Obsessive-compulsive disorder is too often misunderstood. Many folks use the abbreviation OCD as shorthand for anyone who is very organized or hygiene-focused. But it’s so much more than that. As the name suggests, OCD involves a cycle of obsessions and compulsions. The obsessions are anxiety-causing thoughts and fears. In response, someone with OCD will perform rituals meant to prevent danger from happening. These are the compulsions — some of which may involve the aforementioned bent toward order or cleanliness.

OCD’s intrusive sequence of events can interfere with daily functioning, thus making this a very serious disorder. Fortunately, exposure and response prevention (ERP) therapy has become an effective form of treatment for people with OCD.

What is ERP for OCD?

The “exposure” part of ERP is precisely what you’d imagine it is. In other words, ERP is not about avoiding obsessions but, rather, facing them and changing part two: your “response.” This is a realistic approach because distress and its triggers can never be deleted from anyone’s life. What matters most is how we react to these inevitable trials.

Yes, it can feel challenging at first to provoke intrusive thoughts, but ERP’s long-term effect is worth the initial discomfort. 

How It Works

Of course, every person is different, and every manifestation of OCD is unique. Thus, ERP will be adapted on a case-by-case basis. Be that as it may, we can still explore one form of ERP. 

You’re exposed to a trigger and, therefore, feel a powerful need to perform a compulsion to neutralize it. For the sake of this description, let’s say the compulsion needs to be performed immediately, and it involves 6 or 7 parts. Here are some steps you can take via ERP:

• Delay the first step. Challenge the immediacy by taking time (maybe ten seconds, maybe ten minutes) before taking any action. This may feel scary, but just control yourself before allowing the compulsion to take control. Over time, you will want to lengthen the duration of the delay. This weakens the power of the cycle and transfers some of that power back to you.

• Perform the compulsion, but remove one of the five steps. So yes, you still submitted to the compulsion, but not without removing a little more of its control.

From there, with your therapist’s support, you can incrementally increase the delay time while slowly removing other phases of the compulsion. Over a time frame that feels right for you, ERP will eat away at the OCD cycle until you can experience an intrusive thought but not perform the compulsion.

This is not a guarantee or a “miracle cure.” You may slide at times and go back to restart at an earlier point. What matters is that ERP causes improvement, which, in turn, infuses the entire process with hope. ERP, combined with other therapies or possibly medication, can be a game-changer for someone with OCD.

How ERP is Used

Initially, ERP is done in a clinical setting. Your therapist may use pictures or videos to expose you to a known trigger gently. As things progress and you improve in maintaining control, it may become your responsibility to envision common obsessions (with a visual cue). With the therapist nearby, you will then practice the steps of ERP. Next comes homework, e.g., the client is guided on how to practice ERP coping skills outside the therapy setting.

Thanks to ERP, you can learn more about OCD and more about what it takes to control it. OCD has no known cure but approaches like ERP offer hope when it comes to managing the symptoms and regaining control of your day-to-day life. 

Learn more about OCD Treatment.