The Intersection of EMDR, Parts Work, and ERP: The Three-Way Braid

There's a moment every EMDR clinician knows: you're mid-set, the client has been tracking steadily, and then the SUD stalls. Not resistance, exactly; more like the reprocessing has hit a wall it can't get past. In my own work, that wall is almost never really a wall. It's a part.

When I slide over from EMDR into parts work at that exact moment, naming what's showing up, asking it what it's afraid will happen if the target keeps moving, something reliable happens. Once that part is heard, once the exile underneath it is rescued rather than reprocessed around, we go back to the target and the SUD drops. Not eventually. Immediately, and consistently.

The same braid shows up with OCD. Once a client has exposures to run as homework, I'll sometimes use EMDR's imaginal-exposure structure, bilateral stimulation while the client sits inside the feared scenario, as a way to run that exposure with the OCD parts explicitly in the room: the part sounding the alarm, the part reaching for the compulsion, and the Self that's trying to stay present through both.

I've come to think of this as a three-way braid: EMDR, Internal Family Systems (parts work), and Exposure and Response Prevention, rather than three separate tools I reach for in sequence. And it turns out I'm not alone in sensing this, even though almost no one has written about all three together.

What's already established, in pairs

EMDR and parts work. This is the most mature of the three combinations. The Trauma Therapist Institute and PESI have both published frameworks built around a simple reframe: a stall in reprocessing isn't a failure of the protocol, it's a protector part asking for consent before the work goes further. Get that consent, unblend, work with what's underneath, and the target moves again (Trauma Therapist Institute, "Why EMDR Therapists Need Parts Language: Bringing IFS Into the 8 Phases"; PESI, "Five IFS Principles to Support Effective EMDR Trauma Reprocessing"). A 2026 interpretative phenomenological study out of Alliant International University, indexed through EMDRIA, interviewed ten clinicians doing exactly this integration and found the same pattern across all of them: securing protector consent before processing, treating stuck points as diagnostic rather than obstructive, and leaning on the therapeutic relationship as the container that makes the deeper work possible.

Parts work and ERP. This lineage belongs largely to Melissa Mose, LMFT, whose book Internal Family Systems Therapy for OCD: A Clinician's Guide (Routledge) is close to the only manualized treatment of this specific pairing. Her framing will likely sound familiar: she describes obsessions as "Obsessional Managers" and compulsions as "Compulsive Firefighters," protective parts doing what they know how to do, and positions IFS as a layer underneath ERP, not a replacement for it. Parts work builds willingness before an exposure, holds Self-energy during it, and debriefs the protectors afterward on what they just survived without the compulsion. She's also candid about the risk clinicians run here: IFS's "all parts are welcome" stance can quietly become permission to accommodate a compulsion if the clinician isn't fluent in ERP first. That caution is worth repeating to any clinician curious about this work: parts language should never soften the exposure itself.

EMDR and ERP. The thinnest but still real of the three. The clearest published protocol is the Distancing Approach (Krentzel & Tattersall, 2024, Journal of EMDR Practice and Research), which pairs EMDR's phobia protocol with a distancing technique and a future-rehearsal phase that functions, in practice, as bilateral-stimulation-supported imaginal exposure. There's a small but growing case-study base behind it too: three cases of attachment-focused EMDR for OCD (EMDR Therapy Quarterly, 2024), earlier case series in the Journal of EMDR Practice and Research, and a randomized controlled trial combining EMDR with ERP for anxiety and OCD symptoms tied to identifiable stressful life events. The consistent clinical logic across this literature: ERP interrupts the compulsion-anxiety cycle directly, while EMDR works the memory network underneath it, and the two can be interleaved once it's clear which triggers are trauma-driven and which are purely OCD's own architecture. The International OCD Foundation is worth citing here too, if only to keep the ground steady: ERP remains first-line, gold-standard care for OCD, and nothing in this braid is meant to replace it.

Where the braid becomes its own thing

What I haven't found anywhere in the literature is the version where all three are live in the same session, moving in and out of each other in real time: not "add EMDR when trauma shows up" or "add parts work when ERP stalls," but treating the three as one continuous practice with three registers.

Vignette one: the stuck SUD. A client processing a childhood memory of being humiliated in front of a group plateaus at a SUD of 4 for three sets running. Rather than push through, I ask what's here that doesn't want this to move. A part surfaces, young, and furious that no one stepped in. Working with that part directly, we find the exile it's been guarding: a much younger part who believed, in that moment, that she was fundamentally unlikeable. Once she's witnessed and unburdened, we return to the original target. The next set drops the SUD to 1, and it holds.

Vignette two: imaginal exposure with OCD parts present. A client with contamination OCD has "touch the doorknob and don't wash" on this week's exposure list. In session, we run it imaginally with bilateral stimulation, but with the parts named as we go: the Obsessional Manager sounding the alarm, the Compulsive Firefighter reaching for the sink, and the client's Self staying in the room with both. By the third pass, the urgency drops, not because the obsession went quiet, but because the client's relationship to the parts sounding it changed. The at-home exposure that follows lands easier than it has in weeks

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Why weave three instead of two

Each pairwise combination already has a rationale in the literature: parts work resolves what blocks EMDR, parts work builds willingness for ERP, EMDR reaches the memory network that ERP alone doesn't touch. Braided together, they seem to compound rather than just coexist: the exile work that unblocks an EMDR target is the same relational move that makes an OCD part willing to let an exposure happen; the imaginal-exposure structure of EMDR turns out to be a natural container for doing parts work with OCD's protectors instead of just around them.

The caution that runs through all three bodies of literature applies just as much here, maybe more: this only works safely in the hands of a clinician who is independently fluent in all three modalities. Parts language can't be allowed to soften an exposure. Protector consent can't be allowed to stall reprocessing indefinitely. None of this is a shortcut past training in any one of the three; it's what becomes possible once you don't need to think about any of them separately anymore.

A note on where this stands

To be clear about the state of the field: each of these three combinations has real published support behind it. The full braid, moving fluidly between all three within a single session, doesn't yet exist as a named, manualized approach anywhere I could find. That makes this less a summary of established practice and more a field note from clinicians (myself very much included) who've arrived at the same integration independently, from the inside of the work. If that's true for you too, I'd genuinely like to hear how it shows up in your sessions.

Selected sources

• Mose, M. Internal Family Systems Therapy for OCD: A Clinician's Guide. Routledge.

• Krentzel, A. & Tattersall, K. (2024). The Distancing Approach: A Comprehensive EMDR Psychotherapy for Obsessive-Compulsive Disorder. Journal of EMDR Practice and Research.

• PESI. Five IFS Principles to Support Effective EMDR Trauma Reprocessing.

• Trauma Therapist Institute. Why EMDR Therapists Need Parts Language: Bringing IFS Into the 8 Phases.

• Alliant International University (2026). The Integration of EMDR and IFS in Trauma Treatment: An Interpretative Phenomenological Study. (Indexed via EMDR International Association.)

• EMDR Therapy Quarterly (2024). Attachment-Focused EMDR for Obsessive-Compulsive Disorder: Three Case Studies.

• International OCD Foundation. OCD Treatment Guide: Exposure and Response Prevention.