What is Exposure and Response Prevention (ERP)?
Extensive research has shown that the single most effective OCD therapy is Exposure and Response Prevention (ERP). This is a specialized treatment that is much more active than your typical “talk” therapy. With ERP, your therapist supports you in identifying all of the things your OCD and Anxiety have been telling you not to do. This list will naturally be different for each person, but might include things like driving a car, having a thought or feeling you don’t like, or touching something that is “contaminated.” With your therapist’s support, you then design a range of “exposures” that will allow you to gradually become more comfortable doing these things. Here are some more things to consider about OCD therapy using ERP:
Gradually Exposing Yourself
One of the critical elements of effective ERP therapy is making sure that your exposures never feel overwhelming. It is important that you experience just enough anxiety and discomfort to have a positive therapeutic experience. The goal is to help your brain learn that you can actually handle these things you’ve been avoiding, and that there hasn’t been anything to be afraid of. Exposures that are too overwhelming are less likely to be helpful and therapeutic.
Relearning Through Experience
Most people with OCD report being aware that their OCD fears don’t make much sense, and yet they can’t stop themselves from being afraid. This is because, with OCD, the thinking part of the brain is still functioning well. The problem is that the emotional part of the brain (the part that makes you feel anxiety and other uncomfortable emotions) is getting triggered at the wrong time, and it’s not calming down even when your thinking brain tells it to. In order to retrain this deeper, emotional part of your brain, you have to have actual experiences that prove to your emotional brain that you are safe. This is why traditional talk therapy has it’s limits and why ERP is the recommended treatment.
Three Important Elements of ERP
- Trigger: Exposures are planned therapeutic experiences, during which you purposely expose yourself to a feared situation (or trigger) that causes you to experience uncomfortable thoughts and emotions.
- Response Prevention: While you are in your feared situation, you must resist the urge to engage in the rituals and avoidance that you usually would.
- Habituation: Through repeated exposure to your feared situations, you gradually get used to them, and your brain re-learns that you can handle whatever it is you have been avoiding.
ERP is Simple but not Easy
The basic concept of ERP is pretty simple: figure out what your OCD and Anxiety are telling you not to do, and start doing those things in small, gradual steps. But the therapy is far from easy. In fact, many people who have engaged in this treatment say it is the single hardest thing they have ever done in their life. But there’s one thing that keeps them going. It works. The more you practice things, the easier they get.
Find a Therapist Who Can Provide OCD Therapy using ERP in Pittsburgh
If you are struggling with OCD or an OC Spectrum Disorder in the Pittsburgh area and are looking for an ERP therapist, contact us at The Center for OCD and Anxiety to make an intake appointment with one of our OCD therapists.
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International OCD Foundation on Exposure and Response Prevention
The Anxiety and Depression Association of America on Exposure and Response Prevention