Reviewed by Whitney White, MS CMHC, NCC., LPC
To understand how ERP could help cope with OCD, we should train our attention to the mind. The mind works by protecting itself and strengthening your identity. In the case of OCD patients, the mind appears to be working overtime. Extraneous thoughts that should otherwise have been ignored start to appear useful. This false sense of usefulness tricks the mind into a pattern of compulsions and avoidances. Slowly, these obsessive reactions start to form patterns of the same.
Exposure and Response Prevention Definition
Exposure and response prevention therapy interrupt these patterns. The patient is encouraged to be proactive when facing their fears – such as knives, shoes, or even creatures like snakes or spiders. A process of learning and discovery starts to take place. That is because the self is going to go against the advice of the mind. The mind would not be able to trick the self into a pattern of obsessions that eventually leads to OCD.
Gradually, this begins to take the shape of interaction with fearful stimuli or experiences in a safe, habituated way. As you notice that you can respond healthily to what was fearful earlier, your mind begins to open. You will begin to observe how you do not have to listen to your mind and ignore the advice that comes out of it. Gradually the assumptions that are coming out of your mind will begin to be exposed and your new experiences invalidate the old thoughts.
Cognitive-behavioral therapists tend to refer to this as a type of inner wisdom. Instead of the previous assumptions, you will find yourself drawn and habituated to your inner wisdom, handling situations that had once been difficult for you on a day-to-day basis.
ERP Therapy for OCD Helps You Focus on The Outside
The therapist will first get to work on your system of beliefs. If they can tweak that system to work for you even just a little bit, consider your investment worthwhile. For example, for ERP to work, your therapist has to get you to focus away from your thoughts and feelings, particularly the aspect of control over them. Many patients fighting OCD feel like they need to control their system of thought processing and the way they should feel about experiences. They believe that this is the way to address the intrusive quality in such thoughts, which leads to anxiety. Some believe that they may not be able to move on in life unless they have a terminator like control over their thoughts and feelings. Until then, everything in life is put on a backburner, including plans to start a new business, go back to school, start a new relationship, etc. Your therapist is there to teach you to disconnect from internal experiences and to craft them anew.
The therapist also needs to teach you that your system of beliefs and feelings make up what is known as internal events. This means that reacting to them as if they were external is not going to be helpful. That is because external events can be easily discarded. For example, if the rack and pinion assembly malfunctioned in your car, you could simply overhaul your steering system. However, you can't do that with your thoughts and feelings. The overall idea is to not react and get yourself in a negative pattern. This negative factor eventually turns into a full-blown anxiety cycle.
My Peer Circle Has Already Told Me What It Entails
ERP therapy for OCD may look like varies from person to person. This is because every treatment plan is specifically designed for every individual patient. There is no merit in learning about what the treatment was like for another person and how much success they had. Your ERP treatment plan is going to focus on your triggers and whatever is meaningful to you. The job of your counselor is to channel your experiences through ERP therapy in a productive fashion.
This likely means that your OCD treatment will not be hierarchical in that the most significant of your triggers come first. Instead, you can expect it to be kind of like life is. Your counselor may work with you to get you used to experiencing triggers and stimuli just as they would occur to you in day-to-day life—randomly.
Keep in mind that you are going to learn before, through, and after exposure. As you find yourself repeatedly exposed to triggering events, you will learn to better handle your internal reactions in terms of your emotions, sensations, fears, etc. You will also learn to stop engaging with or fighting with them.
Gaining control over your internal reactions will give you greater freedom. OCD patients also report a sense of empowerment once they can channel experiences away from the internal reaction.
Even if your counselor hasn’t gone over this, considering answering the three following questions after every exposure:
- Did you learn something from this exposure?
- How could you be more flexible in your response if a similar trigger would come unto you in the future?
- Are there safe opportunities for you to practice a response to a similar fear in the future that will lead to an improvement in your overall well-being?
Eventually, a patient can learn to observe their internal responses via a different mindset. The learning was all about observing them, much like you would a gas balloon floating away, without engaging at all. That will gradually improve the quality of your life.
You Can Overcome Your OCD
At all times, you have a choice: to be active or to be passive when dealing with your OCD mind. The choices are also extreme. You’re either controlling your emotions, your mood, and eventually, your life, or you're getting entirely trapped. Using ERP therapy to treat OCD is about looking your fears in the eyes and somehow finding even greater courage and intensity to make it through the moment. This process is similar to how many people suffering from obsessions and compulsions deal with their condition daily. You must carry your mind along for a ride and observe the balloons floating away.
We have put together a complimentary test for you to evaluate your OCD symptoms. This test will allow you to see how much your symptoms match and how you are managing your condition. This will give you the information you need to discuss your treatment plan with your doctor or therapist.