• A traumatic experience (first-hand or second-hand) that links germs or dirt with a negative emotional response
: his brother push her into the lagoon?
• A seemingly benign situation such as a scene from a television show or film
: fear factor, the contestant have to go through into the mud
• A preexisting tendency to worry that has been compounded by current happenings
: the H1N1 issues
Exposure and Response Prevention (ERP)
The mostly widely practised behaviour therapy for OCD is called exposure and response prevention (ERP).
The "exposure" part of this treatment involves direct or imagined controlled exposure to objects or situations that trigger obsessions that arouse anxiety. Over time, exposure to obsessional cues leads to less and less anxiety. Eventually, exposure to the obsessional cue arouses little anxiety at all. This process of getting "used to" obsessional cues is called "habituation."
The "response" in "response prevention" refers to the ritual behaviours that people with OCD engage in to reduce anxiety. In ERP treatment, patients learn to resist the compulsion to perform rituals and are eventually able to stop engaging in these behaviours.
How does ERP work?
Before starting ERP treatment, patients make a list, or what is termed a "hierarchy" of situations that provoke obsessional fears. For example, a person with fears of contamination might create a list of obsessional cues that looks like this: 1. touching garbage
2. using the toilet
3. shaking hands.
Treatment starts with exposure to situations that cause mild to moderate anxiety, and as the patient habituates to these situations, he or she gradually works up to situations that cause greater anxiety. The time it takes to progress in treatment depends on the patient's ability to tolerate anxiety and to resist compulsive behaviours.
Exposure tasks are usually first performed with the therapist...