OCD Treatment - How to do ERP for Pure OCD

erp pure ocd Aug 21, 2018

OCD Treatment - How to do ERP for Pure OCD


In this video, I talk about the Exposure and Response Prevention and how it applies to the treatment of Pure OCD. The whole point of ERP is to expose yourself to or experience something that triggers your anxiety and then prevent yourself from responding with compulsions.

When you do this correctly you allow yourself to achieve habituation and successfully face down your fears. In this video, I give a brief description of how to apply ERP with Pure OCD treatment.

Video Transcript

00:00 All right. Hello and welcome to this episode where I'm going to talk about Erp for pure ocd. So again, my name is Matt Codde. I'm a licensed clinical social worker and the founder of the OCD Academy. And in this video I want to talk about is a really common question I did where when we talk about Erp and, um, people say, well, why don't do compulsion? So what if I don't do compulsion's or you know, what if I only have a obsessions and you know, I have pure ocd so I can't do Erp some kind of context of that question. Right? And so, so it's a question that I get very, very frequently. And so when I talk about Erp, right, I talked about this in, in the last episode, I talked about what Erp was and, and really I explained, you know, an exposure that I did, um, you know, on my own journey to recovery and I kind of gave the context of this idea of a scary movie watching it.

00:52 And, um, when, when we talk about Erp for pure ocd, the, the thing is, is that a lot of people with pure ocd have compulsion's but they actually just do them right in their head, right? And so what I've found actually with pretty much the overwhelming, overwhelming majority of the people I've worked with is that most compulsion's take place right in your head. But one of the things that I always say, uh, to, to anyone that I've worked with is this idea that all compulsion's are created equal, right? So whether it's physical compulsion's or whether it's mental compulsion, it doesn't really matter because the compulsion itself is what's reinforcing the fear and keeping you trapped in that loop. So with Erp, the example that I gave of, you know, I'm someone who touches contaminated objects and then presents themselves from washing their hands than they experienced the uncertainty, right?

01:48 That they experience from, you know, doing that, that, that certain process and the anxiety, but then naturally their body habituates to that process and they realize that, oh, you know, this isn't something that I need to do. Um, but when we come to, when it comes to pure ocd, um, or, you know, and I, and I say pure ocd, but again, I, I totally believe that's a myth because I've never met someone who literally just has obsessions and doesn't do compulsion. I just, they usually are just doing mental compulsion's, um, which again are equal to physical compulsion. So they're just done right in the head. And so mental compulsions can be things like thought, suppression, thought, checking, analyzing, counting, praying, um, you know, uh, the various things, anything you do mentally to try to reassure yourself, anything you do to try to analyze or check if you're obsessing anything you do to avoid or control, right?

02:40 So all those things, or even subtle things like asking your significant other questions so that they say something so that you feel better. Those are all examples of compulsions, right? And so people with OCD can be very, very tricky, um, even even to themselves when it comes to compulsion's and, and not even that they're doing compulsion's, right? Because again, they're driven so much by anxiety and fear that a lot of times, you know, learning what compulsions are and really doing a complete inventory of your compulsions is really, I'm such a crucial process to your recovery. And so one of the things that I did was I put together a free compulsion inventory and you can get access to that below. Um, and again, it's free to download you just head over to the site. I'm OCD academy and he and I have a link in the notes, but anyways, when it comes to this idea of, of Erp for pure ocd, it really is the exact same process.

03:35 It is experiencing the thoughts. So when, when people have what they call Piro, ocd, again, it usually falls into three categories. It usually falls into some kind of sexual obsessions, harmful obsessions or obsessions that revolve around religion. And they can be or existential, they can be various obsessions, right? And all of those categories. And you might experience all of them, you know. But the point is, is that those categories seem to be kind of the broad three, uh, that, that really someone can usually falls into one of those categories. So let's say for instance, that someone has a kind of an existential oct, let's just use that example, right? Where they're having these obsessive thoughts of like, Oh, you know, what if God doesn't exist, or what if, uh, you know, what if I don't know my meaning of what's my meaning of life? And they'll get obsessed on that thought, right?

