Cognitive Behavior Therapy (CBT) is a form of psychological treatment that has been demonstrated to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. Exposure and Response Prevention (ERP) is a type of CBT, considered to be the first-line psychotherapy for OCD. The “exposure” refers to purposefully exposing yourself to intrusive thoughts, images, objects and situations (obsessions) that cause anxiety. The “response prevention” refers to the act of consciously not engaging in the compulsive behavior (compulsions) once the obsession is triggered. The idea is that continuous exposure will, over time, decrease your anxiety in relations to the obsession.
I have struggled with contamination obsessions and compulsions. I used to fear a lot of things in our environment were toxic and would avoid touching them or compulsively wash my hands when exposed. BPA was a huge concern of mine; I wasn’t able to take receipts from cashiers, I refused to touch plastic bags and panicked if my children did.
My therapist worked with me to develop “exposures” for these obsessions/compulsions. I started by having to touch a plastic bag, with one finger, quickly and document my anxiety on a scale of 0-7 (7 being insufferable). Next, I would have to sit with that anxiety until it came down by half and document the time it took (Example: Starting Anxiety – 6, Final Anxiety – 3, Time Elapsed – 6 minutes). With time, I was able to bring my anxiety down to a 0/1 after touching a plastic bag, with one finger, quickly. The next exposure was to hold my finger on the bag for 5 seconds, where I followed the same process. Next, I had to hold the bag, then have my groceries bagged in plastic and so on and so on. I was, eventually, able to work up to having my kids hold a plastic bag. When doing these exposures I could not engage in any compulsive behaviors (washing hands, etc.). After completing the exposures, I was able to use plastic bags with minimal anxiety.
ERP was, 100%, my saving grace; unfortunately, it took me years to find it.
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