ERP for OCD: What It Is (and Why It Works)
If you’ve ever had a thought that felt disturbing, alarming, or “not you”…
If you’ve ever found yourself stuck in mental loops, reassurance seeking, or checking behaviours…
If you’ve ever felt like your brain won’t let something go until you do something to “fix it”…
You’re not alone.
And you’re not broken.
Many people experience OCD-like patterns — especially around intrusive thoughts and anxiety.
One of the most effective and well-researched approaches for treating OCD is:
ERP (Exposure and Response Prevention).
This article is meant to offer helpful context and education — not to diagnose you. If any of this resonates, support from a trained therapist can make a meaningful difference.
What is ERP?
ERP stands for Exposure and Response Prevention.
It’s a therapy approach designed to help you gradually:
face feared thoughts, feelings, or situations
reduce compulsions and reassurance behaviours
retrain your brain to tolerate uncertainty
build confidence in your ability to handle discomfort
ERP is not about “getting rid of thoughts.”
It’s about changing your relationship to them — so they stop running your life.
The OCD cycle (why it keeps repeating)
OCD tends to work in a very specific loop:
Obsessions
An intrusive thought, image, urge, or doubt shows up (often unwanted).Anxiety / distress
Your body reacts as if something is urgent, unsafe, or unresolved.Compulsions
You do something to try to neutralize the anxiety (physically or mentally).Temporary relief
The anxiety drops… briefly.The cycle gets stronger
Your brain learns:
“That compulsion worked — do it again next time.”
This is how OCD stays sticky.
Not because you’re weak…
…but because the brain learns through relief.
What counts as a compulsion?
When people hear “compulsions,” they often picture physical actions like washing hands.
But compulsions can also be mental and subtle, such as:
checking your feelings
replaying conversations
mentally reviewing “what if” scenarios
reassurance seeking (“Are you sure I’m okay?”)
confessing
researching endlessly
seeking certainty
avoiding triggers
asking others for validation
trying to “feel right” before moving on
Many high-functioning people don’t realize they’re doing compulsions because they’re happening internally.
Intrusive thoughts are more common than people think
One of the hardest parts of OCD is how convincing it feels.
Intrusive thoughts can be about:
harm
contamination
morality
relationships
sexuality
“what if I snap?”
“what if I don’t actually love them?”
“what if I did something wrong?”
“what if I’m a bad person?”
The presence of an intrusive thought does not mean it reflects your character.
OCD often targets what you care about most.
So how does ERP help?
ERP helps by doing something that feels counterintuitive at first:
Instead of neutralizing anxiety…
you practice allowing it.
Instead of chasing certainty…
you practice tolerating uncertainty.
Instead of compulsively “fixing” the thought…
you practice letting it exist without responding.
Over time, your nervous system learns:
“I can handle discomfort.”
“I don’t need to solve this thought.”
“Urgency is not the same as danger.”
“I can live my life even with uncertainty present.”
That is real freedom.
What ERP looks like in real life (examples)
ERP is always individualized, and good ERP is done with care.
Some examples might include:
Contamination fears
touching a surface and not immediately washing
delaying cleaning rituals gradually
Checking OCD
leaving the house without re-checking
accepting the discomfort of uncertainty
Intrusive thoughts
allowing the thought to be there without mental reviewing
practicing “maybe, maybe not” responses rather than reassurance
Relationship OCD
resisting the urge to “check feelings”
allowing uncertainty about perfect certainty
ERP isn’t a punishment.
It’s practice.
Response prevention: the part that creates change
The “RP” in ERP is often the hardest part.
Response prevention means you stop doing the thing that reduces anxiety short-term.
Not forever. Not perfectly.
But enough that your brain learns a new pathway.
Because compulsions teach:
“Anxiety is intolerable.”
ERP teaches:
“Anxiety is uncomfortable — and survivable.”
ERP doesn’t mean you do it alone
It’s normal for ERP to bring up:
fear
discomfort
doubt
resistance
emotional exhaustion
That’s why support matters.
A therapist trained in OCD treatment can help you:
create a safe exposure hierarchy
move at the right pace
reduce reassurance cycles
stay accountable without shame
build confidence through practice
A gentle reminder: this isn’t about “fighting your brain”
ERP is not about being tough or forcing yourself through pain.
It’s about retraining the nervous system in a structured, compassionate way.
And it works best when it’s done with support.
How therapy can help
If you feel stuck in intrusive thoughts, checking, reassurance seeking, or repetitive mental loops, therapy can help you understand what’s happening and build a plan forward.
At Carbon Psychology, we support clients in Calgary with grounded therapy for anxiety and intrusive thought patterns, including evidence-based approaches like ERP when appropriate.
Book with Michael Grisonich at Carbon Psychology for ERP and support with OCD and intrusive thoughts.
Quick FAQs
Is ERP the same as exposure therapy?
ERP includes exposure, but the key difference is response prevention — learning to resist compulsions or reassurance behaviours after exposure.
Will ERP make my anxiety worse?
ERP can feel uncomfortable at first because you’re practicing tolerating anxiety instead of neutralizing it. Over time, most people experience reduced distress and fewer compulsions.
Do I need to be diagnosed with OCD to benefit from this?
Not necessarily. Many people experience intrusive thoughts and compulsive patterns. A therapist can help clarify what’s happening and what support is appropriate.