Exposure and Response Prevention

Exposure and response prevention (ERP), used for treating OCD and anxiety disorders, involves having individuals confront triggers for anxiety, starting with lower anxiety triggers, working up a hierarchy to more challenging triggers. During exposure the individual agrees not to engage in rituals or avoidance. The individual experiences anxiety, and with uninterrupted exposure, one experiences anxiety fading, or habituating.  ERP essentially retrains the brain, by triggering anxiety (exposure) and not interrupting habituation with rituals or avoidance (response prevention), which leads to reducing or eliminating anxiety in response to these triggers. A process called Inhibitory Learning takes place through repeated exposure and repeated habituation of anxiety, so that triggers come to be associated with Safety in place of being associated with Danger. The bottom line is, ERP removes the disorder from controlling one’s life and allows one to lead a life more of one’s choosing.

Acceptance & Commitment Therapy

Acceptance and Commitment Therapy, considered the third wave of CBT, is used as an adjunct to other CBT approaches. ACT involves using mindfulness techniques, aimed at having an objective awareness of anxiety-producing thoughts, or other feelings and reactions.  It advocates having a willingness to experience one’s thoughts, feelings, and reactions, possibly experiencing anxiety in the process, without attachment to having to eliminate them.  Increasing tolerance of these reactions substantially decreases suffering. ACT also aims to help individuals identify their values and to live more in alignment with these values, less deterred by their anxiety disorders.