Exposure and response prevention (ERP) therapy is the evidence-based psychological treatment of choice for obsessive-compulsive disorder. Basically, the person with OCD is exposed to his or her obsessions, encouraged to feel the anxiety, and asked to refrain from engaging in rituals (compulsions) to reduce the fear.
I hear from many people with OCD who say that while they understand what ERP therapy is, and even how it could be helpful to many people, they don’t think it would work for their type of OCD, and therefore they don’t pursue treatment. This is indeed unfortunate as ERP can truly benefit all those who deal with obsessive-compulsive disorder.
But wait a minute. What if people’s obsessions involve horrible things happening to those they love, or a fear of going to hell? What if their worst obsession is the fear of being involved in a fatal car crash? Certainly these are not obsessions we want to, or are even able to, expose ourselves to. How can ERP ever help someone with these types of obsessions?
I previously addressed this issue when I discussed imaginal exposures, which are based on imagining different scenarios as opposed to them actually happening. These types of exposures can be extremely helpful in certain cases. So you see, while OCD can be tricky, it can always be beaten. Sometimes you just need to be more creative than usual.
Speaking of creativity, researchers at Stanford University have been studying the use of virtual reality (VR) in the treatment of various brain disorders including OCD. They describe VR as using “computer technology to simulate physical environments, sights, sounds and other sensations to make the computer images seem more ‘real’.”
Now that could be quite an exposure!
“In illnesses such as OCD, a patient faces situations such as contamination fear,” Professor of psychiatry Elias Aboujaoude said. “VR provides a convincing atmosphere so the patient can expose themselves to the stimulus and gradually become desensitized to this fear.”
Dr. Aboujaoude believes VR can be effective but acknowledges it is not available to everyone. VR is also still typically associated with video games, and that perception might be a hindrance.
While the research at Stanford is new, the use of virtual reality in the treatment of OCD has been around for a while. In this 2009 NIH article the use of VR in the assessment and treatment of OCD is evaluated and discussed. The article is long and detailed for those who wish to read it, but the bottom line is researchers conclude that the use of VR does have value for those with OCD.
While the premise of ERP therapy might be simple, its implementation is not always straight forward. But we are smarter than OCD, and as I said earlier in this post, it can always be beaten. If you are willing to engage wholeheartedly in ERP therapy with a qualified therapist who understands the importance of imaginal exposures and possibly even VR, you will be on your way to a life of freedom from OCD.