Exposure and response prevention (ERP) is an effective non-pharmacological treatment for obsessive-compulsive disorder (OCD), supported by STRONG research. While not the most enjoyable treatment, it can be extremely freeing and rewarding. In this article, I’d like to propose a way of looking at ERP that can, hopefully, increase our willingness to do it. I will attempt this by drawing parallels between spirituality and ERP.
So much of life is uncertain. Debates have gone on for centuries about the existence of reality, life after death, ethics, and morals. As a society, we still don't have clear answers to seemingly simple things, such as what’s healthy to eat. Yet life continues. We can argue that many of our actions in life are based on faith or trust. When I got in my car this morning, I wasn't thinking it could be the last time I'll ever do it because I might be involved in a fatal collision in the next five minutes. But I do know that's a possibility. My decision to continue driving anyway is an act of trust.
A quick word on trust and faith: these terms can be defined in many ways. I’m not advocating for ultimate correctness in these definitions and examples, only seeking to broaden our perspective with the hope of being helpful. Trust is often based on logic or prior experience with evidence to support it, while faith often does not require such "evidence."
Based on my prior experience and the experience of others, I choose to take the risk and drive nearly every day - an act of trust. Will I die in a wreck? I hope not, but I can't be sure. I have faith that it’ll work out.
Something I appreciate about religion and spirituality is the emphasis on faith (and arguably trust). It can take a great deal of courage to act based on something we cannot prove without a shadow of a doubt, such as living as if Karma, Heaven, or God exists; stepping into the unknown with the faith that there will be a step to place our foot on. Others can tell us it worked out for them, but this is far from taking the step ourselves.
So much of our life is lived in faith and trust. From getting on an airplane to praying to our Higher Power, to getting picked up by a friend at the airport. Faith and trust are often strengthened with repeated action despite the doubt that might be present. When our spiritual or religious faith is tested, it can be an opportunity for a pivotal moment leading to spiritual growth. I believe ERP lets us create and experience more pivotal moments.
We have evidence supporting ERP as a highly effective treatment for OCD; however, this often isn’t enough to motivate someone to do it effortlessly. Engaging in ERP can be an act of faith - something I believe can be extremely powerful. We may have a sense that it will work out, or things will be okay, but we don't really know. I believe faith is built in these moments. The moment we choose and begin to take that step despite uncertainty and doubt - this can be a spiritual experience.
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