Repetitive Thoughts
Persistent, unwanted, and distressing thoughts are a common struggle for people living with anxiety or obsessive-compulsive disorder (OCD). These thoughts can become exhausting and disruptive, creating a cycle that feels impossible to break. One highly effective, evidence-based approach to managing them is Exposure and Response Prevention (ERP).
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ERP is a form of Cognitive Behavioral Therapy (CBT) designed to reduce the intensity and frequency of intrusive thoughts. It works through two main components: exposure and response prevention. Exposure involves deliberately confronting the thought or situation that triggers anxiety. Response prevention means resisting the urge to engage in compulsive behaviors, like seeking reassurance or avoiding the trigger.
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To manage repetitive thoughts using ERP, a client and therapist will begin by identifying the thought causing distress. They will then develop a hierarchy of feared thoughts or scenarios, starting with those that are least anxiety-provoking then working up to thoughts or scenarios that are most distressing. Gradual exposure can include writing the thought repeatedly, saying it aloud, or imagining it in detail. While doing this, the client will learn how to limit their use of rituals, distractions, or other avoidance behaviors.
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Discomfort is expected during ERP. The goal is not to eliminate the thought, but to reduce its impact. Over time, the brain learns that the feared outcome doesn’t happen, or is tolerable, and the thought loses its power.
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Research strongly supports ERP’s effectiveness. A study by Kuckertz (2019) confirmed ERP’s success in real-world clinical settings, reducing OCD symptoms significantly. Similarly, Twohig (2018) found ERP beneficial across a range of conditions involving intrusive thoughts, not just OCD.
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While ERP can be challenging, it offers hope. With persistence and the support of a trained therapist, individuals can break the cycle of repetitive thoughts and reclaim their mental space.
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If you are interested in exploring repetitive thoughts and ERP with a therapist, visit my Headway profile to schedule a consultation.
References:
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Kuckertz, J. M., et al. (2019). Depression and Anxiety, 36(5), 399–416.
Twohig, M. P., et al. (2018). Clinical Psychology Review, 61, 20–30.
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