5 Common Fears About ERP
There’s an element of hopefulness in hearing that Exposure and Response Prevention (ERP) is the gold-standard treatment for obsessive compulsive disorder (OCD)… but if you also experience a pang of fear at the thought of treating your OCD, you’re not alone. The idea of deliberately facing the thoughts, situations, or feelings you’ve worked so hard to avoid can sound overwhelming.
This is a normal reaction. Many people feel apprehensive about ERP before they start, often because they’ve heard myths about the process or can’t imagine doing anything other than their rituals to manage their anxiety and fears.
In this post, we’ll walk through five common fears people have about ERP and I’ll share a little bit about what actually happens in therapy. My goal is to help you approach ERP with more clarity, less dread, and the reassurance that you’ll never be forced into something unsafe or harmful.
Why ERP Can Feel Scary at First
ERP works by helping you face the situations that trigger your obsessions and anxiety while resisting the urge to perform compulsions. This process interrupts the OCD cycle and retrains the brain’s threat detection system. Throughout the course of treatment, your tolerance for anxiety and uncertainty increases and you begin to learn that your compulsions are not necessary.
But here’s the challenge: the very thought of touching a “contaminated” surface, leaving the stove unchecked, or sitting with uncertainty can spike anxiety. When you’ve relied on compulsions for relief, the idea of not doing them feels like losing your safety net. For some, it might not even feel possible.
The good news is that ERP is done in a gradual, collaborative way, designed to empower you rather than overwhelm you.
Addressing the 5 Most Common Fears About ERP
From my experience as an OCD therapist, here are the five fears I hear most often—and the truth behind them:
“I’ll have to face my worst fear on day one.”
ERP starts gradually. We create a fear hierarchy and begin with manageable challenges, building up over time. I like to refer to this as a “baby step” approach. I meet you where you are and we gradually work up the ladder at a pace that is appropriate for you.“The anxiety will never go away.”
Anxiety naturally rises during exposures but then decreases on its own. Over time, your brain learns it doesn’t need compulsions to feel safe.“ERP will make my OCD worse.”
While anxiety can feel stronger at first, consistent practice weakens OCD’s hold. The long-term outcome is less distress and fewer symptoms.“I’ll lose control or have a breakdown.”
ERP is structured and supported—you’re never alone, and nothing is done without your consent.“ERP will change who I am; I won’t be myself anymore.”
ERP targets the symptoms of OCD, not who you are. Since OCD is an ego-dystonic condition, most people feel more like themselves once OCD’s control weakens. (To learn more about OCD, check out my blog post titled Understanding OCD.)
How to Approach ERP with Confidence
If you’re nervous about starting ERP, here are some tips to help make the process more manageable:
Choose a trained OCD specialist – ERP is a specialized treatment. Working with a therapist who specializes in OCD and has received proper ERP training ensures the process is safe and effective.
Collaborate on your treatment plan – You’ll create your fear hierarchy together, making sure the exposures feel challenging but doable.
Track your wins – Notice even small improvements in anxiety tolerance—they add up over time.
Practice self-compassion – ERP progress isn’t linear. It feels hard because it is hard - and you can do hard things. Remind yourself that discomfort means your brain is learning.
Educate yourself – Resources like the International OCD Foundation (iocdf.org) can help you feel prepared and supported.
Example:
A client who feared contaminating loved ones once avoided hugging them altogether. Through gradual ERP, starting with sitting near others and working up to physical contact, they regained closeness without constant anxiety.
ERP can sound intimidating, but fear is part of OCD’s grip—not the reality of the treatment. When done with a skilled therapist, ERP is structured, collaborative, and designed to meet you where you are.
By addressing these five common fears, you can approach ERP with more confidence and less dread. The process may be challenging, but it’s also empowering; my goal is to provide you with the skills you need to face your OCD head-on and reclaim your life.
If you’re ready to begin ERP with a supportive and skilled OCD therapist, reach out today to schedule a consultation. Together, we can create a treatment plan that feels challenging yet manageable, helping you move toward freedom from OCD.
