Updated: Feb 9
There's a chance that if you have OCD, you've heard that Cognitive Behavioral Therapy (CBT) is the best way to treat it. But did you know - there are multiple forms of CBT, and not all of them work for OCD? For example, one way a therapist can do CBT is teach you how to use logic to challenge your thinking - but that doesn't usually work for OCD! For folks with OCD, that can often turn into an anxious spiral or an endless internal argument. Instead of this form of talk therapy, the form of CBT that works best for OCD almost always involves Exposure and Response Prevention (ERP, or EX/RP).
ERP, in essence, involves learning the skills to experience the distress associated with obsessions, without doing rituals or other compulsive behavior.
Learning those skills requires that you work toward facing your obsessional triggers, without doing any rituals.
Think about it like this - when you have OCD, your brain has a faulty alarm system. Your brain is telling you that certain things are a HUGE threat to you - and no matter how much you try to talk yourself out of that fear, the alarm system keeps blaring.
Whenever you do a compulsive behavior, the alarm shuts up - for a little while. Sweet relief! Thing is, the next time it comes on, it's louder, and more annoying than ever. Not to mention, all that effort to quiet the alarm system can take up a whole lot of time and energy. Eventually, this whole thing can really wreck your life.
Exposures help you learn how to let the alarm blare until the batteries die. Rather than trying to control the alarm system with compulsions, you can learn skills in tolerating the noise. Eventually - you get stronger, and the noise gets quieter.
OCD specialists are trained to design exposure exercises that result in lasting change.
Just facing your fears isn't going to cut it - you've probably already tried. But facing your fears in the right way - for the right length of time, with the right frequency - making sure no rituals take place - and with helpful processing before and after - may start to help you gain mastery over OCD. In ERP, your therapist is there with you - making sense of your OCD, helping you identify what you need to learn, designing exposures, checking in on compulsive behaviors, holding you accountable, and cheering you on. Something this hard to do - is so much harder to do alone.
ERP is hard work - but so very worth it. OCD can wreck your life, and ERP helps you gain the skills to get your freedom back. When obsessions and compulsions are taking up hours of your valuable time, making you miserable, hurting your relationships, or holding you back from the life you want to live - seek out an ERP therapist. There's a light at the end of this tunnel.
Providers at the Anxiety and Trauma Clinic of Atlanta are trained to provide high-quality Exposure and Response Prevention. Other OCD specialists can be found online in the IOCDF directory: https://iocdf.org/find-help/