Exposure and Response Prevention (ERP) is a type of therapy that has been shown to be extremely effective in treating OCD. It involves confronting the thoughts, images, objects, and situations that make you anxious and then stopping doing the rituals (your compulsions). Typically, this rapidly increases your anxiety, making it harder and harder for you to continue refraining from their neutralizing compulsion. But, nonetheless, you’re asked to sit in your anxiety and when you do that, the anxiety begins to decrease in time. The reduction in anxiety that happens when you are able to expose yourself to your stressor without responding compulsively is called habituation.
In essence, OCD puts you on high alert when no threat really exists. It hijacks your body, warning you of danger that is not there. ERP aims to reset your body’s alarm system.
ERP uses a careful, systematic approach, starting with creating your list of triggers and then ranking their difficulty (your level of anxiety) on a scale of 1-100. This way you expose yourself to more manageable fears before progressing into more challenging ones. Your confidence will increase, thus making it easier to enhance your skills and better learn to handle your anxiety. This ultimately prepares you for the harder exposures that lie ahead.
As an OCD therapist, I use ERP with elements of Acceptance and Commitment Therapy (ACT). Instead of focusing on just symptom reduction, we focus on your rated willingness (acceptance) to experience exposures. And integrating mindfulness, another feature of ACT, into your exposures will teach you how to have your obsessions and anxiety without trying to get rid of them. This will free up your time & energy so you can focus on what really matters to you.
ERP may be coupled with relaxation techniques that enhance your ability to withstand your discomfort. These relaxation methods may include deep breathing, progressive muscle relaxation (tensing and then relaxing the muscles in the body), guided imagery (or relaxation visualization), and meditation.
And, of course, we also pay attention to your nutritional health, physical activity, and sleep quality – super important factors to your overall health.
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