OCD and ERP made simple - The Meeting Matters
 

OCD and ERP made simple - The Meeting Matters

March 8, 2024by Iqra Hidayat0

Before Understanding OCD and ERP What if I tell you that you are the first human being on this planet and you for the first time feel hunger, accidently you come across an apple and eat it unknowing of the fact that it is going to satisfy the hunger. To your surprise, the apple alleviates the feeling of hunger. So, what are you going to do whenever the hunger strikes again? You will eat something right? Because you know doing so will result in the desired outcome. This is because getting a favorable outcome (relief from hunger) reinforces the behavior of eating in the future as well.

Now imagine you feel pain and you take a painkiller because as humans our first instinct is to suppress the pain and gain relief. Of course, the painkiller helps so you will again take the same painkiller the next day when pain attacks you again. You will do this every day but the initial dose is not suppressing the pain, so you are increasing the dose every day. Sure, it helps you suppress the pain eventually. So, what is known to us as a temporary relief is reinforcing the continuous usage of painkillers because even if it is temporary, it is still helping us. It indeed is helping in the short term but in the long term, it is destroying the stomach. In the same way, obsessions, and compulsions work. Too much noise in the head causes us mental pain and to alleviate the pain we perform compulsions. Compulsions do temporarily help the pain go away for example if the obsessions are centered around contaminated hands, then the only thing that is going to lift the burden off is hand washing. Hand washing does help with subsiding the noisy obsessions but what started as 20 times of hand washing will increase to 60 times and will keep increasing this is regard as OCD. Because now the brain is wired to perform compulsions every time you have obsessions, this wiring keeps you stuck in the cycle. How are we going to break the cycle?

Gold Standard therapy for OCD

Yes, you guessed it right. It’s possible with the gold standard therapy for OCD which is Exposure and Response Prevention. What does it do? It breaks the rigid link between obsessions and compulsions which is kept strong by the reinforcement of temporary relief. And how does it break it? It provides us with experiences where we still have obsessional thoughts, but we simply do not act on them. For example, if obsessional thoughts involve contamination of hands, we resist washing hands. This repeated experience involves exposing oneself to triggers that give rise to obsessions and resisting the compulsions. The patient before ERP only knew that to fight the noisy obsessional thoughts, they must perform the compulsions. During ERP the person repeatedly exposes himself to triggering or feared situations while resisting the need to engage in compulsive behavior. The exposure accompanied by the prevention of compulsions eventually leads to changes in response patterns of the brain. What it does is that it forms new neural connections via the process of neuroplasticity. The ability of the brain to restructure and form new neural connections in response to experiences, learning, and changes in the environment is referred to as neuroplasticity. So What happens when a person with OCD encounters these situations?
In the beginning, when the person with OCD encounters these situations because the situations are feared by the individual, their amygdala (the region associated with fear and anxiety) has a high level of activation. This elevated activation reinforces the link between feared stimuli and the anxiety response. But when the person encounters these circumstances again and time again without exhibiting compulsive behaviors, neuroplasticity takes hold and the brain starts to adjust. The feared stimuli cause alterations in neural connections and patterns of brain activity over time. For professional help regarding OCD visit our clinic.

 

Iqra Hidayat

Leave a Reply

Your email address will not be published. Required fields are marked *

×