Considered the “Gold Standard,” in the treatment of OCD.
ERP is about leaning into anxiety and increasing courage.
Helpful items to be familiar with before starting ERP:
Mindfulness: We want clients to be a little familiar with mindfulness. If you are NOT. No worries, I can teach it to you! ERP requires clients to mindfully be present in anxious situations. If a client with OCD wanted to limit the amount of time they spend washing their hands. We would ask them to set a reasonable limit for themselves, and then to wash their hands. During their time and after they finish washing their hands instead of trying to think of something else, watching a movie, Candy Crush, or other distractions. I want you to sit with those feelings.
I washed my hands for minutes. OCD feels like that isn’t enough time. OCD wants me to do it again. I am feeling . OCD wants me to think I will catch the flu now. This feeling will pass.
Cognitive Behavioral Therapy: I want clients to have a little knowledge in the techniques of CBT. I need my folx to be able to recognize unhelpful thinking styles or cognitive distortions. OCD LOVES cognitive distortions. Again, if you aren’t familiar with this, that’s okay! I can spend a session or two giving you the basics!
7 steps of ERP
- Assessment: (questionnaires verbal and written to see how anxiety affects you! Everyone is different)
- Motivation: (What are your motivators for doing this hard work? Maybe you want to take fewer showers. Maybe you want to be able to eat at restaurants? Perhaps you want more time for fun, and to spend less time organizing your sock drawer. You might want to be reduce all the thinking and thinking and worrying.
- Preparation: This one is tough to explain in a blog post. But there are a few things we do in therapy sessions together to help get you ready for ERP. One is developing self-compassion. You’re struggling with OCD, you aren’t weird, and you aren’t alone. The next is education on the process. I want you to feel informed on ERP and know what’s going to happen. We also talk about mindfulness and uncertainty. (You know OCD loves absolute certainty…right?)
- Create a hierarchy: This is a fancy word for a list of hard things yoy are going to do to step outside your comfort zone. (You don’t have to do anything you aren’t ready for, and I won’t make you do something I wouldn’t do)
- Begin ERP: Let’s do the hard things!
- Prevent Avoidance and Safety Behaviors
- Repeat all: We do it all again.
I offer a free 10 minute phone consult