I’ve been having a bit of a moan recently about ERP therapists.  It’s not that they’re not well intentioned but it’s my belief that they don’t show much empathy for just how hard ERP (Exposure Response Prevention) therapy actually is and it irritates me. 

Of course in theory ERP is straight forward:

• Write a list of exposures
• Push yourself into those exposures/outside of your comfort zone
• Don’t complete any compulsions
• Sit with the associated anxiety 

Easy right?

The reality however is that you are asking someone to push into things that their brain – for whatever reason – has told them are dangerous and should be avoided/worked out/prioritised at all costs!  

This is a system which is designed to get people to ACT urgently.  A system which is so powerful it turns off the cognitive brain and takes over!! 

Our brains are designed to prioritise this system over all others to keep us safe.  It is instinctive, irrational and isn’t able to access the logical strategies that made complete sense in your therapists office.

Not only that but this system throws cortisol and adrenalin around our bodies, which is incredibly tiring, making ERP therapy exhausting! 

So what we’re really asking of someone with OCD, is for them to push themselves daily into a system which is designed to make you do the opposite.

Everyone has fears, things they don’t like/avoid and most people don’t have to push into them, maybe ever. 

So just know, when doing your exposures, you are being asked to do something that most other people avoid like the plague and you’re being asked to do it again and again and again by someone sitting comfortably in their office, probably not living the ERP lifestyle themselves. 

A lot of OCD therapists come from backgrounds with OCD so have some understanding BUT once you’ve done ERP for a while and you’re making good progress, it can be very easy to forget how hard it is. 

This happened to me recently when I started to learn to swim.  I’ve always had fears associated swimming, following an incident when I was younger, where I found myself out of my depth in a lake and basically freaked out. Since then I haven’t liked being out of my depth or putting my head under the water.

I was feeling pretty strong mentally so why not push further out of my comfort zone? Push into some of those long held fears, which start to become your identity!

We’ve all got them, finish this sentence for me: ‘I just don’t like________’


I’m great at this ERP malarky, I was thinking, little did I know what was coming my way!

To encourage myself to push into this one I signed myself up to a Sprint triathlon, the first part of which is a 400m swim. 
I started doing some lessons with one of my colleagues who’s a swim teacher and OMG putting my head under the water was completely terrifying.  I wanted nothing more than to get out of that water, go home and never get back in that pool again, not only that but the next day I was completely exhausted. Reality check for me and big reminder of how hard it can be.  

I knew I had to go back the following week and it was still hard, but maybe not 100%, perhaps 97%, my brain was still screaming at me to get out the whole time.

Honestly, I’m still making progress with this one, fears, especially ones held for a long time, do not disappear quickly and require continued exposure – sorry! 

Being able to recognise this and keep going is a skill we have to hone and it is extremely hard.  If you can master it, you are stronger mentally than 99% of the population. 
As people with OCD we’re already dealing with a fault in this system, alerting us unnecessarily daily and then we’re being asked to add more on top. 

Honestly, we deserve medals and more recognition for how tough this work is and it is work, HARD work! 

So here’s the biggest well done from me to you, for not giving up, for fighting every day for something you didn’t ask for and definitely don’t deserve. 

You are amazing, you are not alone,
Stay Strong xxx