Tips for Maximizing the Benefits of Anxiety and OCD Treatment

Here at WholeMind, we provide services that are evidence-based – that is, the treatments that are shown to be effective through high-quality, thorough research. For the treatment of obsessive-compulsive disorder (OCD) and anxiety disorders such as social anxiety, panic disorder, agoraphobia, and specific phobias, that gold-standard treatment is called exposure and response prevention, or ERP. Although it may sound intimidating at first, this approach is all about 1) taking a stepwise approach to facing the very thing that’s scary, and 2) gradually reducing the thing you do in response to what scares you. 

For example, someone with social anxiety might avoid group gatherings and, if required to go, may do specific things to reduce their distress: bring mints or a water bottle, avoid eye contact, speak softly. We call these “safety behaviors.” In working with this person, an ERP therapist would help the individual break the feared situation down into manageable steps – starting with small groups for brief periods of time, for example – and would support them in reducing safety behaviors. In the case of someone with OCD, a child with intrusive thoughts about illness (obsession) might repeatedly wash their hands to protect themselves from germs (compulsion). ERP treatment would focus on gradually approaching what feels contaminated and resisting the urge to wash hands. Although exposure therapy can be overwhelming to learn about, our therapists find inspiration in our work every day, as we get to see this approach restore clients’ freedom and sense of control over their lives.

One critical element in the successful treatment of anxiety and OCD is the stance – or attitude – we take toward exposures. In the example of social anxiety above, the person might attend a monthly club meeting and say to themselves: “Well, I did an exposure by attending that mandatory meeting.” A key factor for success, however, is seeking out exposures – actively looking for more opportunities to face our fears. For anxiety about being in groups, this might involve purposefully eating in the cafeteria or inviting a third person to a hangout after school or work. If we look for exposures instead of waiting for life to force exposures upon us, we can more effectively take back the power from anxiety or OCD.

Another component of treatment success is called “over-learning.” We human beings have a tricky tendency to drift. We might commit to a new habit and then find that, over time, we’ve trended toward past behaviors. Hence the saying: old habits die hard! We account for this in therapy by including exposures that go beyond typical action. Eating in the cafeteria? Pretty standard for lots of folks. Hanging out at the park with two friends? Commonplace for many. Attending a Dork Dancing event, wherein a group of strangers get together and dance in public places? Now that’s over-learning!

At our practice, we frame exposures as not just being against anxiety or OCD, but as opportunities to move towards what matters to you. Fear has a powerful way of taking the joy out of things, which can make individuals’ worlds feel smaller and less colorful than they used to be. So, in our social anxiety example, could this person join a group that brings them closer to something meaningful? Perhaps they value travel and want to plan a trip abroad; in that case, they might join a foreign language conversation group. Perhaps they used to create with their hands and miss that part of their life; it may feel fulfilling to sign up for a small-group pottery class.

Ultimately, effective exposure therapists don’t make anyone do anything. We are here to partner with our clients – to help them take the power back from anxiety and to do more of what makes life feel meaningful.