The Process of Exposure and Response Prevention Therapy

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Last Updated on May 11, 2021 by

Exposure and Response Prevention Therapy (ERP) is a new behavioral therapy technique for treating anxiety disorders. Exposure therapy involves the patient’s direct exposure to the stress source or its environment without the intent to cause any harm. Doing so is believed to help patients overcome their emotional distress or anxiety. According to research, Cognitive Behavioral Therapy and EIP may prove to be effective in the long term. This article focuses on ERP for treating anxiety.

An anxiety disorder or panic attack is common, especially in today’s society, when there are more stresses in our daily lives. Stress and anxiety can trigger or worsen an anxiety disorder that can eventually lead to a panic attack. Stressful situations may trigger anxiety attacks, worrying about something that is not yet resolved, or even just plain old getting the feeling of being insecure.

People who have not experienced an anxiety attack would find it hard to understand how exposure and response prevention therapy works. This therapy was developed to help people who have not gone through a spell, to teach them how to deal with anxiety disorders such as panic attacks. In this exposure therapy method, the patient is exposed to the stressor or situation that triggers their attack factors that lead to an anxiety attack. Once this is done, the patient will then learn how to minimize or eliminate the stressor from their lives.

When preparing for exposure, the first thing that the patient should do is to calm down. This step is very crucial as it allows the person to think clearly and make rational decisions. As he or she becomes calm, he or she may now begin to think of possible options. During this stage, the patient may start calculating the pros and cons of each viable option. Once this has been completed, the person can then go back to the stressful situation. With this preparation, the patient now has a better understanding of how to handle an anxiety disorder.

Exposure and response prevention therapy involves teaching the person to identify the trigger event that causes their anxiety attacks. Once this is determined, the person can learn to think of possible alternative scenarios. For example, suppose a staff member is too closely monitoring the stressor’s cause. In that case, the person may learn to monitor their stress level by performing relaxation techniques such as stretching and deep breathing. He or she can then think of creative ways to spend their time with their friends and family.

Once this type of alternative decision-making process has been developed, the patient can begin to look at each possible scenario’s possible consequences. While this may seem a little abstract, it will be easy to see that these consequences will have a direct bearing on how they will react to the stressor. In other words, rather than focusing on the immediate discomfort of the situation, the patient will be focusing on the long-term adverse effects that may occur if he or she does not change their behavior. This may mean that they do not eat at all in that particular restaurant or drive to another location.

Another example may be something as simple as using a friend’s car instead of one’s own. People can have their vehicles while under the supervision of a therapist because they know that doing so will not result in stress or anger that would trigger an attack. However, what if that same friend becomes overly attached to using their car and decides to cancel out their car usage? Now the issue becomes, how will he or she react if that happens? More importantly, will they be able to handle their emotional reaction if the situation should arise and choose to use the vehicle instead?

How Does Exposure and Response Prevention Therapy Work?

Exposure and Response Prevention  is a scientifically proven, scientifically supported treatment for chronic anxiety disorders, including Obsessive Compulsive Disorder, Borderline Personality Disorder, and BPD. The theory behind this therapy is that the very causes of those anxiety symptoms are often present or latent in some other form. This is an effective treatment option because those who suffer from anxiety disorders don’t even realize that they are suffering from the disease until their symptoms are significantly reduced or eliminated. The Psychotherapy Brown Bag blog describes ERP as the “frontline psychotherapy for OCD.” However, for those who suffer from an anxiety disorder, this treatment method offers the most hope of eliminating anxiety and returning to a healthy and everyday life.

Treating Phobias with ERP

An example of ERP therapy for patients with phobias of spiders (one of the top 10 worldwide), would be gradually exposing the patient to spiders – gradually – as part of their treatment program to overcome arachnophobia in the patient. It is illegal to touch or allow a spider to touch you while you’re alive so as to inflict serious bodily harm on another being, such as death. Habituation describes what it means for something that would normally evoke an anxiety reaction to become accustomed to it.

Exposure and response prevention therapy is a beneficial technique in behavioral therapy to treat phobias. However, it isn’t appropriate for everyone because of the potential for causing more anxiety in the patient and potentially leading them to feel even more pressure. This can lead someone on the road to recovery to feel overwhelmed with all of their symptoms and feelings of discomfort. However, using exposure therapy effectively in conjunction with behavioral therapy can help a great deal. So how is exposure therapy effective in treating social anxiety.

