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The Gold Standard OCD Treatment

Why Exposures?

Exposures are the gold standard treatment approach for OCD. Exposures are also known as any of the following: Exposure therapy, Exposure and Response Prevention, Exposure and Ritual Prevention, ERP, or EXRP. When doing exposures, people intentionally do the things that trigger their OCD and learn to face their fears. Of equal importance when doing exposures, is for people to not do compulsions while facing their fears.


Oftentimes, stopping all compulsions at once is too difficult; in these situations, the goal is to reduce and delay rituals, with the ultimate goal of getting to the point where the person can do the exposure without any compulsions. 

Exposures are so powerful for OCD because it is an active and behavioral approach that helps people change their relationship with their obsessions and compulsions. Exposures help people learn they do not have to respond to their intrusive thoughts with compulsions. It teaches them that anxiety can be accepted and does not need to be controlled. It also helps people learn they are capable of doing many things even while feeling very anxious or uncomfortable – it is an empowering process.

OCD is comprised of two parts: obsessions (i.e., anxiety-producing intrusive thoughts, images, and urges) and compulsions (i.e., behaviors done to try to make the intrusive thoughts and anxiety go away). When people with OCD have an intrusive thought, they often experience a surge in anxiety and try to do whatever they can to feel better and make the thought and resulting anxiety go away.


Compulsions “work” in the moment – people often feel temporary relief – but compulsions are really making the OCD stronger in the long run. For example, if a person with OCD has intrusive thoughts that say something bad may happen if both lamps in a room are not on at the same time, then it makes sense that the person is going to always turn both lamps on at the same time (i.e., the compulsion). This compulsion may not seem like a big deal. However, the problem is that OCD is greedy and always wants more – the more that a person gives into the OCD by doing compulsions the more the OCD will demand from them. The intrusive thoughts become more frequent and attach to other areas and compulsions increase and grow as well. 

Exposures are a direct approach designed to help people learn how to break this obsession-compulsion cycle. Learning how to welcome intrusive thoughts and anxiety while not giving into compulsions helps people get their life back from OCD!

Are Exposures just about facing your fears?

Yes and no! Exposures are about learning how to face one’s fears. However, there are many aspects that go into the exposure process.


Understanding the various aspects and components of exposures is important; otherwise, people can think they are doing exposures and get understandably confused, frustrated, and give-up when the exposures “aren’t working.”

Gaining awareness of aspects such as the different types of exposures and how/when to use them, being familiar with the timing and duration of exposures, and also being aware of potential exposure pitfalls so you can identify them and know how to tackle them is an important step in the exposure process.

There are multiple aspects when it comes to exposures, including:

 1.  Different Types of Exposures:  

In Vivo Exposures


Imaginal Exposures

Interoceptive Exposures


Combination Exposures

 2.  Timing and Duration of Exposures:  

How long "should" exposures be?


How often "should" exposures be done?

 3.  Navigating Exposure Pitfalls:  

Is perfectionism interfering with exposures?


Are exposures being used as compulsions?


Are compulsions being done during exposures? 

We hope you have found this introductory Guide helpful in learning about exposure therapy and why it is such a powerful treatment for OCD. Wherever you are in your journey, we encourage you to keep an open mind to the exposure process, as it is one of the most powerful tools out there for OCD recovery!

The associated Educational Guides go into depth regarding the following ins and outs of Exposures:

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