S3C5. What Progress Looks Like in ERP

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The common misconception is that they would be expected to stop all their compulsions at once when they start ERP. Some people come for therapy with a feeling of hopelessness. They claim that they have tried to stop their compulsions themselves but have not succeeded. But progress in ERP does not mean stopping everything at once. It means a systematic reduction in compulsions through a process of learning.

Think of a small child who enters first grade. If they are shown a book of advanced mathematics, they are going to panic. They may begin to believe that they cannot handle it, and they would be right, since advanced concepts are beyond them at this stage. But they are not even expected to handle that at their age. They are expected to understand basic addition. As they grow, they would be taught to handle more complex concepts, and then eventually they may graduate to advanced concepts.

Similarly, starting ERP is like being in the first grade. You need to only handle those obsessions and resist those compulsions that are the easiest. The time for handling bigger ones will come later. If you try to handle everything together, you will fail.

Not just you may – you will.

If you don’t even try because you think that it will be too much, you may be giving up because you expect the first grader in you to be able to handle advanced mathematics. This is bound to seem like an impossible task.

So, first, understand that recovery will be slow and requires practice in building fundamentals. Progress in OCD can be measured in a number of different ways that I want to talk about.

  • Compulsions may be reduced in duration. If you are engaged in episodes of rumination, and your typical rumination episode lasts for one hour, reducing that to fifty minutes is progress.
  • Compulsions may be reduced in frequency. If you are engaged in a compulsion of mentally apologizing for your thoughts five times to get rid of them, progress would mean bringing the apologies down from five times to four times.
  • Compulsions may be reduced by creating a gap between the obsession and compulsion or between two instances of compulsions. If you are engaged in the compulsion of reassurance seeking from your family, you may wait for ten minutes between the trigger and the reassurance seeking or between two instances of reassurance seeking. Even this is progress.

Often, small progress is dismissed as no progress. People may think that you are not putting in enough effort. This may deter you because you know how much effort you are putting in to bring about small changes. You may need to give yourself credit for the effort made. And you may need to build on the success you have experienced, no matter how small.

Another concern people have is that it would take a very long time to recover if progress is so slow. Well, yes. It may, and it probably will. But the alternative is to continue to struggle for life. Besides, as you get better at managing your compulsions, progress is much faster. You will be able to handle more as you progress in your recovery journey. So, while all this may seem overwhelming and never-ending when you start, it really won’t be. You need to push through the first few weeks or months of excruciating work before it starts feeling manageable.

Another expectation sufferers may have from ERP is gaining certainty about being good. But even people who do not have OCD can never be (or remain) certain about how good they are. So, ERP won’t give you that certainty. It can make you look at your imperfection more healthily, though, so that you can live a happy life. These are the simple goals that you need to set for yourself.

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