A new friend came over to my apartment the other week, and we got to talking about Exposure and Response Prevention (ERP) therapy, and I shared a metaphor with her that I’d like to share with you now.
We put out fires, but what we need to do is shoot the arsonist.
The problem with attempting to “solve” an OC’s obsession is that, as soon as it’s solved, a new obsession will take its place. In that way, you’re only putting out fires, not dealing with the root issue, which is an inability to handle uncertainty. For years and years, I watched my obsessions hop from one thing to the next. My compulsions– and even my talk therapy sometimes– were shortsightedly stamping out the flames in one corner of my mind while OCD set a new fire in another corner.
How can you possibly manage to keep up that way? It’s not sustainable.
That’s why I agree with so many of the OCD experts in this country that the best way to fight OCD is with Exposure and Response Prevention therapy. ERP is so very different from most standard therapies. In it, obsessive-compulsives are exposed to a trigger that prompts in them deep anxiety; then they are not allowed to respond with an anxiety-easing compulsion. Instead, they are forced to sit in that discomfort. Doing this repeatedly actually re-wires the obsessive-compulsive’s brain in a way that they learn to live with uncertainty and their quality of life improves dramatically.
It’s been four years since I turned my attention from the bonfires to the disorder that was setting them.
It’s been a good four years.