Why do ERP therapists advise against seeking constant reassurance for OCD?

Yes, ERP is very hard and at the beginning will increase anxiety….been there, done that. Had me in tears several times! BUT…..it works and is totally worth it. Started ERP therapy in august and my last session is next month (went from twice a week to now once every month). If you have a good therapist you’ll do a erp “ladder”. You start off low with things that will give you a little anxiety and work up from there. I didn’t think I’d ever get better but I’m proof that recovery is possible. Trust the process and YOU GOT THIS!!! 👍🤜

ERP is incredibly difficult at first. Asking for reassurance feeds the beast of OCD. My first few weeks of ERP were an incredibly difficult time and my anxiety levels went up during the sessions but before I knew it my overall, daily anxiety levels were much lower. Think of it like exercise. The first few weeks are the most difficult. Your body and mind doesn’t know what your doing to yourself, it’s unfamiliar, but as you build physical or mental strength thru your practice, your resilience to physical and mental stressors increases exponentially. Stay strong friend and give it a chance. It can seem very counterintuitive, but it works.

Constant reassurance seeking is a compulsion and a temporary fix for the anxiety you’re experiencing and is only going to make things worse in the long run. The point is to learn to sit with the uncertainty, doubt and anxiety and all of the “bad” feelings and sensations that this causes. When you’re first starting ERP, it is very common for the anxiety and agitation to increase because you’re no longer giving into your compulsions, which in this case is seeking reassurance. Once you learn ERP and practice it enough, (which is HARD, I know) the anxiety should gradually reduce from there over time.

The idea is, through exposure and response prevention, you are learning to tolerate uncertainty. When we reassurance seek, we are trying to alleviate not just uncertainty but also the uncomfortable (and that’s putting it mildly) feelings associated with uncertainty. The agitation/anxiety you feel when you are told to just ask once is also part of the “response prevention.” Just as you allow the uncertainty to be there so as to learn to get more comfortable with it, you also allow the feelings of agitation and anxiety to be there without trying to alleviate them (this is the response prevention). Yes it feels bad but it’s how you get better. Like Ethan Smith from the IOCDF always say, “you have to feel all the feelings”. You should Google his IOCDF key note speech. It’s so helpful.

The people above me explained it well. I'll just add that after a while, the reassurance stops working and that's when the real shit hits the fan. Think about it like this. Say you ask someone, "Do you think that red stuff in my food at the restaurant was blood?" Of course they're going to say no because they want to reassure you that you're fine and not increase your anxiety. In reality, they just flat out lied to you. They have no idea it was blood. It could have been blood, it could not have been blood. Then when you ask something really important, you won't know if they're lying to you or not. The whole point of ERP is to not know and to accept and live with that fact because nothing in life is certain. People with OCD live in the definite like that thing definitely happened. You can say it's a possibility. Something possibly happening doesn't seem as scary.