'%20x='0'%20y='0'%20height='100%25'%20width='100%25'%20%0A%20%20%20%20%20%20%20%20%20%20xlink%3Ahref='data:image/jpg;base64,/9j/2wBDAAYEBQYFBAYGBQYHBwYIChAKCgkJChQODwwQFxQYGBcUFhYaHSUfGhsjHBYWICwgIyYnKSopGR8tMC0oMCUoKSj/2wBDAQcHBwoIChMKChMoGhYaKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCgoKCj/wgARCAAGAAoDASIAAhEBAxEB/8QAFgABAQEAAAAAAAAAAAAAAAAAAAMI/8QAFQEBAQAAAAAAAAAAAAAAAAAAAgP/2gAMAwEAAhADEAAAANExJL//xAAgEAAABQMFAAAAAAAAAAAAAAABAgMEBQAREgYic4HS/9oACAEBAAE/AJjT808c5ISRU0ciiBQUOS3QUMa7vuTa35Dea//EABYRAAMAAAAAAAAAAAAAAAAAAAABQf/aAAgBAgEBPwCs/8QAFBEBAAAAAAAAAAAAAAAAAAAAAP/aAAgBAwEBPwB//9k='%3E%3C/image%3E%3C/svg%3E)
How can exposing yourself to your fears possibly help improve your condition? Exposure and Response Prevention can sound counterintuitive in its treatment of Obsessive Compulsive Disorder (OCD), but it can actually do wonders. ERP involves exposure to your fears and response (ritual/compulsion) prevention.
OCD is a serious mental health concern that disrupts functioning for many individuals struggling with it. It is characterized by obsessions and intrusive thoughts that keep popping in an individual's mind time and again. These thoughts are ego dystonic, which means that the individual does not want to experience them. To potentially stop the obsessions, the individual engages in compulsions and the cycle goes on.
Thus, how does ERP then help an individual with managing their thoughts and behaviors?
Exposure and Response Prevention Therapy OCD
Exposure and Response Prevention in OCD is not just popular but also an effective treatment for OCD. A mental health professional has to be trained in this particular modality.
An ERP therapist will first have you rank all of your fears on subjective units of distress (SUDS) scale. This is a scale that can range from 1-7 or 1-10 (the higher numbers indicating a higher anxiety level or fear). This is called a worry hierarchy.
You will begin with exposures to fears lower on the hierarchy and work your way up. This can be a scary step to take, but beginning therapy doesn't mean its always going to be comfortable. Exposure and response prevention can be hard work. Your anxiety is supposed to rise during an exposure, but it will eventually fall.
How Does Exposure and Response Prevention Work?
As emotionally taxing as this process can be, Exposure and Response Prevention can work for you! There will be times when you might not want to expose yourself to a particular situation. This is a completely natural response in facing your fears. However, these are going to be times we need to push through the hardest to enhance our resilience and become better at dealing with our obsessions.
The goal of Exposure and Response Prevention is to learn that your fears are not as daunting as they once seemed and that compulsions are not necessary. You may also learn that you can learn to tolerate the high levels of anxiety.
There are majorly two types of exposure. Either you can begin by imagining the situations on the worry hierarchy (mental imagination) or you can engage in real-time experiences. Your therapist will never force you to expose yourself. Once you gain confidence in exposing yourself to the first level, your mental health professional will encourage you to move to the next.
In response prevention, you are actively discouraged from engaging in typical compulsive behaviors. These behaviors are thought to reduce anxiety or neutralize the distress caused by the obsessions. However, in response prevention you stop using safety behaviors.
Exposure and Response Prevention therapy is one of the most beneficial modalities not only for OCD, but also other anxiety disorders. However, if you don't do the work consistently or if you continue to complete compulsions, you won't get a reduction in symptoms.
Example Of Exposure and Response Prevention
Let us take an example of someone who has intrusive thoughts about organization, and they feel compelled to organize everything around them excessively. They think that by doing this, they can alleviate the anxiety.
In ERP, they would be encouraged to expose themselves to situations that trigger the organization obsession (example, messy cupboards, scattered toys, clothes with wrinkles, etc.) and then be instructed not to organize those items.
Over time, as the person consistently refrains from organizing excessively, their anxiety gradually decreases. They eventually learn that they can tolerate the distress without the need to perform their compulsions.
Exposure Response Prevention is now considered the gold standard treatment for Obsessive Compulsive Disorder. However, it is important to set realistic expectations when you start this modality of therapy. You are likely to still experience fear, anxiety, and disgust when you encounter triggers.
Further, you are also likely to feel uncomfortable when intrusive thoughts pop up. However, with skills you learn through ERP, you can move towards a more positive direction. This direction takes you away from OCD and towards a better life.
Janvi Kapur is a counselor with a master's degree in applied psychology with a specialization in clinical psychology.
What do you think of this story? Tell us in the comments section below.
