Ask anyone who has ever engaged in the form of Cognitive-Behavioral Therapy called Exposure and Response Prevention (ERP), and without a doubt, you will hear stories of how it was one of the hardest things they have ever done. You may hear that it revs up your anxiety/discomfort to new heights, and pushes the limits with respect to what you feel you are capable of enduring. All of this is true, which begs the question, "why would I ever want to engage in this form of treatment?" The answer is: because it works! However, making the commitment to ERP can be challenging. As a therapist working almost exclusively with individuals with Obsessive-Compulsive Disorder, I see how difficult it can be for clients to fully buy in to the treatment, and confidently say, "I'm ready to do this!" If you are on the fence about starting ERP, below are a few points to reflect on to help improve your motivation.
1. GENERATE A LIST OF MOTIVATORS
Before starting ERP, it is important to identify your reasons for doing so. These reasons need to outweigh your reasons for not engaging in this form of treatment.
Here are a few questions to think about:
- What made me begin looking into treatment options for OCD?
- What would my life look like if I continued on my current path, without treatment/ERP?
- How would my life be different if my OCD symptoms did not play as big a role?
- Is there anything I'm missing out on because of my OCD symptoms?
- What have my OCD symptoms cost me? (socially, personally, financially, academically, at work?)
- Even though ERP is challenging, could I confidently say my life right now isn't challenging?
2. READ SUCCESS STORIES
Success stories can inspire hope. They are written by individuals who were once in your shoes, experiencing the same fear and doubt about engaging in ERP as you. They are also the same individuals who gave ERP a chance, embraced the discomfort and uncertainty that came along with it, and can now share how worth it the entire experience was for them. This doesn't mean they enjoyed ERP, or even liked it; but remember, the goal of ERP is not to enjoy it - it's to work hard, confront your fears, and in the end, experience a life you enjoy. ERP requires an exchange of short-term discomfort for long-term joy, accomplishment, and meaning.
3. REFLECT ON OTHER CHALLENGES YOU HAVE EXPERIENCED, AND HAVE GOTTEN THROUGH
Think back to past challenges that might have felt overwhelming at the time, or moments when you thought to yourself, "I don't know how I'll ever get through this." This can be helpful evidence that thinking and doing are not the same thing - just because you thought you couldn't overcome a challenge, did not mean you couldn't actually overcome that hurdle. Same applies with ERP treatment. Very often clients will share that they don't believe they can handle the anxiety/discomfort that ERP will elicit, but I encourage them to explore whether this belief is true. We review that anxiety/discomfort in and of itself is not dangerous, just annoying, and if something is not dangerous, then there's no reason we need to avoid it or run away from it. OCD tells a convincing little lie that discomfort cannot be tolerated, and as a result, individuals will use compulsions to find temporary relief, which only perpetuates and strengthens the OCD cycle.
4. TAKE THE FIRST STEP
Getting started is often the hardest part. Because ERP is consistently associated with words such as "challenging," "hard," "anxiety-provoking," etc..., it can be easy to build it up in your head as an insurmountable obstacle. One thing is for sure - ERP is not insurmountable. Once you get started, you are able to see for yourself just how challenging it will be, and what your mind and body is capable of tolerating. Everyone has a different tolerance for discomfort, so you don't want to make any assumptions, especially ones that are negative, with respect to how your experience will be. Choose a low-level exposure exercise you can do to "get your feet wet," and evaluate the outcome. Once you get a few ERP exercises under your belt, and begin to see progress, you are likely to feel motivated to continue challenging yourself further in greater, meaningful ways.
Additional thoughts: If you find yourself reflecting on your motivators, listening to success stories, learning about ERP, and even getting started, only to realize "this isn't for me," that's okay. For some, the timing may not be right to make this commitment. Perhaps you have other stressors on your plate at the moment, and are unable to make the emotional investment in ERP at this time. Or perhaps your OCD symptoms are uncomfortable, but they still allow you to go about your day-to-day activities with minimal interference. Remember, your reasons for engaging in ERP need to outweigh your reasons for not engaging. If you choose to put ERP on hold, know you can always revisit and recommit at a later time. Situations change, commitment levels change, and symptoms change - just know that when the timing is right, ERP will be there waiting to help.
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DISCLAIMER: The blog posts shared on www.StacySmithCounseling.com contain the opinions of Stacy Smith, MS, LPC, and do not reflect the opinions of any organizations or affiliates. While Stacy is a licensed mental health professional, all blog posts on her site are for informational purposes only, and are never a substitute for professional advice catered to your individual needs. Stacy Smith is not liable for any diagnosis, treatment plans, or decisions made based on the information presented on this website.