Managing Fears of Starting Exposure and Response Prevention Treatment.
What to expect in Exposure and Response Prevention Treatment.
Starting therapy can be one of the most difficult things one can do for their mental health. Many factors exist that may prevent someone from seeking treatment. Reducing stigmas and fears around therapy can allow access to evidence based treatments that can help reduce distress from mental health concerns. Particularly with OCD, there is research to support that untreated OCD getting worse on its own. Fortunately, evidence based treatment exists in the form of Exposure and Response Prevention (ERP).
ERP looks at the idea that triggering situations and thoughts are at the core of OCD. Ongoing exposure to these triggers without engagement in rituals can reduce the severity felt. While ERP has shown to be the gold standard for OCD, there are still people who are hesitant to start treatment. In this post, I hope to educate those about the experience in ERP and expectations to help mitigate any fears. By taking away any fears or stigmas with treatment, hopefully you may feel more confident in seeking out treatment that could help improve quality of life.
Common ERP fears:
Exposures are dangerous.
Exposures are illegal.
Exposures will be too difficult.
How is being exposed to fears supposed to make me feel better?
All valid fears and concerns within ERP. Lets look at some expectations of ERP to gain a better understanding. In ERP treatment, no exposure will be illegal or dangerous. Exposures can be situations or stimuli that you are exposed to gradually. It could be something you physically do, read about, write about, watch, listen to, or imagine that causes a level of distress. You and I in early sessions will look to develop a gradual list of exposures.
We will rate each exposure on a severity scale. Exposures are done gradually. We are trying to habituate or acclimate to the distress of the exposures to gain that comfort and confidence. That is always done in a gradual sense. We will develop a hierarchy of exposures collaboratively so that we know exactly what we are working on each session. We will move on to harder exposures as we gain confidence with the previous exposures. Exposures last until your distress score reduces in half. With practice and consistency, it will take shorter time each exposure to reduce that distress down. We will monitor together all this information so you can look back and see progress being made.
Exposure are not dangerous or illegal. I would not ask you to do an exposure that I myself am not comfortable doing. Exposures can be distressing but we can look to manage distress. ERP helps challenge the way we think. When we build in response prevention measures, we are looking to challenge how we view certain thoughts or emotions. Treatment might include helping change the relationship we have with our thoughts or emotions.
Exposures to fears in a gradual sense with effective response prevention measures will strengthen your ability to manage obsessions and fears without the need for compulsions. You can prove to yourself that you can face the fears and triggers and handle it without OCD. We are using the exposures as the vessel to practice the response prevention. In ERP treatment, we will do exposures in sessions as well as planning for exposures for you to work on by yourself. Like any skill, ERP is a skill that needs to be practiced. The more exposures you face, the easier it will be to habituate to the distress.
In our first few sessions, we will go more into the psycho education of ERP. As well as spending time developing our treatment plan goals and exposures. We are following the protocol of ERP to help yield the best results, using evidence based practices so you can see the improvements with your OCD. In treatment, I hope for you to see that you can handle distress better than you think. That the thoughts and fears in our head are much worse than what would happen in actuality.
As a licensed mental health therapist trained in ERP, I will assist you through the exposures and how to implement effective response prevention measures. If you feel that OCD has had a negative impact on your life, you might consider counseling and ERP to learn how to handle it more effectively. Please feel free to reach out for a free consultation, where we can discuss the impacts of OCD and benefits of counseling/ERP.
