ERP Therapy for OCD

Exposure and Response Prevention

ERP therapy for OCD is an evidence based psychotherapy that helps reduce anxiety by exposing oneself to obsessions while preventing compulsions.

OBSESSIONS are unwanted and distressing images, thoughts, or urges that repeatedly enter your mind. Sometimes they are disgusting to you, you may recognize them as senseless, and they may not fit your values.

Obsessions differ from worries in that worries are about possible negative things related to life problems that you are afraid might happen. For example, you may worry about failing an exam, about finances, health, or personal relationships. In contrast to obsessions, your worries don’t usually seem totally senseless, disgusting, or inconsistent with your values.

COMPULSIONS, are behaviors or acts that you feel you have to perform although you may recognize them as senseless or excessive. Usually compulsions are performed in response to an obsession to help you feel better. At times, you may try to resist doing them but this may prove difficult. You may experience discomfort that does not diminish until the behavior is completed. Examples of a compulsions are the need to repeatedly check appliances, and the lock on the front door before you can leave the house and repeated hand-washing. While most compulsions are observable behaviors, some are unobservable mental acts, such as silent checking or having to recite nonsense phrases to yourself each time you have a bad thought. Compulsions, as we define them here, are not to be confused with other kinds of compulsive behavior such as overeating, gambling, drinking alcohol, over-shopping, or other “addictive behaviors.”


  • Concerns about Germs and Contamination

-Thoughts or feelings that you are contaminated because you came into contact with (or were nearby) a certain object or person.

-The feeling of being contaminated because you were in a certain place (such as a bathroom).

-Thoughts about germs, sickness, or the possibility of spreading contamination.

-Washing your hands, using hand sanitizer gels, showering, changing your clothes, or cleaning objects because of concerns about contamination.

-Following a certain routine (e.g., in the bathroom, getting dressed) because of contamination

-Avoiding certain people, objects, or places because of contamination.

  • Concerns about being Responsible for Harm, Injury, or Bad Luck

-A doubt that you might have made a mistake that could cause something awful or harmful to happen.

-The thought that a terrible accident, disaster, injury, or other bad luck might have occurred and you weren’t careful enough to prevent it.

-The thought that you could prevent harm or bad luck by doing things in a certain way, counting to certain numbers, or by avoiding certain “bad” numbers or words.

-Thought of losing something important that you are unlikely to lose (e.g., wallet, identify theft, papers).

-Checking things such as locks, switches, your wallet, etc. more often than is necessary.

-Repeatedly asking or checking for reassurance that something bad did not (or will not) happen.

-Mentally reviewing past events to make sure you didn’t do anything wrong.

-The need to follow a special routine because it will prevent harm or disasters from occurring.

-The need to count to certain numbers, or avoid certain bad numbers, due to the fear of harm.

  • Unacceptable Thoughts

-Unpleasant thoughts about sex, immorality, or violence that come to mind against your will.

-Thoughts about doing awful, improper, or embarrassing things that you don’t really want to do.

-Repeating an action or following a special routine because of a bad thought.

-Mentally performing an action or saying prayers to get rid of an unwanted or unpleasant thought.

-Avoidance of certain people, places, situations or other triggers of unwanted or unpleasant thoughts

  • Concerns about Symmetry, Completeness, and the Need for Things to be "Just Right"

-The need for symmetry, evenness, balance, or exactness.

-Feelings that something isn’t “just right.”

-Repeating a routine action until it feels “just right” or “balanced.”

-Counting senseless things (e.g., ceiling tiles, words in a sentence).

-Unnecessarily arranging things in “order.”

-Having to say something over and over in the same way until it feels “just right.”