Here's an edited summary of ERP that I wrote along time ago.
Your job is to apply the "feeling like I have to pee perfectly"concept here. Just treat it like any other compulsion.
----------
If you put ERP in a nutshell, there's a couple main tenants that are REALLY important to understand. Here they are...
1.) You have to treat the thoughts as though they don't mean anything (because, in real life, they actually don't mean anything!)
2.). You have to deny yourself any safety behaviors that you do because of the thoughts (because these are all compulsions)
3.). When you deny the safety behaviors (i.e., the compulsions), it will cause your brain and even your body to go into anxiety mode. (In other words, your brain freaks out because you feel like you did something that was NOT SAFE.)
4.). But you have to "ride out" the anxiety feelings until they subside on their own. The more you practice doing this, the easier it gets. The anxiety spikes will get smaller and smaller. Eventually, you will be able to prevent yourself from doing compulsions without feeling anxiety.
----------------------//////-------///////-------
Okay, so let's talk about each of these things, one at time.
Let's start with #1... The Thoughts
Everyone with OCD has repetitive, disturbing, intrusive thoughts. The fact that they are intrusive means that they come into our heads unwanted. This is the hallmark of OCD.
The big trap, however, is that most of us believe that these thoughts mean something. We all have to learn that these thoughts are meaningless and to stop fighting them off. In other words, it's OK if they are in our heads.
If you try to fight them off, they’re just going to get worse. My therapist explained it like this:
Imagine a tree planted by river. The leaves from the tree fall off and float down the river. You watch the leaves fall, but you don’t try to stop them. You just let them float down the river.
This is the same with ALL intrusive thoughts. It doesn’t matter if these are bad thoughts about God, violence, sex, attractions, etc. All intrusive thoughts are the SAME. You just let them fall off the tree and float down the river.
-----///////--------///////---------//////-------///-
Okay, let's talk about #2. The compulsions.
When you boil them down, all compulsions are SAFETY BEHAVIORS. They are designed to negate the thoughts and keep you safe.
It's important to remember that AVOIDANCE can be a safety behavior. For example, if you avoid saying certain words because you don't know the intentions behind it, then you are actually doing a compulsion.
In ERP therapy, you have to practice denying the compulsions. However, you don't do this all at once. That is way too scary, and no one can handle that. Instead, you start with the very easiest compulsions.
Remember to not get discouraged if the treatment takes longer than you expect. The OCD journey tends to take a long time, with baby steps, and lots of circling back and starting over, lol. Just remember that this is part of the process.
-------///////--------////////--------///////-----//
Okay, let's talk about #3: The Anxiety Episodes
When you deny compulsions, it feels unsafe. It feels like you are going to die or that someone you love is going to die. It feels like the consequences are huge, like the end of the world or some terrible disaster.
Let me give you an example. When I feel like I did something "unsafe," I can usually pass over it and realize that I am okay. I have had years of practice doing this. But every once in a while, when I deny a compulsion, it feels so UNSAFE that I spiral into an anxiety pit. It can take hours, days, or weeks before I feel better.
What you have to understand is that this is a NORMAL part of the recovery process. It seems strange to say this, because the episodes feel so awful. But in order to defeat OCD, we actually have to practice putting ourselves though the terrible anxiety that always accompanies "breaking the OCD rules."
---------///////---------//////-------------///---
And lastly, let's talk about #4: You have to "ride out" the anxiety episodes.
There's no way to defeat OCD without pain. It takes a lot of work. But if you put the work in, you can get to the other side and start living the life you have wanted to live!
So, it's important to understand this going in to journey. It's going to take a lot of work. It's going to take "pain" in the sense that you are going to make yourself experience these awful anxiety episodes. However, this is the only way to recover.
But you have to take it slowly. Start with the simple things. And then take baby steps. If you don't, you will be overwhelmed and it won't work.
Let's put this into an example. Let's say Jake has OCD, and he is afraid of crossing bridges. First, the therapist will ask him to just THINK about a bridge. If that causes anxiety, then Jake can practice thinking about bridges and then accept the anxiety that comes.
The next session, the therapist might ask Jake to sit next to a bridge. This might cause even more anxiety. Jake has to practice sitting next to the bridge and "riding out" the anxiety that comes.
The next time the therapist might ask Jake to put one foot on the bridge--and so on.
The point is that at each step, Jake is successful at the required task, and he allows himself to experience the waves of anxiety that come.
Yes, anxiety is like a wave. It has a peak, and then it slides downward after that. No one can stay in full anxiety mode forever. So we have to train ourselves to allow the anxiety to run its course. Eventually, it will get better. And the more we practice, the anxiety peaks will get smaller and smaller. And eventually, we won't have anxiety at all when we deny our compulsions.
Okay, feel free to write back and talk to me about what you think. :):) I aways enjoy talking to people on this app.
Here's some resources:
NOCD is the first one I recommend. They will do ERP therapy with you, just the way I have described it. NOCD was founded so that all people could get this type of therapy.
I also really like Nathan Peterson. He has a channel on YouTube with lots of helpful, free videos. And he also has an online master course, where you can go through ERP therapy on your own.
If you have Scrupulosity (religious OCD) like I do, I have other sites that I can send you to also. I have spent years batting against religious OCD, and I am much closer to God now than I used to be. I have a lot to talk about if people want to talk about this kind of OCD.
I hope you were able to read all these posts. And please feel free to write anytime. The good thing about OCD is that it is treatable! We tend to think that we are going to be stuck forever in this torture chamber inside our heads. But the good news is that there has been a lot of good research into OCD in these past years, and there are some therapists really understand it. There is good treatment out there that works!
If you decide to get a therapist, I would just be careful that you one who does ERP. Sometimes therapists try other therapy, and they mostly do not work.
