How Does ERP Therapy Help With OCD?

Updated March 05, 2020

Medically Reviewed By: Sonya Bruner


Obsessive-compulsive disorder (OCD) is more than just a feeling you get when you want to check something more than once. It's a debilitating disorder that can take over your life. In this post, we will talk about OCD and how ERP therapy may help.

What Is OCD?

OCD involves people who feel they must repeat certain rituals, check certain things, or think the same thoughts over and over. These actions are uncontrollable and can run a person's life.

One habit an OCD person might repeat is washing your hands. It's a good idea to wash your hands a few times a day, but someone with OCD will repeatedly do this and never feel satisfied. This can consume their life, and many wish they could stop doing it. They know these actions don't make sense, but they do it anyway.


No one knows the exact cause, but there are some genetic connections and possible childhood trauma to blame. To treat OCD, someone may use counseling or medication to help treat the symptoms. One method is through cognitive behavioral therapy (CBT.) CBT involves gradually exposing ones' self to the causes of your problems while not letting your OCD actions happen. Medications are good for the symptoms, but one must not rely on them in the long run, ad they don't treat the cause. If not treated, you can have OCD for decades, or even life.

So that's what OCD is. It's more than just a person who is meticulous; it's a serious disorder that can affect one's livelihood. Now, let's look at how ERP can help with OCD.

What Is ERP?

ERP is short for exposure and response prevention. It's a way for OCD people to be able to face their fears slowly, which can help them defeat OCD. In summary, ERP is divided into two steps. First, you expose yourself to your triggers. If your hand washing is triggered by touching an unclean surface, you touch it.

Then, the response prevention step comes in. This is when you avoid the obsessive hand washing and avoid it altogether.

It's a simple, yet a challenging way for people to stop their OCD. Let's go deeper into this concept.

Knowing Your OCD

For ERP to work, one must know their OCD. One must try to figure out their obsessions. Odds are, you have a good idea of what you're obsessing over. Afterward, you can try to find your triggers. These are events that can make your obsessions and compulsions appear.

Many things can trigger you, from something harmless to something obvious. Whenever you're having an episode, record what happened. What do you think triggered it? Keep track and write down everything you think triggers you. As you identify triggers, write down how much fear you felt when you were triggered, usually on a scale from 0-10.

Once that is over, look at the compulsions you've made. Write them down and learn the unhelpful and helpful strategies you performed to help with that fear. Once you've written them all down, you can have a good overview of your OCD. When you record these emotions, make sure you're doing it ASAP, so the memory is still fresh.

Fear Ladders

Record your obsessions for a week, and then you may be able to write a list of all your fears. Since you have a list of your fears and how much terror you've felt whenever you experienced them, rank them. Order them from least fearful to most. Often, there will be different rankings for your fears. If you fear to get your hands dirty, you may feel less fearful at home than you would in public.

There doesn't need just to be one fear ladder, either. You can make different ladders for different types of fears. The more detailed and organized your ladders are, the better. This can make them easier to climb. It's easier to climb a few smaller ladders than it is to climb one bigger ladder.


Climbing The Ladder

After creating your ladder or ladders, now it's time to climb them. You start at what makes you the least fearful, yet gives you an impulse. Then, you try your best to be able to control your compulsions. It's a challenge. While the bottom steps may be easier, once you've reached an extremely fearful situation, it can be harder to control your impulses. This is why we start with the easiest fear first. It can help build the courage needed to tackle those fears that are much harder on you.

As you climb the ladder, track your progress. When you are facing fear, monitor your anxiety and see how it makes you feel. This can be a good way for you to figure out how to cope. If the anxiety is too low, then you don't have to worry. However, too high for anxiety can be a problem. One thing you have to remember is that your fear will eventually go away. If you are exposed to anxiety, if left alone, it will taper off. It can be hard to resist, but by building yourself up, you can do it.

As you climb the ladder, make sure you're not trying to avoid your fears. Some people may use a technique known as subtle avoidance. For instance, if they fear to put their hand on a surface, they may just put one finger. Some may try to distract themselves from their fears. This is not how you handle your fears. Instead, you need to face them head-on. By avoiding them, even subtly, this can prevent you from being able to conquer your OCD.

Just remember that as you climb the ladder, you shouldn't rush your treatment. When you're on a step that gives you fear, you want to stay on it until the fear associated with your trigger goes down. Make sure the fear drops by half. Don't try to tackle multiple fears at once and do not try to rush from fear to fear. It's important to conquer all your triggers, but don't bite off more than you can chew.

How To Prevent A Compulsion

When you want to enact on your fears, you may wonder how you can stop them. Here are a few steps.

  • Try resisting. We know it's hard for you to resist the urge to act on compulsion, but you must do it. Do not carry out the compulsion. It's a terrible coping mechanism you must not do.
  • If the compulsion you perform has been long-term, it's especially tough to figure out how to live without performing it. You may need to seek a role model if you want to make sure you can do it. A family member or a friend can help you safely perform the compulsion. For hand washing, they can teach you how to wash them fast and not repeat it.
  • That's another way to tackle a ritual. Sometimes, you may need to perform it. When you do that, you should reduce its severity. Like if you're washing your hands, you can increase the time after touching something to wash your hands, and then decrease how long you wash your hands. By gradually delaying and reducing the time you perform the ritual, you can conquer your fears.
  • If you perform the ritual, what you should do is expose yourself again to the fear and then keep doing it until your fear lessens. Use delays and reduction to help you reduce your fears, and keep doing it until you feel less fear and less compulsion. It may take a few tries, but by performing this, you can be able to reduce your fears and live a better life.

After your fears are reduced, you should move to the next step on the ladder. The process then repeats. As you can see, ERP therapy works by being a common sense way to tackle your fears. By gradually exposing yourself to fear and taking small steps to conquer it, you will see progress. You may not notice it at first, but if you keep trying, you can reduce your OCD, or eliminate it.

The appeal of ERP is also because you can do it yourself. You make your lists and tackle your fears in your way. No need to see a professional. Many have tried it, and many succeed. With that said, it's okay if you need a professional to help you.

Seek Help!

In addition to ERP, asking for professional help is a good idea as well. A therapist can help you figure out strategies to help cope with your OCD, and together, you can be able to learn how to tackle it. OCD is a challenge, but it's one that you can conquer. All you need is some time and patience. You can improve, and you can end your fears.

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