Exposure and Response Prevention (ERP)
Exposure and Response Prevention Therapy is the gold standard intervention for Obsessive Compulsive Disorder. It is a specific form of Cognitive Behavioral Therapy where you are repeatedly exposed to the triggers to your anxiety and taught how to resist the urges to engage in the compulsive or ritualistic behaviors that typically follow.
We often start by creating an exposure hierarchy (sometimes called an anxiety hierarchy), which is a list of all of the triggers to obsessive or ritualistic behaviors. We then systematically work our way through this list while also learning a variety of strategies to help you resist the urge to engage in a compulsion.
For many people, just hearing this strategy described is enough to create a spike in their anxiety. My treatment approach is to always move at a pace that feels comfortable for you. The process of making change in therapy is not always easy because discomfort is often part of change. Our job together is to find the correct balance of discomfort, where there is enough discomfort to create lasting and meaningful change but not so much discomfort that it is paralyzing. When we develop strategies for coping with the discomfort that comes from challenging rituals, it ultimately gives you the gift of freedom from your obsessions and compulsions.