If ERP is supposed to work for any OCD theme, no matter the content, why is ERP actually focused on the content. I understand the therapy method of experiencing your intrusive thoughts/not doing the compulsion, but I'm having a hard time seeing where ERP follows this method.

Evelyn4416

Date posted: 5y

If I understand this correctly, ERP treats any OCD theme the same because regardless of the specific fears each one of us encounters, we use the technique of ERP to combat it (using an exercise that has us trigger our fear, not using compulsions to have the anxiety lower on its own). In order to create the exercise, it has to be curated to our specific theme. Then we take that exercise and use the ERP method as a form of treatment. Does that make any sense I hope?

canigetawitness

Date posted: 5y

Yeah, that makes sense, thank you. Where I get confused for one example is if I have the intrusive thought "Did I lock the front door before I left the house?" And my compulsion is to check the door, I get confused on what ERP's goal becomes. I personally believe one should sit with the initial thought of "Did I lock the door?" And accept maybe I did, maybe I didn't. I also see ERP practices where a therapist would have someone intentionally unlock the door when they left. This is where I'm getting thrown off, because the thought "Did I lock the door?" is different than actually unlocking the door. I see this with quite a few themes where the therapy strays from just letting the thought be there and not giving into compulsions. I don't know if I'm making sense. Haha. But yeah, what you said makes sense and I agree with you.

Evelyn4416

Date posted: 5y

@canigetawitness I see what you mean and how it can get confusing! Yes I agree that it’s supposed to be learning to be okay with uncertainty, so maybe I locked the door and maybe I didn’t. The fear I imagine would be if the door is unlocked when what would follow (perhaps a stranger enters the home). With the leaving it unlocked exercise, you are purposely doing what the fear is, which I would imagine is to say “hey, I left the door unlocked and nothing happened”. I think each therapist maneuvers different with ERP or maybe they’ll implement both exercises, doing one first then doing the other. I think the first method of being okay with uncertainty is the main one but that’s just my opinion haha

canigetawitness

Date posted: 5y

@Evelyn4416 That's a good way to look at, that you could use both to implement. Yeah, I still agree letting the thought be there is the main way too.

ocdillustrated

Date posted: 5y

It sounds like you're more familiar with imaginal than in vivo exposure. Ultimately, if in vivo exposures are possible, they are super important to do. Being comfortable thinking about leaving the door unlocked does very little good if you still check the lock repeatedly every time you leave the house

canigetawitness

Date posted: 5y

What could be an in vivo exposure for wondering if you've locked your door or not?

ocdillustrated

Date posted: 5y

@canigetawitness Leaving the house without checking the door at all.

ocdillustrated

Date posted: 5y

@NOCD Advocate - Katie Imaginal exposures are for situations we can't expose ourselves to in real life, like running someone over with a car, or changing sexuality.

canigetawitness

Date posted: 5y

@NOCD Advocate - Katie Oh okay, that makes sense. Thanks.

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