Let’s Discuss Common Exposure and Response Prevention (ERP) Questions!

ERP is the gold-standard treatment for OCD. This blog is dedicated to answering some common questions regarding the ERP process. Let’s dive in…

Can ERP be done virtually?

Yes!! While ERP is effective in the traditional in-person, office settings, the increased ability to do exposures outside of the office when doing virtual sessions can actually increase the effectiveness of ERP. Many times OCD shows up within one’s home environment. Virtual sessions allow for the client and therapist to actively work on exposures in the client’s home during the sessions, which is not possible to do during office only sessions. Virtual sessions also allow for exposures to be practiced in other locations where the OCD is commonly triggered, such as stores, school, or work. If you are questioning whether in-person ERP is more helpful than virtual ERP, they are both highly effective and remote sessions provide more flexibility regarding the types of exposures that can be practiced in session.

 Can ERP become a compulsion?

This is another question I frequently hear. The answer is yes, ERP can become a compulsion. This happens when people try to perfect the ERP process. If this is happening for you, that is okay, it is not concerning, it is just part of how your OCD and/or perfectionism is showing up and an area to integrate into your therapy or self-directed OCD recovery process.

 Here are some examples of how ERP can be used as a compulsion:

 Can ERP make OCD worse?

This is a tricky question! ERP does initially “make OCD worse” in the sense that doing exposures triggers the OCD. Furthermore, by working on resisting and reducing the rituals (part of the ERP process), in the moment people often feel worse. However, with continued ERP practice, people are rewiring their relationship to their anxiety (or other challenging emotions such as disgust, guilt, distress) and learning that they can be with the uncomfortable thoughts, emotions, and physical sensations without doing the rituals that feed the OCD. ERP is what breaks the OCD cycle and leads to OCD recovery. As there are many nuances to the ERP process if you are doing ERP, feeling it is not helping or that your OCD is getting worse, it may be worth scheduling an educational OCD consultation appointment to further discuss your ERP experiences and what factors may be worth modifying.

 Can ERP cure OCD?

Through ERP, it is possible for people with OCD to no longer meet diagnostic criteria for OCD. However, the word “cure” is an unhelpful term to use in regards to OCD recovery. Everybody has intrusive thoughts at times and people with OCD are more likely to get stuck on their intrusive thoughts. When people use the word “cure” for OCD, they tend to imply that the person will no longer have intrusive thoughts. While this is an understandable desire, unfortunately it is not possible, since intrusive thoughts are a part of life. The goal is not to “cure” OCD but to help empower individuals with OCD to be able to not care when their intrusive thoughts are showing up, resist giving into rituals, and to continue about their days. This doesn’t mean that intrusive thoughts will never cause a spike or that you will never give into rituals again, as the goal is not perfection! ERP is highly effective for OCD and it is also very helpful to shift from viewing ERP as the cure, to ERP as a lifestyle approach that is helpful for all people (OCD and non-OCD).

For more OCD, anxiety and mental health related resources, Kimberly is on Instagram (@breakthecyclewithkim) and LinkedIn.

Written By: Kimberly Glazier Leonte, PhD