Exposure and ritual prevention (ERP) is the most effective behavioral therapy for obsessive-compulsive disorder. Behavioral Therapy is an important part of Cognitive-Behavioral Therapy.
This therapy aims at exposing a person to a feared situation or object while helping to prevent the compulsive act they normally turn to by teaching them how to properly deal with the anxiety they are feeling.
With OCD, compulsions are created as an attempt by the sufferer to relieve their anxiety. Problem is, these compulsions, although they help temporarily, only aggravate the anxiety they feel and make matters worse.
Obsessive-compulsive disorder begins with anxiety, then is followed by obsessions, then followed by compulsions, then followed by more anxiety. Unless a person begins exposure and ritual prevention, they will find themselves stuck in this cycle, unable to get out.
Exposure and ritual prevention helps to systematically desensitize those suffering with OCD through repetitive exposure and appropriate response. It is this repetitive behavior that helps to reprogram the mind to see things differently and helps people to overcome their fears directly.
As with OCD, exposure and ritual prevention therapy is also used for specific phobias, agoraphobia, social anxiety, panic disorder and Post-Traumatic Stress Disorder (PTSD). In this case, another name for this behavioral therapy is Exposure and Response Prevention.
Exposure Therapy Video Demonstrations
I hope these video demonstrations will help you understand exposure and ritual prevention better.
Please be patient while the videos load.
This next video is a demonstration of Intensive Exposure Therapy for someone with Agoraphobia. Although she does not have OCD, her response/ritual to her anxiety is to avoid or leave the situation altogether. This exposure therapy aims at helping her overcome her fear of panic.
Exposure therapy training is definitely hard work. Although some people can do this behavioral therapy by themselves, many people find that they need the help of a professional therapist to get started.
Exposure Therapy Steps
Facing fear of an avoided situation or object is never easy. However, using baby steps as a gradual way of desensitizing your nerves helps a lot.
To apply exposure and ritual/response prevention, there are some basic steps you can follow when practicing.
- Before you begin, you must be willing to commit. You cannot overcome OCD or any other anxiety disorder without being persistant and fully committed.
- Start with visualization. Before you begin exposing your physical self to the situation, it's important to expose yourself to it in your mind. This means walking through the feared situation visually, imagining what you will do and the steps you will take.
- Don't forget to use your cognitive skills. This means remembering to encourage yourself along the way. Repeating the truth about what you are doing and the truths you were told by your therapist about your condition.
- Remember to use proper breathing and relaxation methods. When you are experiencing high anxiety during a practice session of exposure therapy, be sure to remember your breathing as well as your relaxation response. It helps to master these things prior to doing exposure therapy.
Self-Help for Obsessive-Compulsive Disorder
For those interested in using self-help methods for exposure and ritual prevention to overcoming their OCD, the books below may offer some real guidance as to the cognitive-behavioral steps you should be taking when you practice.
Overcoming Obsessive-Compulsive Disorder by David Veale and Rob Willson
Getting Over OCD: A 10-Step Workbook for Taking Back Your Life (Guilford Self-help Workbook Series) by Jonathan S. Abramowitz by Jonathan S. Abramowitz, Ph.D. This book will help you to:
- Understand your obsessions, compulsions, and exposure and ritual prevention
- Develop a customized action plan
- Take gradual steps to safely confront and master the situations you avoid
- Find relief from intrusive thoughts, no matter how distressing
- Overcome compulsion urges
- Reduce anxiety and improve your relationships