Exposure and Response Prevention
Exposure with Response (Ritual) Prevention (ERP) is my preferred treatment for Obsessive-Compulsive Disorder (OCD). It is a scientifically proven model for helping people recover from OCD (Franklin, Abramowicz, Kozak, Levitt Foa, 2000). It’s been rewarding over the years to see many of my clients get their lives back and become liberated from their anxiety-provoking thoughts and behaviors. Contamination, sexual orientation, and ordering/symmetry-related fears are some of the many OCD concerns I have treated.
https://psycnet.apa.org/record/2000-05084-008
ERP targets the person’s symptoms through in-vivo (real-life) and imaginal exposure to fear-inducing situations while preventing the person from engaging in compulsive behaviors that strengthen OCD. On the surface, this may seem lacking in compassion, but allowing the OCD process to continue unabated is the actual disservice to clients. What’s more, it doesn’t take long for distress to decrease through exposure to feared behaviors and thoughts. As an experienced ERP therapist, I simultaneously apply Socratic dialogue to help the person view her experience more accurately without reassuring her. (Many well-intentioned but inexperienced therapists reassure patients, which serves to strengthen the OCD symptoms.) (Foa, Yadin, Lichner, 2012).
Throughout the process, the person is directed to follow ERP rules for not engaging in rituals, or compulsive behaviors. Clients learn to ask themselves questions such as, “Would person X [who does not have OCD] check this sent email message?” or “Would my significant other wash her hands after touching the doorknob?” The client, often with the assistance of a trusted support person who understands and buys into ERP, follows the rules for non-OCD behaviors and sees their urges to ritualize decrease over time.
Like all of my treatment techniques, I apply ERP with the constant awareness that my client is an actual person with human emotions, fears, and insecurities. People often highlight the risks of exposure therapy—temporarily experiencing unwanted thoughts and emotions—while overlooking the risks of not participating in therapy: near-constant, ongoing anxiety that is time-consuming and interferes with participation in meaningful activities. With this in mind, I warmly invite you to commit to the valuable step of taking back your life from OCD. Like many of my clients, I’m confident that you’ll be glad you did.
- Aaron George
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https://www.nami.org/Blogs/NAMI-Blog/February-2018/What-To-Do-if-Your-Workplace-is-Anxiety-Inducing