THERAPEUTIC RECOVERY NETWORK
Exposure & Response Prevention (ERP)
The psychotherapy of choice for the treatment of OCD is exposure and response prevention (ERP), which is a form of CBT. In ERP therapy, people who have OCD are placed in situations where they are gradually exposed to their obsessions and asked not to perform the compulsions that usually ease their anxiety and distress.
More about OCD
One of the hallmark symptoms of OCD is obsessions, which are unwanted, intrusive thoughts, images, ideas, or urges that cause significant distress. These can include doubts about one’s own identity, intrusive thoughts about doing harm to others, unwanted fixation on physical sensations, and a wide range of countless others. OCD also includes compulsions, which are physical or mental behaviors done to reduce this distress created by the obsessions. Compulsions are often done with the aim of detecting and neutralizing a perceived threat to prevent a feared outcome from occurring. Compulsions may provide short-term relief from the distress caused by obsessions, but it reinforces the belief that compulsions successfully dealt with a real danger or threat, allowing obsessions to return more frequently and causing more distress over time.
What is ERP Therapy
ERP therapy alters OCD's pattern by addressing both obsessions and compulsions. In ERP, an individual is encouraged to confront the stimuli that trigger distress related to their obsessions while also resisting the urge to perform compulsions in an attempt to reduce their distress.
Instead of responding with compulsions in order to resolve distress or avoid a feared outcome, someone in ERP therapy will learn to accept the uncertainty behind their obsessions and allow their distress to dissipate over time. Additionally, instead of avoiding their obsessions or distracting themselves from them, someone in ERP will simply acknowledge that they are having an unwanted thought, idea, image, or urge, without giving it any particular attention.
The success of ERP often depends on consistently practicing exposures outside of therapy sessions. This may occur in planned, structured activities, or due to sudden, unplanned situations that naturally arise in daily life. Response prevention skills are crucial to addressing either of these circumstances. With proper guidance, these skills can be built over time, eventually becoming habits for the person with OCD.