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Therapy for OCD doesn't just happen to you. You play a really big role in deciding how therapy unfolds. And there's some tips that I wanted to give you that can help you get the most out of your treatment. I'm Dr. Patrick McGrath. I'm the Chief Clinical Officer for NOCD. If you're looking for help for OCD or related conditions, check us out@nocd.com that's nocd.com if you like our work, subscribe to our NOCD YouTube channel. You can watch our recorded webinars and also see the get to Know OCD podcast that I host. Let's talk a little bit about exposure and response prevention therapy. What it is. Well, it's purposely exposing people to whatever their obsessions are. Now, people with OCD are always being exposed to these things. Exposure is not the curative part of treatment. It is the response prevention that's really important. The exposures are important in the sense that we do need to expose you to things that are uncomfortable or triggering, but you always have a choice after that. Do you do a compulsion or other safety behavior or do you do response prevention? And response prevention is the key thing to do. That's the curative piece. Because response prevention is the elimination of the safety behavior of the compulsion. It turns out it's those safety behaviors, it's those compulsions that actually keep people stuck because they're immediately gratifying, they're immediately relieving of discomfort. They don't teach you how to handle things better in the long term, though. ERP allows for that to happen. By not giving into the compulsions, by not doing avoidance, reassurance seeking, distraction, using substances, something like that, you allow yourself to recognize that though uncomfortable, you can handle the discomfort that the obsession brings without having to do something to neutralize it. And the more that you do that and learn that you can handle it, the less likely you will be to do compulsions. And. And that's when you start to really get your life back. So here's what I would say, a couple of tips. Number one, there's not a great time to start therapy in the sense that if you're going to say to yourself, well, it's just not the right time, or I'm just going to wait till I'm ready to start therapy. I don't think you'll ever get to a point that you're going to say, yes, this is the best time ever. I liken that to the example of is there ever a good time to get a Flat tire, probably not, right? Nobody really wants that to happen. So instead of waiting for it to feel like you're ready or to do it at the quote, unquote, right time, make this the right time, right? OCD is not going to allow you to feel ready. OCD is going to say, yeah, today's not a good day either. Maybe tomorrow, maybe tomorrow will be the right time to do it, right? But tomorrow comes and then it's, no, not today either. Maybe tomorrow. And that's going to keep going. And there's an infinite number of tomorrows, unfortunately, that you're going to have. And you're not going to get to a point where OCD is going to allow you to feel as if today is the right day to do it. So you have to feel fears and discomfort and know that you can do this anyway. Sometimes people say, well, I want to feel better first, and then I'll start therapy. The reality is you're not probably going to feel better until you start therapy. So starting therapy is really the key thing to do. Second, be sure you're honest with your therapist. We know that OCD can go to really taboo or disturbing types of thoughts or images or urges. Your therapist, though, will specialize in these things. If they're trained in obsessive compulsive disorder diagnosis and treatment, they will understand what's going on. They're not there to try to report you or to ridicule you, belittle you, make fun of you, anything of that nature. They're there to be compassionate and to truly help you learn how to live with OCD instead of keep trying to run away from whatever those thoughts and images and urges are. The one thing that I say to people is, it doesn't matter where you go. Your brain goes with you, which means your obsessions go with you. You're not going to be able to escape them, but you can learn to live with them. And some people even say, well, I don't want to live with it, right? Or, I don't think that I should live with it. And that's another trick of OCD saying to you that you're not a good person or something of that nature. We don't judge people based on the things that just pop into their head. I'm going to really take a look more at the kinds of actions that people are going to take. And what I have found, especially doing ERP with people, is they don't take the actions that their brains tell them they will. I have stood at the top of staircases with people behind me and their hands on my shoulders who were so afraid of, what if I push somebody down the stairs? And I've offered them the opportunity to do so with me, They've been behind me, they've had their hands on my shoulders. And I've said, said, if you're going to do it, this is your chance. Here you go. No one has ever done it. Right? Now, there's been a lot of but what if I dos, but I'm not afraid of what ifs. I'm concerned about what people actually do. And then people say, but what if I do it in the future again? I'm going to just live with that uncertainty, live with that doubt. OCD says there should be no doubt about anything. I don't think we can be human and have no doubt, right? So we live with doubt, we live in uncertainty. Some people are afraid about the white knuckling your way through, right? Where I'm just going to, you know, just experience just discomfort, discomfort, discomfort, discomfort, discomfort. And. And I'm so going to be focused on that, that I'm not allowing myself to learn that I can actually handle the experience. So if. If you're white knuckling it and you're just like, I just got to get through that, just got to get through, through this. I think that you're focusing on that more than you are. I don't like this. It's not very comfortable. But I'm going to allow myself to learn that I can handle it. Right? We don't