OCD and Exposure Therapy: What to Expect
Do you find yourself stuck in endless cycles of intrusive thoughts and compulsive behaviors?
If you've been struggling with obsessive-compulsive disorder (OCD) or suspect you might have it, you're not alone. Many people find themselves frustrated from patterns where disturbing thoughts pop into their minds, followed by the need to perform certain behaviors to make the anxiety go away. Exposure and Response Prevention (ERP) therapy has been shown to be one of the most effective treatments for OCD. Understanding what to expect from this process can help you feel more prepared and hopeful about your journey toward recovery.
What is ERP Therapy?
Exposure and Response Prevention therapy works by gradually exposing you to situations that trigger your obsessive thoughts while preventing you from performing the compulsive behaviors that typically follow. This might sound intimidating at first, but it's done systematically and with professional support.
Your brain has learned that by doing compulsions (e.g., excessive handwashing or checking) reduces anxiety in the short term. But this strengthens the OCD cycle. ERP helps retrain your brain to realize that you can handle the anxiety without the compulsions.
How Long Does Treatment Take and How Often Do You Need to Go?
Many people begin to see meaningful relief within 8-10 weekly sessions, though this varies depending on the severity of your symptoms. We typically start with weekly sessions, which provides consistent support while allowing time between sessions to practice what you've learned.
Building Your Exposure Ladder
One of the first steps in ERP is creating what we call an "exposure hierarchy" or ladder. This is a personalized list of situations that trigger your OCD, ranked from least to most anxiety-provoking.
For example, someone with checking compulsions might begin with:
Leaving the house after checking the stove only once (anxiety level 4)
Leaving without checking certain light switches (anxiety level 6)
Not checking the front door lock at all (anxiety level 8)
This collaborative process ensures that you're never thrown into situations that feel completely overwhelming. Instead, you build confidence and skills with each step.
What You'll Be Doing Between Sessions
Your work doesn't stop when you leave the counseling office. Between sessions, you'll have specific homework assignments designed to reinforce your progress. This typically includes practicing relaxation exercises like deep breathing and progressive muscle relaxation, which help you manage anxiety during exposures.
You'll also work on identifying and challenging unhelpful thought patterns that fuel your OCD. Most importantly, you'll gradually practice exposure exercises on your own. These might start small - perhaps touching a "contaminated" object and waiting before washing your hands, or checking a lock only once before leaving home.
Here's the thing: doing exposures on your own can be challenging. You might find yourself wanting to avoid them or give in to compulsions. This is completely normal and exactly why having a counselor guide you through this process is so important. They can help you brainstorm solutions to obstacles and develop strategies to avoid common pitfalls and setbacks.
How We Track Your Progress
Throughout treatment, we use standardized assessments to objectively measure your progress. These tools help both you and your therapist see how your symptoms are changing over time, even when day-to-day progress might feel less obvious. Many people find it encouraging to see concrete evidence of their improvement.
These assessments track things like how often you're having obsessive thoughts, how long you're spending on compulsions, and how much your OCD is interfering with your daily life. Seeing these numbers go down over time can be incredibly motivating.
What to Expect: The Good and the Challenging
ERP isn't always easy. You might have days where your anxiety feels higher or where you struggle more with exposures. This is completely normal and doesn't mean you're failing. Temporary setbacks or plateaus are part of the recovery process.
Progress isn't always linear. You might do great for several weeks, then have a rough day where OCD feels stronger. This is where having a professional guide you becomes crucial. They can help you understand that setbacks are normal, help you problem-solve obstacles, and prevent minor challenges from becoming major ones.
But here's what many people experience as they progress through ERP: the anxiety during exposures starts to feel more manageable. The time between obsessive thoughts gets longer. The compulsions start to feel less urgent. You begin to trust that you can handle uncertainty and discomfort.
Still Struggling With OCD? We Can Help.
If you find yourself stuck in the exhausting cycle of OCD, know that effective help is available. ERP therapy is the “gold standard” in OCD treatment. Having a skilled counselor guide you through this process can make all the difference in your recovery journey. Reach out today with any questions you may have or to schedule a free 15-minute consultation session. We look forward to hearing from you.