Exposure and Response Prevention (ERP)
In ERP, a person with OCD practises approaching feared situations (exposure) while not doing compulsions (response prevention). It’s done in a safe, graded way, starting with easier situations and working up.
The goal of ERP isn’t to make the trigger feel good or to get rid of anxiety; it is about creating new learning, to teach us that we can handle the discomfort without doing compulsions.
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ERP: Exposure
Exposure means purposefully approaching the experiences that OCD tells you to avoid or that you feel you can’t handle. Avoidance might feel safer in the moment, but it ultimately allows anxiety and OCD to grow stronger.
When we choose to approach the experiences we’ve been avoiding, we gradually and safely build our capacity to cope with discomfort. Over time, this helps reduce OCD’s influence and allows us to focus on living a meaningful life with fewer rules and restrictions.
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ERP: Resist
Resisting OCD compulsions means not doing the actions that OCD says will keep us safe, reduce our distress, or prevent something bad from happening.
Resisting compulsions feels wrong in the moment, but it’s the most effective step; tough in the moment, but the quickest path to long-term progress.
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ERP: Delay
Delay means slowing down our response to OCD urges instead of acting immediately. OCD tries to create a sense of urgency, but even pausing for a few seconds or minutes lets us take back some control. We may still do the compulsion later, but on our own terms, not at OCD’s command.
Even a short delay is a win because it interrupts the automatic OCD cycle.
Every fleeting moment that we stand strong against OCD, we are getting stronger and OCD is getting weaker. What might start off as a delay of a few seconds can build to minutes, hours, and then days.
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ERP: Reduce
Reduce means that we may still do the compulsion, but not completely according to OCD’s rules. We purposely reduce how much you obey OCD’s demands.
The goal is to stop the compulsion before you get the feeling of “completion.” In other words, we want things to feel a little unfinished or not quite right on purpose.
Any mini-rebellion against OCD counts as a win.
You get stronger each time you do it.
Printable Handout
ERP: Refocus
Refocus means redirecting our attention away from compelling OCD narratives. OCD dictates that we must give all our attention on what it considers to be important. When we refocus, we notice OCD without giving it our full attention, and intentionally shift our main focus onto something more meaningful or important.
You already have this skill and you can learn how to apply it to OCD.
Refocusing is not a one-and-done process but every time we try, we are training our brain to stop treating OCD as urgent or important.