Dealing with uncertainty via Exposure and Response Prevention (ERP)

One of the most intriguing and indeed difficult areas of OCD to treat is what might be called False Memory / Real Event OCD. To summarise, it is where your brain takes a real memory that is innocuous and turns it into something horrific that gives you crippling anxiety. 

For instance, you may have a memory of a childhood tiff, something that most people go through at some point in the playground. Your OCD could, for instance, start to conjure up stories that in said ‘tiff’ you actually wanted to kill that person, and that you are inherently bad. You may see a series of images that feel really very true, when in fact they are not. It is utterly terrifying – I have personal experience of this.

I say it is difficult to treat when in fact, to contradict myself, it actually isn’t, if you are willing to stay with the anxiety in Exposure and Response Prevention (ERP), one of the fundamentals of my therapy practice nowadays. What is difficult is staying with this type of anxiety, sitting with the prospect that it may or may not have been true. ‘Maybe or maybe not’ is the calling card of ERP therapy. We have to accept uncertainty, say ‘maybe or maybe not,’ and go from a certainty that it is not true, to a ‘hunch.’ ‘My hunch is that it is unlikely that xyz didn’t happen,’ for instance. This acceptance (part of Acceptance and Commitment Therapy or ACT, another cornerstone of my practice) is tricky and an ongoing process, but it can be done with the help of a good practitioner.

When, slowly but surely and with the guidance from a therapist, we are able to sit with this prospect, the brain starts to acclimatise, and the fight or flight goes down. It becomes more ‘ok’ with the uncertainty that you are practising, and stops firing up more possibilities. If you stay it the loop of anxiety (see earlier posts) then you get temporary relief, but your OCD is just waiting in the wings to conjure up more hideousness. 

Contact me for a session jessica@jessicadrake.biz to break free from the most hideous thing – OCD.