The Little Boy and His Crickets

Let’s talk about ERP. (Rhymes with burp.) The initials of ERP stand for Exposure & Response Prevention (preventing the response anxiety is telling you to take) or otherwise known as Exposure and Ritual Prevention.

ERP is the most highly recommended type of therapy used to treat OCD. It’s what’s called an evidenced-based intervention. Evidence from studies have proven ERP is very effective. Basically you expose yourself to something that makes you uncomfortable and you do nothing to alleviate the discomfort.

160_F_100424984_bJ1ZAQ1ILMccEmbvbMXlDMoMlNI6fJe6First you build a hierarchy of people, places, things or situations that trigger your anxiety or discomfort. You place them on the hierarchy (ladder) in terms of easiest to hardest to face. “If you were going to face this fear would this be easier to face than this?” Then you make a plan to gradually climb the hierarchy from easiest to hardest. You’ll know it’s time to move to another step when you’ve become bored or desensitized with the step you’re on.

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I once knew a boy who was afraid of crickets. He couldn’t go outside because he was terrified that a cricket would land on him and bite him. He designed a hierarchy of gradually exposing himself to being near crickets. It started with being in a room with crickets living in a secure container. He ran into the room counted to 10 and ran out of the room as fast as he could. Gradually he increased the amount of time to 2 minutes. Eventually he was quite comfortable being in a room with crickets in a secure container. He could even hold the closed container in his lap. The next phase was to open the lid of the container, and through similar incremental steps he worked his way up to placing his hand in the container.

The response he had to prevent during these exercises was to not reassure himself that crickets were harmless or couldn’t get out of the container. He had to accept the possibility of escape and being bitten. He talked like this to prevent himself from neutralizing his anxiety. This is Response Prevention. He tolerated the discomfort and in fact I encouraged him to say he wanted the anxiety. He said, “I hope I’m anxious. I don’t care anymore. I want to be able to go outside and play with my friends. So go ahead. Make me anxious.”

At the top of his hierarchy was a plan to go outside where there were crickets freely living in a garden. But before he did that, he said he would need to take his shirt off and allow crickets to climb all over his body. Yikes! First he did this with his shirt on and then eventually he took his shirt off. Crickets were crawling and hopping all over him. He was pretty tense at first, but suddenly he started to giggle, “It tickles.”

Every now and then I think I hear one of his crickets chirping in my office. I’m reminded of his courage and determination. He makes me smile.

This is day 9 of a 30 day challenge: Can you accept anxiety? Can you say, “bring it?” And if you can, where would you like to start?

6 thoughts on “The Little Boy and His Crickets”

  1. So funny… On my DEFY card this morning (before I read this) I have E as my primary strategy! The subject of my E is housecleaning. Seems silly, but that’s where I am. My anxiety is really high right now, so I guess I am saying “bring it” to OCD and getting started.

  2. Wow an an inspirational story. I can accept anxiety and I can begin by staying active despite the side show!

    1. …and when your plans for the big “E” don’t work out, be extra kind to yourself, breathe deeply, and start over… tomorrow is another day. That’s what I ended up having to do today. Oddly enough, I learned from it. What did it make possible? A whole new cleaning strategy… scheduling one micro task at a time 🙂

      1. Our greatest weakness lies in giving up. The most certain way to succeed is always to try just one more time.
        -Thomas Edison

  3. Trying just one more time today… this time, starting laundry, making a shopping list and going to the grocery store and drug store was excruciating! I have to say that I haven’t been “storming” like this for a long time. Was so anxious that I lost one of my coupons in the grocery store. Made it through though. I think this is not about house cleaning or shopping so much as it is about having to ask for help with yard work. Now that they are here, I am much better. I am glad I went shopping and the laundry is almost done.

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