So how exactly do I approach ERP (exposure and response prevention therapy) for OCD? I share the anatomy of ERP for OCD below, but before we get started, let me define the difference between proactive and reactive ERP.
Proactive vs. reactive ERP
- Proactive ERP is when you’re purposely triggering OCD by doing something that is important to you that your OCD doesn’t like, i.e. you choose the timing and content.
- Reactive ERP is when your OCD gets triggered and you respond by using a variety of ERP skills, i.e. your OCD chooses the timing and content.
Sometimes when you’re doing proactive ERP, OCD will trigger you about something else, and then you’re doing a combination of proactive and reactive ERP. (A good example of this is my Making OCD Pass Out video.) After you’ve finished a proactive ERP session, you’ll probably need to do reactive ERP in the hours after the exposure because you’ve riled up your OCD about that topic and it might decide to poke you back.
Taming OCD requires both proactive and reactive ERP. If you’re only doing reactive ERP, then OCD is unfortunately in charge of your recovery, because you’re only poking at it when it pokes you first.
The Anatomy of ERP for OCD
A few months ago I was on a Zoom call with a friend on a Sunday evening when he said something that made my OCD completely melt down. It was one of those 0 to 60 moments, where one minute I was fine and the next I was awash in adrenaline with my OCD having a tantrum on the floor. (Personifying my OCD has been an exceptionally useful tool in my OCD recovery, by the way…)
But it’s okay, this happens at times because there’s no cure for OCD, and you can still live a joyful life anyway, especially if you embrace all the ERP tools available.
To help you in this process, here are the steps I took and the tools I used to manage that episode. I’ve written extensively about all of these tools, and I’ve linked to other blog posts or resources where you can learn more about each.
Would you like to do a deep dive into the anatomy of ERP for OCD? Check out ERP School, created by Kimberley Quinlan, LMFT, one of the most talented ERP therapists I know.
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My blogs are not a replacement for therapy, and I encourage all readers who have obsessive compulsive disorder to find a competent ERP therapist. See the IOCDF treatment provider database for a provider near you. And never give up hope, because you can tame OCD and reclaim your life!
Weightlifting brain image © Can Stock Photo / abidal