The OCD cycle begins with an obsession, to which meaning is applied, causing a spike in distress. The person, believing that their distress will continue to mount until it is unbearable, or finding it unbearable already, engages in a compulsion, which provides relief! Unfortunately, the relief is increasingly short-lived, but all the brain remembers is that it worked, and that psychogenic experience trains the brain to do exactly the same thing when the obsession re-appears, which it inevitably does. The obsession has not been confronted, just momentarily avoided, and the underlying relationship with fear (or emotional distress/discomfort) worsens.

 

ERP works to quickly and effectively break this cycle by helping individuals learn to tolerate distress without engaging in compulsions, tapping into the body's own ability to regulate emotion and face even the most challenging fears. While OCD is better understood today than it has ever been, it should still be treated by a therapist with specific training in OCD and ERP or ICBT (another effective modality) as some approaches commonly used for other related issues can inadvertently exacerbate the problem.