I talk a lot about how Exposure and Response Prevention (ERP) Therapy is the frontline treatment for obsessive-compulsive disorder, but haven’t delved much into the actual therapy. For starters, I’m not a therapist, and certainly not an expert on ERP. But I think it’s important for anyone whose life has been touched by OCD to, at the very least, have a basic understanding of this therapy. Maybe the more knowledgeable we are, the less daunting treatment will seem.
The premise behind ERP Therapy is straightforward: face your fears repeatedly, and eventually they will cease to frighten you. Sounds easy (well, at least to those of us without OCD). But as we know, nothing related to obsessive-compulsive disorder is simple, and in fact, treating OCD sufferers with ERP Therapy can be quite complicated. Just as an example, I’d suggest taking a look at this great guest post written by Dr. Seth Gillihan, on mental rituals, OCD, and ERP. His discussion and the ensuing comments demonstrate how important it is to work with an experienced therapist who really understands the complexities of OCD and ERP.
Like OCD, ERP Therapy is often misrepresented by the media and misunderstood by the general public. Reality shows where patients are asked to do things like lick toilet seats (not sure if that really happened but you get my point) do more harm than good. An OCD sufferer who is already apprehensive about beginning treatment will surely stay away after seeing this portrayal.
And so we need accurate, quality information. While this article, written by Tom Corboy, MFT of the OCD Center of Los Angeles, focuses on ERP Therapy for the treatment of Harm OCD, it can easily be applied to the treatment of other types of OCD as well. I love the analogy he uses in the last sentences when explaining ERP Therapy:
The primary behavioral therapy tool used when dealing with Harm OCD is called Exposure and Response Prevention (ERP). While cognitive therapy challenges the content of our intrusive thoughts, and mindfulness addresses our perspective towards those thoughts, ERP directly confronts the behaviors done in response to those thoughts. While mindfulness and cognitive therapy set the table, ERP is the main course. This is where the real work gets done.
I recommend reading the whole article, but also want to share Mr. Corboy’s clarification of some basic ground rules of ERP Therapy:
- We won’t ask you to do anything we wouldn’t do ourselves.
- We won’t ask you to do anything illegal, immoral, or dangerous.
- We will never force you do anything.
Just as we need to spread the word as to what OCD really is and is not, we also need to provide accurate information about Exposure and Response Prevention Therapy. I believe all of you who have already successfully undergone ERP Therapy for OCD are an invaluable resource. Was it different from what you expected? Were there any big surprises? How helpful was it to you? What were some of your best/worst experiences? Demystifying ERP Therapy might be all that is needed to inspire some sufferers to commit to it. And as so many of us know, that can be the beginning of a dramatic change in their lives…for the better.