Exposure and Response Prevention Therapy for OCD

If you’ve been reading my articles for a while, you know I’m a big proponent of exposure and response prevention (ERP) therapy for the treatment of obsessive-compulsive disorder. I don’t delve into the details often, as I’m not a therapist or an expert on ERP. However, I do think it’s important for anyone whose life has been touched by OCD to have a good basic understanding of this therapy.

The premise behind ERP Therapy is straightforward: face your fears repeatedly, and eventually they will cease to frighten you. Sounds easy (well, at least to those of us without OCD). But as we know, nothing related to obsessive-compulsive disorder is simple, and in fact, ERP Therapy can get quite complicated. This article titled “Common Pitfalls in Exposure and Response prevention (EX/RP) for OCD” by Seth J. Gillihan was published in the Journal of Obsessive-Compulsive and Related Disorders in May 2012 and discusses various mistakes that well-meaning therapists might make while using ERP therapy. For example, some therapists don’t encourage their clients to go far enough in their exposures — to do what is most difficult for them. Other therapists might choose the wrong type of exposures, or even interfere with proper therapy by encouraging the use of distraction. Some other topics discussed in the article, which I highly recommend reading, include providing reassurance, treating peripheral symptoms and not the core fear, and ineffectively handling mental compulsions. Dr. Gillihan’s analysis demonstrates how important it is to work with experienced therapists who truly understand the complexities of OCD and ERP.

Also, ERP Therapy, like OCD, is often misrepresented by the media and misunderstood by the general public. Reality shows where patients are asked to do things such as licking toilet seats do more harm than good. Someone with OCD who is already apprehensive about beginning treatment will surely stay away after seeing this portrayal.

We need to present accurate, quality information. Exposure and response prevention (ERP) therapy is the evidence-based psychological therapy recommended by the American Psychological Association for the treatment of obsessive-compulsive disorder. Some basic rules of ERP therapy that are important to know include:

1. You won’t be asked to do anything your therapists wouldn’t do themselves.
2. You won’t be asked to do anything illegal, immoral, or dangerous.
3. You won’t be forced to do anything against your will.

Just as we need to spread the word as to what OCD really is and is not, we also need to provide the truth about exposure and response prevention therapy. And who better to do that than those who have embraced ERP therapy to free themselves from OCD? I have heard from many of these people and not one of them has ever regretted committing themselves to exposure and response prevention therapy. In fact, the only regret I ever hear mentioned is the wish that they had attempted ERP sooner. So if you have OCD and have been avoiding ERP therapy, please take the plunge. You won’t be sorry. Because with successful ERP therapy comes what everyone with obsessive-compulsive disorder wishes for — a life not dictated by this insidious disorder.