EMDR for Obsessive Thoughts: Therapy for OCD
Key Takeaways
EMDR (Eye Movement Desensitization and Reprocessing) can help reduce the emotional “charge” behind intrusive thoughts and compulsions—especially when OCD is tied to distressing memories, shame, or “stuck” beliefs.
ERP (Exposure and Response Prevention) remains the gold-standard for OCD; EMDR is best used alongside ERP or when trauma, panic, or avoidance keeps ERP from moving forward.
EMDR works by pairing brief attention to the feared thought/memory with bilateral stimulation (eye movements/taps/tones) to help the brain reprocess the experience and install more adaptive beliefs.
Many clients report less reactivity to triggers, fewer mental rituals, and a stronger sense of “I can handle this” after targeted EMDR work.
You don’t have to do it alone—learn what to expect in sessions, how to decide if EMDR is a fit, and how it pairs with other proven OCD treatments.
What is OCD—and why EMDR might help
Obsessive-Compulsive Disorder includes obsessions (intrusive, unwanted thoughts, images, or urges) and compulsions (behaviors or mental rituals performed to reduce anxiety or “prevent” harm). Common themes include contamination, checking, harm, morality/scrupulosity, health, relationships, and “just-right” perfectionism. Obsessive symptoms often persist despite diagnosis and can significantly impact daily functioning. Obsessions are typically experienced as negative thoughts that are distressing and ego-dystonic, making them difficult to ignore or dismiss.
The most proven, first-line therapy for OCD is Exposure and Response Prevention (ERP), a form of Cognitive Behavioral Therapy that helps you face triggers without doing compulsions, so your brain relearns safety. See the International OCD Foundation’s overview of ERP (iocdf.org) and the NICE guidance on OCD care (nice.org.uk).
So where does fit? EMDR is an evidence-based trauma treatment that helps the brain “digest” experiences that feel stuck. Originally developed to treat post-traumatic stress disorder (PTSD), EMDR has also shown effectiveness in treating obsessive-compulsive disorder (OCD). Preliminary research supports the use of EMDR for OCD, indicating its potential benefit. For some people with OCD, obsessions are fueled by earlier experiences—a medical scare, a shaming event at school, a moral mistake, a frightening news story, or even the first panic attack. Experienced traumatic events and traumas, especially in childhood or relationships, can contribute to the development of OCD symptoms. EMDR can take the heat out of those drivers so ERP becomes easier and faster. When trauma is a factor in OCD, it makes sense to use EMDR as part of the treatment approach.
If you’re new to EMDR, start with this primer: Understanding EMDR Therapy: A Guide for Trauma Recovery. You can also see what sessions feel like here: What to Expect in EMDR Therapy.
The basic principles of EMDR—processing distressing memories and reducing their emotional charge—can be applied to OCD to address trauma-related obsessions. Adopting a broader understanding of OCD that includes trauma-informed approaches can improve outcomes and provide more comprehensive care.
Understanding OCD Symptoms
Obsessive Compulsive Disorder (OCD) is a complex mental health condition that affects people in deeply personal ways. At its core, OCD is marked by persistent, unwanted thoughts or urges—known as obsessions—and repetitive actions or mental rituals—called compulsions—that a person feels driven to perform. These ocd symptoms can show up in countless forms: some people might find themselves stuck in cycles of excessive cleaning or handwashing, while others may be caught in endless checking of locks, appliances, or even their own memories. Intrusive thoughts about harm, contamination, or making a mistake are also common, and can be incredibly distressing.
Understanding the unique pattern of obsessions and compulsions in obsessive compulsive disorder ocd is essential for finding the right therapy. For many, these symptoms are not just random—they can be linked to earlier traumatic memories or stressful life events that the brain hasn’t fully processed. This is where Eye Movement Desensitization and Reprocessing (EMDR) therapy can play a powerful role. By using movement desensitization and reprocessing techniques, EMDR helps people revisit and reprocess those distressing memories, reducing the emotional charge that fuels their OCD. As a result, EMDR therapy is becoming recognized as an effective treatment for certain types of ocd symptoms, especially when traditional approaches need extra support. If you or someone you care about is struggling with obsessions, compulsions, or intrusive thoughts, know that there are therapies—like desensitization and reprocessing emdr—that can help you reclaim your life.
How EMDR works for intrusive thoughts
EMDR follows a structured, eight-phase protocol. In OCD care, the therapist and client:
Map triggers and “stuck” memories. These might include your first/worst intrusive thought, a shame memory (e.g., “I contaminated someone”), or a panic moment that convinced you “I’m not safe unless I check.”
