What’s the Purpose of Exposure & Response Prevention?

The most widely used treatment for OCD is Exposure & Response Prevention (ERP.)

ERP is very effective when done right. The reason it works is because it updates the brain. In the past I’ve used other words to explain the effects of ERP. I’ve said “ERP is like getting a front-end alignment” and “ERP works because it re-calibrates the brain.”

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I recently received this tweet: “Recalibration is such a robotic word. Why do you think we apply inhuman words to ourselves?” While I don’t think we are robots, we sure can act like robots.

Studies suggest that 90% of what we do, we’re not even clear why we’re doing it. We have free will but without mindfulness we do only what the brain does by default:

1. Watch for danger and
2. Conserve energy.

If you don’t take your brain off automatic pilot your brain focuses on one thing: survival. Every single unwanted intrusive thought is about somebody’s safety. Every single mental act or compulsion is about reducing threat.

It’s all about safety and survival. Every time you resist a ritual or compulsion, you’re recalibrating or making tiny adjustments in the brain. Every time you expose yourself to a “threat” you are updating your brain.

Every tiny adjustment leads to an eventual rewiring of the brain. It takes time. Be patient. Engage in ERP and your brain will heal.

But, I digress and haven’t answered the question. Isn’t it inhumane to use a robotic word like “recalibrate” to reference humans? This never occurred to me and it would never be my intention to be inhumane.

I don’t think of OCD as a psychological problem as much as a neurological problem. How one reacts to OCD is psychological but the problem itself is faulty wiring within the brain. So that’s why I use mechanical terms I guess.

But, now that I know it can be hurtful I will certainly be more mindful of my choice of words. It just felt good to have one word that captured the science behind neuroplasticity (the brain’s capacity to change.)

If you’re keeping a journal answer these three questions:

What could you discover by confronting OCD and conducting exposure exercises?
How might you get stuck if you don’t engage in ERP?
How can you make it real and take action today?

5 thoughts on “What’s the Purpose of Exposure & Response Prevention?”

  1. I thought about this for a while, and what I came up with was, “ERP helps me to make the mountain into a mole hill.” Of course, this makes no sense on its own, so I’ll expand: Think of the mountain as some obsession (fear) that you’re trying to conquer. When you first come up against it, the mountain seems gigantic! When you look up, the top isn’t even visible because it’s above the clouds. Even attempting to climb it seems futile. However, once you even attempt to climb the mountain without responding to your obsessions with compulsions, you gain power. You may only make it a little bit up the mountain before going back down, but at least you tried. The second time (or third, or fiftieth) you climb the mountain, you finally succeed! When you come back to it after a success, you may notice that it is a bit smaller. When you come back again, it’s smaller still. Eventually, you get to the “mountain” and discover it’s only a molehill. You may say to yourself, “Wow, I was once afraid of that? I don’t believe it.”

    Now an example: suppose the obsession is driving (the particular obsession doesn’t matter, but I digress…) Even getting in the seat of a car may seem like an impossible task. However, once you sit in that seat enough times, you may get enough bravery to drive, even if it’s only a very tiny amount or a short amount of time. After you’ve done that for a while, you may be able to drive even further. Repeated exposure without responding builds strength. If you can drive without paying attention to your negative thoughts (or answering them the proper way), you build strength, even if you can’t see it at the time. After enough time passes, you may look back and say “I can’t even believe I was afraid to do that!”

  2. I did something similar with using a power washer. I bought one and then OCD told me I couldn’t use it. It took me awhile (more than a year, I think), but once I took the emotion out of it and decided to do it, it was easy. I do look back on it and say “I can’t believe I was afraid to do that!”

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