Treating OCD with ERP

According to the National Institute of Mental Health obsessive-compulsive disorder is widespread in the US Population 3.15 million. ERP can be used for their treatment. An example is the behavior of checking. This is a form of obsessive-compulsive disorder in which a person will repetitively attempt to maintain a particular level of cleanliness and order in their surroundings, in order to maintain their appearance. Checking is a mental disorder in which an individual obsessively checks that key items, such as light bulbs or stove elements, are switched on or off, no matter their location.

Checking Anxiety Arises From:

  • Fear that someone may steal my stuff if my alarm is not set or confirmed to be on.
  • Fear the stove is not confirmed off or if someone does not confirm the stove is off, there is strong fear the whole house will burn down.
  • Fear to leave a light switch on if we didn’t confirm that it was off, fearing the house will burn down.

The patient will be exposed to situations that elicit mild OCD-related anxiety symptoms through exposure and response prevention therapy. Eventually, the patients will have the ability to adjust to the cues as they become more accustomed to them. The severity of OCD cues in the situations will be gradually increased by the therapist. Having overcome the mild sensation of OCD, and that ERP therapy limits their response, they end up facing the sheer unreasonableness of their fears that causes an OCD reaction.

Other Uses of ERP

A 1995 article published in the journal of Behavior Research and Therapy (“Exposure with Response Prevention Treatment of Anorexia Nervosa-Bulimic Subtype and Bulimia Nervosa”) and reviewed by Vanderbilt University shows how ERP can be used to treat eating disorders. Exposure and Response Prevention Therapy is broken up into several discrete steps

  • The first step is education. Once you have identified your anxiety’s cause or factors, you will need to know how to react to those conditions when you encounter them. This step is crucial because it allows you to “cope” instead of living in fear and avoidance those situations that cause you anxiety.
  • The second step is the careful observation of your thought processes and behaviors. This step trains you to observe your thoughts and actions without judging them. Many anxiety sufferers are programmed to respond to their anxiety by becoming consumed in an internal dialogue about the circumstances and people involved with them rather than paying close attention to their environment and behavior. This can be very dangerous because the person suffering from the disorder may begin to believe that they are out of control and unable to control their environment and other people. This leads to the next stage of treatment: to counter the distorted beliefs with realistic, accurate representations of the situation. 
  • Exposure and response prevention treatments are often used with other methods such as relaxation techniques. By learning how to focus your breathing, muscle relaxation, and other skills, you can learn to calm yourself before an episode even begins. This allows you to recognize the beginning signs of an anxiety attack and take appropriate actions based on your experience and knowledge of the symptoms of the disorder. This step is essential to the overall success of the Exposure and Response Prevention Therapy process.
  • In the next step of the process, you will be taught how to cope with various discomforts, such as chest pain, heart palpitations, excessive sweating, dizziness, or trouble breathing. While this process can be frightening for some people, it is necessary to help people overcome their anxiety. Most people will eventually overcome the discomfort and lead everyday lives using this exposure management technique. Once a person learns how to react to the various symptoms adequately, they can begin to live a much happier life.

Many people have already benefited from Exposure and Response Prevention . It has been used successfully in the treatment of many different forms of anxiety, including social anxiety. It has also been shown to be effective when dealing with panic disorders. The positive results from Therapy can be further enhanced by using the technique in conjunction with other mental health treatment forms. A qualified mental health professional should determine if EMR and REP are appropriate steps for your particular situation. Your doctor will be able to give you the options that are right for your needs.

Importance of ERP

The importance of exposure and response prevention therapy cannot be underestimated. It is highly recommended that anyone who has anxiety-related issues should work closely with a trained therapist. They can help determine the case’s underlying causes and develop an effective plan to deal with it. Through education, a positive outlook, and practical coping skills, many individuals may find that they can overcome their issues and live happier lives.

Is The Theory Effective or Extreme?