Name the negative belief linked to the obsession (e.g., “I’m dangerous,” “I can’t tolerate uncertainty,” “If I don’t ritualize, something terrible will happen”).
Pair that target with bilateral stimulation (eye movements/taps/tones) in short sets. EMDR involves bilateral movement of the eyes while recalling traumatic memories to help process them gently. Your mind naturally shifts among images, sensations, and beliefs as the distress drops. This bilateral stimulation and reprocessing may help rewire neural pathways associated with distressing memories and intrusive thoughts.
Install a healthier belief (e.g., “I can handle uncertainty,” “I’m responsible enough,” “Thoughts are not facts”) until it feels true.
Future-template practice: mentally rehearse facing a trigger without the ritual, while holding your new belief and calm body state.
Why this matters for OCD: compulsions are attempts to regulate emotion. When EMDR lowers the emotional load tied to a thought or memory, the intensity of the emotional response often decreases, and the urge to ritualize often decreases, and ERP exposures feel much more doable.
Learn more about the eight phases here: What to Expect in EMDR Therapy.
When EMDR shines for OCD
EMDR is especially helpful when:
Trauma or adversity amplifies your OCD (bullying, illness, car crash, religious shaming, a bad therapy/medical experience), especially when a traumatic experience or traumatic event has triggered or worsened symptoms.
Your OCD includes panic attacks or intense body fear. EMDR can reduce the fear-of-fear loop so exposures feel safer. See: Can EMDR Help with Panic Attacks?.
Guilt, disgust, or shame keep you stuck (“I’m a bad person,” “I could snap and harm someone”).
You do a lot of mental compulsions (reassurance seeking, reviewing, neutralizing prayers) and feel flooded when trying ERP.
Past treatment stalled because triggers felt too big to face—EMDR can be the bridge that gets ERP moving again.
You’re doing care online and want a structured method that adapts well to telehealth. Read: Telehealth EMDR: How Online EMDR Therapy Works.
EMDR is always conducted in a safe environment to help you process difficult or traumatic memories with support and security.
**Bottom line:**ERP is still the foundation for OCD. EMDR is a powerful booster—reducing reactivity, processing sticky memories, and strengthening the belief that you can choose not to ritualize.
For an overview of anxiety applications, see: EMDR Therapy for Anxiety.
What a combined ERP + EMDR plan can look like
Phase 1 — Stabilize and skill up
Psychoeducation about OCD, ERP, and EMDR.
Build coping tools: grounding, breathing, butterfly hug tapping, and values-based motivation.
Clarify medications with your prescriber if needed. (It’s fine to do EMDR while on SSRIs.)
A comprehensive trauma and attachment history is essential when planning EMDR treatment for OCD. Effective treatment planning for OCD involves understanding your unique triggers, trauma history, and any comorbidities to tailor the most effective interventions.
Phase 2 — Target setting
Identify hot memories (first/worst obsessions, shaming scenes, medical fright, religious fear moments).
Identify current triggers (sinks, stove, doors, knives, church, phone searches, doctor portals).
Name negative/positive beliefs to track (e.g., from “I can’t handle uncertainty” to “I can feel uncertain and carry on”).
Phase 3 — EMDR reprocessing
Process targets in short, titrated sets so you stay inside your window of tolerance.
Expect rapid shifts: images change, the memory feels farther away, your body settles, beliefs soften.
Phase 4 — ERP exposures
With the heat turned down, you lean into exposure (touch the doorknob, skip the prayer, close the app, leave the stove unchecked) without rituals.
Track wins and setbacks. Use EMDR again if you hit a stuck point.
Phase 5 — Future templates & relapse prevention
Rehearse challenging situations (doctor appointments, flights, communion, babysitting, presentations) while holding your new belief.
Create a maintenance plan and know the cost/logistics up front: How Much Is EMDR Therapy? (2025).
Combining ERP and EMDR offers a comprehensive approach to OCD treatment, drawing on both traditional and alternative effective treatments to address symptoms from multiple angles.
Want help choosing between therapies? Read: EMDR vs. CBT: Which Therapy Is Right for You?.
What EMDR can change in OCD
People often report:
Less intensity when an intrusive thought pops up (it still arrives, but it doesn’t hijack your day).
Shorter rituals and more “I noticed the urge and let it pass.”
