ERP Therapy – A Well-Guarded Secret?


by stuart miles

OCD Awareness Week has come and gone and there were many successful, informative events to help all those whose lives have been touched by obsessive-compulsive disorder. I think the IOCDF always does a great job with its programming.

There was also attention paid to OCD through the national media, though I’m not sure if the two shows I watched/listened to were broadcasted because of OCD Awareness Week. While I think the productions both did a good job debunking the myths of OCD and illustrating what the disorder is all about (as much as you can without actually having OCD), I believe they were sorely lacking in one extremely important area – treatment.

The first show was a podcast sponsored by American Public Media. Six people with OCD recorded their thoughts and feelings throughout the course of a day, giving the listener an idea of how OCD operates. I think it was a great idea. But I kept waiting for the host of the program – or anyone – to inform us that, if you have OCD, you do not have to be controlled by it – it is treatable. While I realize that treatment was not the focus of the podcast, I also believe that not saying anything about recovery leads people to believe “that’s the way it is,” and there is no treatment for the disorder. I wasn’t asking for a lot. One sentence saying, “OCD is very treatable” would have satisfied me. But there was nothing. NOTHING! I think one of the six people with OCD might have used the word “Prozac” once in passing but that was it.

The second event was a segment of 60 Minutes with author John Green (The Fault in Our Stars, Turtles All the Way Down). John has obsessive-compulsive disorder, which is the subject of his novel Turtles All the Way Down. What an inspiration he is to everyone (young people in particular) with OCD! When asked what he does to help himself, I believe his only answer was “exercise.” I don’t know what type of therapy, if any, Mr. Green has tried, but again, I was still hoping that at some point during the broadcast the interviewer would throw in at least one sentence: “OCD is treatable.” But sadly, again, nothing.

I believe these firsthand accounts of living with OCD are invaluable. I really do. But when you (or a loved one) are suffering from this potentially devastating disorder, the only question you’re likely asking is “How can I get better?” I believe we are doing a poor job of answering this question.

Ten years ago my son Dan suffered from severe OCD. As my book jacket says, “he went from seven therapists to ten medications to a nine-week stay at a world-renowned residential program.” I believe exposure and response prevention (ERP) therapy saved Dan’s life, but finding this treatment was difficult. I became an advocate for OCD awareness and proper treatment precisely for this reason – to let others know that ERP therapy is the evidence-based, first-line psychological treatment for OCD as recommended by the American Psychological Association, and to spread the word that OCD, no matter how severe, is treatable.

Ten years later, for reasons that I just can’t fathom, this therapy still seems to be a well-guarded secret.






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12 Responses to ERP Therapy – A Well-Guarded Secret?

  1. As always, thanks for the post! Regarding lack of any information about treatment: That simply blows my mind, and is a massive and tragic oversight.
    All the Best,
    Paul K.

  2. Lena says:

    Great post! Thank you! My daughter is 14 and suffering from OCD. She’s very upset because of that thinking that there is no treatment and her future is ruined because of the OCD. Im absolutely agree that media should bring more attention to the cure, to the examples of other people successful recovery.

  3. Thanks for writing this. As a psychologist, I am always surprised to hear that ERP is so rarely discussed. It is the most widely used and effective treatment available. Unfortunately, it is very distressing for clients to use, so many people are unwilling to pursue it. But when someone has the courage to utilize it, they can greatly benefit from it. Thank you for spreading information about this.

    • You’re welcome, Gail, and thank you for your insight. As distressing as ERP can be for some people, I believe living with “active” OCD is worse. At least with ERP, the distress you are feeling has a purpose – to help you recover. The payoff is huge! That’s what I tell people who are afraid of treatment.

  4. Tsaheylu says:

    Agreed. It’s like talking about not feeling strong physically and forgetting to mention diet and exercise etc.

    Maps and tools..auplort and understanding are needed so much.

    Thanks for writing!


  5. Thanks so much for this interesting article! So disheartening though. ERP literally saved my life and continues to be my main therapy tool. I found it myself, online, after years of seeing ‘specialists’ who never once mentioned it, I can only assume they have never heard of it. Perhaps it is because it is not a money spinner like talking therapy or pharmaceuticals. A cynical viewpoint but in a profit driven medical industry it doesn’t seem unlikely. Love your info. ❤

    • Thanks for sharing, violetgoddess. Unfortunately your story of “specialists” and having to find the right help on your own is all too common. And I do agree with you about money playing a part in ERP’s low profile. For a therapist to offer good ERP therapy, he/she would need to be properly trained and that would cost them money. Some therapists might feel they can do as good a job helping people their “own way.”

      I wrote the post below about 5 1/2 years ago which discusses this issue in more detail:

      Bottom line – people are not getting the treatment they need and deserve and they are suffering needlessly.

  6. Bluebird says:

    Hi there-this is the first time I have read your blog. I’m glad to have found it as my son has suffered from OCD since around the age 8 and he is 19 now. I have so many questions and will read more to help figure some answers. My question now though-Is ERP the same as seeing someone who uses Behavior/Exposure Therapy? Like your son we have been to countless therapists, doctors, tried too many medications and he has done exposure therapy. The fears have such a hold on him that he is petrified to work on things. Just yesterday he has another new medication and his psychologist (who saw him for only 12 minutes-don’t get me started grrr) is recommended a type of magnet therapy. I am researching that as well. I feel like we grasp as straws hoping for the best. Sorry for the lengthy post and I appreciate any feedback:)

    • Hi Bluebird, I’m glad you found my blog. Exposure and response prevention (ERP) is a specific type of Cognitive Behavioral Therapy (CBT) used to treat OCD. I am not a psychologist but I’ve never heard it referred to as Behavior/Exposure Therapy. I would suggest you check out the IOCDF website for more information on how to find a good therapist.
      I don’t know if you’ve read my book, but I go into detail regarding the different medications my son was on. Meds do help some people, but they only seemed to hurt my son.
      It is common for those with OCD to be afraid of ERP therapy, but a therapist who specializes in treating OCD will know how to help your son move forward with the therapy.
      Is the magnet therapy you are talking about recommended by a psychologist who specializes in ERP therapy and treating OCD? There is no such therapy recommended to treat OCD as far as I know.
      Good luck as you move forward and please feel free to keep in touch.

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