Exposure and Response Prevention - The Science Behind It

anxiety cbt erp ocd science

Welcome back!  In the week’s episode of Your Anxiety Toolkit Podcast, we are addressing the science of Exposure and Response Prevention (ERP).  It seems counter-intuitive to expose ourselves to what makes us MORE anxious and MOST uncertain, and I know that many of you are wondering why we would do this.  We’re going to discuss the many reasons WHY today as we dive right into the science of Exposure and Response Prevention.

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Let me break this down simply for you.  We have been trained for many years to instinctually run from fear. When we are faced with serious, threatening events, we go into fight, flight, and freeze.  In truly dangerous emergency situations, we are very lucky to respond in this way because it keeps us safe.  Fight, flight, and freeze is a sophisticated human response that keeps us alive and well.

However, our brain makes mistakes.  Often, when we are bombarded with THOUGHTS of serious threatening events, our brain experiences them as if we were in actual danger.  It makes a mistake and tells us that there is danger right here, close to us, that is imminent.

This becomes a problem when we react to the thought, image, urge, or sensation as if it IS an imminent threat that is putting us in real danger.  We fight it, freeze, or run away from it, therefore reinforcing that the thought IS dangerous by responding in this way.  The following cycle is created: fear --> avoidance response --> fear…this is a perpetuating cycle.

This is where the Exposure and Response Prevention (ERP) comes into place.  Instead of fighting the thought, running from it, or freezing, we can stare our fear directly in the face.  We utilize ERP by changing our behavior (or response) to the original obsession (thought, image, urge, sensation) and exposing ourselves to our feared consequence.  If this makes you cringe, you are not the only one!

Facing your fear is hard, but not nearly as hard as running away from fear.  When we run, it’s so much worse than it is when we actually TOLERATE fear.

WHY ERP is so important and HOW ERP changes our brains:

  • There are differences in the brains of those with Obsessive Compulsive Disorder (OCD) compared to those without OCD.  Research finds that using ERP increases the connectivity between areas of the brain (particularly the cerebellum) affected with OCD.  It improves these connections.  Your brain is actually changing!
  • By strengthening the connectivity of the cerebellum, it increases our ability to hold discomfort and resist going into repetitive and destructive rituals (compulsions).
  • Another study shows that doing ERP with the goal of reducing fear only does not have great outcomes. When trying to reduce your fear, it increases your chance of obsessions and anxiety returning.
  • When staring fear in the face to TOLERATE it, rather than get rid of it, you will fear future events much less because you will have a sense of mastery over your anxiety.  It is not about getting rid of anxiety.  You are learning how to handle anxiety in almost all situations.  There is science to PROVE that staring fear in the face will help you see that fear does not run the show.  It will change your life.

ERP is really hard, but it is a beautiful day to do hard things!  You are not alone!!


About Kimberley Quinlan

Kimberley Quinlan is a Licensed Marriage and Family Therapist who specializes in Anxiety, Obsessive Compulsive Disorder (OCD), Eating Disorders, Panic Disorder and Body Focused Repetitive Behaviors (BFRB’s).  Kimberley is highly trained in Cognitive-Behavioral Therapy (CBT), with a heavy emphasis on Exposure Response Prevention (ERP), and has been practicing meditation and mindfulness for many years.  Kimberley has a special interest in the integration of mindfulness principles with CBT for OCD, Anxiety Disorders, and Eating Disorders.  Kimberley has experience treating adults, adolescents, and children, and tailors each program to suit the age and cognitive development of each client.  Kimberley has a private practice in Calabasas and Westlake Village. 

For more information, you can find Kimberley at the following:

Website: https://kimberleyquinlan-lmft.com

Instagram: https://www.instagram.com/kimberleyquinlan

Facebook: https://www.facebook.com/KimberleyQuinlanCBTschool/