Reducing anxiety around triggers that once felt impossible is a key outcome.
Healthier beliefs (e.g., “I can handle not knowing,” “A thought isn’t a threat,” “Being careful doesn’t mean being controlled”).
More capacity to do ERP—and to live life between sessions.
EMDR can also help with depression, which often co-occurs with OCD.
If dissociation, spacing out, or overwhelm has been an issue for you, ask your therapist about stabilization work that pairs well with EMDR: EMDR, Dissociation & Stabilization Techniques.
Will EMDR work for my type of OCD?
Every case is unique, but EMDR has been used (often with ERP) across common subtypes. Obsessive compulsive symptoms can present differently depending on the subtype, such as contamination fears, checking, or intrusive thoughts:
Contamination & washing: Process the origin story (illness, caregiver rules, news events) so “dirty = danger” softens. Then exposures (touch and don’t wash).
Checking & responsibility: Target “what if I caused harm?” memories (e.g., past mistake). Install “I act responsibly; I don’t have to check to be safe.”
Harm/Suicidal/Violent/Sexual intrusive thoughts (often called “Pure-O”): Reduce shame and fear around the thought itself so you can drop mental rituals.
Scrupulosity (moral/religious): Process specific moments of fear or shaming messages; strengthen the value “I honor my faith without compulsions.”
Health anxiety: Target medical scares or losses; pair with exposures (leaving the portal unread, not Googling).
EMDR helps people process trauma-related stress that may underlie or worsen obsessive compulsive symptoms, allowing for more effective symptom reduction and management.
For trauma-woven histories or Complex PTSD overlays, see: EMDR for Complex PTSD and Childhood Trauma. Traumas such as sexual abuse and physical abuse are common underlying factors in OCD, and addressing these experiences can be crucial for recovery.
Benefits of Working with an EMDR Therapist
Choosing to work with an EMDR therapist can make a significant difference for those seeking to treat ocd and reduce the impact of ocd symptoms. EMDR therapists are specially trained to help individuals process traumatic memories that may be at the root of obsessive thoughts and compulsive behaviors. Through the use of bilateral stimulation—such as guided eye movements or gentle tapping—an EMDR therapist helps the brain reprocess distressing experiences, making them feel less overwhelming and less likely to trigger compulsions.
The benefits of EMDR therapy for OCD go beyond just symptom reduction. Many people notice that their obsessive thoughts become less frequent and less intense, and that the urge to engage in compulsive behaviors starts to fade. This can lead to greater emotional balance, improved coping skills, and a renewed sense of control in daily life. Working with an EMDR therapist also means having a supportive guide who understands the complexities of OCD and can tailor therapy to your unique needs. Whether you’re dealing with long-standing ocd symptoms or new challenges, EMDR therapists can help you move forward, one step at a time, toward a life less dominated by anxiety and ritual.
Evidence snapshot (and a realistic view)
ERP remains first-line per major guidelines (e.g., IOCDF, NICE).
Research on EMDR for OCD is growing but smaller than for ERP. Initial evidence and research suggests EMDR may be effective for OCD, with studies showing it can reduce obsessional distress and improve ERP engagement, especially when trauma, shame, or panic are central. Studies have also indicated that EMDR can improve anxiety and depressive symptoms associated with OCD, and that anxiety disorders are often comorbid with OCD, making EMDR's application relevant for both. A randomized controlled trial published by researchers found that EMDR was comparable to ERP in reducing OCD symptoms, though more research is needed to confirm EMDR's role in OCD treatment. Springer Publishing provides clinical research and scholarly literature on EMDR, OCD, and trauma, supporting the evidence base. Additionally, an ethno phenomenological case series has explored culturally sensitive experiences of EMDR for OCD, highlighting the importance of individual and cultural factors in treatment outcomes.
A combined plan frequently gives the best results: process the fuel with EMDR, retrain the habit loop with ERP.
If symptoms are severe, medication (SSRIs) may help create stability so therapy sticks—talk with your prescriber.
For a broader anxiety overview with citations, visit trusted organizations like iocdf.org and apa.org.
Is online EMDR an option?
Yes. EMDR adapts well to telehealth with on-screen light bars, alternating tones, or self-tapping guided by your therapist. Many OCD clients prefer telehealth for at-home exposures (e.g., kitchen, bathroom, door locks). Learn how it works: Telehealth EMDR: How Online EMDR Therapy Works.
Safety, pacing, and “window of tolerance”
The goal is effective change without overwhelm. Your therapist will:
Build stabilization skills first.
