ERP is known as the gold-standard treatment for OCD. Spoiler alert- it’s exactly what it sounds like: we identify triggers for your obsessions, trigger them on purpose, and then DON’T do compulsions to relieve the anxiety that gets riled up. However! This isn’t a therapy where you pick your worst fear and just get thrown in the deep end and try not to drown.

After we identify the different ways your obsessions show up (some folks have contamination fears, others have relationship OCD, some obsessions insist you *might be* a danger to children, etc), we identify what triggers them, such as touching a doorknob in public for someone with contamination OCD. You rate how intense your distress is about the trigger/obsession, and we rank them from highest to lowest. You’ll track symptoms between sessions, identifying your triggers, how strong their negative emotions are, and how long you engage with compulsive behaviors. This gives us an idea of when, how often, how severe, etc., your symptoms are.

Once we have our list (which can be updated as needed), we start the whole process of doing exposures while preventing responses (i.e., not letting yourself do compulsions). Remember: Exposure starts at the lower end of the scale! We do not start with your worst fear or trigger. Instead, we start with something that might be a 40 on a scale of 0-100. We want there to be a leeetle bit of anxiety present, but not so much that you’re thrown into a full-blown panic attack.

When you give yourself time to purposely trigger an obsession and let yourself hang out with the anxiety without trying to make the anxiety go away, what happens is pretty cool: your brain learns that the anxiety doesn’t last forever– because it doesn’t. Our nervous systems can get REALLY worked up, for sure, but the energy required to sustain major anxiety or panic is just not limitless. Can it resurface over and over? Yeah, that’s probably what you’ve been noticing. But unfortunately, giving in to compulsions makes OCD stronger- it’s like feeding a monster. Sure, monster quiets down for a little while because it’s been fed, but being fed makes it stronger- it could get more and more persistent next time it’s ‘hungry’.

So when you’re brave enough to start with a lower-level trigger, engage with it on purpose without doing compulsions, and your brain starts learning anxiety goes down even though you didn’t re-check the door seven times- you’ve started breaking the cycle!

We start the exposure process together in sessions, too – this isn’t something you’re going at all alone. We’ll work up to having you do the same exposure project on your own between sessions, and can troubleshoot any problems as needed.

Eventually, you can experience that lower-level trigger and feel… practically nothing. It’s not pressing. It’s not overwhelming. It might be a little irritating.. but if you keep resisting the urge to do compulsions, you may even realize that urge to do compulsions isn’t really even there anymore??!! It’s really cool.