have to keep telling ourselves how terrible something is. We know already. We can allow ourselves to experience how something feels and also learn that we can handle how that feels. Right? The brain will learn that feared outcomes either won't happen or, or if they do, they're usually nowhere near as bad as we thought that they would be. And that the discomfort that we experience really not that dangerous. Right? So we're not wanting to send a message that anxiety itself is a threat, that it's bad. We want people to feel feelings. We want people to learn that they can handle feel feelings, right? And let anxiety come, let it go, let discomfort go, let shame go, let guilt go, let it come and go as it will cause. OCD can use all of those uncomfortable emot emotions. And when people do that and allow themselves to learn that they can handle those things, well, then guess what? They start to live those lives they want to live and not the life OCD wants them to live. We don't want to distract ourselves. Distraction can be Another safety behavior that people use, right? This is why we don't teach people things like diaphragmatic breathing or muscle relaxation. This is why we don't say to people with ocd, well, when you have a thought that you don't like, we want you to replace it with a thought that you do like, right? That's not what we want to do. Those just become compulsions for so many people. So instead of doing things to kind of push the discomfort away and try to feel better, we allow people to learn to live with doubt and discomfort, learn that they can become comfortable being uncomfortable in a way, and that their lives are better by allowing for these emotions and things to be there, instead of their lives being ruled by trying to push all of this stuff away. Because the pushing away just doesn't work and makes itself more of a compulsion over. Over time. And people get stuck in that more over time. And when people get stuck in that, then their lives are all about alleviating this thing right here in the moment. Instead of knowing that I can handle something that's uncomfortable, this can create new neural pathways. In the past thing, we've talked about neuroplasticity, the idea that the brain can change when we practice things, right? And so what we want right now is to change the way your brain is working, because right now, your brain is working in such a way that it jumps to compulsions or other safety behavior. We want to now go to a better thing to do, which is not giving into that, and to learn that there's another way to reply to these obsessions that doesn't involve safety behaviors, but can just involve learning to live with something and be with something. And that that doesn't have to mean anything whatsoever, right? You do this between sessions, you get good outcomes, right? You keep practicing and practicing. This is something that you and your therapist are going to work on making a plan together for. Also, if you can involve loved ones, that's helpful, too. People who can support you through treatment is so important. It brings your whole team together, your whole family together as all people supporting you, living the life you want to live and kicking maybe OCD out of the house, right? OCD is an uninvited house guest. It's kind of like things like fish that you might leave out on the counter for after a few days. Pretty, pretty stinky, right? And OCD is like that. It's really stinky after a couple of days. And many, many families would like OCD to not be an invited guest in the home anymore. So what can we do to uninvite OCD from the home? And how can the whole family support that? I don't just want to do therapy with somebody and then not involve the family, and the family not know what we're doing and then either look at what we're doing, like, oh, my child's uncomfortable. This therapist is terrible because my child's uncomfortable. Well, your child's uncomfortable because we're doing ERP and the discomfort is what we're learning how to handle. Or families don't know that they're providing safety behaviors. And when therapy's over, they go right into providing safety behaviors for someone, which just keeps you stuck in ocd. So getting everybody involved is important. I know it's maybe tempting to try some of these things on your own, but really working with a therapist who specializes in OCD is going to make a huge difference because they're really going to be able to help you stay motivated. If there's a tripper along the way, they're going to help you get back up and do these things. Know that our therapists are extensively trained in OCD and ERP here at ocd and they can help you implement exactly the kinds of evidence based strategies that you'll need to really live the lives you want to live and not the life that OCD wants you to live. Why? Because it's important. Because when you are living your life, what do you get? You get jobs and school and family and friends and all of those things. And that's the kind of stuff that's so important for all of us to have in our lives. Between sessions, there's trackers to see how your symptoms are changing. There's exercises that you and your NOCD therapist will create that you'll be able to utilize. Through our NOCD app, you can message your therapist between sessions. If anything comes up and you need some extra support, there's live support groups that we have going on all the time. And you have access to the world's largest OCD community too, where people are so supportive of each other. If this sounds intriguing to you and something you want to try, give us a call or go online or download the NOCD app. But hit that therapist button anywhere that you can go to nocd.com and we would be happy to set you up with one of our intake agents who will chat with you and get you aligned with one of our well trained licensed therapists where you live. That can be here in the US where we do take lots of insurance and it can be internationally as well. We want to make sure that you get the best care possible. So I hope this has been inspiring to you and gives you that push that you need to give ERP a try. We hope to see you soon.