Exposure and response prevention therapy (ERP) is currently considered by many mental health professionals to be the most effective treatment for OCD.
ERP is a form of cognitive-behavioral therapy, a method that addresses the connection between thinking, feeling, and behaviors. Frequently, ERP treatment is combined with family therapy, psycho-education, and medication.
About ERP
In ERP people are exposed to the source of an obsession and asked to gradually refrain from performing the ritual associated with it. So, if you feel compelled to check the door locks 12 times before going to sleep, the therapist will help you become clear about why locked doors are an obsession and encourage you to cut back on nightly checks.
Becoming aware of the triggers behind an obsession, and refraining from the associated compulsive behavior, is meant to disrupt the feedback loop that exists between the anxious thought and the ritual.
As you might hope, people starting ERP typically face their lesser obsessions and compulsions first. Having success managing them builds confidence for addressing more entrenched obsessions and rituals.
What To Expect
ERP can only be successful if participants are willing to expose themselves to situations that trigger their anxiety producing obsession, and then refrain - often gradually - from the behavior performed to relieve the anxiety. This work is done during counseling sessions and through homework assigned by the therapist.
For instance, if you always check the door locks a dozen times before going to sleep, a homework assignment might be to check the locks 11 times each night for the next three weeks, then 10 times per night the following three weeks, and so on.
As people continue in ERP they begin to notice a reduction in obsession anxiety. Then, the urge to perform anxiety-reducing rituals decreases as well. With time, patience, and practice triggers weaken, and the OCD is more manageable.
Photo credit: Richard Lewis