Universal OCD Treatment

One of my regular readers observed recently that I don’t write very much about treating Obsessive Compulsive disorder. His comment made me think about how we could all benefit on occasion from an evidence-based treatment that I use for my clients with OCD. ERP, or exposure and response prevention, helps clients face their fears/obsessions while refraining from engaging their compulsions. Whether we have OCD or not, we all have this in common, we try to avoid or neutralize unpleasant feelings in some way.

So how can you benefit from ERP? ERP can help us grow our tolerance for distress in different forms. Start by looking at situations that you have been avoiding and why you have been avoiding them. For my clients with OCD, this might mean they avoid touching people or doorknobs because they are obsessed with the thought of getting contaminated. For someone without OCD, it could mean avoiding certain people, conversation topics, or situations because they are afraid that they cannot contain their feelings without behaving badly or imploding in some way.

With ERP, clients get their hands dirty and face the anxiety they feel without washing. Anxiety doesn’t feel good, but all of our brains (including those of us with no OCD symptoms) need a little training to understand that we can survive the experience of heightened anxiety or negative feeling states. What might exposure and response prevention look like for you?

  • Interacting with that annoying co-worker or family member (exposure) and allowing the feeling of irritation (negative feeling) without lashing out (response prevention).
  • Participating in a group process that you are not leading and is not being led well (exposure), allowing the feeling of frustration (negative feeling), and refraining from correcting the leader of taking over the process (response prevention).
  • Talking with someone you wish to impress (exposure), feeling uncertainty about his or her opinion of you (negative feeling), without exaggerating or casting yourself in an overly favorable light (response prevention).

You see, there is a genius to this treatment because, at the core, we humans function very similarly. While folks with OCD have overly sensitized sections of their brain that need retraining, all of us tend to pull away from experiencing negative feelings from time to time, and sometimes that winds up hurting us or others around us. We are actually created to contain an unbelievable variety and vastness of emotions. Most of us make a mistake when we think we cannot handle it! Perhaps that feeling that feelings cannot be contained is a good indicator that you might benefit from psychotherapy. The process of therapy should broaden and expand your ability to contain more emotions, whether you are getting treatment for OCD, anger management, or broken relationships.

So, do you need a little ERP?

6 comments


  • Great thoughts, Janice. I really appreciate how you compare ERP to the every day act of leaning into tension and soothing ourselves through it. That self-soothing has so many neurological benefits, as you’ve said. And it’s an invaluable way to ground ourselves in the present without being emotionally uprooted.

    March 28, 2013
  • shannon

    I may quote you at NST next week. Very timely. Thanks

    March 28, 2013
    • Janice

      great!

      March 28, 2013
  • Jeana

    Janice, your words ring true. I can’t tell you how often I have done self-guided (or rather God-guided) ERP and I have come into a greater place of freedom internally and in my relationships!

    April 1, 2013
  • Right thoughts, Obsessive-compulsive disorder treatment can be difficult, and treatment may not result in a cure. You may need treatment for the rest of your life.

    April 18, 2013
  • This is real as I heard if you have obsessive compulsive disorder (OCD), your treatment will depend on the how much the condition is affecting your ability to function.

    May 21, 2013

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