04:26 Well, in order to counteract that thought, they might do a variety of things. They might avoid situations that triggered that thought, right? They might try to push that thought away. They might try to, against oppressive thought, replace the thought. They might try to pray to counteract that thought. So exposure and response prevention is really straightforward. It just is about really identifying all the pieces correctly. So the obsession, right? Whatever that obsession is, whether it's unwanted sexual thought on one or harmful thought or religious thought, um, you know, we have the thought, right and generates the fear and then we present, prevent ourselves from responding compulsively. So in this instance, if prayer, let's say was a big compulsion, and this is where it gets a little a little tricky because, you know, as, as a therapist, I never want to tell someone that they can't pray, so, um, you know, especially if that's a big part of their recovery process and their beliefs, but praying in the context of a compulsive way, we need to, we need to separate the two, right?

05:31 We need to separate the idea of praying compulsively to relieve anxiety and praying in regards to faith. Right? And, and so that's one of the things that's like, and I can do a complete episode just on this one concept because I've had this conversation so many times with people, but really when we understand that prayer, if you're praying compulsively that it's making you worse, we need to understand that you're using prayer in, in an effective way, right? Or an inappropriate way. I'll even say, because what it's doing is it's reinforcing the fear which is keeping you trapped in that loop. Now I know there will be people that probably will disagree with me on this, um, you know, but again, it really is like, it's not that you can pray, but when we, what we need to do is learn how to habituate to the actual fear and experience it.

06:14 So when you're using prayer to try to remove anxiety, alright and not experience it, then what's that? What that's going to do is ultimately reinforced that loop and keep you stuck. So praying in the context of strength, uh, you know, so you can experience the anxiety is a really good example that, um, you know, that I've helped people go on as well. And so, um, are you use prayer in that context as well. So again, it's not, it's not that you shouldn't pray, but you're, but what context you're praying in and, and what you're using it specifically for. You have to be honest with yourself and that's where the compulsion inventory comes in. And so, but, uh, but even things like thought replacement, thought suppression, counting, you know, and all that prayer is kind of one of those, I'm kind of controversial topics and so I don't even know why I use that as an example, but you know, the, the, the thing is it's real and, and a lot of people use it and, and I, you know, I, I want to be honest about what you need to do to really get better.

07:09 And so if you're praying in a, in a context of trying to remove feelings, well that's, that's actually going to keep you stuck in that loop, right? And so it's not that you shouldn't pray ever again, but we need to learn to experience all of our feelings, right? And, and realize that our goal is not just to be happy, right all the time. And our goal is not to always feel comfortable. And sometimes through feeling anxiety and through feeling fear, a lot of growth actually happens, right? And so when we can kind of understand everything from the context of pure necessity, whether it's whatever thought you're experiencing, and then whatever you do to try to control a check, reassure or avoid those thoughts, what we do is we start removing those behaviors. We experienced the thoughts head on whatever they are, right? We allow their presence.

07:59 We don't try to push them away, we don't try to do anything to get rid of them. We actually experienced them. That is the exposure sometime with bureau city. A lot of times just having the thought itself is the exposure. And then we can even do things in, in, you know, physically like watching movies or things like that that will help stimulate those thoughts as well. And then we prevent ourselves from responding compulsively. So hopefully that makes sense. Again, I have a compulsion inventory, uh, that they're totally free that you can get access to in the notes where is a little link, you can click overhead over the site and grab it. And, um, but again, hopefully when we talk about Erp in the context of the study that this was helpful and understanding that you need to identify all the compulsion to do even if there are, even if you only do compulsions that take place right in your head.

08:44 All right. And so that wraps up this episode again, just to recap, we talked about what pure ocd is, we talked about Erp and how to do that context, how to do it in the context city. And then we talked about different compulsion's people do, especially the mental compulsion is in how all compulsions are created equal and the process is exactly the same. It's just a matter of actually identifying what compulsions you do. So with all that said, thank you so much for watching this episode. Again, be sure to like, subscribe, comment, um, you know, and let me know if there are certain videos that you want me to create in the future episodes that you want me to do, a topic, questions, all that stuff. And um, please be sure to head over to the site, claim your compulsive compulsion inventory. I also have my masterclass, um, you know, if you want to continue on this journey where I dive in-depth into all of this stuff about setting up hierarchies and actually walking you through the recovery process as well. So again, thank you so much for tuning in. And in the next episode, I'm actually gonna I'm David. One more, a little more in-depth on this idea of Erp as well. So I will see you over in the next episode. Until then, have a wonderful day.

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