Common Treatment Mistakes - Using ERP as a CURE

Common Treatment Mistakes - Using ERP as a CURE

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In this episode of our series entitled ‘the most common mistakes in OCD treatment’, we are going to discuss common mistakes with ERP or Exposure Response Prevention Therapy.  ERP is a type of behavioral therapy that exposes people to situations that provoke their obsessions and the resulting distress while helping them prevent their compulsive responses. 

If you’re suffering from OCD, you may find yourself wondering “does ERP really work?”. I often get a lot of questions regarding if ERP Therapy is effective or too extreme? I hope this episode can answer some of your questions relating to ERP Treatment.

Join me as I explain some of the most Common Treatment Mistakes for OCD Treatment. I hope this helps in your journey to overcoming OCD.

TRANSCRIPT

(00:11):

All right. Hello. And welcome to this episode where we're going to continue our series on common mistakes that people make when it comes to OCD and anxiety recovery. And so for those of you that don't know me, my name's Mac Codde, and I'm the founder of restored minds, and I'm also a licensed clinical social worker. And I specialize in OCD and anxiety. And today I want to talk about the third mistake that people make, that I see very common. Um, and it's really this idea of trying to use the tools to cure OCD and anxiety. And so what I mean by that is, is that when people are starting off in their journey to recovery, right? Um, what con, what commonly happens is, is that they are looking for a solution to what they perceive to be the problem, right? Meaning if they are having intrusive thoughts that are, you know, running through their mind, if they're having, um, you know, a lot of anxiety, panic, uh, you know, all sorts of stuff, right?

(01:13):

That's, that's, that's what people perceive to be the problem. That's what I perceived to be the problem. In fact, even beyond that, there'll be worrying about what the content of the thoughts they're having is right. And that's what they even perceive to be the problem when they're really, really lost in that chaos. And the reality is is that when you, when you think that's your problem, then you're looking for tools to solve that problem. And you get presented with this idea of exposure and response prevention, right. And which was commonly called E R P. Right. And what the mistake that people make is, is that they try to use ERP to cure quote, unquote, their OCD and anxiety. And that creates a lot of frustration because ERP is not designed to do that. Right. I mean, and, and so you're using this tool to try to get a result that you, that you believe is, is the end result you want, and you're not going to get it using that tool.

(02:11):

So it creates frustration with both the person seeking help and, you know, the treatment provider, or, you know, just, just the whole situation in general. And so what I want to do today is I kind of want to talk about what ERP is really used for. Right. And so when I'm talking about ERP, again, I'm talking about exposure and response prevention. And what we're really talking about here is exposing yourself or experiencing the very thing that you're afraid of, both like in all the internal stuff. Right? So, um, external and internal. So we're talking about the thoughts that you don't want to have, and we're also talking about the feelings that you don't want to have, right? So the thoughts and anxiety, and then we're preventing ourself from doing anything that's gonna reinforce that, right. Uh, you know, a very common example of this is the idea of someone with a fear of contamination, and they will expose themselves to the, um, uh, contaminated object.

(03:09):

Let's say a door handle and the touch it, right. And this flood of anxiety will come up. A lot of thoughts will race. Um, you know, well, what if it's contaminated? What if I get this disease? What if I die? All these kinds of thoughts, right? And that, that is the exception, right? The exposure is too ring up all the internal stuff like that. And what we do with exposure, um, in response prevention, exposure therapy is we are experiencing the feared situation, right? And then we're not getting in the conversation essentially, right? We're not getting into the voice in our head. We're not going to start analyzing the thoughts. We're not going to start trying to get rid of the feelings. We're just going to let it all happen. Right. And it's really uncomfortable, right. Which is one of the reasons people don't like ERP, right?

