Tip #15 How can ERP help?

ERP stands for exposure and response prevention. It is one of the psychological treatments of choice for Obsessive and Compulsive Disorders.

The idea behind it is to decrease your anxiety levels by exposing you to the things that make your anxiety spike. This sort of therapy normally starts by gradual increase of anxiety triggers e.g. start with the things that might you spike less and slowly work towards those that make you spike more.

I read a quote once that said something like this: “It is best to suffer the worse right now than to live in perpetual fear of it”

The same it is with anxiety related ROCD. And this is what ERP intends to do: to take the perpetual fear of something and put it into the present, enabling us to face our fears. The more we do this, the less fearful or anxious we become.There are different methods of delivery for this type of therapy: self-help through books, online-phone sessions and face to face sessions. One might be more beneficial for some than others.


    1. Very good question, I must say! The first thing would be not to run away from situations that make you uncomfortable or trigger certain ROCD thoughts. Then gradually exposing yourself to thoughts or situations that you know will trigger ROCD thoughts. I must also say that this should be a controlled process i.e. directed by someone with experience in ERP.

  1. Hi, just want to let you know that I’m very grateful (and so are many others) for what you are doing with this blog. There is not much help you can get for ROCD on the internet so this is so so very valuable. In regard to this post, ERP is really very important. For me what works the most is ERP and mindfulness as well. My triggers are usually: talking to other men, being away from boyfriend, listening to love songs….etc I used to run away from all those situations but after forcing myself to be exposed to them, the triggers just scare me less and less. 🙂 I know I’m on my way to recovery

  2. Thanks again for all of your help. Would you mind saying a bit more about how to practice ERP with ROCD. For example, for those who are scared of leaving the stove on, there is a tangible ERP solution. For me, I get bothered when my fiancee and I are talking or when I think about how he might not be smart/competent/etc. enough for me while I’m sitting around. How would ERP work for these kinds of “mental” ruminations? I’ve been searching online for ERP for ROCD but I haven’t seen much. I want to do the hard work needed but I’m not sure exactly how to do it!
    Right now I’m not in a place where I can afford a therapist (hopefully that will change soon) so I want to be the best therapist I can be.

    I want to fight this so I can enjoy my life– and, more importantly, not ruin my partner’s life. I feel SO guilty for having this. Sometimes I wonder if I should just let him go so that he can find someone who isn’t such a crazy person and who isn’t constantly consumed by worry because I fear that this will always define my life and I will have also ruined his in the process.

    1. Hi Evie,

      Yes it is slightly more problematic doing exposure when the compulsions are mental rather than physical or tangible as you described. However, from what I have read when you are dealing with obsessive thoughts most of the work revolves around creating a script and re-reading and/or re-imagining it. The data also seems to point out that ERP is as effective as mindfulness/CBT based approach. I would not recommend ERP as a self-help therapy though because you might need some sort of support through it. Living with the other person that we are obsessing about is ERP enough! I would recommend a mindfulness approach. Drop me a line if you want to have a phone chat sometime on skype.

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