EMDR – It’s not just for trauma

EMDR is widely recognized as a highly effective treatment for trauma but I’ve found it to be very helpful in the treatment of phobias and OCD. I don’t have a specific interest in any one set of interventions being “the best”. I use a variety of interventions in helping clients resolve issues. My use of EMDR in treating OCD and Phobias has to do with the limitations involved in treating these issues in an outpatient setting.

The primary limitation involves the use of in vivo exposure in an outpatient setting – one cannot always adequately reproduce the necessary conditions for this sort of work in the office.  Many times I would find that CBT and DBT skills were helpful but not enough to bridge the session to a real world application of self initiated/guided exposure.  I could always refer a client to a higher level of care but waiting lists, time constraints on the part of the client, costs and insurance coverage present as real barriers to accessing this type of care.

The logic in using EMDR basically resides in the fact that it has demonstrated efficacy in desensitizing clients to the images and memories of traumatic experiences while shifting negative beliefs they hold about themselves and the world around them to something more adaptive. I figured if it works for trauma, why not OCD or Phobias?

I found it to be highly effective in eliminating symptoms of social phobia and OCD in younger adolescents, effective with adults in alleviating social anxiety and moderately effective in helping adults with OCD become more comfortable in hitting targets for self initiated/guided exposure outside the office.  In each situation cognitive interweave and resource enhancement exercises were heavily applied and EMDR was one of three modalities used; CBT and DBT skills were the others.

Much of what I read about EMDR’s application in treating phobias and OCD was essentially anecdotal (like this article) but I found one research article that sort of confirmed what I felt about it.

 Both uncontrolled and controlled studies on the application of EMDR with specific phobias demonstrate that EMDR can produce significant improvements within a limited number of sessions. With regard to the treatment of childhood spider phobia, EMDR has been found to be more effective than a placebo control condition, but less effective than exposure in vivo.  link

I’m not sure why EMDR has not been researched more aggressively in the treatment of these issues given that the logic is a good fit and preliminary data shows promise. The folks at the OCD Recovery center appear to be doing some neat work and I hope they decide to eventually publish some of their data.

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