Exposure and Response Prevention (ERP)
Exposure and response prevention, or ERP, is a cognitive-behavioral therapy treatment approach considered to be the gold standard for treatment of OCD…The “exposure” part of ERP involves confronting feared intrusive thoughts, urges, or images and situations that trigger them. The “response prevention” part means not engaging in your usual responses and instead staying in situations, accepting your feelings of anxiety and distress, and not using compulsions. Initially, your anxiety is likely to increase as you face your fears rather than avoid them, but if you stay with your feelings and don’t try to escape from them, you’ll learn that you can handle them and that your fears are not likely to be realized. Of course, you’ll never know this to be true unless you try it. That’s the problem with the OCD cycle: you repeat the pattern of trying to escape and avoid uncomfortable feelings, so you don’t learn what happens if you allow yourself to feel discomfort. In ERP, instead of trying to escape discomfort, you intentionally face thoughts, urges, and images. New learning takes place.
Ted “When I started ERP, I thought I would work through my ERP items, and when I finished the last one, my OCD would be gone. But obsessions aren’t static. There’s not just one clear set of distressing events. New ones always come up. ..The most important result of my treatment is that now I know there’s an answer. I know what to do: I need to practice ERP…As stressful as immersing myself in the fear might sound, eventually it leads to immense relief.”
This is the end of the excerpts from Daring to Challenge OCD: Overcome Your Fear of Treatment and Take Control of Your Life Using Exposure and Response Prevention by Joan Davidson, Ph.D. All excerpts are with permission of the author.