Exposure and Response Prevention (ERP) is considered the ‘gold standard’ in treatment for OCD and other anxiety disorders. The name implies the treatment – a skilled clinician supports a client in exposing themselves to the stimuli they fear and then preventing their normal (typically, avoidant) response. Research shows that 60-70% of persons diagnosed with OCD benefit from this form of treatment, demonstrating that it can be widely beneficial.
In example, if a client has contamination fears and will not cook raw chicken, the therapist will work with the client to gradually approach handling raw meat. For some clients, this work moves slowly and we begin by simply discussing the idea of cooking raw meat. We might then look at images of raw chicken, imagine what it would be like to touch it, write a script about cooking raw chicken, and then progress to holding a package of it without actually touching the raw meat. For some, just reading this post will serve as exposure. While approaching the thing they fear, clients are coached to be aware of any avoidance tactics (“safety behaviors”) they might be employing such as telling themselves that everything will be ok or not fully immersing themselves in the experience.
One of the most important parts of this work is that the client is in the driver’s seat and is determining how fast we progress through exposures. If I am dictating a client’s treatment, then I am no better than the OCD or anxiety. That said, it is my job to gently push my clients to consider if they are capable of handling slightly more stress than they think they can. The answer, 9 times out of 10, is yes.
ERP work with me is client-driven, respectful, and often incorporates humor and compassion.