(03:53):

And obviously no one likes going through it. But what happens is, is if we actually don't respond to a way that reinforces it, then our brain learns that it's not actually dangerous. And it essentially event eventually stopped setting off that alarm. But the moment that we, you know, touch that contaminated object, then wash our hands, will our brains going to learn that that's dangerous, right. Through conditioning. And it ultimately keeps setting that alarm off in the future. And then we're going to have to wash more to get the same relief. And that's why the anxiety cycle and the OCD cycle is a big trap that people fall in is because if it's essentially a false alarm going off and with ERP, what we're actually doing is we're showing our brain that it doesn't need to set off that alarm, but we have to do that through removing the behaviors.

(04:37):

So again, DRP is not designed to get rid of your anxiety. In fact, what it's designed to do is, is to feel it and actually trigger it. Right. But the reason is, is because if we do that and we do it effectively, then what happens is, is that our brain learns that it wasn't dangerous and eventually we'll stop setting it off. So the, the secondary effect of ERP is over the long-term your brain stops producing that, that anxiety, response, that fear response, that stress response to that incident. Right? Because it learns that it's not dangerous, but the only way it can learn to do that is if you do nothing behaviourally to refor reinforce the idea that it's dangerous, because it was really important that we make that make that connection. Because what so many people do is they, they read about ERP or they go on the internet or, and they see a video and they're like, okay, well, I tried ERP and it didn't work well.

(05:29):

One of the reasons that it didn't work is, is that yeah, you were using it in the wrong context. If you use the ERP in the instill, feel anxiety. Well, yeah, by its very nature that quote didn't work because you're not using it correctly. It's like using a hammer to saw a piece of wood in half. Right. If you're, if you're in goal is, is not correct, then this tool is going to seem like it doesn't work again. The goal of ERP is not to get rid of thoughts and feelings. Right? What what's the paradoxical effect of ERP is that if we do it enough and we actually don't respond, our brain stops producing those thoughts and feelings. But if we're using it to try to achieve that result, we're always going to consistently check for thoughts, check for feelings, analyze, do all these compulsion's, which is going to keep that loop going.

(06:21):

And that's the, that's the trap that people fall in the mistake is that they use ERP as a, like, thinking that it's an do a and I get B right. A plus B, right. You know, it's like this result is going to come in and it doesn't happen the way they think it should, because again, they misunderstand the problem. And then therefore they think that the tool doesn't work for them and they just give up and, and that's, that's the big, a big common mistake. And so I want to address that in this episode, because if we understand why we're doing ERP, and more importantly, we understand what the real problem is with anxiety. You no state, which again is behavioral, right? Um, that's why cognitive behavioral therapy is shown again and again, to be the best treatment for it, meaning how we respond to our thoughts and how we respond to our feelings, right?

(07:10):

And the behaviors that we engage in, like that is what we're ultimately changing and essentially reprogramming and rewiring our brain through neuroplasticity. Once we understand that that's what ERP is actually doing well, then it makes sense in the grander scale. Now we go much more in-depth to this, into our, you know, our taking back control program. And we, you know, we teach you the steps about specifically how you need to respond to each thought what to do. Behaviorly all that. But what I want to talk about specifically in this episode really is just this idea

(07:40):

Of you

(07:43):

Can't use ERP to try to cure yourself because you're going to fall into that trap of doing ERP, checking to see how you're feeling, checking to see if your thoughts are still there, checking to see if this still makes you anxious. And when they notice any kind of feeling or thought, you're going to think that ERP doesn't work, but you're, if that's the case, you're just using it incorrectly. And again, when we understand the big picture goal of why we do ERP and how it works, that's what allows us to apply it successfully. And then as a secondary gain, when we actually apply it successfully, that's when we actually get the lower levels of anxiety, the decrease in thoughts and, and all that as a, as a secondary gain of doing ERP correctly. So hopefully that makes sense. And, um, you know, I hope you found this helpful and, uh, again, if you did, we would really appreciate your support by liking and subscribing and leaving a review, uh, over on iTunes as well. And also we have some additional resources for you on your journey, uh, including some more additional free training over at our site restored minds. Um, and we also have some additional downloads and, and just other things to help you on your journey as well as our coaching programs and consulting programs. So thank you so much for tuning in this week, and I hope you guys have a great week and I look forward to seeing you on the next episode,

(08:58):

Take care.