Exposure and Response Prevention

, Psychologist, liyap.com 2.4K reads

From depression and anxiety, to phobias and OCD, for best results, every mood disorder should be addressed using both cognitive and behavioral techniques.

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Up until now, you have mainly focused on the cognitive aspects of OCD, which included lots of useful techniques, such as thought challenging, relaxation, and psychoeducation. Now it’s time for something new. Something that might seem a bit intimidating at first, because it requires a lot of effort on your part. But don’t worry! As soon as the first results emerge, you’ll come to realize that it was all worth it.

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What Is ERP?

ERP, or exposure and response prevention, is a behavioral technique specifically designed for OCD and other impulse control disorders. In short, ERP puts you face to face with your worst fears and obsessions, in order to help you refrain from ritualizing.

At first, it might feel a bit uncomfortable, but keep in mind that ERP is a gradual process that provides long-term results, rather than an immediate turnaround. In other words, you do it at your own pace, by starting slow and gradually building resilience over time.

One Obsession at a Time

If this is your first attempt, it would probably be a good idea to start with the least distressing obsessions. Use the list of obsessive thoughts that you have already created, to help you identify potential “candidates” for this exercise. If engaged in the exercise, you should have a complete list of obsessions, along with your perceived level of anxiety for each one of them. If not, now is the time to do so.

When working on facing your fear, you don’t always have to wait for an obsessive thought to appear. For instance, if you’re preoccupied with germs or contamination, try touching the toilet seat at home and refrain from washing your hands for a little while.

Adopt a Gradual Approach

The main focus of ERP is to reduce the level of anxiety associated with each obsessive thought. In other words, it’s not about how much time you spend in the situation, but rather how you manage to stay away from ritualizing. This means that you should wait until your anxiety drops to a certain level.

For instance, if your preoccupation was rated as 7 on the anxiety scale, you should remain in the exposure situation until your anxiety drops to a 5. Next time, you can go even further by aiming to reduce anxiety down to 3 and so on. Of course, this was just an example to illustrate what it means to perform ERP in a gradual manner. You can choose to go as fast or as slow as you can.

Repetition Is Key

Practice makes perfect, which is why you have to repeat this exercise over and over again, until your obsessive thought or images no longer make you feel anxious. After you’re done with one obsession, you can move up the hierarchy by choosing another one from the list.

Under no circumstances should you move to another obsession, until you’re absolutely certain that the one you’re currently working on is anxiety free. If you move on without having fully attended to a preoccupation, it might reemerge and deter your progress later on.

Refrain from Compulsive Behaviors

During the exposure exercise, you should do your very best to stay away from rituals, compulsions and other distractions that might reduce your anxiety in an artificial manner. If you fail to resist the temptation, start from the top by re-exposing yourself to the same situation. Remain in that situation until your anxiety drops to a pre-established level.

This worksheet will help you keep track of your progress

Date/Time

 

Duration

 

Obsession

Level of anxiety

Before the exercise

At the beginning

At the end

Nov. 12th/10:00 AM

 

5 minutes

 

Fear of contamination

 

6

 

6

 

4

Nov. 13th/ 11:00 AM

 

6 minutes

 

Fear of contamination

 

5

 

4

 

3

Full reference: 

(Mar 9, 2016). Exposure and Response Prevention. Retrieved Dec 14, 2018 from Explorable.com: https://explorable.com/e/exposure-and-response-prevention

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