Exposure and Response Prevention (ERP)
Anxiety, phobias, and OCD…
That’s what we treat with ERP.
It’s based on the idea that you can “get over” your anxiety, fear, obsession, or compulsion by gradually exposing yourself to it.
In time, your nervous system will habituate to it (“get used to it”), and it will no longer trigger your mind and body.
The key is doing it safely and strategically.
That’s why you come to Potomac Behavioral Health.
Deliberately exposing yourself to whatever’s triggering your anxiety might seem like torture.
But avoiding those triggers is what’s keeping you in a paralyzing cycle of fear.
So, we’ll expose you to them in safe, graduate doses. You’ll never be asked to do more than you’re ready or comfortable doing, and you’ll go at your own pace.
We’ll start with imagining exposure to it, and we’ll work our way up from there.
Here’s how habituation works…
Think of a scary movie you once saw. Think of how you reacted to it the first time – and then the third time – and then the TENTH time.
It’s much less frightening after that tenth exposure, isn’t it? In fact, you might even laugh at how campy the “jump scares” are or how silly the premise is.
It works the same way with the source of your fear, anxiety, or obsession. Eventually, your brain will realize that introducing yourself to a stranger, giving a speech, or encountering a bird is not a life-threatening situation, and your physical fear response will dissipate.
If you have compulsions that provide you temporary relief from anxiety, ERP will focus on delaying that urge or behavior. Eventually, you’ll break the connection between the anxiety and the response.
Practice doesn’t make perfect…
Practice makes prepared.
When you practice exposure and response prevention in the safety of the therapeutic environment, you’ll:
- Increase your ability to tolerate uncertainty.
- Strengthen your impulse control.
- Reframe your thinking.
- Stop reacting out of fear and start responding intentionally.
Mike’s* ERP success story…
Mike’s social anxiety started in high school.
But when he got to college, it took a life of its own. When he walked into class, he felt overwhelmed; his nervous system went into overdrive. His heart raced, he was flushed, and he had butterflies in his stomach. The anxiety was intolerable, so he left class after only a few minutes.
In therapy, Mike learned that what he was doing was avoidance.
And the worst part about avoidance is that it WORKS. Every time he left class, he immediately felt relief. The more he paired avoidance and relief, the quicker that became his default response. Eventually, he wasn’t attending any classes at all and felt intense shame in telling his parents he would not pass his first semester at college.
Mike and I started with imaginal exposure scripts.
He wrote short paragraphs narrating the experience of tolerating anxiety in class, then recorded himself reading the script that he listened to daily.
Eventually, he moved up to exposure exercises…
… like introducing himself to one person a day.
He then eventually engaged in intentionally embarrassing situations…
… like ordering a steak at McDonalds.
Through the exercises, he retrained his brain and no longer felt that the threat of embarrassment or rejection was life-threatening.
The more he challenged himself with exposure exercises, the more he realized that change and growth can happen if you just do the work.
*The above name and story are fictionalized composite of real clients I’ve supported.
Break the cycle today.
Let’s start retraining your brain.
Call (202) 753-9836 for a free 15-minute consultation.