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People wonder why they can feel worse before they start to get better when they start OCD treatment. And so I wanted to spend some time talking about that because I don't want people to be scared away from good evidence based care if when they start to do it, they start to feel worse. Why would one feel worse when they start to do OCD treatment? Well, when we're removing the compulsions and other safety behaviors that people do, you're going to kind of have the kid in the candy store experience where that child is not being given the candy that they want. So instead of saying, oh, okay, what do they do? They're like, I've gotten candy before, I'm not getting it now. Let's raise the ante. Then let's throw ourselves on the ground and throw a tantrum and scream and yell, hoping that that will get us the candy right now. Parents in that situation have a few options. One, they could reward that behavior and give the kid candy. Or they could say, hmm, well, since you're acting that way, I guess we're just going to leave the store now and you'll get nothing. And that's what we want to do to ocd. So OCD is going to likely throw a tantrum. And we have two ways to respond to that tantrum. Reward the tantrum by doing a compulsion to stop the tantrum, or do the opposite and just steadfastly hold on to this notion that we are not giving in to ocd. So I don't want people stopping OCD therapy because you feel like your symptoms are getting worse after a few sessions. And in fact, to me, that's a sign that the therapy's actually working right now, that therapy, we call that exposure and response prevention. It's two parts purposely exposing people to things that are uncomfortable. Those are those obsessions, those thoughts and images and urges that you're experienc, that you feel maybe are inappropriate, unwanted, intrusive, however you label them, they lead to a lot of uncomfortable emotions. Shame, guilt, disgust, anxiety, discomfort, whatever it might be. And we do a behavior, a safety behavior, specifically for ocd, a compulsion. But you could also do avoidance or reassurance, distraction, substance use. But when you do these safety behaviors, they're done to alleviate the discomfort, the other emotions that being exposed to those obsessions brings about. Or you could do what we call response prevention, which is the elimination of the safety behaviors, and allow yourself to learn that you can handle the discomfort brought on by being exposed to those obsessions. Now, ERP wants you confronting your Fears, despite any doubts that you may have about being able to handle it. And we want you to resist compulsions. It is breaking these habits that OCD needs us to do to go away. Otherwise, OCD sticks around. Right. So if you want to break a habit and see OCD go, you do response prevention. If you want to see OCD stick around, you do compulsions. Now, it's not uncommon for anxiety to increase before it decreases. Why? Because OCD is like, wait a minute, we've done these things for so long and in doing them, nothing bad has ever happened. Shouldn't we just stick with that? No, we shouldn't stick with that because we've been lied to. This is a false flag. Right? We're not being told the truth in this situation. We have been duped into believing that compulsions are actually helpful. They are not. What do they do? They bring about quick relief, but they don't allow us to learn that we can handle being uncomfortable. Right. So we're therefore looking at it like, oh, I'm getting uncomfortable. This has failed. This isn't working. No, in reality, I'm getting uncomfortable. Good. This is the opportunity for me to learn that I can handle that. So what you're doing is there's a couple of options to think about. There's habituation, this idea that anxiety and other emotions decrease over the passage of time, where we're training ourselves to learn that we can handle uncomfortable experiences. The likelihood is these things will go down and as we do, more and more exposure to them. There's also the idea of inhibitory learning. We're learning a new way to reply to a stimuli as we practice the new way. And it can interfere in the old way of doing it, even in the recall of the old way of doing it. So we're going to have short term relief if we do compulsions. That's not what we want. How about short term discomfort? If we're doing erp, but at least then we have an opportunity for long term freedom from ocd. There's no opportunity by doing compulsions to alleviate ocd. We've never seen it happen. We've only seen that if you do erp, if you do response prevention and you don't give into the obsession with a safety behavior and compulsion being the main one, only then do you have a chance to have freedom from ocd. Now, progress can happen quickly with erp, and it can happen even faster than in other types of therapy. But I've even had people have said to me, wait a minute, what you're saying makes no sense because I've been to far five, six therapists already and they've all said to do it this other way. Why are you saying something different? And I say, how did those other four, five, six therapies turn out? Well, I still have ocd. Maybe you need something different, right? Maybe that's the reason why those therapies haven't worked. They all tried the same thing and it didn't work. Remember, don't try harder at something that isn't working. It's time to do something else. It's time to do something different instead. I want you to be willing to give ERP a chance. I want you to really come in open minded, recognizing that you'll be able to handle the discomfort. Our team of therapists can help you really pick back up with therapy. If you've stopped therapy in the past and you want to try it again, or if you're brand new to therapy, our therapist will walk you through the process so that you'll be able to handle whatever it is that we're doing. We are not going to throw you in the deep end of the pool. We're going to start by putting a toe in the water, see how it feels and we're going to build from there. That's how we're going to do erp. I'm not here to scare you away. We're going to walk through this together. If you're looking for help for OCD and what I've said is intriguing to you, reach out to us@nocd.com or download the NOCD app. You can book a free call with us and we will be waiting to chat with you so that you can start to live the life that you want to live and not the life that OCD wants you to live.