Exposure Therapy for OCD

Psychotherapists regularly use exposure therapy for OCD to effectively reduce common symptoms associated with obsessive-compulsive behaviors. It’s thought to reduce relapses post-treatment as well. Exposure and response prevention (ERP) therapy is a type of exposure therapy, and its goal is often specific to OCD treatment. Exposure therapy moderates compulsive behaviors by safely and slowly exposing you to situations that would typically trigger an obsessive or compulsive response.

Exposure therapy isn’t harmful when done by a mental health professional who uses ethical procedures. That said, it can be difficult, especially if you’re used to more traditional forms of psychotherapy (talk therapy). Most people find the benefits far outweigh the discomfort, though. Exposure therapy has not just been proven effective, it also offers the potential to see greater success in a shorter time period. Keep reading to learn more about how exposure therapy can help treat OCD, what models are used, the types there are, and how long it generally takes before you begin seeing improvement for OCD symptoms.

How Exposure Therapy Helps Treat OCD

Behaviors or thought patterns associated with OCD can become ritualistic and habitual. They might include:

• An obsession with contamination
• Compulsive self-harming behaviors
• Repeated checking
• An obsession with symmetry or order

Sometimes, having intrusive thoughts and compulsive behavior become a substitute for an appropriate emotional response or a coping mechanism you use to rid yourself of unpleasant feelings. Your behavior might seem irrational by other people’s standards, but it likely seems completely and perfectly normal to you.

For OCD treatment, exposure therapy recognizes that the root of the problem with OCD is habituation. Treatment through exposure allows you to identify your habits and, thus, begin to act based on cognitive reasoning and preliminary thought.

A skilled therapist can help you learn to pay attention to your triggers, which might be an act, an object, a place, a person, or a thought. Then, they’ll help you learn to respond differently — or to not respond at all.

Models of Exposure Therapy for OCD

Two common models of exposure therapy are used in OCD treatment.

Habituation model

ERP is based on the principle that most people develop habits in response to negative behaviors or thoughts. When we get so used to a habit, we stop recognizing that our behavior might be negative or a stressor.

The goals of the OCD exposure therapy habituation model are to reduce anxiety and replace compulsions. Over time, you’ll begin to transfer from negative behaviors to ones that are more appropriate for the circumstances.

Inhibitory learning model

Any effective ERP treatment model is a systematic OCD treatment that, at its root, involves confronting your fears, thoughts, or behaviors and then learning to resist the compulsive response.

The inhibitory learning model (ILM) helps you essentially erase, or unlearn, your compulsive responses or obsessive thoughts. ILM is a newer model of OCD therapy, and it works for teaching you new reactions or behaviors while focusing on preventing you from expressing previous ones.

Types of Exposure Therapy for OCD

There are three types of exposure therapy: in vivo, imaginal, and flooding.

In vivo

In vivo means real-life exposure therapy, when you’re exposed to the thing that causes you anxiety. Sometimes it might be a simulation (online or in a safe space), sometimes it may be talking through a scenario, or it might even be going to a place that triggers your fear.

Imaginal

Imaginal exposure therapy is when you participate in a guided imagery session where you imagine yourself doing the thing that triggers your anxiety. While doing this, a therapist can help you use coping mechanisms and talk you through some of the things that trigger you in real time. This type of therapy can help you become more secure as you gradually work through your anxiety.

Flooding

The third type of exposure therapy is called flooding. Flooding is when you’re exposed to the most anxiety-provoking and triggering situation you can think of, instead of allowing it to build up. It’s done very quickly. This type of exposure needs to be handled gently, because it can overwhelm and sometimes overload you. It also can’t be done for a long period of time in each session.

How Long Does Exposure Therapy Take to Work?

Like any form of therapy for OCD, OCD exposure therapy won’t work overnight. It takes time and care to develop new habits or learn new thought patterns. A full course of treatment can range from a few weeks , to a few months, to a year or more. The time it takes to see improvement depends on the severity, the subset or type of OCD you have, and your willingness to engage in treatment. Response to treatment can vary.Many people see results and improvement in as little as 6 to 12 sessions. Others take 6 months to a year. 

Like any other treatment for mental health conditions, exposure therapy for OCD is not guaranteed to deliver the same results in every person. It’s important to understand what successful treatment looks like.

With the habituation model of therapy, the intensity of your reaction to the stimulus should reduce drastically, or even disappear, over time as you become more accustomed to your new behavior patterns.

If you’re treated with the inhibitory learning model, you should start seeing reduced fear associated with certain stimuli. This can happen gradually, as you become conditioned or learn that the terrible consequence you’re afraid of isn’t likely to happen.

So, when questioning how much time it takes for exposure therapy to work, it’s important to understand that it depends on how deeply your learned behavior or perceived fear is embedded in your consciousness. In either case, the stimuli may never fully resolve, but your reaction can change from habitual to cognitive, and your thoughts can change from fear to calm.

Starting Therapy for OCD

According to the International OCD Foundation, obsessive compulsive disorder doesn’t discriminate and can affect men, women, and children of all ages, races, ethnicities, and backgrounds, starting from preschool age through adulthood. Most people present symptoms between the ages of 8 and 12 , or during the late teen years into early adulthood.

Unfortunately, it’s all too common for people to not receive the right diagnosis or treatment until years after their OCD symptoms have interfered with their quality of life. When you start therapy for obsessive thoughts or compulsive behaviors, your doctor or therapist will likely perform a full mental diagnosis to determine the severity of your condition.

Next, a course of psychotherapy will probably be suggested, and sometimes OCD medication can be prescribed. As mentioned, OCD exposure therapy is a subset therapy under the CBT umbrella. CBT, or cognitive therapy, is an effective therapeutic technique used to identify and modify negative thoughts, feelings, behaviors, and physical sensations.

A licensed mental health professional might suggest that you start treatment with traditional cognitive behavioral therapy before moving on to exposure therapy. Cognitive behavior therapy sessions can often last from 30 to 45 minutes, while exposure therapy will typically last at least an hour.

These are the first lines of treatments for severe OCD and often the starting points for patient diagnosis and treatment. Of course, further treatments can be sought if the OCD treatment exposure therapy technique doesn’t seem to be working. Other options could include intensive treatment programs and might involve partial hospitalization or inpatient treatment at a mental health hospital in extreme cases.

With modern OCD exposure therapy, one treatment outcome you can learn to heal from unhealthy habitual and learned reactions. Talkspace is an online therapy platform that’s changing how people think and feel about therapy. Our convenient, affordable, easy-to-access therapy with licensed and trained therapists makes learning to manage your OCD with online exposure therapy and other types of therapy simple. If you’re ready to get help, we’re here for you. Learn how you can start the process by reaching out today. You can also learn about exposure therapy for anxiety disorder and exposure therapy for PTSD.