ERP and Exposure Therapy For OCD and Phobias

Are you struggling with intrusive thoughts, struggling to stop unwanted compulsions, or fears that are preventing you from living the live you want?

Exposure and Response Prevention (ERP) is a first-line treatment for OCD, and exposure therapy is a first-line treatment for specific phobias. including emetophobia (fear of vomiting).

What is ERP/Exposure Therapy and how does it work?

In essence, ERP and exposure therapy involve a therapist and client working together to identify things that feel scary and gradually approaching them in ways that feel challenging but manageable. With OCD, we also work on resisting the compulsions or avoidance that OCD tells you that you need to do.

Research suggests that ERP/exposure therapy helps your brain learn that anxiety, uncertainty, and uncomfortable thoughts are things you can tolerate without having to do a compulsion to make them go away. Over time, this can change the way your brain responds to the things you fear, often leading the fear to decrease and your ability to cope with any remaining fear to improve.

This may sound scary, and you may even have confronted your fears before and think that doing more of this may not be helpful. But the way we do it in therapy is very different from being exposed to your fear in other parts of life.

First, we will talk about the biology behind exposure therapy and what makes an exposure useful. We will talk about how to get through the anxiety that comes up, and we will create a list of easy, medium, and difficult exposures that we can choose from later.

We will do as many exposures together in session as possible so that you do not have to do them on your own. Many clients find that doing exposures together makes them less intimidating, and they can sometimes even be fun.

Examples of Exposures

Here are some examples of exposures that I have done in the past with clients:

  • looking at cartoon photos of a feared object or situation

  • listening to sounds associated with the feared object or situation

  • playing Mad Libs and other word games using only words associated with the fear

  • practicing washing hands for a healthy amount of time with clients who struggle with excessive hand washing

  • watching videos related to the fear

  • creating or writing stories related to the fear

This list is not exhaustive, but is meant to illustrate how much exposures can vary in intensity. They don't always involve doing the thing you are most afraid of right away, and they don't have to be miserable to be effective.

All exposures are done with your full consent, and the whole process is as collaborative as possible. You are never going to be surprised with an exposure or forced to do something you have not agreed to.

Like my other work, all ERP and exposure therapy is done online with clients located in Maine, Massachusetts, New Hampshire, and Vermont.

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