Obsessive/compulsive disorder (OCD) can seriously disrupt someone’s everyday life. Unwanted intrusive thoughts, or obsessions, can cause tremendous anxiety. The physical and mental actions someone takes to relieve the anxiety of OCD can also decrease their quality of life. Exposure and response prevention (ERP) therapy is an effective treatment for OCD.
ERP is a type of cognitive-behavioral therapy (CBT), which is a type of “talk therapy” or psychotherapy that works to alter unwanted behavior patterns. The International OCD Foundation says that ERP is the most important type of cognitive-behavioral therapy for OCD.
OCD takes over the body’s “alarm system” which normally protects us from danger. In other words, OCD causes feelings of being in real danger, even when the threat is very small. It is normal to feel concerned when someone who looks ill coughs on you, for example, but OCD can cause you to feel extreme anxiety at the mere thought of germs on a doorknob or your hands.
Obsessive/compulsive disorder affects 2.2 million adults in the United States or about 1 percent of the adult population. Obsessions are repeated thoughts, mental images, or urges that cause anxiety. Common obsessions include:
- Fear of germs or contamination with germs
- Concerns about harm towards yourself or someone else
- Needing things arranged in or lined up in a specific way
- Unwanted or “forbidden” thoughts about religion or sex
- Thoughts of aggression towards yourself or others
Experiencing these thoughts can cause anxiety. Compulsions are behaviors that you feel you must perform repeatedly to reduce anxiety or stop the obsessive thoughts. Compulsive behaviors may include:
- Excessive handwashing or cleaning
- Repeatedly checking on things, such as making sure the oven is off or the door is locked
- Arranging and rearranging things in a particular way
- Compulsive counting
What is ERP?
ERP therapy gradually exposes people with OCD to situations that provoke their obsessions and anxiety in a safe environment. While the therapy does not completely remove all distressing situations and anxious thoughts, ERD does make it possible for people with OCD to cope with everyday situations without the need to engage in compulsive behaviors.
Therapists guide patients through ERP by providing the person with coping skills they can use when a triggering situation presents itself. In the first stages of therapy, the patient may simply look at the item or items that trigger anxiety. As therapy progresses, the individual may hold the item or use it normally. With practice in a safe environment, the person with OCD can then use these skills to prevent their compulsion from taking over their everyday life.
How ERP Works
The exact techniques used in ERP depend largely on the specific obsession and compulsions a person has, but often involve exposing the individual to the trigger slowly and reinforcing healthy behaviors that reduce anxiety.
Someone who is afraid of germs may experience extreme anxiety when they have to touch a doorknob, for example. ERP would involve having the individual touch a clean doorknob in the safety of their clinician’s office. As therapy progresses, the clinician may encourage the person to touch the doorknob then touch their face to address the patient’s fear of spreading germs.
ERP can help people with OCD overcome their obsessions and control their compulsions. For more information about ERP, consult with your psychiatrist.
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