surprised by what comes up.

If you ever feel worse over time, not just stirred up for a bit, we pause, reassess, and adjust the plan.

Finding OCD-informed EMDR therapy

If you are searching for “OCD therapist near me” or “EMDR therapy for OCD,” it can be hard to sort through options. Here are some concrete steps.

1. Look for EMDR training from a trusted organization

Search in directories such as:

• EMDR International Association (EMDRIA) therapist directory

Then cross check that the therapist also treats OCD, not just trauma.

2. Ask directly about OCD experience

You can ask questions like:

• How often do you work with OCD, and what kinds of OCD themes do you see?

• Do you use ERP or other CBT tools, or do you mainly use EMDR?

• How do you handle harm, sexual, or religious obsessions in a way that is nonjudgmental and still safe?

You are allowed to screen your therapist. This is your brain and your time.

3. Ask how they integrate EMDR and ERP

An OCD-informed EMDR therapist should be able to explain, in simple language:

• when they would use ERP alone

• when they would add EMDR

• how they decide what to target

• how they keep you grounded if your OCD uses therapy content as a new obsession

If the plan sounds vague or like a miracle fix, that is a red flag.

4. Consider Emberly Counseling if you live in Pennsylvania

At Emberly Counseling, we offer:

• evidence based therapy for OCD, anxiety, trauma, and perinatal concerns

• EMDR therapy integrated with CBT and ERP

• a person centered, nonjudgmental space where you can bring the “weird” thoughts without shock or shame

If you are in Pennsylvania and want to explore EMDR therapy for OCD with us, you can reach out through our contact page to schedule a consultation and see if it feels like a good fit.

FAQs about EMDR therapy for OCD and Emberly Counseling

• What is EMDR therapy for OCD?

  EMDR therapy for OCD uses standard EMDR tools, like bilateral stimulation and memory processing, to work with experiences and worst case images that seem to fuel your OCD. It is usually combined with CBT and ERP rather than used on its own.

• Is EMDR a replacement for ERP or medication?

  No. ERP and CBT remain the gold standard psychological treatments for OCD, and medication helps many people too. EMDR is best thought of as an add on for trauma and certain OCD related memories, not a replacement for ERP or meds.

• Can EMDR make OCD worse?

  Temporary spikes in anxiety or intrusive thoughts are possible in any focused OCD treatment, including ERP and EMDR. With good preparation and pacing, EMDR is generally safe. If symptoms worsen over time instead of easing, a good therapist will slow down, adjust the plan, or focus more on skills and stabilization.

• How many EMDR sessions will I need for OCD?

  There is no set number. It depends on:

  • how severe your OCD is

  • how much trauma is involved

  • how long symptoms have been around

  • how often you can attend sessions

  For some people, a short block of EMDR focused on a few key memories is enough. Others may use EMDR off and on over a longer course of OCD treatment.

• Do I need a formal OCD diagnosis to work with you?

  No. If you are unsure whether you have OCD, but you are dealing with intrusive thoughts, rituals, or constant doubt, we can explore that together. We will help clarify what is going on and discuss options, with or without an official label.

• Do you only see people with OCD?

  No. We work with teens and adults dealing with trauma, anxiety, depression, relationship strain, perinatal and postpartum concerns, and OCD. Many people have a mix of these, and treatment plans are tailored rather than boxed into one category.

• Do you offer online therapy?

  If you live in Pennsylvania, we can talk about options for in person or secure online sessions, depending on your location, needs, and preferences.

• What makes Emberly Counseling different?

  We aim to offer evidence based therapy with a human touch. That means:

  • no shame about symptoms or coping

  • clear explanations in plain language

  • practical tools you can use between sessions

  • steady support at your pace, with a plan

  If you are curious about EMDR therapy for OCD or want help deciding between options, you are welcome to reach out and ask questions before you commit to ongoing work.