By Desiree Roberts, LPC, ERP-Certified Therapist
Have you ever had an intrusive thought? Maybe you’re driving and suddenly think, “Hmm…I could run off the road right now.” It’s weird, uncomfortable, maybe even a little scary, but then your attention shifts back to the road, the music playing, or where you’re headed. You keep driving and probably don’t think much about it again.
But what if your brain didn’t let it go? Why did I think that? What if I actually wanted to do it? What if I lose control? What if it happens next time? Now you’re gripping the steering wheel tighter, avoiding certain roads, only driving when someone else is with you, or eventually avoiding driving altogether. This is one example of how OCD and anxiety can quietly start making someone’s world smaller.
We all have an internal alarm system. Anxiety is actually supposed to help us; it alerts us when something might be wrong. The problem is that sometimes the alarm becomes a little too sensitive. Think about a smoke detector going off because you burned a piece of toast. The alarm is LOUD, your body reacts, and everything is telling you there’s a fire…but the house isn’t actually burning down. For someone struggling with OCD or an anxiety-related disorder, the alarm can feel just as real even when the threat is uncertain, exaggerated, or simply a false alarm.
This is where a lot of people get stuck. They start organizing their lives around making sure that alarm doesn’t go off. They check. Avoid. Google. Ask for reassurance. Replay conversations. Wash. Prepare. Overthink. Cancel plans. Or sometimes, they simply push through. They go to work, take care of their kids, show up for their friends and family, and get through the day while fighting an exhausting battle in their head that no one else can see. You can look like you’re functioning and still be struggling.
So, what do we do when the alarm keeps going off? This is where Exposure and Response Prevention (ERP) comes in. ERP helps us stop treating every alarm like an emergency. Instead of spending all of our energy trying to make anxiety disappear, we gradually practice approaching what our brain tells us to avoid and changing how we respond when the alarm goes off. The exposure is facing the fear, and the response prevention is resisting the usual escape route, the checking, reassurance, avoidance, rituals, or whatever we normally do to feel safe again.
Over time, we’re teaching the brain something different: I can feel uncertain and keep going. I can have a scary thought without figuring it out. I can be uncomfortable without escaping. My alarm can be loud without running my life.
ERP is a first-line, evidence-based treatment for OCD, and exposure-based treatments are also used for a range of anxiety-related disorders. The goal isn’t to promise that you’ll never feel anxious or have another intrusive thought. We’re humans; that’s not realistic. The goal is to help you build a life where those thoughts and feelings no longer get to make all the decisions.
So, if you’ve gotten really good at “pushing through,” but behind the scenes you’re avoiding, checking, overthinking, seeking reassurance, or slowly giving up pieces of your life to anxiety, it may be worth paying attention to that alarm.
Sometimes the goal isn’t to make the alarm stop.
It’s learning that you don’t have to run every time it goes off.