Exposure and Response Prevention Therapy (ERP) for OCD
If you or someone you know has Obsessive Compulsive Disorder (OCD), chances are you’ve considered mental health therapy as a treatment option. But not all types of therapy are best suited to help people with OCD. It’s important to find a therapist that specializes in treating OCD so that you can learn the right tools and coping mechanisms to challenge your compulsions. Exposure and Response Prevention (ERP) Therapy is a viable option for most clients looking to find relief from their OCD symptoms. Other options for OCD treatment include ACT and I-CBT. Even IFS is gaining some traction with OCD (personally I found it helpful for the deeper roots of my OCD), though it isn’t evidence based yet and shouldn’t be used as a stand alone treatment for OCD. Typically, people need a blend of approaches to find lasting healing- and ERP is a foundational one for most OCD sufferers.
What is Exposure and Response Prevention (ERP) Therapy and How Does it Work?
ERP Therapy is a type of Cognitive Behavioral Therapy (CBT) that is designed to treat OCD symptoms specifically. It differs from traditional talk therapy as it aims to target and prevent the ritual behaviors (compulsions) of those with OCD. To break it down, you and your therapist will work together on gradually exposing yourself to any thoughts, circumstances, images, and/or objects that trigger your obsessions. In doing so, you will learn how to deliberately prevent yourself from acting on your compulsions despite the anxiety that comes along with the exposure. Confronting the fears and reducing the compulsions is on YOUR terms, we will support you in going at whatever pace feels most doable. There are also many ways to break down the exposures to feel more manageable and values based.
I know this may sound scary at first, but your provider will guide you through how to safely confront your obsessions (fears/intrusive thoughts) and will even do it with you if that feels supportive. Your therapist will also help you develop strategies for preventing the compulsions. Once you’ve had some practice with the techniques of ERP therapy, you will notice that your anxiety decreases (over time, not right away) when you don’t give into your compulsions. Despite what your OCD tries to make you believe, you will actually feel better when you are exposed to the things that make you anxious without reacting. This is because when we stop avoiding the distress of the intrusive thoughts, our brain gets to learn that the thoughts are not important or scary, and we can tolerate the anxiety they bring without using rituals. In fact, the rituals fuel the anxiety in the long run, despite the temporary relief they also provide.
Eventually, we can grow to accept your intrusive thoughts as they are (this doesn’t mean you like them, you just accept that they are part of your brain being a brain) rather than feeling the desperate need to neutralize them. Reducing the need to carry out your compulsions is known as habituation, and it plays a major role in the healing process of ERP therapy because after repeated exposure to a fear, we begin to adapt and feel less afraid. Think of the first time you drove a car on the freeway- was it scary? Did you eventually get used to it to the point where it felt like second nature? That’s habituation! ERP also works through a process called inhibitory learning, which you can learn more about here.
How Do you Know if ERP Therapy is Right For you?
Seeking professional help for your OCD can be challenging. Deciding to start ERP Therapy can feel like you’re betraying yourself – why put yourself through the discomfort of exposing yourself to the very things that send your anxiety into overdrive? However, extensive research has shown that ERP, as well as medication, and adjunctive therapies like ACT and I-CBT have been deemed the most effective modalities of treatment for OCD. If you’re exhausted from the constant cycle of feeling like you’re in danger unless you act on your compulsions, it may be time to find a therapist that can provide support- and my team has professional and lived experience with OCD, we’d love to help you.
OCD can truly feel like a mental cage; your mind sets off alarm bells for threats that aren’t actually present and it can feel like the only way to shut the alarm off is to engage in compulsive behaviors. With time, persistence, a lot of self compassion and willingness, ERP therapy will equip you with the techniques you need to change the way your brain works. This way, you can challenge your OCD instead of fueling it.
*It’s important to note that ERP shows slightly less effectiveness when it comes to treating autistic folks with OCD- especially if their intrusive thoughts involve sensory differences. There are ways to adapt ERP to be autistic affirming, and some folks do find relief with this model, but if this doesn’t feel like a fit because of your neurotype, we also offer I-CBT which is completely different and does not require exposure! That being said, it is super important to find a neurodiversity affirming OCD therapist if you are autistic. Reece and Parisa on my team are both well versed in this area.
Getting Started in OCD Treatment
Are you ready to move forward in your OCD recovery journey? We offer online therapy to folks in CA, WA, UT, FL and MD. We have limited in person availability in San Diego, CA. You deserve to be free from the hold that your OCD rituals have over you, and we can work together to achieve that. We offer free consultation calls if you’d like to reach out to talk more about getting started in online OCD treatment.
At Eating Disorder OCD Therapy, we offer compassionate, relational, and individualized care, rooted in the belief that healing is not one-size-fits-all. Honoring client autonomy, collaboration, and anti-oppressive, neurodivergent-affirming practices, we walk alongside you as the expert in your own life. We provide therapy for Eating Disorders, OCD, Body Image, Trauma, Maternal Mental Health, and offer Ketamine Assisted Psychotherapy (KAP), Group Therapy (globally), Recovery Coaching (globally), and Clinical Consultation and Supervision for clinicians. We are currently accepting new clients for in-person therapy in San Diego and virtual services in California, Washington, Utah, Maryland and Florida.
