If you suffer from OCD, you know how much anxiety your triggers and compulsions cause.
And while you may attempt to avoid these, it doesn't solve anything in the long run.
Often when seeking treatment for a mental illness, talk therapy may come to mind. While this may be beneficial, it is not always the most effective for treating OCD.
The most effective treatment for OCD is Exposure Response Prevention. ERP is a twofold process:
Expose a patient to their triggers and encourage them to disrupt the compulsive urge. So, how does ERP work? Can it improve your quality of life?
Exposure to Obsessions
It's completely normal and natural to want to run away or hide from situations that cause extreme stress. When our bodies sense we are in danger, an internal alarm system goes off. No wonder those who struggle with OCD tend to avoid their stressors! There are so many different ways this can manifest depending on the person.
Some common examples of avoidance can include:
- Staying away from a public bathroom (Contamination OCD)
- Obsessing about a romantic relationship (Relationship anxiety)
- Refraining from “sinful” acts (Religious fear)
While this may provide temporary relief, avoidance can cause more harm than good.
True recovery from OCD starts with facing those fears head-on- with some help, of course.
In a session, you’re encouraged to explore triggers in a safe environment.
This safe environment is what helps disrupt the OCD cycle!
Since each person's OCD varies, treatment’s personalized and tailored to individual needs.
ERP works to shift distorted beliefs into healthier ones through continuous exposure.
With a safe environment to experience uncomfortable feelings, profound changes can occur.
If you think you may have OCD, or want to gain more insight on what types you may deal with, you can take a free online test.
It's important to note that online tests are not a diagnosis. So check in with your healthcare provider if you need support and confirmation.
So, what does this exposure look like?
Types of Exposure
There are 3 main modes of exposure used in ERP Therapy. The most practiced is Vivo Exposure.
It exposes the patient to their trigger and encourages them not to act on the compulsion. With time and practice, the patient's anxiety becomes desensitized.
Virtual Reality & Imaginal Exposure are not as practiced as Vivo Exposure.
Virtual Reality Exposure uses technology, acting as a visual experience for the patient. While Imaginal Exposure uses imagination and visualization techniques.
While picturing situations in a safe space can be beneficial, it can also be a fast track to major anxieties. This is why Vivo Exposure is the safest and most effective form of ERP.
It's important to mention that medication is usually paired with ERP treatment. Having a variety of tools at work can make all the difference in the recovery process.
With that said, let's take a look at some different methods a therapist may use or suggest in treatment.
Methods of Exposure
What can we expect when we place our trust in someone who triggers you and helps you simultaneously?
Luckily, you do have a say in how you receive this treatment. Personal boundaries and limits are key in a professional setting. Your therapist is there to listen.
The safest and most effective exposure method is gradual exposure.
Patients explore and experience their triggers while desensitizing them little by little. Over time, the intensity of exposure increases.
It is the safest method because it exposes the patient in gradual steps rather than all at once.
An example of how you may approach this is by establishing an Exposure Hierarchy. You can work with your therapist to discern which stressors cause the most and least anxiety.
Another method is Flooding, exposing the patient to intense emotions, anxieties, and triggers.
While flooding can be effective for some people it can discourage future treatments. Up to 30% of patients drop out of treatment because of the anxiety it can cause.
Communicate with your therapist about how you are feeling to ensure the best results.
So what happens after getting exposed to triggers?
Responding vs. Reacting
Coping with triggers looks different for everyone. A lot of the time, the coping mechanisms used to soothe anxiety and stress can perpetuate the cycle.
The second aspect of ERP therapy touches on responding rather than reacting:
What you do after you get triggered is the key cornerstone for recovery.
You may tend to react to the stressor and engage in the compulsion. Thus maintaining the destructive cycles with no positive change.
This is where the disruption comes in. The therapist instructs you to embrace the discomfort and refrain from the compulsion.
The more you practice, the less likely you are to engage in the compulsion. This creates a more productive pathway your brain and body get used to over time.
When you focus on the automatic reaction, there is an opportunity for change. At the end of the day, you are in control.
A Note on Prevention
ERP treatment aims to prevent the cyclical nature of OCD, and the rituals one engages in to cope. So true prevention only occurs when the reaction turns into consistent positive responses.
Once the anxiety has surfaced, the positive response rate becomes quicker and easier. Prevention becomes the growing buffer between the feeling and the potential reaction. All together, making it much easier to move forward in a healthier and positive direction.
Closing Thoughts
There are ways to improve your life with OCD. It doesn't have to always be this way.
ERP allows the opportunity to do that.
It's important to understand that ERP treatment is not a cure, but a practice.
ERP requires 8-12 weeks to see noticeable results in behavior.
So patience and self-compassion are key in the recovery process. Small steps are still steps towards a stabilized future.
Contact your healthcare provider for support and referrals to learn more about ERP Therapy and how it can help you or a loved one.
