The ERP Approach

Exposure and Response Prevention therapy, or "ERP", is the gold standard for treating Obsessive-Compulsive Disorder and other anxiety disorders. It challenges the patient to directly experience uncertainty, fear, and doubt, 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 and other anxiety disorders like panic and phobias.

The Structure of ERP

Identify Triggers

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

Create an Exposure List

This involves making a structured list of what triggers are most troubling you. You and I then determine which of these triggers is worth tackling in what order.

Exposure and Response Prevention

Once we choose which trigger to work on first, we will practice exposures together. This involves intentionally and voluntarily exposing yourself to a trigger in a controlled environment. During these exposure, you will not perform any safety behaviors. You will sit with the discomfort for an extended period of time. You will naturally learn that the experience is tolerable.

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 reading it and listen to the recording.

Prolonged Practice

After you learn how to use Exposure and 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 anxiety disorders 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.