When Should You Consider Exposure Therapy and Response Prevention?

By: Suzanne Feinstein, PhD

According to the National Institute of Mental Health, Obsessive-Compulsive Disorder (OCD) affects 2.5 million US adults today.

If you or someone close to you has OCD, you’ll know that living with this disorder can be a struggle. Exposure therapy and response prevention, commonly referred to as ERP, is the gold standard of treatment for OCD. It is a specific form of Cognitive Behavior Therapy that encourages you to manage your obsessions without performing any behavior that might neutralize or negate them. In this article, we’ll explain when it’s time to consider this approach.

Read on to learn more.

Understanding OCD and Its Challenges

OCD is a mental health disorder that involves intrusive thoughts, images, preoccupations, or feelings (obsessions) and corrective repetitive actions (compulsions.) Some common forms of OCD include:

  • Contamination obsessions/ Cleaning and avoidance compulsions
  • Symmetry obsessions/ ordering and arranging compulsions
  • Intrusive thoughts / checking or reassurance seeking
  • Superstitious fears / counting, repeating, silent prayer
  • Feel right obsessions / touching, tapping, blinking, staring rituals

ODC is a cycle. It involves a recurring pattern of thoughts and behaviors that reinforce each other. The obsessions trigger strong feelings of distress. These emotions are very uncomfortable and in turn, this leads the individual to seek relief.

The compulsions provide a temporary sense of relief from the anxiety triggered by the obsessions. This reinforces the idea that compulsions can reduce the distress caused by obsessions. 

However, the relief gained from compulsions is short-lived. Compulsions don’t address the underlying anxiety triggered by the obsessions. This leads to a continuous loop, and the cycle starts again.

Treatment Options

While traditional treatment for OCD has its merits, exposure therapy and response prevention (ERP) have shown remarkable efficacy.

Both therapy options are rooted in Cognitive Behavioral Therapy (CBT). This goal-oriented therapeutic approach aims to change patterns of thinking and behavior. 

The right approach will vary from case to case. Consult with a therapist to find out what works best for you. 

What is Exposure Therapy?

Exposure therapy involves confronting the triggers that cause obsessions head-on. The goal is to confront fears and learn better ways to manage anxiety.

For example, a person with OCD who fears germs might undergo exposure therapy by touching objects they believe are contaminated and then refraining from washing their hands for a manageable period of time. If the disorder centers around checking locks, they could deliberately leave their door unlocked for a specified time. 

By gradually increasing the amount of time spent around triggers, combined with healthy coping strategies, OCD sufferers can gain some control and begin to break down unhealthy habits.

What is Response Prevention?

Response prevention runs alongside exposure therapy. It focuses on helping individuals resist the urge to perform compulsions after being exposed to their triggers.

That way, they learn to deal with anxiety without resorting to their rituals. This process weakens the link between obsessions and compulsions, ultimately reducing their impact.

The process can be challenging. However, the results are often life-changing. With commitment and courage, those who receive ERP can improve their day-to-day lives and reach new strengths. 

The Benefits of Exposure Therapy and Response Prevention

Let’s explore the many benefits of ERP. Here’s what OCD patients can stand to gain: 

Empowerment Through Confrontation

Exposure therapy involves facing fears and triggers head-on. This means that those undergoing ERP can gain a sense of empowerment. As they confront their anxieties in a controlled environment, they gradually learn that their feared outcomes are unlikely to occur.

Confronting fears and anxieties through exposure therapy can be a transformative experience. It encourages individuals to challenge the limitations that their fears have imposed upon their lives. As they gradually expand their comfort zones, they open doors to new possibilities and experiences that were once overshadowed by their anxieties.

Rewiring Neural Pathways

As individuals repeatedly face their fears without giving in to compulsions, the brain’s response to these triggers grows less. This process, known as habituation, helps break the cycle of obsessions and compulsions. As people learn to challenge their fears and discomforts, their perception of risk decreases and/or their level of distress tolerance increases.

Reduction in Anxiety and Distress

Through ERP, anxiety decreases over time. This reduced emotional response allows patients to regain control over their thoughts and actions. This can lead to a significant improvement in their overall well-being.

By deliberately exposing themselves to their fears without engaging in their usual rituals or avoidance tactics, they learn that their anxieties don’t have the power to control them. This process gradually weakens the grip of anxiety and compulsion, leading to a sense of liberation.

The improvement in well-being is not limited to a reduction in anxiety alone. The success of ERP often translates into enhanced self-esteem, increased confidence and feelings of resiliency, and a greater capacity to cope with stress.

Improved Coping Mechanisms

Exposure therapy and response prevention equip individuals with better coping mechanisms. Instead of relying on compulsions, they learn healthier ways to manage their feelings. This not only helps in dealing with OCD but also teaches them to apply the same strategies when coping with other challenges.

Prevention of Avoidance Behaviors

Avoidance behaviors are common among individuals with OCD. These behaviors provide temporary relief but reinforce the cycle. ERP targets these behaviors by encouraging people to face their fears. Over time, this helps them develop resilience against the urge to engage in compulsive actions.

Overcoming the Challenge

The path to progress is not always smooth. There may be setbacks during exposure sessions. These challenges, when managed with patience and support, contribute to long-term resilience.

Exposure therapy is conducted in a gradual and controlled manner guided by a professional therapist. This ensures that individuals are only exposed to manageable levels of stress and supported throughout the process. Therapists work together with patients to create a customized treatment plan. 

If you’re struggling, ask for help. While addressing OCD can be daunting, the benefits are immeasurable. One step at a time, you’ll find yourself breaking free from the shackles of OCD.

Take Control With ERP

Overcoming obsessions is possible through exposure therapy and response prevention. By directly addressing fears and gradually lessening anxiety, healthier ways of managing distress are cultivated.

If you or someone you care about is struggling, don’t worry. Help is at hand. The first step is reaching out and learning how to start the process.  

If you’re prepared to start this journey, talk to us at Advanced Behavioural Health. Our team is ready to guide and support you every step of the way toward regaining control over your life and finding relief from OCD’s grip. You can contact us here.

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