Healing the Roots and Rewiring the Habits: EMDR and Exposure Therapy for Anxiety and OCD

When it comes to treating anxiety and Obsessive-Compulsive Disorder (OCD), there’s no one-size-fits-all approach. Two evidence-based therapies—Exposure and Response Prevention (ERP) and Eye Movement Desensitization and Reprocessing (EMDR)—can be especially powerful when used in tandem. While ERP focuses on reshaping current habits and behaviors, EMDR dives into the deeper emotional roots of anxiety, often stemming from past trauma.

🔁 Exposure Therapy: Breaking the Cycle of Fear and Compulsion

ERP, a form of cognitive-behavioral therapy, is considered the gold standard for OCD. It helps clients gradually confront their fears without resorting to rituals or avoidance. This repeated exposure reduces anxiety over time through a process called habituation, and helps the brain learn that the feared consequence is unlikely or manageable (Craske et al., 2014).

For many, ERP is essential for rewiring habitual responses—especially those tied to compulsive checking, cleaning, or reassurance-seeking.

💥 EMDR Therapy: Healing the Emotional Roots

While ERP treats the symptoms, EMDR often addresses what lies beneath them. Many clients with OCD or chronic anxiety have a history of unresolved trauma, shame, or emotionally overwhelming experiences. EMDR helps the brain process these “stuck” memories so that they no longer carry the same emotional charge (Shapiro, 2018).

Research has shown that EMDR can significantly reduce OCD symptoms, especially for those with co-occurring trauma or early adverse experiences (Nazari et al., 2011; Marsden et al., 2018). EMDR supports the integration of painful memories, allowing clients to shift core beliefs like “I am not safe” or “I am broken.”

🧩 Why Both May Be Needed

For some individuals, ERP alone may not be enough—particularly if the compulsive behaviors are tied to trauma-related beliefs or emotions. In these cases, ERP helps build new behavioral patterns, while EMDR addresses the original emotional learning that made those patterns feel necessary.

In a 2020 randomized controlled trial, combining EMDR with ERP led to greater reductions in anxiety and OCD symptoms than ERP alone in participants with trauma histories (Sarichloo et al., 2020). This supports the growing recognition that targeting both the symptoms and the source can lead to more complete healing.

Final Thoughts

If you've tried exposure therapy or behavioral approaches but still feel stuck, it might be worth exploring whether unresolved emotional trauma is playing a role. EMDR offers a structured and research-supported way to work through those experiences and can be a valuable part of your healing journey—especially when integrated with other therapies.

📚 Citations:

• Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10–23.

• Marsden, Z., Lovell, K., Blore, D., Ali, S., & Delgadillo, J. (2018). A randomized controlled trial comparing EMDR and CBT for obsessive-compulsive disorder. Clinical Psychology & Psychotherapy, 25(1), e10–e18.

• Nazari, H., Momeni, F., Jariani, M., & Tarrahi, M. J. (2011). Comparison of eye movement desensitization and reprocessing with citalopram in treatment of obsessive-compulsive disorder. Acta Medica Iranica, 49(11), 701–706.

• Sarichloo, M. E., Taremian, F., Dolatshahee, B., & Haji Seyed Javadi, S. A. (2020). Effectiveness of ERP plus EMDR in reducing anxiety and OCD symptoms associated with stressful life experiences. Iranian Journal of Psychiatry and Behavioral Sciences, 14(3), e101535.

• Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures (3rd ed.). Guilford Press.