Exposure and Response Prevention
Exposure and response prevention (ERP) is the most empirically validated treatment for obsessive-compulsive disorder (OCD).
ERP is a behaviorally based therapy where people are exposed to situations involving their obsessions and are prevented from engaging in compulsions. The goal of ERP is to free people from the cycle of obsessions and compulsions.
The key is response prevention because anything that reduces stress makes it impossible for us to get used to it. When people do not engage in compulsions, they are able to accept their obsessions instead of desperately trying to get rid of them. The thoughts may still be difficult but no longer seem like a huge problem.
The process of getting acclimated to something is what psychologists call habituation. When people habituate to the feelings their obsessions bring up and lower their reliance on compulsions, they spend less time and energy avoiding discomfort
ERP is about changing one’s orientation to difficult thoughts and feelings – not getting rid of them. When we can deal with discomfort, obsessions are not reinforced by avoidance behaviors that tell them the content of their thoughts are dangerous and unmanageable. When we don’t feel the need for full certainty about ourselves, the world, and our future we can live without unneeded suffering.