Who invented exposure and response prevention

When an obsessive thought occurs, feelings of anxiety and uncertainty immediately follow. These feelings are uncomfortable, and as a result, people with OCD typically do something to relieve the anxiety or uncertainty. Exactly what they do takes many forms. For others, seeking reassurance from a loved one or elsewhere will relieve the anxiety. The internet has become a popular resource for OCD sufferers who seek to reassure themselves and thus lower their anxiety.

Still others with OCD would love to find something that would relieve their anxiety but have not been able to. Whatever the strategy people use to deal with the increased anxiety, they operate from a desire to rid themselves of the feeling if at all possible. By doing so, one can experience obsessive thoughts and the need to perform compulsions differently. This kind of change is a difficult one to enact and takes some hard work.

Through these exercises, one gradually learns to tolerate feelings of anxiety better. We are creatures of habit. Those of us with OCD can see the truth in this when we consider how entrenched OCD can become in our thoughts and our actions. People suffering from OCD have developed habitual ways of dealing with feelings of anxiety when they arise.

If these habits result in a quick lessening of anxiety, then each time we do it, the habit becomes a bit stronger. This is a principle of behavioral psychology known as negative reinforcement. Negative reinforcement is when the removal of a negative stimulus follows the performance of a certain action, thus making us more likely to perform that action again next time. This is illustrated in the case of Sara, described below. Sara not her real name , a young woman living in New York, experienced anxiety whenever the thought of AIDS came into her mind.

She found that she could reduce this anxiety by checking on the internet to confirm that nothing she was doing in her life right now put her at risk for contracting HIV. Sara was rewarded for her internet research with reduced anxiety. While she had found a short-term fix for her anxiety, she found that over time, she had to spend more and more time on the internet. This began to impact her personal life and her work life.

Exposure takes different forms depending on the nature of the obsessions or compulsions. Typically, such an exercise will have little appeal to the person with HIV obsessions. The answer to the above question is simply this: beating OCD involves changing your habits.

Sara had taken up the habit of checking on the internet whenever she became anxious that she had contracted HIV. If a website could convince her that she was not infected, she would feel at ease once again.

She exposed herself to the anxiety that accompanied thoughts of HIV infection without responding in her habitual way. When done correctly, this type of exposure exercise has the effect of helping achieve a long-term reduction in obsessions, and in the anxiety they cause. Sometimes these exposure exercises will last only a few minutes, sometimes significantly longer. A stimulus-response analysis of anxiety and its role as a reinforcing agent. Psychol Rev. Abramowitz JS.

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As patients habituate to the feelings their obsessions bring up and reduce their reliance on compulsions, they spend less time and energy avoiding pain. When we feel able to handle discomfort, obsessions which used to create a sense of profound uncertainty are no longer reinforced by avoidant behaviors that teach them the content of their every thought is both important and reflective of their true nature. Developed in the s, ERP is recommended by the American Psychological Association and many other organizations for its wealth of scientific backing.

Studies show that everyone experiences some of the intrusive thoughts involved in OCD. People without OCD are usually able to write off distressing thoughts as strange and random occurrences, but those with this condition feel compelled to neutralize them. Obsessions and compulsions reinforce one another because it seems like a thought that had to be avoided with a compulsion must have been pretty important and worthy of more fear.

In most cases OCD symptoms do not resolve on their own. A cognitive approach— traditional CBT, for example— asks patients to challenge their obsessions. Any behavior that engages with the obsession— e.

By preventing these behaviors, ERP teaches people that they can tolerate their distress without turning to compulsions. It thereby drains obsessions of their power. Especially when paired with medication and other types of therapy, ERP is consistently demonstrated to be the most effective form of treatment for OCD.

And this suspicious comes from a place of empathy— why make people go through pain? Is it strange to think that you could treat a psychiatric condition by doing things like telling yourself over and over that you might lose control and become a pedophile?