About
The exposure component of ERP refers to practicing confronting the thoughts, images, objects, and situations that make you anxious and/or provoke your obsessions. The response prevention part of ERP refers to making a choice not to do a compulsive behavior once the anxiety or obsessions have been “triggered.” All of this is done under the guidance of a therapist at the beginning — though you will eventually learn to do your own ERP exercises to help manage your symptoms. Over time, the treatment will “retrain your brain” to no longer see the object of the obsession as a threat.
This strategy of purposefully exposing yourself to things that make you anxious may not sound quite right to you. Maybe it sounds difficult. If you have OCD, you have probably tried to confront your obsessions and anxiety only to see that you become very anxious and fearful. With ERP, the difference is that a trained clinician is working with you to develop a plan for exposure. Then, that therapist coaches you through confronting the situation, leaning into the feelings it provokes, sticking with it, and resisting the urge to engage in compulsive behavior.
Doing ERP is challenging, for sure! But when you do it correctly, the following things happen:
You will feel an initial increase in anxiety, uncertainty, and obsessional thoughts.
You will find that these feelings and thoughts are distressing, but also that they can’t hurt you — they are safe and manageable.
You will find that when you stop fighting the obsessions and anxiety, these feelings will eventually begin to subside.
This natural drop in anxiety that happens when you stay “exposed” and “prevent” the compulsive “response” is called habituation.
You will find that your fears are less likely to come true than you thought.
You will get better at managing “everyday” levels of risk and uncertainty.