![]() A good goal would be “go to the swimming pool without feeling too anxious.” It targets a specific problem you’re having and is something you can work towards. It’s unattainable and doesn’t focus on a particular problem. For example, “never being anxious again” is not a good choice. If it’s too broad, you won’t be able to come up with a plan for beating it. The goal should be conquerable and specific. Based on the issue you’ve identified, you then set a “goal” you’d like to reach. To create a fear ladder, you identify a specific OCD-based issue that you’re having. They’ll then work with you to develop something frequently referred to as a fear ladder - a hierarchy of activities that will help you slowly overcome your anxiety. In ERP therapy, a professional will work with you to understand your symptoms, your triggers, your avoidance techniques and how OCD is interfering with daily tasks. OCD is an extremely complex disorder, which means therapy needs to be personalized to our unique fears and how they impact our everyday life. It could be fears about picking up pieces of glass on the street and using them to harm passerbys, or worrying about randomly attacking loved ones. For instance, if a person has Relationship OCD, their fear might be “obsessing over my partner’s physical characteristics” or “being unable to focus during sex because I’m worrying about our compatibility.” For people with Harm OCD, it might not be as straightforward as fearing knives (not to say that isn’t very upsetting). But it’s often a lot less obvious than that. For someone with Pedophilia OCD, it might be a playground of children. For someone with Contamination OCD, it might be a kitchen sink. Let’s start by explaining ERP a little bit further.ĮRP is all about exposing yourself to the source of your anxiety. The two most trusted therapies for OCD - ERP and ACT - are both types of CBT therapy. ![]() CBT Therapists help patients evaluate themselves, recognize harmful thoughts, behavior and emotions, and learn to react to them in less-distressing ways. It is rooted in the idea that symptoms of mental disorders can be minimized by learning new ways to process information and develop healthy coping habits. CBT focuses on creating strategies for managing negative thinking, behavior and emotions. Certain apps, like nOCD, make ERP more convenient and accessible.Īll recommended therapies for OCD fall under a model of treatment known as Cognitive-Behavioral Therapy, or CBT. The more and more you rope its techniques into your everyday life, the stronger your coping mechanisms become. While their harm thoughts may not go away entirely, they are no longer debilitating.ĮRP practices should be used inside and outside of therapy for the greatest impact. Over time, their massive fear diminishes and their brain realizes that they are not a threat to themselves or others. From there, they may be asked to carry a pocket knife around with them. By repeatedly facing something you’re afraid of, you force your brain to recognize how irrational it is.įor example, a person with Harm OCD who is afraid of being around kitchen knives might be asked to start cooking dinner with one nearby. In ERP, you voluntarily expose yourself to the source of your fear over and over and over again, without acting out any compulsions to neutralize or stop the fear. Instead of avoiding people, places, or objects, confront them (you can do this gradually).ERP, or Exposure and Response Prevention therapy, is the gold-standard for OCD treatment. Then read this story 15x each day while visualizing the consequences. Write out a detailed, imaginal exposure story in which your worst OCD fears/obsessions come true. You can also make a voice recording of yourself saying triggering thoughts and phrases, that you can listen to on repeat throughout the day. Instead of neutralizing a bad thought with a good thought, allow yourself to intentionally be in the presence of "bad thoughts," just like in example #1. Perhaps you said something offensive, or acted in a manner that you would feel makes you a bad person. Instead of replaying events or conversations looking for reassurance, tell yourself that what you fear is true. Instead of avoiding specific thoughts via distraction, or telling yourself "don't think about _," practice intentionally thinking these thoughts, either by agreeing with them, repeating them to yourself, or writing them out on index cards and leaving them around your house.
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