Virtual therapy in Los Angeles and across California
Exposure Response Prevention
The gold standard treatment for OCD
Intrusive thoughts don’t have to dictate your life.
You know the drill.
Intrusive thoughts are just thoughts; they don’t have to mean anything.
But
Even though you’ve been through this before you can’t help but worry about what could happen. So it begins again, the (seemingly) never ending cycle of intrusive thought, spiked anxiety, and compulsion to get out of anxiety. Wash, rinse, repeat (literally).
What would life look like if you were no longer controlled by doubt and fear?
ERP can help you get back to the life you actually want.
Not the one OCD is forcing on you.
Exposure Response Prevention is an evidence-based practice for treating OCD. This practice allows you to gradually build tolerance to the things that make you anxious by exposing you to them and taking away the compulsions. This can sound really scary! And to be fair, it is. The goal here is to learn how to handle scary thoughts and situations so they don’t control your life.
Because giving up your compulsions can feel really intimidating or impossible, we start with the easier things first, the stuff that only makes you a little anxious. You probably already have a few things like this where you pushed through without doing a compulsion. Every time you expose yourself to an anxiety provoking thought or situation and then SKIP the compulsive behavior, you’re teaching your brain and body that you can handle it. Giving into the compulsion does the opposite and reinforces the fear, leading to more and more avoidance and compulsions that take over your life.
ERP can help you reclaim your life.
Let’s make a plan
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You and I will sit down and talk about alllll the ways OCD is impacting your life; detailing the specifics of what you feel like you’ve lost, types of intrusive thoughts you have, and the ways you try to get rid of your anxiety (compulsions). We’ll also do a YBOCS questionnaire to get a baseline severity score. This will give us a measurable way to track your progress over time.
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I will teach you about distress tolerance skills and go into more detail of how exposures work to help you manage your anxiety. This might be review if you’ve done ERP before. Then we will build an Exposure Hierarchy of situations and thoughts that feel triggering. We rate them using the SUDs scale (Subjective Units of Distress), essentially listing things from easiest to hardest. Making a hierarchy can take a little creativity. We’ll collaborate on this and update it over time.
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Using the knowledge about distress tolerance you just gained, and the exposure hierarchy we developed, we will start doing exposures, together. I will guide you through exposures during sessions, coaching you as you sit with uncertainty and strengthen your tolerance. You will also do exposures in between sessions. This is the bread and butter of treatment because it allows you to integrate everything you’ve learned into your day-to-day. This is how you reclaim your life.
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After you graduate from therapy (yay!), you might want to check in from time to time and get a refresher or extra support. Sometimes stress or a life change (even good ones) can make OCD flare up again. And sometimes OCD likes to be sneaky and switch themes so it’s harder to realize that it’s actually an OCD thought. If you’re struggling to use your therapy skills, you can always come back for a check in.
ERP can help you…
Shake off intrusive thoughts instead of spiraling into a pit of despair
Have more time in the day to do things that are important to you instead of losing hours of your life to compulsions (all those “little” things add up!)
Strengthen relationships with people you care about because you can actually spend time with them again.
Try new things and go new places, even when you feel uncertain.
Take back the hobbies that OCD stole from you
Frequently asked questions about ERP
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Great question - talk therapy is a broad term that can encompass a lot of approaches, but essentially you talk through your problems and emotions to develop insight. ERP on the other hand is very behaviorally based. It’s not that there’s never any talking, but the emphasis of ERP is in changing your behavior to build distress tolerance and have lived experiences where you successfully coped with the fear brought on by your intrusive thoughts. Basically arriving at “this is hard/scary AND I can handle it”.
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Honestly, it usually is. The goal of ERP is to help you confront your fears, so if it’s not scary at all, we’re probably not doing it right. Remember though, we will build an exposure hierarchy together and start treatment with the easiest things on the list, gradually increasing the difficulty to build your distress tolerance “muscle”.
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Just let me know! I will talk through it with you and meet you where you’re at. Sometimes that might mean adjusting treatment to reduce overwhelm, and sometimes that might mean taking a break. Remember, therapy is FOR YOU. I may challenge you to keep going, but I will always respect your decision.
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Inhibitory learning is a way to help people change their fearful reactions by creating new, positive associations with things that scare them. Instead of trying to erase old fears, it teaches the brain that these fears aren’t as bad as they seem by facing them in a safe and controlled way. This method helps make these new, calmer reactions stronger and more flexible, making it easier to handle anxiety and reducing the chances of those old fears coming back. The most current research shows that inhibitory learning is the most effective way to engage in ERP for lasting results.