Obsessive Compulsive Disorder (OCD) was considered an untreatable illness. But breakthroughs came about in the 1960s with the development of Exposure and Response Prevention therapy (ERP therapy). 

Since then, ERP therapy has been the most prevalent and go-to treatment option for OCD. Supplemental medication and alternative forms of treatment have also emerged, but ERP therapy still reigns as the foremost treatment option for OCD. 

But is ERP really for everyone? 

While ERP therapy is largely effective, not everyone may benefit from it to treat their OCD. In reality, ERP therapy for OCD is extremely challenging, and nearly a third of the patients undergoing ERP therapy can not endure it. 

So if you want to gauge whether ERP therapy will work for you, here are some things to consider. 

What Is ERP Therapy? 

ERP therapy is a form of cognitive behavioral therapy (CBT). Much like regular psychotherapy, ERP therapy involves weekly sessions with a trained ERP therapist who talks and guides you through your issues and problems. 

But ERP therapy goes a few steps beyond talk therapy. It emphasizes changing your thinking patterns and behaviors by making you face your OCD triggers in a safe and controlled environment. 

For example, let’s say you suffer from checking OCD, making you quadruple-check whether you locked all your doors and windows, switched off all the lights, turned off all electrical appliances, and closed all faucets. You and your therapist eventually identify that you experienced a traumatic break-in that triggered your OCD. You will then roleplay your current routine of leaving the house, and your therapist will urge you not to carry out your compulsive rituals. 

Additionally, your therapist will also help you overcome the underlying fears, self-doubt, and guilt that drives your OCD. These sessions will continue for anywhere between 12 to 24 weeks, depending on the severity of your symptoms. 

The end goal of ERP therapy isn’t to cure your OCD; after all, OCD is an incurable disease. But through these sessions, you will be better equipped to handle your intrusive thoughts without performing your compulsions.  

6 Things to Expect From OCD Therapy

ERP therapy sounds straightforward, yet it’s anything but. Here are some things to expect from ERP therapy. 

It Gets Worse Before it gets Better

As the previous section discusses, ERP therapy makes you sit with your intrusive thoughts, fears, and anxieties. It is purposefully distressing and is by no means an easy feat. 

But don’t worry; the point of ERP therapy isn’t to put you in agony. Instead, ERP therapy aims to teach you how to engage with and triumph over your intrusive thoughts. As you acquire these skills over time, things will become easier. 

You Have to Be Honest

Full transparency and honesty are central to OCD therapy. If your therapist doesn’t know the precise details of your obsessions and compulsions, they can’t customize the ERP therapy to your benefit. 

Understandably, some things are difficult to talk about, especially if they’re a source of distress. Moreover, some thoughts and obsessions are so taboo in nature that the sufferer feels too ashamed to talk about them.

But you have to cast aside fears of being judged if you want to reap the full benefits of ERP therapy. 

It’s a Lifestyle Change

ERP therapy is all about teaching you how to engage with and overcome your intrusive thoughts in a healthy way without performing your compulsions. Think of it like learning a healthy coping mechanism that gradually gives you more and more control over your OCD.  

But to perfect this coping mechanism, you need to practice what you learn. You need to apply what you learn in your therapy sessions to real life until it becomes a habit

With repetition and practice, you’ll rewire your brain to shun the intrusive thoughts, embrace uncertainty, and break free from your compulsions. 

You Might Require Medication

Over half of the people under treatment for OCD take low-dose medication for years, if not for life. These medications include selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, benzodiazepines, and antipsychotics. 

However, it is important to emphasize that medication alone is not sufficient treatment for OCD. 

The foremost reason that medication is prescribed is to make ERP therapy a little more bearable. Moreover, OCD is often comorbid with other mental disorders, such as depression, anxiety, addiction, and eating disorders. 

Hence, medication supplements ERP therapy by mitigating these symptoms. 

Setbacks Are Likely

While OCD is treatable, it is a chronic and incurable disorder. As such, relapses and other setbacks are common. 

If OCD is a manipulative and hostile voice in your head, ERP therapy teaches you to quieten that voice. You may be years into recovery, but there might be days when you end up succumbing to the voice. Maybe you had a rough day or experienced something traumatic, so you’re too exhausted to confront that ever-present voice. 

Rest assured; though, you’ll have more days that are quiet than not. 

It Can Get Expensive

On average, one ERP therapy session costs $200-$300, and some can even go as high as $500. If you have one session per week for up to a year (the average treatment time), you’ll rack up anywhere between $10,000 to $26,000. 

However, there are ways to work around this admittedly unreasonable fee, including insurance, scholarships, teletherapy, sliding scale payment plans, and participation in research studies. 

Alternative Treatment Options For OCD

There are countless reasons why ERP therapy may not work for someone. But that doesn’t mean they have to raise the white flag in front of the monster that is OCD. 

Fortunately, while ERP therapy is the foremost treatment option for OCD, it’s not the only one. As we learn more and more about this once-mystifying disorder, new and innovative treatment options continue to emerge, including: 

  • Deep Brain Stimulation
  • Repetitive Transcranial Magnetic Stimulation
  • D-cycloserine supplemental treatments
  • Exercise

The Verdict— Will ERP Therapy Work for You?

Considering all the hardships and challenges of ERP therapy, is this treatment option suitable for everyone? 

The short answer is a resounding “yes!”ERP therapy is the most extensively researched and effective treatment option for OCD. 

With that said, ERP therapy is extremely difficult by nature, and it doesn’t signal weakness in a patient if they are unable to see it through. But if you find that ERP therapy isn’t working for you, you might benefit from working with a different OCD specialist. 

You can also seek alternative treatment options, but your best bet is to find a good therapist who can make ERP therapy work for you.