Obsessive Compulsive Disorder can be scary and debilitating, but it is treatable. You don’t have to continue to suffer from it or let it interfere with your life. Working with a therapist who provides skilled and accurate exposure and response prevention (ERP) can help you completely break free of all compulsions. But for this, you have to include everything.
Here is one way I explain ERP to my clients:
A brave but cautious knight came along the road. One way led him to the East, the other to the West. In front of the knight was a stone with instructions engraved on it. “To the East,” said the stone, “is a life full of adventure, creativityfun, family, friends and learning.” The knight read this and nodded excitedly; these were all the things he wanted in his life.
But the inscription on the stone continued: “For the West, life is full of certainty.” Again, the knight nodded. This was the life he wanted.
Every day she spent hours getting all the details right and going over everything she did that day to make sure she didn’t say or do anything that could cause offense or harm. He reassured himself that he was doing the right thing. He sought reassurance from those close to him to make sure he had done nothing wrong; he hates to feel as if he could possibly be responsible for anything that might cause trouble. He would sometimes even retrace his steps to make sure he didn’t hit anything in his path.
The problem was that the knight valued being brave and moving towards the life he wanted, but at the same time he also felt a strong need to be completely and utterly certain: 99% certainty was not enough because he felt the price of not being good was too high to pay.
So she pushed herself to take a step towards the East by doing something she cared about.
He then took a step towards the West, checking to make sure he didn’t hurt anyone with his previous step.
Then he condescended to take another step towards the East with the help of a friend.
Then West took another step by going over everything she had done in her mind to make sure everything was okay.
After that, she reluctantly took another step towards the East, which did the fun thing.
Then another step to the West by giving assurance that what he did was safe.
Then another step East…
Then another step West…
At the end of the day, she was tired, but still in the same place. Still trying to move East and West at the same time.
As a clinical psychologist who works with it OCDI often meet people who are like this brave but cautious knight. They know that the treatment plan includes Exposure and Response Prevention (ERP), so they force themselves to take a step in this direction in advance, while trying to move in the opposite direction with compulsions that no one else can observe, such as self-confidence, history checking, dealing with OCD (for example, I am doing this now and more). At the end of this ERP, they’re exhausted because they’ve pushed themselves really hard, but they still don’t feel any closer to beating OCD.
Therefore, it is important to implement ERP with curiosity and precision. Notice that you have thoughts and worries; Notice where you are now and you are more than OCD. So choose to be all with your ERP and leave all avoidance as well all observable and unobservable compulsions and instead move toward a life that truly matters to you. It’s a scary ride, but in the long run, you’ll be so glad you took these hearty steps now.
To find a therapist, Visit the Psychology Today Therapy Directory.
