There are many different approaches to treating and managing panic disorder and obsessive compulsive disorder (OCD).
While these two conditions are not the same, there are some similarities in commonly prescribed treatments. One such method that therapists can utilize for both conditions is exposure therapy and response prevention (ERP).
Exposure therapy may sound like an oxymoron. After all, how can exposing yourself to the things you fear most actually be an effective therapeutic treatment for a mental health condition? While it may sound contradictory, this method is actually quite sound.
Here’s how using exposure therapy under the guidance of a qualified therapist can help people with panic disorder and OCD.
The Basis of Exposure Therapy with Response Prevention
So, what is the basic principle behind exposure therapy? In general, people with OCD or panic disorder do their best to avoid the situations that trigger their fears. This is a completely rational response to fear. And in the short term, it is the easiest way to protect yourself from what you’re afraid of.
Exposure therapy, however, aims to eliminate that urge to avoid certain situations. Throughout the course of treatment, you will ideally learn that the thing you were fearing doesn’t pose a real threat or danger after all. And, if you’re dealing with OCD, you also will slowly let go of your compulsive need for certain rituals before facing specific situations. By choosing to stop the compulsions (i.e. prevent the responses), you will learn to habituate to the anxiety feelings and decrease the intensity and frequency of the obsessive thoughts. The ERP approach allows you to break free from the vicious cycle of anxiety.
What’s Wrong With Avoidance?
We all go out of our way to avoid things that make us feel anxious or afraid sometimes. So, if we all do it occasionally, how bad can avoidance really be?
When avoidance becomes your sole strategy for dealing with a particular fear, and it begins to interfere with your everyday life and holds you back from doing what you love, another approach is necessary. Avoidance is a form of temporary relief, but it does not actually improve your overall quality of life in the long term. Eventually, it can lead to the development of other harmful behavior patterns. Over time, avoiding the fear or participating in compulsive thoughts or rituals actually increases your anxiety and may lead to extreme responses such as never leaving the house.
How can you begin exposure therapy sessions? It starts with the therapist working closely together with you to establish a trusting relationship and identify exactly what you fear. They will also discuss what you may view as your “worst-case scenario.”
Essentially, the goal of this collaboration is to target exactly what you’re most afraid of happening. To prepare for the treatment phase, the therapist will use everything they’ve gathered to put together a careful, step-by-step plan (also called hierarchy of fears) for gradual exposure.
How It Works
Over time, the therapist will slowly expose you to what you fear. This may include imaginal (thinking about your fears) or in-vivo (in real life). The in-vivo exposure will take place in a completely safe environment with the support and company of the therapist. You will never have to enter a chaotic situation during treatment where you have to face your triggers with no support. The idea is to start with less distressing fears and gradually move up to more fearful situations as you gain confidence to face your anxiety.
In these scenarios, you’re not supposed to make any efforts to avoid or minimize your exposure to the trigger. Of course, this can be very difficult. But with their therapist’s support it can get easier. And that’s exactly why they’re there.
By the end of the treatment course, the ultimate goal of exposure therapy is to ensure that you no longer feel the need to avoid the trigger. Alternatively, if you have OCD, you will recognize that you will be safe without performing rituals and mental compulsions or responses. Through consistent exposure therapy followed by response prevention, you can begin to see that the situation you thought was so dangerous is not the threat that your mind built it up to be.
Ideally, you will slowly stop practicing avoidance in your daily life.
Exposure therapy is not a method of erasing memories of traumatic events or telling a person that their fears don’t matter. To the contrary, proving to them that they are capable of facing these triggers without being harmed is the ultimate goal.
Do you suffer from panic disorder or OCD? Are you interested in trying exposure therapy and response prevention (ERP) to see if this approach can help you in your healing journey? As a trained CBT and ERP psychologist, I can help you decide if ERP would be helpful for you. Feel free to contact me to discuss the benefits of exposure therapy and next steps.