EMDR in the Treatment of
Obsessive Compulsive
Disorder
John Marr
College Counsellor (Finchale Training College Durham)
'3rd Autumn Workshop Conference, Durham 2011'
Workshop 5
1
AGENDA
 20 Minutes Background

Explanation on method and reason developed
 20 Minutes Practicum

Think of a small ‘t’ OCD event
 10 minutes Question and Answer
2
OCD Clients who could not engage
with CBT Exposure Response Therapy
 The World Health Organisation has listed
OCD in the top 10 most disabling illnesses in
the world.
 Although Ex/RP therapy can be highly
effective for around 50% of people who
complete Ex/RP treatment there are a
number of recognized drawbacks.
(Psychological Medicine, 40, pp 2013-2023)
3
Recognized Drawbacks
 Ex/RP therapy involves the individual facing their
worst fears; many individuals are unable to complete
treatment as a result.
 Ex/RP therapy can be hard work and will require the
completion of homework between sessions.
 Ex/RP therapy may not be effective for individuals
who experience obsessions without compulsions.
Psychological Medicine, 40, pp 2013-2023
4
 De Silver & Marks, 1999 suggest that there is a causal link
between the onset of OCD and a traumatic event in the clients
life that still has a direct affect upon the clients symptomatology.
 Dr Robin Logie 2011 has also been working with the use of
‘neat’ EMDR on the treatment of OCD, and he will be providing
a presentation later today. Robin also noted that the future
template was a vital part of the treatment process.
 One of the biggest problems with Ex/RP is the
relapse rate which is high (57.3%) and which hasn't
improved in past 20 years. World Health Organization; Global Burden of
Disease 2000, Draft 21-08-06; Maher et al. 2010

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What are the options
 Continue with EX/RP therapy
 Medicate
 Do Nothing
 Discover the causal link
 Be Innovative
6
My Option
 Use a combination of the Phobia Protocol
and Mental Video Playback
 A standard Phobia Protocol with exceptions
 Mental Video Playback replaces EX/RP
 EMDR reprocess the response to the mental
exposure
7
Demonstration
 During the history taking identify the OCD
Triggers






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Electric Plugs
Taps
Touching People
Water
Locking Doors
Infection
ETC
8
Mental Video Playback
 Teach self-control procedures to handle the
“fear of fear”
 Working on each trigger to start



Which of the identified triggers would you like to
work on today?
I want you to play a mental video of the “first,
worst, last” time this happened. (I use the last)
As you play the video if you feel any stress stop
the video and let me know.
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
When the client experiences stress and stops use
a basic protocol.
 Image
 Emotion
 Bodily sensation
 You can take a SUD’s for reference
 Process as normal
 Check SUD’s for evidence of change
 When change is satisfactory, have client return to the
Mental Video Playback and continue playback until
the next stress is experienced.
10
 Past Memories

Target and reprocess the following:




Antecedent or ancillary events that contribute to the OCD
The first time the OCD was experienced
The most disturbing experiences
The most recent time it was experienced
 Present Triggers
 Any associated present stimuli
 The physical sensations or other manifestations of OCD, fear or unrest,
including hyperventilation
 Future Template

Incorporate a positive template for OCD -free future action (as mentioned
in a recent article by Dr Robin Logie)


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Arrange contract for action
Run mental videotape of full sequence and reprocess disturbance
Complete reprocessing of targets revealed between sessions
 To use the full Protocol, all 6 steps should be included
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Y-BOCS (session 1 – 6)
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Y-BOCS (session 1 – 14)
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Y-BOCS
(session 1 – 14) session 30 follow up
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Weeks
14
Feedback
 I think that this paper will make a strong and
very important contribution to the literature.
 This is the first successful treatment of OCD
and you have come at it in an innovative and
effective direction.
 Congratulations!
 It’s wonderful.
 Louise Maxfield; London Health Sciences Centre; University of Western
Ontario and Lakehead University; London ON Canada
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