Looking to augment exposure work with your OCD therapist?

Exposure and response prevention (ERP; EXRP) is the gold standard for Obsessive Compulsive Disorder (OCD treatment). But if you’re looking for ways to augment your exposure work with your OCD therapist, there are three supports we recommend considering. Mindfulness meditation, aerobic exercise, and medication might by helpful additions to your OCD therapy.

1. Mindfulness Meditation

Meditation has blown up in the media in the past decade. Promises of feeling relaxed, having clear thinking, and being happier abound. Research backs up the numerous potential benefits of meditation: decreased stress, improvement in mood, improved attention, greater kindness, and pain management. What sometimes gets lost in the marketing campaigns and media frenzy is that meditation is not always pleasant in the short-term. An overwhelming sense of calm and relaxation doesn’t necessarily follow every meditation session.

This is good news for people with OCD who are looking to develop mental practices to better tolerate distress, uncomfortable emotions, and bothersome thoughts. You might ask, “Why would I want to do that?” The ability to be present with any thought or emotion that comes your way and not let it control you is truly powerful. Developing these kinds of mental muscles can help you ride out urges to avoid or engage in compulsions, thereby cutting off OCD at its metaphorical knees and breaking you out of the vicious anxiety-avoidance cycle that underpins OCD. 

Furthermore, recognition of the myth that every meditation session will end with a deep sense of calm might help you persist in your mindfulness meditation routine. While goals of meditation vary, thinking about mindfulness meditation as the nonjudgmental practice of refocusing your attention back to the present moment tends to be helpful when using it to support exposure work for OCD. There’s no expectation that you empty your mind or constantly stay focused on the present. Each time your attention wanders is an opportunity to practice bringing it back to the present moment. This awareness might aid you in continuing with mindfulness meditation (even when the immediate results of meditation vary). If you’re starting out in meditation, it might take 6-8 weeks to see more noticeable results. So, keep at it.

Your OCD therapist can also teach you ways to incorporate mindfulness into exposure sessions. Oftentimes, people fall into negative self-talk and self-judgment about the content of unwanted intrusive thoughts (obsessions). However, the nonjudgmental focus on the present moment (that mindfulness meditation helps to instill) can help to combat a tendency to judge and mentally beat yourself up.

2. Aerobic Exercise

Aerobic exercise increases your heart rate, activating your cardiovascular system. It uses your larger muscle groups in a rhythmic and repetitive pattern.

Common examples of aerobic exercise:

•  using an elliptical

• riding a bike

• jogging outside

• walking up hill or an incline 

Regular aerobic exercise also has numerous mental health benefits. It can improve sleep, make a measurable difference in mild depression, and help to manage stress. Recent research indicates it might also provide measurable benefits when used as an adjunctive to Exposure and Response Prevention for OCD. We also encourage you to continue in your aerobic exercise routines after you complete ERP treatment for OCD, incorporating it into your healthier lifestyle.

A gradual approach to building up an aerobic exercise routine might be best. If you’re considering starting an aerobic exercise routine, it would be helpful to first run the program by your physician. You can start gradually working up to a regular aerobic exercise routine. Starting small can be more manageable and still get you to where you want to be. For example, you could begin with a 10-minute walk outside twice per week, then three times per week, then 15-minute walks three times per week. Once you are comfortable with your routine, you might choose to gradually add in a couple minutes of jogging along your walk, eventually you could be jogging for 30 minutes three times per week.  

3. Selective-Serotonin Reuptake Inhibitors (SSRIs)

Often referred to as SSRIs, Selective Serotonin Reuptake Inhibitors are a third way to give you more support as you engage in Exposure and Response Prevention for OCD. Medication is not a fit for everyone. Some people don’t need or want to use an SSRI to help manage OCD symptoms. Other people find the support of an SSRI helps them in the short-term to be able to really engage in the work of ERP that helps them in the long-term. If you’re curious about medication support for OCD, reach out to a local psychiatrist to schedule an intake appointment. Afterall, psychiatrists are the experts on psychiatric medication. Scheduling an intake with a psychiatrist does not mean you have to start taking medication. It gives you the opportunity to ask questions to an authority on the topic and get recommendations from someone who has learned about your history and medical needs. At the end of the day, you choose. 

If you’re interested in reading more about medication options for OCD, we like the brief overview that the IOCDF website offers on medications for OCD.

The Best Treatment for OCD

While meditation, exercise, and medication can be helpful adjunctives to the best treatment for OCD, they are not a substitute for Exposure and Response Prevention. Learn more about how OCD therapy with TherLively can help you.

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