What Makes ERP So Effective For OCD

If you’re reading this article, chances are you or someone you love knows what it’s like to get stuck in the cycle of obsessive compulsive disorder (OCD). It starts with those intrusive, ruminating thoughts that make you feel uneasy or anxious, and next thing you know you’re doing a compulsion (ie. repeating an action, counting, confessing, etc.) that seems to make them subside, bringing with it a wave of relief. After all, your OCD told you that if you would just do the compulsion, it would take away all your anxiety and discomfort. 

But then a few minutes, hours, or days later, your intrusive thoughts return and you’re right back to where you started, maybe even feeling worse. 

This is because each time you engage in a compulsion, it reinforces a reward pathway in your brain, sending the message that anxiety = bad, and compulsion = no anxiety. Your brain then continues creating intrusive thoughts because it knows that the reward of relief and relaxation that accompanies the compulsion will follow, and the cycle continues. It looks a little like this:

So how do we break this cycle? And how does Exposure and Response Prevention (ERP) help? 

The thing that your OCD won’t tell you is that your anxiety will eventually go down on its own, even if you’re not doing anything except letting time pass. Your anxiety can’t stay at a 10/10 forever, even though it feels extremely uncomfortable when it is that high. 

With ERP, the goal is to learn how to tolerate intrusive thoughts and obsessions without engaging in compulsions, helping you break down that reward pathway and ultimately teaching your brain to stop the cycle of OCD. Here’s what that cycle looks like once you start ERP:

This process can feel scary at first, because facing your fears is never easy. But even after one exposure, most clients begin to feel tremendous hope for what ERP can do for them. Finding the right therapist makes all the difference, too. A good OCD therapist will not only be trained and experienced in using ERP to treat OCD, but will do so with compassion, patience, and understanding. ERP can be challenging, but with proper support, you can take back control of your life and stop letting OCD run the show.

If you’ve been struggling with OCD and are looking to start therapy, we can help! We have therapists trained in ERP who are ready to help you navigate treatment in a safe and supportive environment, either in-office or from the comfort of your home. Contact us here to get started.