Updated: Apr 18
EMDR and ICBT as options in the treatment of Obsessive Compulsive Disorder
OCD impacts men, women and children of all ethnicities and backgrounds. It can onset at any time from preschool to adulthood, most commonly first appearing around age 8 and 12, late teen years or early adulthood. OCD can suddenly onset post certain types of medical infections which is known as PANS/PANDAS. Other related disorders with OCD are Hoarding Disorder, Body Dysmorphic Disorder, Body Focused Repetitive Behaviors, Olfactory Reference Syndrome, Misophonia, Emetophobia. There is also a relationship of OCD and trauma. It is often misdiagnosed and often takes many years to be effectively recognized.
What is Obsessive Compulsive Disorder (OCD)?
According to the DSM-V, Obsessive Compulsive Disorder is defined as the presence of obsessions, compulsions or both of these. It may be surprising to learn that OCD is no longer classified along with other anxiety disorders and is now in its own classification of disorders.
OCD must be diagnosed by a professional and in general there are 3 things present:
Obsessions (recurrent, persistent thoughts, urges, or images that are experienced as unwanted, intrusive and cause marked anxiety or distress).
The person also attempts to ignore, suppress or neutralize these with some thought (mental act) or action (behavior or compulsion)
These obsessions, compulsions take up a lot of time (more than 1 hr a day) and get in the way of things the person enjoys, and values.
Types of Obsessions
Contamination - Fears of coming into contact with perceived contaminated substances, things such as body fluids, germs, environmental contaminants, and other household chemicals. Responsibility - Fears of being responsible for something terrible happening, harming others due to not being careful enough Perfectionism- excessive concern about symmetry, exactness, or need to know/remember, fear of losing, forgetting important information or throwing something out, being excessive concerns with performing tasks perfectly, correctly or just right. Religious/Moral Obsessions (Scrupulosity) - Excessive concerns with offending God, damnation about what is right/wrong or other aspects of morality. Identity - Excessive concerns with one's sexual orientation, or gender identity Violence - Fears of acting on an impulse to harm oneself, others, or fear of violent images in one's mind Sexual - Unwanted thoughts, mental images related to sex, including fear of acting on sex-related impulses, sexually harming children, relatives, others, fears about aggressive sexual behaviors toward others Other Obsessions - Relationship-related obsessions, Death/Existential related obsessions, Real/False memory obsessions, Emotional Contamination obsessions.
Types of Compulsions
Washing/Cleaning - Excessive hand washing in specific way, showering, bathing, etc.; excessive cleaning household objects, doing things that prevent contact with contaminants Checking - Check you didn't harm in self or others, that nothing terrible happened, you didn't make a mistake, and/or checking parts of physical condition or body Mental compulsions - Mentally reviewing event to prevent harm to self, others, or prevent terrible consequences, praying (excessively) to prevent harm , counting while performing tasks, having 'safe' numbers, having to cancel, or undo (example needing to say a good word to cancel out a bad word) Other Compulsions - Excessive orderliness, Excessive arranging until just 'feels right', telling others/asking, confessing in order to get reassurance, avoiding situations that may trigger obsessions.
Treatments for OCD
Typically treatment for OCD includes medication and psychotherapy. Cognitive therapies such as Exposure Response Prevention (ERP), Acceptance and Commitment Therapy (ACT) are the most recognized forms of treatment. For more information on these treatments: https://iocdf.org/about-ocd/ocd-treatment/
Inference-Based Cognitive Behavioral Therapy (ICBT)
Inference-Based Cognitive Behavioral Therapy is a unique form of cognitive therapy in which use of working with inferential confusion. This is also a cognitive therapy, however rather than desensitization of the compulsion, ICBT focuses on thinking, cognitive, skills addressing inferential confusion that generates obsessional doubts.
Inference Based Cognitive Behavioral Therapy: https://icbt.online/what-is-icbt/
Inference Based Cognitive Behavioral Workbook by Brittany Goff: https://a.co/d/a0rqRJm
Inference Based Cognitive Behavioral You Tube Channel: https://www.youtube.com/@Inference-based-therapy/about
* Yale Brown (YBOCS): https://drive.google.com/file/d/1AoTOawAhaL-Fg7MV9EI5QCiPmD0GRDuq/view?usp=share_link
Othere Measures mayb include ICQ-EV and POPS:
Eye Movement Desensitization Reprocessing Therapy (EMDR)
EMDR is a memory-based therapy that is an evidenced based therapy for the treatment of post-traumatic stress. EMDR has been widely researched and applied as a treatment for a number of other disorders and concerns such as addiction, anxiety, major depression, and even performance anxiety.
As there is may often a relationship of Trauma and OCD, EMDR can be utilized as a possible treatment option in a two-prong approach with OCD and Trauma. In my practice I offer ICBT for treatment of the OCD and then additionally work within the eight phases of EMDR working with a neurobiological approach in treatment of the trauma factors that may underlay or co-incide within the nervous system. Typically EMDR helps resolve traumatic material, can aid in desensitizing vulnerable themes and other traumatic memories that may have occurred in the experiences of OCD (such as medical traumas, bullying, relational responses and so forth) https://www.emdria.org/public-resources/emdr-therapy-and-ocd/
*Article: OM Magazine - Kundalini Protocol and EMDR https://omtimes.com/2020/01/noninvasive-treatments-ocd/
FLASH Technique and Parts Work Therapies
FLASH Technique is a method developed my Dr. Phil Manfield that can aid is rapid processing of traumatic and/or overwhelming material within the nervous system. FLASH can be applied within the 8 phases of EMDR as a method of assisting reduction in trauma and desensitization. https://flashtechnique.com/wp/
Parts Work Therapies
Parts Work refers to the parts, or aspects of self that may be more disconnected and/or inaccessible due to various factors (trauma, complex trauma, etc). Internal Family Systems, Ego State Therapy and Structural Dissociation Therapy can also aid in the treatment of both trauma and co-occurring OCD. In these therapies we are able to build communication within the parts of Self which can increase our sense of agency, empowerment, and ability to be within present moment, present time.
If you are trying to manage OCD and trauma, it may be helpful to consider a two-prong approach of treatment using both ICBT and EMDR therapy. Hopefully these resources will aid in recovery and better quality of daily life. If you are looking for an EMDR therapist in your area you can search for a provider at https://www.emdria.org/,
If you are interested in EMDR consultation https://www.juliecardoza.com/emdr-consultation