Starting Exposure Therapy: What’s it Like?
Posted by Steven J. Seay, Ph.D. in ERP, Obsessive-compulsive disorder (OCD)For anyone new to exposure-based therapy, such as exposure and response prevention (ERP), there is often much anticipatory anxiety about starting treatment.
“What is it? What will it be like? How bad will it be? Can I handle it? Will I be forced to do things I’m unwilling to do?”
These uncertainties are typical for most people beginning the process. They’re also understandable. When you begin treatment, it often feels like you’re putting your fate in someone else’s hands. Because that someone is typically a stranger (i.e., your therapist), it would be a bit odd if you didn’t feel that way.
Moreover, if you know the basics of exposure therapy, you understand that eventually you’ll be confronting the very things you fear. Some people accept this prospect with dread but others feel a sort of nervous anticipation. Although they expect that treatment will be challenging, they also realize that life without treatment is often more challenging.
Starting therapy is a calculated risk. Sure, it’s possible that treatment will be hard. However, it’s probable that life without therapy will be hard.
If you remember the old Choose Your Own Adventure books from the 80’s/90’s, you have a good idea about how therapy isn’t.
If you or your kids were a fan of the series, you probably recall just how easy it was to fall into a ravine or get eaten by a pterodactyl. Death abounded at nearly every turn. There was usually only one way to get the “right” ending, and I for one could usually only discover it by reading the book backwards and cross-referencing the pages in order to see how the story “should” unfold. With these books, one mistake could totally derail the ending.
Therapy isn’t like that.
Sure, there are some potential “traps” that are better off avoided. However, most of these traps involve rituals, and once you get better at spotting your rituals, the process gets easier.
Treatment doesn’t lock you into a predetermined linear path. Instead, it helps you become better at recognizing when you’re at a decision point. It then supports you in making choices that reflect your values rather than your symptoms. Because this is a skill-based process, you learn to make better decisions over time.
You transform from pterodactyl prey to pterodactyl hunter.
Unlike Choose Your Own Adventure books, therapy is a forgiving process; it doesn’t require perfection. Treatment gives you many potential paths to pursue, all roads leading to the same basic ending: you taking your life back.
Pterodactyls beware. We’re coming for you.
Questions? Comments? What adventure will you choose today? …or continue the discussion on Facebook, Twitter, or Google+.