Treating OCD: the journey of Exposure and Response Prevention

A different look at the steps of doing ERP — how is it like going on a journey?

Step 1 – Getting Ready

When you set out on any big journey, the first step is often an invisible one. The first step is deciding to go. We don’t think about this when we decide to take a hike or go on a big trip, but it’s there, and it’s crucial. Deciding that you want to go to Florida rather than Michigan or New York is the most important part of your entire excursion. And it’s like this with OCD treatment as well. A person must decide that they are going to go on this journey. You wouldn’t decide to cross the country and visit a new place if you didn’t know what was there. You want to look at the brochures and get a picture in your mind of what’s in store for you.

Fingers on a spinning globe. OCD treatment takes preparation. As an OCD therapist in Denver, I help you prep for the journey.

You want to look at the brochures and get a picture in your mind of what’s in store for you.

Our first step in defeating OCD is to define what it is your working toward and exactly why it’s important to you.

Our first step in defeating OCD is to define what it is you’re working toward and exactly why it’s important to you. This may seem obvious. “I want to get out of this misery!” “I want to get my life back!” “I want to stop doing X, Y, or Z, all the time because it’s driving me crazy!” This is a jumping off point: what you want to leave behind. But we also need to name what you do want, what you have to gain, and what you have to recover. An OCD-focused therapist can help you identify these powerful and motivating goals. They will be the fuel to your fire, the boost you need when things get difficult along the way. So get ready to blast off.

Step 2 – Plotting the Course

The next big step in the journey from one place to another is making a map and planning the route. You wouldn’t set out on a trip across the country without first getting a sense of the roads you would take. You might head off in the wrong direction. And without a map, how would you know if you got sidetracked or lost? To make the trip successful, we first spend a little time identifying the lay of the land, the specific directions to go, and the signposts of success.

GPS screen shows the way. The steps to treating OCD are outlined clearly by a good OCD therapist.

To make the trip successful, we first spend a little time identifying the lay of the land, the specific directions to go, and the signposts of success.

In treatment terms, this means getting specific about the kind of OCD you have.

In treatment terms, this means getting specific about the kind of OCD you have. (Yes, there are different kinds, called subtypes.) We will identify the routes that your OCD uses to make life difficult, all the twists, turns and horrible dead ends. Through this process you become an expert on your OCD, and when we know the lay of the land—how your specific OCD works—we plan a customized course of action to expertly navigate out of the confusion and back to the life you want.

Step 3 – Get moving!

Motivated to take the ride, equipped with the knowledge of the road, here’s where we get moving. OCD is constantly telling you what is safe and what is not. Its trying to grab the wheel and either hit the gas or slam on the break. Our job is to take the control back, no matter what OCD says, and prove to it—and ourselves—that if we drive steady, we will get where we are going and safely.

Man stands on precipice overlooking a beautiful valley. Getting started with OCD therapy is scary, but with help and guidance, you can get better and overcome.

Our job is to take the control back, no matter what OCD says,…

To prove to ourselves, and our brains that we are in full control, and that we are okay.

The way we do this is a full commitment to not engage in the safety behaviors, rituals, or avoidance that OCD tells us is neccassary. With all our will and every trick in the book (CBT techniques, values work, an “OCD buddy”) we decide that we are going to face our exposures without ritualizing. Each exposure has a clear beginning, middle, and end, with clear guidelines on what is expected. Within the safety of this frame, we commit to fully experiencing the discomfort. Why? To prove to ourselves, and our brains that we are in full control, and that we are okay.

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