Written by Lauren Faylor
Obsessive-Compulsive Disorder (OCD) is a challenging mental health condition that affects millions of people around the world. Traditionally, treatments like Exposure Therapy, Acceptance and Commitment Therapy (ACT), and Cognitive Behavioral Therapy (CBT) have been the main therapies to manage OCD symptoms. These were the methods Dr. Mark Chamberlain had been using in his practice. However, in his groundbreaking keynote presentation titled “ART for OCD – Using Accelerated Resolution Therapy to Treat Obsessive-Compulsive Struggles,” delivered at the 2024 IS-ART Conference, Dr. Chamberlain explores Accelerated Resolution Therapy (ART) as a faster, more effective, and more enjoyable approach to treating OCD.
Traditional Treatments for OCD- Why They Fall Short
Exposure Therapy, ACT, and CBT are well-established treatments for OCD, but they often require significant time and effort and can be ineffective. Dr. Chamberlain, a seasoned clinician, expressed his frustration with these traditional methods, saying, “I was getting too old to treat OCD because it takes so long.” He felt these methods were like “hacking at the branches” rather than addressing the core issues. This realization led him to explore ART, a therapy that allowed him to work more directly and effectively with scenes and sensations rather than with cognitions.
The Core of OCD Struggles
Dr. Chamberlain acknowledges that Obsessive-Compulsive Disorder (OCD) involves rigid, ingrained coping patterns rather than troubling scenes, which are often typical of PTSD.
People with OCD experience intrusive thoughts and engage in repetitive behaviors such as excessive hand-washing, checking locks, or counting. These behaviors are attempts to alleviate anxiety and prevent feared outcomes, but they can become all-consuming. Dr. Chamberlain likens the OCD pattern to receiving relentless, unhelpful “marching orders” from a “drill sergeant who isn’t on your side.” The goal of Accelerated Resolution Therapy (ART) is to shift clients out of these automatic responses.
Mark describes OCD as a “misapplication of survival responses,” meaning the brain mistakenly treats non-threatening situations as dangerous, leading to repetitive, anxiety-reducing thoughts and behaviors. Using metaphors and sensory experiences, ART helps clients reprocess these responses and develop healthier patterns. Dr. Chamberlain shared several compelling case studies that illustrate the power of ART in treating OCD. He has worked with clients who had OCD related to scrupulosity, an extreme form of guilt or morality, and those obsessed with staying out of danger and protecting loved ones. By addressing these deeply rooted survival responses, ART offers a new, effective way to treat the core struggles of OCD.
Ethan’s Story: A Case Example
One of the most compelling cases Dr. Chamberlain shared was that of “Ethan”, an 11-year-old boy whose severe OCD confined him to a wheelchair for six weeks. Ethan was convinced that walking through doorways would harm his family. Traditional talk therapy proved ineffective in past visits with other therapists, so Dr. Chamberlain employed ART.
Dr. Chamberlain first met Ethan when the boy was stuck in a wheelchair at his office door. His OCD had advanced to the point where he refused to go through a doorway at all, even while in a wheelchair.
At first, Ethan remained unresponsive to any verbal engagement attempts made by Dr. Chamberlain. He kept his head in his lap and grunted answers to questions. So, Dr. Chamberlain began the ART session right in his office’s doorway. He encouraged Ethan to focus on his bodily sensations and imagine his feelings as fireworks inside his body, asking him what color they were. When Ethan responded, “Blue,” Dr. Chamberlain instructed him to transform these fireworks into a ball of blue yarn and let an animal play with it. This imaginative process, involving Shep, the family rescue dog, helped Ethan reprocess his fears.
After just a few sessions, Ethan was able to walk out of Dr. Chamberlain’s office, free from his wheelchair. This case underscores ART’s ability to quickly and effectively address OCD symptoms by engaging the unconscious mind and reprocessing sensory experiences. Dr. Chamberlain noted that this case would have taken years to resolve with traditional talk therapy.
Engaging Vivid Metaphors
Dr. Chamberlain discovered that clients were more successful in treatment when they understood the “why” behind their struggles. What purpose was their OCD serving? What would it mean for their lives if they didn’t carry out the OCD behavior?
Mark emphasizes that no additional preparation is needed before an ART session. The “why” naturally unfolds from the Basic protocol of an ART session, and the relevant details arise effortlessly.
Although clients are not required to share the details of their stories or thoughts, Mark finds that listening to the language and metaphors clients use to describe their feelings around their struggles creates turning points in reframing solutions. These plot twists often emerge powerfully during the eye movement process. From there, the client can become unattached to the driving force behind the OCD behaviors.
More support of ART for OCD “A Tale of Two Compulsions – Two Case Studies Using Accelerated Resolution Therapy (ART) for Obsessive Compulsive Disorder (OCD)”
This study performed by JoEllen Schimmels, PMHNP, APRN, CNP and Wendi Waits, MD explores the efficacy of Accelerated Resolution Therapy (ART) for treating Obsessive Compulsive Disorder (OCD) through two detailed case studies. ART, initially developed for PTSD, is a brief, eye movement-based therapy that helps patients by facilitating memory reconsolidation.
How ART Works for OCD
When ART is used for OCD, a client is directed to focus on memories of the unwanted behaviors and the corresponding sensations and feelings that arise in the body while practicing bilateral eye movements guided by the ART therapist. The patient is asked to mentally visualize their day, including their obsessions and compulsions, to activate these memories in a controlled setting. While continuing the bilateral eye movements, the client visualizes the problematic behaviors with new insights and sensations to establish a new more positive pattern. This process happens in the window of reconsolidation, facilitating the growth of new neural pathways.
Case Studies:
- Case 1: A 36-year-old single male had been struggling with severe OCD for 15 years, which manifested in prolonged daily showers and significant anxiety related to contamination. He underwent four sessions of Accelerated Resolution Therapy (ART), where he visualized and modified typical OCD scenes during the therapy. After the third session, the patient experienced significant symptom relief, which he maintained without medication for over 24 months.
- Case 2: A 39-year-old single male with OCD and Excoriation Disorder dealt with intense anxiety about being judged and compulsive skin-picking behaviors. He participated in four ART sessions that involved metaphor processing and visualization techniques to address his symptoms. Following the therapy, the patient saw a reduction of over 75% in his symptoms and remained off medication, symptom-free for more than nine months.
The study published in “Military Medicine,” and the case studies presented by Dr. Chamberlain demonstrate that ART is emerging as a promising treatment for severe Obsessive-Compulsive Disorder (OCD), showing significant effectiveness in a fraction of the time compared to traditional therapies.
ART has proven particularly beneficial for clients unable to progress through conventional talk therapies. By focusing on sensory experiences and metaphors, ART helps shift clients out of their autonomic modes and ingrained coping patterns. This innovative approach allows for the reprocessing of survival responses and the development of healthier behaviors, ultimately creating new, empowering stories that replace the old, limiting ones.
Find an ART Trained Therapist near you.
This blog references the keynote presentation titled “ART for OCD: Using Accelerated Resolution Therapy to Treat Obsessive Compulsive Struggles,” delivered by Mark Chamberlain, PhD, at the annual IS-ART conference. If you’re an ART trained clinician, learn more about joining IS-ART.
Sources:
2024 IS-ART Keynote presentation “ART for OCD: Using Accelerated Resolution Therapy to Treat Obsessive Compulsive Struggles” by Dr. Mark Chamberlain
Obsessive-Compulsive Disorder – National Institute of Mental Health (NIMH)