Sometimes the ROCD may impair the major part of the day and you may begin to say ‘I am always triggered’. But that is not entirely true. There are moments of clarity which help you understand the irrationality of your triggers. Those are the moments when you feel that you don’t want to let go of your partner, regardless of what your OCD tells you. They may be few and far between but they are there for sure. That is the reason why you are reading this course book.
Getting exposed to a trigger without you being prepared for it is not a deliberate exposure. It is accidental exposure. Imagine you are sitting on a beach with your back to the waves and a wave slams into you from behind. You will probably get a shock and will be more flustered if you are not ready for the wave. That is accidental exposure.
But if you sit facing the waves, you can see when the wave is about to hit you. If you let it hit you, you are still going to be shocked but lesser so (you are going to be able to brace yourself for the impact). That is deliberate exposure. Hence, deliberate exposures are a key requirement to being able to manage the process of recovery better.
Thus, response prevention (RP) is trying to not do a compulsion when you have accidental or unavoidable exposures. ERP is when you deliberately expose yourself to your triggers and learn to manage them without compulsive behavior. ERP is better than just response prevention because one, you can decide on the time when you would like to face your fears and hence be prepared for them. Two, you can decide on the intensity of exposures and choose not to overwhelm yourself with anxiety
Three, before engaging in ERP, you would observe your behavior and list down your compulsions, even those that have been normalized in your life. When you observe your behavior, you begin to see how many more things have come under the fold of ROCD without your conscious realization. ERP would help in dealing with all these concerns. Hence for these reasons, ERP is more effective than just RP.
In the next chapter we shall understand the concept of neuroplasticity.