Exposures are the gold standard treatment approach for OCD. Exposures are also known as any of the following: Exposure therapy, Exposure and Response Prevention, Exposure and Ritual Prevention, ERP, or EXRP. When doing exposures, people intentionally do the things that trigger their OCD and learn to face their fears. Of equal importance when doing exposures, is for people to not do compulsions while facing their fears.

Oftentimes, stopping all compulsions at once is too difficult; in these situations, the goal is to reduce and delay rituals, with the ultimate goal of getting to the point where the person can do the exposure without any compulsions. 

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Exposures are so powerful for OCD because it is an active and behavioral approach that helps people change their relationship with their obsessions and compulsions. Exposures help people learn they do not have to respond to their intrusive thoughts with compulsions. It teaches them that anxiety can be accepted and does not need to be controlled. It also helps people learn they are capable of doing many things even while feeling very anxious or uncomfortable – it is an empowering process.

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OCD is comprised of two parts: obsessions (i.e., anxiety-producing intrusive thoughts, images, and urges) and compulsions (i.e., behaviors done to try to make the intrusive thoughts and anxiety go away). When people with OCD have an intrusive thought, they often experience a surge in anxiety and try to do whatever they can to feel better and make the thought and resulting anxiety go away.

Compulsions “work” in the moment – people often feel temporary relief – but compulsions are really making the OCD stronger in the long run. For example, if a person with OCD has intrusive thoughts that say something bad may happen if both lamps in a room are not on at the same time, then it makes sense that the person is going to always turn both lamps on at the same time (i.e., the compulsion). This compulsion may not seem like a big deal. However, the problem is that OCD is greedy and always wants more – the more that a person gives into the OCD by doing compulsions the more the OCD will demand from them. The intrusive thoughts become more frequent and attach to other areas and compulsions increase and grow as well.