The ERP Approach

Exposure Response Prevention therapy, or "ERP", is the gold standard for treating Obsessive-Compulsive Disorder. It challenges the patient to directly experience uncertainty, which is at the core of their symptoms. Done in session and out of session, this trains the brain that intrusive thoughts are not a threat and lays down new neural pathways, resulting in an alleviation of symptoms. What's more, it strengthens the individual and builds psychological flexibility. ERP has been used for decades to treat OCD. In fact, it has one of the best success rates of any therapy for any mental health issue.

• Identify Triggers

We will work together to determine what situations, people, contexts, and objects are exacerbating your symptoms.

• Create a Hierarchy

This involves making a structured list of what triggers are most troubling you, using Subjective Units of Distress (SUDs), scaled 1-100.

• Scripts

Depending on your situation, we may decide to draft an imaginative narrative of your triggering thoughts. You will then practice reading this script aloud, or record yourself and listen to it daily.

• Exposure Response Prevention

Once we choose which trigger to work on first, we will practice an exposure together. This involves intentionally and voluntarily exposing yourself to a trigger in a controlled environment. During this exposure, you will not perform any ritual behavior. You will sit with the discomfort for an extended period of time. You will naturally experience a drop-off in anxiety, leading to a decrease in your SUDs score.

• Daily Practice

After you learn how to use Exposure Response Prevention, the most important part of the process is that you practice on your own, outside of session with homework.

• Maintenance Exposures

The human brain is designed for habit. People who have experienced OCD may have relapses of symptoms. Fortunately, once you have learned how to use ERP, you will be equipped to manage these symptoms so they do not control your life.

Because ERP is an uncomfortable process, it requires a significant commitment both on the part of the therapist and the patient. However, the commitment has incredible payoffs in helping you live a more enjoyable life. I promise to be there with you every step of the way.