Exposure and Response Prevention (ERP)
If you visit any reputable website to learn more about Obsessive Compulsive Disorder (OCD) and it's treatment, you will inevitably find mention of Exposure and Response (or Ritual) Prevention, also known as "ERP", as being the "gold standard" of treatment for OCD.
So what does ERP involve?
Exposure and Response Prevention (ERP) is a form of Cognitive Behavioral Therapy. When conducting ERP, your psychologist first starts with an assessment to learn more about your OCD symptoms and how they impact you. This is important because no two people with OCD have the exact same symptoms (which probably reflects how creative the OCD brain can be!)
The psychologist will ask about your obsessions - these are the thoughts, images, or urges you experience as unwanted or distressing in OCD. They will also ask about compulsions or rituals. Rituals are behaviors the person does in order to alleviate distress caused by obsessions, often as a way to prevent some sort of feared outcome (i.e., washing hands repeatedly to prevent getting sick).
The next step is often education! Why? Well, research shows that simply having education about OCD, such as how it operates and how ERP works, helps us to not only engage in treatment but is beneficial overall in reducing symptoms. Essentially, when you're armed with correct information, it's a lot harder for OCD to continue to "boss you around". After that, your therapist will work with you to create a hierarchy of things that you fear or currently avoid doing due to your OCD symptoms. Slowly, and at a pace you feel comfortable, your therapist will work with you to face these fears or avoided behaviors without engaging in your usual rituals. CBT in general, and ERP especially usually involves homework, or practice between sessions. This is important because each time you confront your fear, or skip a ritual, you will see it gradually gets easier.
So, how does ERP work?
Researchers and clinicians who specialize in OCD believe that ERP works for two reasons: First, as you gradually confront a fear, without a feared outcome, you will experience what is known as "habituation". We see this concept even in treatment for phobias. Meaning, if seeing a spider for the first time is a 10 (with 0 being not anxious at all, and 10 being the most anxious one could be), seeing a spider over and over doesn't stay a 10. Your anxiety naturally comes down! This is what is referred to as the habituation model of exposure. The second way exposure works is via what is known as inhibitory learning. What this model suggests is that every time you confront a fear, without engaging in a ritual, and the feared outcome doesn't occur, your brain learns it no longer has to fear this situation and that you can cope with discomfort.
So what does ERP involve?
Exposure and Response Prevention (ERP) is a form of Cognitive Behavioral Therapy. When conducting ERP, your psychologist first starts with an assessment to learn more about your OCD symptoms and how they impact you. This is important because no two people with OCD have the exact same symptoms (which probably reflects how creative the OCD brain can be!)
The psychologist will ask about your obsessions - these are the thoughts, images, or urges you experience as unwanted or distressing in OCD. They will also ask about compulsions or rituals. Rituals are behaviors the person does in order to alleviate distress caused by obsessions, often as a way to prevent some sort of feared outcome (i.e., washing hands repeatedly to prevent getting sick).
The next step is often education! Why? Well, research shows that simply having education about OCD, such as how it operates and how ERP works, helps us to not only engage in treatment but is beneficial overall in reducing symptoms. Essentially, when you're armed with correct information, it's a lot harder for OCD to continue to "boss you around". After that, your therapist will work with you to create a hierarchy of things that you fear or currently avoid doing due to your OCD symptoms. Slowly, and at a pace you feel comfortable, your therapist will work with you to face these fears or avoided behaviors without engaging in your usual rituals. CBT in general, and ERP especially usually involves homework, or practice between sessions. This is important because each time you confront your fear, or skip a ritual, you will see it gradually gets easier.
So, how does ERP work?
Researchers and clinicians who specialize in OCD believe that ERP works for two reasons: First, as you gradually confront a fear, without a feared outcome, you will experience what is known as "habituation". We see this concept even in treatment for phobias. Meaning, if seeing a spider for the first time is a 10 (with 0 being not anxious at all, and 10 being the most anxious one could be), seeing a spider over and over doesn't stay a 10. Your anxiety naturally comes down! This is what is referred to as the habituation model of exposure. The second way exposure works is via what is known as inhibitory learning. What this model suggests is that every time you confront a fear, without engaging in a ritual, and the feared outcome doesn't occur, your brain learns it no longer has to fear this situation and that you can cope with discomfort.