Exposure and Response Prevention (ERP) for OCD
Evidence-based therapy to loosen the grip of obsessions and compulsions.
Obsessive compulsive disorder (OCD) involves unwanted, distressing thoughts, images or urges (obsessions) and the things we do, physically or in our heads, to try to feel safe or relieve the distress (compulsions). It is not about being tidy or particular, and it is not a sign that something is wrong with you as a person.
Exposure and Response Prevention (ERP) is a form of CBT and is the psychological treatment recommended in NICE guidance for OCD. It helps you to face what you fear, gradually and on your own terms, without carrying out the compulsion.
You might notice
- Unwanted thoughts, images or urges that feel distressing or ‘out of character’
- Checking, cleaning, counting, repeating or arranging until it feels ‘right’
- Mental rituals, such as reviewing, praying or going over things in your head
- Seeking reassurance from others, or from the internet
- Avoiding people, places or situations that set off the thoughts
- Spending a lot of time on thoughts and routines, or feeling stuck in doubt and uncertainty
How ERP works
OCD keeps going because compulsions bring short-term relief, but teach the brain that the fear was justified. In ERP we build a ladder of situations that trigger your obsessions, ordered from the manageable to the most difficult. Step by step, you face these triggers while holding back from the compulsion, and learn through experience that the anxiety passes without it, and that you can tolerate uncertainty.
ERP is collaborative. You choose the pace, nothing is done to you, and we plan each step together. Practice takes place in your own life between sessions, which is also why ERP can work well online.
How I work with OCD
I take a warm, non-judgemental approach to OCD, including to thoughts people find hard to say out loud. Intrusive thoughts are common, and having them is not a reflection of who you are. Where self-criticism or shame have built up around OCD, I can combine ERP with Compassion Focused Therapy.
Related areas of support
Take the first step
Contact me here to find out more information or to arrange a free consultation.