On the fence about ERP?
If you have researched Exposure and Response Prevention therapy (ERP), you might have learned that it’s challenging and distressing work that requires a lot from you. In ERP, your therapist guides you to expose yourself to the thoughts, images, objects and situations that make you anxious or spark your obsessions. Sounds like a fun time, right?!
No, it isn’t fun — but the rewards can be life changing. There must be a reason why people sign up for this special kind of torture (and pay good money for it.) ERP has the strongest evidence supporting its use in the treatment of OCD, especially if coupled with a class of medications called serotonin reuptake inhibitors, or SRIs.
Many people struggle to fully commit to ERP because they are hesitant to let go of their rituals and compulsions. In fact, you might even think your compulsions make you more dependable, careful, ahead of the curve, or good at planning. But if you find yourself on the internet searching for more information about treatment, there is probably a part of you that wants change.
What is causing you to think this is a problem?
Consider what it is that is pulling you toward change. Perhaps you find it harder to focus due to the anxious chatter in your head. Perhaps your relationships are suffering from your daily stress or anxiety. Maybe you find yourself getting lost in “what if’s” to the point that it sparks panic. Or maybe you are exhausted from the daily vigilance that your anxiety requires of you. Try to identify what is causing you to think this is a problem.
From there, consider what you might like about making a change. How would your life be different if your OCD or anxiety was managed better?
Why take the risk?
ERP is designed to empower individuals to live a life based on their values rather than fears. By tackling a list of scary-but-approachable tasks, a person gains confidence in their ability to do hard things and tolerate distress. Clients of ERP learn how they can call the shots in life instead of being controlled by their anxieties. They also learn and practice coping skills that can be used when distress gets too escalated, in order to prevent panic.
When contemplating ERP, a former client put it plainly, “So I basically have two options: to be controlled by my OCD in a state of fear and stress, or to grow and learn in a state of fear and stress. I guess I’d rather suffer in the right direction.”
Below you will find a few more quotes from current and past clients who have benefitted from ERP…
“After years of feeling helpless and out of control in the face of OCD, ERP feels like a relief. What I love about the therapy is that it’s so actionable - because of that, I’ve started to break through compulsions that I thought I would never be able to release. Not only do I feel a little more empowered every day, but I feel like this therapy has given me a new language to communicate what’s going on inside my brain.”
“Before ERP, I was terrified to go to the grocery store by myself. In ERP therapy, we came up with baby steps to help conjure my anxiety and compulsions around going to the grocery store. The first of my exposures was just driving to the grocery store by myself when traffic wasn’t bad, then when I felt comfortable with that it went to going into the store and just grabbing three items. Now when I need to go to the grocery store I don’t have hesitation to walk out the door and go because I’ve showed myself (and my anxiety) that I can do it! ERP therapy may seem difficult but it’s so worth it and I’m excited to see what more I can overcome because of it! I finally feel like I have some handle on my anxiety and OCD.”
Still not convinced?
Consider using this tool: Cost/benefit analysis. Created originally for individuals considering sobriety, this exercise can also be used to help you weigh the pros and cons of compulsive behaviors. Follow the instructions at the link and replace “my addiction” with “my compulsions.” Remember, compulsions (AKA rituals) are repetitive behaviors or thoughts that you feel you must do in order to feel relief from obsessions. A good indicator that a behavior is a compulsion is if you feel as though you must do this right now or things won’t be okay.
If you do ultimately decide you’d like to try ERP, it is extremely important to have a therapist who is trained in ERP. Feel free to contact me for availability or referrals.
