Should I First Try ERP on My Own?

Patrick McGrath, PhD

April 25, 2020

Over the years, many people with OCD have asked me about starting Exposure and Response Prevention (ERP) on their own instead of first seeing a licensed therapist with specialty OCD training. Eventually, you should strive to become your own therapist, but conducting therapy on your own is likely not the best way to begin managing your OCD. Here are four reasons why:

1. ERP can be stressful to start.

People on the NOCD team that have OCD have often shared that doing ERP will initially make your OCD symptoms feel worse, so it is crucial to have an OCD therapist to help you persevere during the beginning of your treatment journey. Therapists who have the training to treat OCD know the common responses people have when starting ERP therapy, which allows them to help you stay motivated and less anxious during the process. 

2. To do ERP effectively, you’ll need to have a custom therapy plan.

Therapists that specialize in OCD have the training needed to design ERP exercises that will be most successful. A trained therapist will take the time to understand your symptoms and create a custom ERP therapy plan around them. By beginning ERP on your own without a therapist, you risk starting on an exposure exercise that you're not ready for, which is on par with lifting weights that are too heavy for you without proper form and a spotter. 

3. OCD therapists will teach you how to identify and resist all compulsions.

My former postdoctoral supervisor, Dr. Alec Pollard, Ph.D., has always warned that exposure without response prevention is useless. By starting ERP on your own, you might only identify some of the safety-seeking behaviors, called compulsions, that make your intrusive thoughts worse. By not detecting all of your compulsions, you risk doing those other compulsions during your exposure exercises, which will prevent you from making strides clinically.

4. ERP feels unnatural to start, even if you’re doing it right.

If you decide to pick up golf, you could buy some clubs, go to a driving range, and hit some balls. After a while, you might consistently hit the ball, but you will likely never make progress in your golf game, given how unnatural holding a golf club and swinging it feels. Yet if you began working with a certified instructor while continuing to practice, eventually swinging a golf club with proper form will feel second-nature, and you'll start to drive the ball with improved accuracy and distance. That’s because a golf swing is a complex skill that requires continuous training, supervised practice, and feedback provided over time in order to master it.

In a similar vein, starting ERP feels unnatural because you're supposed to allow thoughts, images, and urges that violate the most fundamental elements of your character in your head as opposed to resisting them. A trained OCD therapist will make ERP feel natural for you, and at a faster pace, preventing you from wanting to metaphorically throw your golf clubs into the lake after your first day on the course.

Because many people on the NOCD team have either treated OCD for decades or suffered from it for just as long, we understand how crucial ERP therapy is. We have seen many times over how much more effectively and quicker symptoms are reduced when you work with an ERP-trained, licensed therapist. That's why we’ve made it our mission is to guide you towards getting better as fast as possible and staying better as long as possible. To help fulfill that mission, we offer live, face-to-face video therapy sessions with OCD therapists (who have ERP specialty training) inside the NOCD telehealth app. You'll also receive ongoing support between sessions from our self-help tools and peer communities.

To learn more about working with one of NOCD’s OCD therapists, schedule a free 15-minute information session with our team.

We look forward to working with you. 

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