One of the most exciting parts of exposure therapy is the use of movies. In this treatment method, a patient would sit in a room with a group of people of the same gender, age, social background, religion, or ethnicity. The therapist would then show the patient a movie, play a video, or play a DVD designed to desensitize them to the situations or objects they were afraid of most. After this, the therapist would either offer the patient a safe stimulus, such as water, touch or ask the patient to do something simple like shaking his hand or patting their hand. This process would desensitize the patient to the idea of connecting the object, and over time, this may be enough to make the patient feel better about them.

Problems Related to ERP 

If you think treatment that requests that individuals do things that truly trouble them is somewhat out of line or bizarre, you’re in good company. What’s more, this dubious comes from a position of compassion. Why make individuals go through torment? Isn’t it alright to be restless about things, and is there any good reason why you wouldn’t be irritated by something as upsetting as a pondered hurting your child? 

Is it unusual to imagine that you could deal with a mental condition by doing things like advising yourself repeatedly that you may let completely go and turn into a paedophile? Indeed, and it’s not the sort of thing the vast majority of us might want to invest our energy doing. In any case, suppose you’re so annoyed by one transitory idea like “I may be pulled in to my 3-year-old nephew” that it makes you debilitated. You think the entire day about it, compose mental arrangements of reasons you’re a decent individual, mastermind your drive to work, so you don’t pass any primary schools or daycare focuses. Yet, at that point, the idea springs up when you see a baby on a bulletin or when a collaborator acquires their child one day. You quit going to visit your sister and nephew, concocting various reasons each time they inquire. The considerations torment you, and it seems like for what seems like forever rotates around evading any idea about how have you been pulled in to a child. 

 It’s not actually about somebody who has one fast pondered paedophilia–we as a whole have considerations we’d prefer not to have. Or maybe, this is a type of treatment for individuals whose lives are stuck in light of their contemplations. That is why patients will push through the torment and bizarreness and why clinicians can briefly exacerbate the agony so things can improve. 

In ERP, a decent measure of misery in certain, and that is a tragic actuality. In any case, clinicians and backers of ERP, similar to the NOCD group, recommend it because the torment of treatment generally winds up immaterial contrasted with the drawn-out enduring of untreated individuals who go through their lives in misery over musings that aren’t worth a huge load of consideration. 

ERP is about more limited term torment for long haul acquire. Be that as it may, it must be done cautiously, with an accomplished clinician you regard and trust. It’s acceptable to gauge the upsides and downsides previously: What do you worth, and how could ERP help you get? What are your objectives? Also, what are your cutoff points for the measure of misery you’re set up to go through? How long would you like to be in treatment? How’s your emotionally supportive network outside of treatment? These inquiries can help direct you as you choose whether or not ERP is ideal for the present. 

A significant note here: paedophiles are seen in our general public as a portion of the most noticeably terrible individuals possible, and this disgrace, without a doubt, burdens individuals anguishing over their musings. Yet, the vital separator between a paedophile and somebody whose OCD bases on paedophilia is that somebody with what specialists call “paedophilia OCD” hates those musings. They can turn into the worst thing about their reality. A paedophile may feel disgrace and may not be without regret, yet presumably will not experience these contemplations despite their qualities or who they truly are. For the two individuals with OCD and most of us, it’s essential to comprehend the contrasts between pondering something and needing to do it. 

OCD takes a wide range of upsetting and troublesome structures. Further, there’s no proof that somebody with all the more regularly “upsetting” fixations (for example, paedophilia, hurting others) endures more than someone else with something that would appear to be more inconsequential to other people. In OCD, there’s nothing of the sort as a fixation that feels inconsequential or trouble that isn’t legitimate. 

ERP is best when the specialist leading the treatment has insight into OCD and preparing for ERP. At NOCD, all advisors work in OCD and get ERP-explicit preparing. If you have questions or figure that you may require ERP treatment for your OCD, call us and talk with our clinical group.

You Can Receive Exposure and Response Prevention Therapy

People who experience anxiety tend to have several abnormal physiological responses. These abnormal bodily responses can be hard to identify because they do not have a typical behavior that is considered normal. When you experience these reactions due to exposure to a stimulus, you are putting yourself at risk for developing an anxiety disorder. Anxiety disorders are severe conditions that can cause a great deal of pain and suffering. Still, the good news is that you don’t have to suffer from anxiety for the rest of your life if you choose to pursue exposure and response prevention therapy.