Graded Exposure and Response Prevention Therapy for OCD
When entering a cold body of water, you might find it uncomfortable or difficult to stay in the water. However, after some time submerged, your body becomes used to the cold sensation and the water becomes much easier to tolerate. Much like cold water, the longer we can sit in the discomfort of anxiety without using compulsions to escape (i.e., get out of the water), the easier it gradually becomes.
Graded Exposure and Response Prevention Therapy (ERP) is a process frequently used in addressing the compulsions of OCD. In this process, the client and the therapist work together to develop an exposure hierarchy, which is like a ladder of different experiences that are gradually more anxiety-provoking. After this, the client is exposed to each level of the ladder over a handful of sessions until each level feels manageable, gradually reaching the top of the ladder. In each instance, the job is to sit in the anxiety without using the compulsion to “escape” (or get out of the pool).
It’s a bit like weightlifting! If we want to lift 100kg and we’ve never touched a weight, it’s going to be very hard because we aren’t strong enough. But if we gradually increase the weight as we build up our strength, eventually we can lift the 100kg! The best thing about this process is that the task in front of us isn’t getting any harder because we are getting stronger. Similarly, our exposure hierarchy doesn’t tend to get much harder because we are building our tolerance to different situations.
ERP is super helpful in addressing compulsions but also facilitates challenging our anxious obsessions. Our anxious voice tells us that we have to use our compulsions in these situations, which we are able to challenge by showing ourselves that we can get through the discomfort without them.
If you would like assistance addressing personal challenges in your own life related to OCD, why not give us a call? Our team of highly skilled and well-experienced psychologists are here to help. Call us now and take that first step towards obtaining the life you deserve!
References
Abramowitz, J. S., Deacon, B. J., & Whiteside, S. P. H. (2010). Exposure therapy for anxiety : Principles and practice. ProQuest Ebook Central ProQuest Ebook Central
Abramowitz, J. S. (2006). The psychological treatment of obsessive—compulsive disorder. The Canadian Journal of Psychiatry, 51(7), 407-416. doi: 10.1177/070674370605100702.
Hezel, D. M., & Simpson, H. B. (2019). Exposure and response prevention for obsessive- compulsive disorder: A review and new directions. Indian Journal of Psychiatry, 61(1), S85. doi:10.4103/psychiatry.IndianJPsychiatry_516_18