OCD Treatment & Exposure and Response Prevention (ERP)
When your mind won’t let go
Maybe it’s the unending loop of intrusive thoughts. Maybe it’s the hours spent checking, replaying, counting, fixing, or avoiding. Maybe it’s the hopelessness and despair given that no matter what you’ve done or tried, the thoughts. won’t. stop. coming.
OCD can make you feel like a prisoner in your mind, where what you care most about fades away as the compulsions take life’s center stage. The relief is tempting, yet fleeting - pairing short-term reprieve with a painful cycle of anxiety and distress. If this sounds familiar, you are not alone. OCD is highly treatable, and you don’t have to keep managing it on your own.
ERP: the gold-standard treatment for OCD
Most people with OCD will recount hours and days spent fruitlessly trying to think their way out of their intrusive thoughts. ERP bypasses this process entirely; it gradually and deliberately places you face to face with the situations, thoughts, or images that trigger your anxiety, while helping you resist the urge to perform the compulsion that usually follows.
It sounds counterintuitive at first. OCD wants nothing more than the distress to go away, so why go toward what triggers it? By sitting with the discomfort and not engaging in compulsions, you’re allowing the brain to learn that the anxiety will fall on its own, without the ritual. It will learn that it can tolerate the discomfort triggered by the thoughts, allowing you to get back in the driver’s seat and focus on taking your life back from OCD.
In practice
Though the processes are the same, OCD looks different from person to person. Whether OCD manifests as fear of contamination, intrusive harm or taboo thoughts, relationship OCD, doubts about morality or religious scrupulosity, or a hyperfocus on symmetry and “rightness,” my approach works for adults dealing with OCD in many forms. We start with by mapping out your specific obsessions and compulsions. From there, we build a list of exposures, ranging from the small and manageable to the seemingly insurmountable and catastrophic, and start with whatever you’re willing to do. You’ll be encouraged to “lean into” the discomfort, but never forced to. I’ll be with you every step of the way, and will never ask you to do something I’m not willing to do myself.
Though ERP is the foundation of my approach to OCD treatment, I incorporate principles from other modalities (e.g. ACT, I-CBT) when appropriate. Regardless of the approach, sessions are collaborative and practical. You’ll leave with specific tools, concrete objectives for out-of-session work, and valuable insight to help change your relationship with the intrusive thoughts and related compulsions. If you’ve tried talk therapy before and found it didn’t have the desired effect, ERP is often the missing piece. It’s a different kind of work that’s designed for precisely this.
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