Obsessive-compulsive disorder involves intrusive, unwanted thoughts that provoke intense anxiety, and repetitive behaviours or mental rituals performed to relieve it. The established psychological treatment is a form of cognitive behavioural therapy built around exposure and response prevention, in which a person deliberately faces what triggers the obsession while resisting the compulsion that usually follows.It works, but not as universally as is sometimes assumed. OCD is regarded as one of the more treatment-resistant non-psychotic mental health conditions, and relatively few people finish therapy completely symptom-free. Exposure and response prevention is also demanding, and some people find it too difficult to begin or to stick with. That leaves a real gap, and a reason to look at alternatives.EMDR is one candidate. Its underlying model holds that psychological difficulties can be maintained by unresolved distressing memories, and in OCD there is often an identifiable memory or fear at the root of the obsession, such as a frightening image of contamination or of harm coming to someone.A pragmatic randomised controlled trial by Zoe Marsden and colleagues, published in *Clinical Psychology and Psychotherapy* (2018), compared the two approaches directly. Fifty-five people with OCD, recruited through a primary care mental health service, were randomly assigned to either EMDR or CBT based on exposure and response prevention, and assessed before treatment, afterwards, and at six months.The results showed no significant difference between the two therapies, either in symptom severity immediately after treatment or at six-month follow-up. Completion rates and the proportion of people achieving meaningful clinical improvement were also similar. In short, EMDR performed comparably to the established treatment.Two honest caveats are needed. First, this was a feasibility trial, designed primarily to test whether such a study could be run well, so it was small and not built to detect fine differences. Second, and more soberingly, the results were modest for both groups: roughly six in ten completed treatment, and around three in ten achieved reliable, clinically significant improvement. That says less about EMDR specifically than about how stubborn OCD can be.The practical conclusion is measured but useful. EMDR appears to be a reasonable alternative for OCD, particularly for people who cannot face or have not benefited from exposure and response prevention. Larger trials are needed before it could be considered a first-line option.*Source: 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 and Psychotherapy, 25(1), e10–e18.*