Chapter 1. Treating OCD: Exposure and Response Prevention

Short Description

This program continues the case of Stephanie who is suffering from OCD (as shown in the video, “Obsessive-Compulsive Disorder: A Young Mother’s Struggle”).

Long Description

Her entire house is subject to a decontamination ritual that is as compulsive as the one she applies to herself.

Stephanie’s treatment began with medication but it has not alleviated her obsessions. Dr. Udean comes to begin cognitive-behavioral therapy. Under the therapist’s guidance, Stephanie retrieves mail from the box on her front porch, something that she has not done for a year. The doctor asks her to assess how anxious she feels. Stephanie fears contamination from the envelopes that someone else has licked in order to close.

The therapist’s goal is to expose Stephanie to the situations that elicit her anxiety, but then prevent her from practicing the compulsive cleaning rituals that have helped her contain it. With the continuous support and encouragement of the therapist, Stephanie opens a letter. She now feels contaminated and her distress is obvious. Although she could not now touch her son Jake, she is able to touch the back of the couch.

The therapist explains to Stephanie that the exposure therapy helps her to experience the feared things that she has been avoiding. Again with support, Stephanie spreads the germs from the letter all around the couch. Rather surprisingly, she now wants also to approach Jake. Although experiencing enormous conflict, she picks up Jake and places him on the coach.

After nine therapy sessions, Stephanie is much improved. On an outdoor walk, she allows Jake to explore the environment freely. She expresses relief, but is still in some conflict over whether she is totally free of obsessions and compulsions.

Questions