Keep EMDR sets short and check in often.
Pause or switch to ERP, grounding, or skills if distress spikes.
Collaborate on consent and choice every step of the way.
If you've ever felt “flooded” in therapy, this approach matters. Read more about pacing here: EMDR, Dissociation & Stabilization Techniques.
Clinical Practice: What to Expect from EMDR Treatment
When you begin EMDR treatment for OCD in a clinical practice setting, the process is designed to be thorough, supportive, and tailored to your needs. The journey typically starts with an initial assessment and detailed history taking, where your EMDR therapist will work with you to identify the specific ocd symptoms, traumatic memories, or distressing events that may be fueling your obsessions and compulsions. This collaborative approach ensures that your treatment plan addresses the root causes of your anxiety and is aligned with your goals.
During EMDR sessions, your therapist will guide you through the process of recalling distressing memories or triggers while using bilateral stimulation—such as eye movements, tapping, or auditory tones—to help your brain reprocess these experiences. The aim of EMDR treatment is to reduce the emotional intensity of these memories, making it easier to manage ocd symptoms in everyday life. Throughout the process, EMDR therapists often incorporate grounding exercises and other coping strategies to help you stay present and manage anxiety during sessions. With consistent EMDR therapy, many individuals experience a noticeable reduction in symptoms and a greater sense of well-being, making it a valuable option for those seeking effective treatment for ocd.
Getting started (and what it costs)
Intake & fit: Share your history, goals, what's helped/not helped.
Plan: Decide how much ERP vs. EMDR to start with, then adjust.
Frequency: Weekly is common; some benefit from intensives.
Cost & insurance: Here's a transparent guide: How Much Is EMDR Therapy? (2025).
If you're in Colorado, our team offers in-person and virtual care: Read more about us here. Nationally, look for EMDR-trained clinicians who also know ERP (ask about IOCDF/CBT training and EMDRIA training).
Quick self-check: Is EMDR a match for me?
Do certain memories (not just triggers) keep my OCD alive?
Do I feel stuck or too anxious to do ERP exposures?
Do I carry heavy shame, guilt, or panic around my obsessions?
Would processing those feelings help me enter ERP with less fear?
If you said yes to one or more, EMDR may be a smart add-on to your OCD plan.
FAQs: EMDR Therapy for OCD
Does EMDR treat OCD by itself?
Sometimes, but not usually. For many people, EMDR is part of care—great for calming sticky memories and beliefs—while ERP retrains the obsession-compulsion cycle. EMDR can also be an alternative treatment to cognitive behavioral therapy (CBT) for OCD. Many clients do best with both.
How long does it take to see results?
It varies. Some feel relief in a few EMDR sessions (e.g., less panic/shame), while habit change through ERP takes consistent practice over weeks. The combo often shortens the overall timeline.
What if my OCD isn't trauma-related?
You don't need a “capital-T” trauma. EMDR can target first/worst triggers, spikes of panic, shaming comments, or the day your OCD “locked in.” Reducing the emotional charge still helps ERP.
Is EMDR safe if I get very anxious or dissociate?
Yes—when paced well. Your therapist will teach stabilization first, keep sets short, and pause when needed. Read more about safety and pacing: EMDR, Dissociation & Stabilization Techniques.
Can I do EMDR while on medication?
Absolutely. SSRIs can reduce baseline distress so EMDR and ERP work better. Any med changes should be made with your prescriber.
Will EMDR erase my intrusive thoughts?
No therapy can erase thoughts. The goal is to make them less alarming and less sticky, so you can choose not to ritualize and get back to life.
Can EMDR help with “Pure-O” (mostly mental rituals)?
Yes. EMDR reduces shame and fear around the thought itself, making it easier to drop mental compulsions while ERP builds tolerance for uncertainty.
Does online EMDR really work?
Yes. With good tech and pacing, telehealth EMDR is effective and convenient—especially when you're doing home-based ERP. See: Telehealth EMDR.
How do I pick the right therapist?
Look for someone trained in both ERP and EMDR (EMDRIA-approved training + OCD/ERP experience). Ask how they blend the two and how they pace treatment.
What's my next step?
If you're ready to calm the fear and take back your time from rituals, start with a consult. Explore EMDR basics here: Understanding EMDR, then reach out to schedule an intake.
You can live with uncertainty—and still live well. With a thoughtful plan that pairs ERP and EMDR, obsessive thoughts lose their grip, and your values lead the way again.
