Why is ERP the recommended treatment for OCD?


Studies show that everyone experiences some of the intrusive thoughts involved in OCD. Maybe you’ve thought I could drive off the road right now or What if I don’t actually love my significant other? People without OCD are usually able to write off distressing thoughts as strange and random occurrences, but those with this condition feel compelled to neutralize them. Obsessions and compulsions reinforce one another because it seems like a thought that had to be avoided with a compulsion must have been pretty important (and worthy of more fear). In most cases OCD symptoms do not resolve on their own.

A cognitive approach– traditional CBT, for example– asks patients to challenge their obsessions. This can actually reinforce the belief that thoughts are significant and that we’re morally responsible for the content of our thoughts. Although cognitive interventions can be useful in many ways, recent studies comparing ERP and CBT suggest that ERP is more effective specifically for OCD.

Any behavior that engages with the obsession– e.g. asking for reassurance, avoidance, rumination– reinforces it. By preventing these behaviors, ERP teaches people that they can tolerate their distress without turning to compulsions. It thereby drains obsessions of their power. Especially when paired with medication and other types of therapy, ERP is consistently demonstrated to be the most effective form of treatment for OCD.

How does someone actually do ERP?

There’s a good chance we’ll be writing more about this soon, but the best way to see how ERP works is to check out the NOCD app on Android and IOS. We built it from the ground up to provide ERP tools, and worked with top experts to make sure it’s closely aligned with the version you’d get in a therapist’s office.