Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Creative Interventions While Doing ERP

By Barbara Zelop, LPC, ATR-BC

Feb 11, 20225 minute read

Reviewed byStacy Quick, LPC

hand holding a brush watercoloring

Creativity can provide people with a sense of empowerment. It can allow people to explore and feel things on a deep level. It allows for difficult emotions to be released. Avenues of creative expression can be vast. There are no right ways to do it. 

That’s the beauty of using creative interventions in treatment, too: they allow you to identify what may be most helpful specifically to you in your healing journey. With OCD treatment, creativity can be a therapeutic intervention, allowing people to work through their intrusive thoughts and compulsions through creative or artistic media. 

Vulnerability is a key component

Creativity isn’t about the end result. It’s about the expression and the process. It’s the messy part where the hidden work lies. The hard work of trying to heal from what is causing the pain, or at least to be able to manage it effectively. This will look different for each person, and it requires vulnerability. 

What does it mean to be vulnerable? It’s to invite uncertainty, which lies at the core of OCD. To be open to the potential of judgment from others, which can be a terrifying experience for people with OCD. OCD doesn’t want you to learn to lean into the anxiety and discomfort that intrusive thoughts inevitably bring about. This keeps you in a constant state of avoidance where you steer clear of anything that feels difficult or uncomfortable. It’s a trick that keeps you trapped in a cycle of thinking you are alone and that no one else feels like you do. 

Being creative in any form requires surrendering to vulnerability. With any mental illness or condition, people often feel unheard, unseen, and unimportant. Through creativity, you can feel heard, seen, and validated—maybe for the first time—and this can be life-changing. 

Why is creative work important?

Leaning into vulnerability to share your truth takes courage, but you can speak your truth in the way that feels best to you, whatever it may be. For some it might look like painting, drawing, or poetry; for others it could be sharing inspirational sayings and encouraging others. It can be completely unique: I once worked with someone who enjoyed making art from legos, and another who loved creating artwork from crayons alone. 

Remember that OCD will try and get you to keep your feelings and thoughts inside, for fear of how others may respond. OCD knows that when you open up about thoughts and urges, you take away their power. To be vulnerable and express yourself is to battle with OCD. 

Expressing yourself creatively can also help you learn self-compassion. You allow yourself to acknowledge that you are struggling. You can start the process of letting go of what OCD says you are, and explore the things you value most through self-expression. When someone leans into vulnerability and is creative, they choose to reveal very deep parts of themselves. Ask yourself: are you truly ready to share those very secret parts of yourself? 

There can be freedom in sharing these emotions and feelings, even when others don’t understand what you’re trying to say. People can always misinterpret and can often only see things from their own point of view, and that’s okay. It’s your story to tell. It’s your truth. 

How to incorporate creative interventions while doing ERP

The use of creative interventions within exposure and response prevention (ERP) therapy can aid treatment for people with OCD. ERP teaches you to sit with uncertainty and to lean into anxiety and discomfort, and to hold your values over your fears. Creativity in ERP allows you to express yourself and your values in the truest way. The goal of using creative strategies is to increase your awareness and identify your strengths and abilities. 

Through creativity, a person can become vulnerable and share things that they may have not otherwise shared. In ERP, creative interventions can provide unique ways to face triggers, finding a delicate balance between addressing core fears and working with what someone is willing to face at a specific point in their treatment process. 

Using creativity in exposures can make a real difference. I have found that some of the most creative exposures come from members themselves, and that these exposures can be the most impactful and effective. This is because, through their own vulnerability, they are choosing to face something they previously thought they couldn’t. 

While working on ERP with several artists or creatives, it can be helpful to use a member’s core fear as the subject for an imaginal exposure. For example, someone working with a fear of knives may benefit from making a sculpture incorporating their intrusive images as a form of exposure. One time, while I worked with a poet, they wrote a poem on the fear of never being left alone. It repeated a phrase: “I’m not certain anymore.”

Others with OCD may experience a theme of perfectionism, or feeling like things need to be “just right.” The beautiful thing about any creative expression is that it cannot be perfect; by nature it is imperfect and incomplete. That’s what makes it honest. It takes a tremendous amount of bravery to say, “I am no longer going to let this thought, image, urge, or feeling control my life.” To live the life you want, in spite of what OCD tells you. 

For members working with a NOCD therapist, NOCD offers a support group that is based on incorporating creativity into OCD treatment. The support group usually begins with a prompt, which can be anything that requires you to embrace an unknown outcome. Keeping in mind that OCD causes many to seek perfection, the support group encourages an environment of experimentation, steering away from perfectionism entirely.  The support group is free to NOCD members currently working with a therapist, and takes place every week.

If you’re struggling with OCD and are not yet working with a therapist, but would like to learn more about starting treatment, NOCD is here for you. Our licensed therapists deeply understand OCD and are specialty-trained in treating OCD with ERP. We work side-by-side with the OCD experts and researchers who designed some of the world’s top OCD treatment programs – and that means the best care for our members. You can book a free 15-minute call with our team to get matched with one and begin receiving the right care.

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