Exposure Response Prevention Therapy (ERP Therapy) is a form of Cognitive Behavioral Therapy (CBT) used for individuals with OCD or Intrusive Thoughts. With ERP Therapy, the sufferer exposes themselves to the object of his/her fear. This “object” can be thoughts, fears, imagery, people, places and situations that bring anxiety and manifests as rituals. Rituals can be anything from ruminating on thoughts or obsessions to pondering or “Checking.”
Here is my own personal story with Intrusive thoughts. I have recently been diagnosed with OCD (OCD is anxiety based) primarily with Harm obsessions 3 months ago in July. On January 15th, 2016 I had my first Intrusive Thought that really struck me.
I remember this day so vividly because the thought was so shocking and against what I wanted to do. Yet the emotion that came with it felt so real and left me shaken to my core with intense anxiety. This, in turn, was feeding the thought – giving it a higher importance.
The thought occurred while home that day from work. While running and watching a bus pass by – in that split second I “saw” myself running in front of the bus and committing suicide. The anxiety that struck me was like nothing I felt before.
I got home that same night and while I was in the bath, I had my first aggressive intrusive thought which had an even more negative effect on me. I don’t feel like I’m ready to talk about that yet, but perhaps you can leave a comment or ask a question if you had a similar thought or experience. The next two days is what started a 7-month long downward spiral until I got to the point where I felt I needed to get outside help.
OCD: What’s going on with Me?
Before I go on, let me say that those two days after were honestly a living hell. I had no idea what was going on with me. All I knew is that this was the complete opposite of my desires and intentions but yet I kept having it over and over and over again. I questioned if I was evil or if I was going insane. I spent a 2-hour drive to Arizona mentally arguing with my thoughts and trying to push the imagery out. I’d say over and over to myself that I was okay and the more I did this the more the Intrusive Thoughts came. This was a daily internal battle that I had for the next 6 Months. OCD is an anxiety based disorder so as you can imagine these intrusive thoughts were being fed with anxiety and compulsions which in turn was leading to more intrusive thoughts and even more anxiety.
Currently, I am in therapy doing ERP as well as practicing Mindfulness techniques which help immensely with my mental compulsions and anxiety. One way I do this is to face my thoughts, not run away from them, I realize the thought is just a thought and not an action. I still struggle with this on a daily basis but I also use an ERP technique I learned which is to face the thought and not push it away. It actually helps me to be mindful and be aware that my actions are separate from the intrusive thought that has occurred. The more you face your fearful thoughts the less importance they have over you and over time you will desensitize to them. This is essentially what ERP is about; facing your thoughts, but with the key characteristic of not engaging or giving in to any OCD tendencies while doing so.
Start small, you can choose one intrusive thought a day to work on. Say to yourself aloud when the thought hits “This is just a thought”.
Please don’t confuse these intrusive thoughts with intrusive thoughts that most people get and shake off as a “weird thought” and go about their business. I’m talking about an individual with OCD who suffers from obsessional thoughts that often come with strong visuals and images that are repetitive, disturbing, and often horrific. For example, thoughts of causing violent or sexual harm to a spouse, significant other/partner, kids or loved ones. The thoughts are repetitive and not voluntarily produced.
These thoughts are often very opposed to the true nature of the individual. Otherwise compassionate and loving people may find that the very idea that they are capable of having these thoughts extremely distressing. This in turn often leads them to extreme anxiety, stress, and mentally fighting one’s self. Trying to push the thought away, they try to convince their self that the thoughts are not who they are. This act of seeking reassurance in any way possible only by doing so feeds into the root problem and leads to worsening the OCD symptoms.
What I have found out in my journey of struggling with this, is that people with OCD are the least likely to act on these thoughts. They go against the individual’s nature which is why they get so distressed and go to great lengths to prevent the thought from truly happening. My therapist and I have been working with CBT and EMDR and today I did my first session of ERP Therapy.
ERP Therapy and Mindfulness
ERP is very beneficial for OCD, which in my case is Pure Obsessional. 4 out of 5 people in the US get intrusive thoughts, but it is the ones who have anxiety and mental health disorders that ruminate upon them which cause a vicious cycle of more worry, panic, and physical manifestations of stress – which I will have to write about in another article.
Another method, I have been using is to sit there with uncomfortable thoughts. Being mindful of the present moment and accepting that a thought is there. When you sit there with the anxiety and not perform compulsions it starts to rewire your brain that there is nothing to fear. The more you resist a thought the more it persists.
For two weeks now, I have been doing this practice daily. Sitting with the anxiety, letting myself actually FEEL it. No longer resisting or mentally arguing with myself but instead facing the thought. My anxiety has lessened. I get intrusive thoughts but they do not have the same power over me. They are thoughts and nothing else.
You have to face your fear and not perform any compulsions while doing so. One thing, I want to say is not to be hard on yourself when you try this this exercise. It just takes small steps. Remember that OCD does not define who you are.
I’m looking forward to progressing onward with my ERP Therapy and Mindfulness and will write more articles in the near future. Please feel free to comment if you have any questions or have similar experiences to share.
Guest post by Alexis Becerra
or more on ERP Therapy, try: Mental Health Page
Also try our free Anxiety and Panic Relief Worksheet Here: Anxiety/Panic Relief Resources