Obsessive Compulsive Disorder
Exposure & Response Prevention Therapy
ERP is an evidence based treatment and one of the golden standards of treatment utilized to treat OCD symptoms.
Think of exposures as experiments in which we test out our fears or hypothesis of what we think might happen if we don’t engage in a compulsion/safety behavior. Exposures address the obsessive thought, image, urge, sensation, feeling, idea, or memory.
Response Prevention targets the compulsion aspect of OCD. Response prevention is making the choice to not engage in a compulsive behavior when OCD is triggered.
The goal is to confront what makes us scared, lean into the uncomfortable, and resist the urge to engage in a compulsion.
Exposure
Gradually exposing patients to situations that trigger their obsessions in a safe environment
Response prevention
Teaching patients to not engage in compulsive behaviors when their anxiety or obsessions are triggered
Inferenced Based Cognitive Behavioral Therapy (ICBT)
An inference is a conclusion we come to when we may not have every single piece of information. We come to a conclusion from using our common sense, knowledge we already knew, and what we can observe in our environment. In this treatment, we learn to use our common sense, existing knowledge, and observation to make conclusions.
OCD is about doubting who you are & what your senses tell you about reality, which leads to us making inferences that don’t make sense. OCD is sustained by a faulty narrative. I-CBT addresses a confused way of reasoning about possibility. In this therapy, we want to learn the difference between real probability and the imaginal possibility.
Inference-based Cognitive-Behavior Therapy (I-CBT) is an evidence-based treatment that is based on the central idea that obsessions are abnormal doubts about what “could be”, or “might be” (e.g. “I might have left the stove on”; “I might be contaminated”; “I might be a deviant”; “I could be a pedophile”). According to this approach, obsessional doubts do not come out of the blue, but they arise as the result of a dysfunctional reasoning narrative that is characterized by a tendency to distrust the senses and an over-reliance on the imagination. As a result, obsessional doubts are able to persist without ever being resolved by carrying out compulsions.