ERP for OCD Works, But It's Expensive and Hard to Find - The Atlantic - 0 views
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The Only Cure for OCD Is Expensive, Elusive, and Scary
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She can’t resist picking up litter whenever she spots it; the other day she cleaned up the entire parking lot of her apartment complex. Each night, she must place her phone in an exact spot on the nightstand in order to fall asleep.
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Since then, a succession of therapists have failed to help her. They’ve told her, “I don't really know how to treat this,” she said. Or, they talked to her about the possible source of her troubles.
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there are no psychologists who specialize in exposure and response prevention, the specific kind of therapy she and many others with OCD require in order to break their crippling thought cycles.
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At its worst, OCD can compel people to spend hours each day rehearsing an intricate mental dance they feel powerless to end.
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Along with medication, exposure and response prevention, or ERP, therapy is the gold-standard treatment for people with OCD. It is radically different from more traditional talk therapy, which excavates patients’ childhoods or past relationships for clues to their present-day problems.
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a person is forced to confront their obsessive thoughts relentlessly. The goal is to make the sufferer so accustomed to their obsessions that they no longer feel tempted to engage in soothing compulsions.
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Because the symptoms can be entirely mental, it can take years for either patients or therapists to recognize OCD for what it is.
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some studies estimate it takes OCD sufferers 17 years to find proper treatment from the onset of symptoms. Seeking certain forms of talk therapy can make them worse, not better. In the meantime, some experience symptoms so debilitating they are confined to their homes.
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Most moderate OCD cases get at least partly better if the patient receives two or three months of ERP.
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There is no mandatory number of hours that psychologists must spend training in either cognitive-behavioral therapy or ERP, said Lynn Bufka, a psychologist with the American Psychological Association. Bufka did not know what percentage of psychotherapists provide ERP, but she suspects it’s “small.”
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Between 3 and 7 million Americans suffer from OCD at some point—a substantial number, but still far fewer than the vast multitudes who seek therapy for anxiety and depression.
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People obsessed with not offending God might hold a satanic ritual. Those assailed by persistent (and baseless) fears they will molest their siblings might read the incest tome Flowers in the Attic.
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Access to ERP therapists is compounded by the already profound shortage of psychotherapists in rural areas. More than half of U.S. counties have no mental-health professionals at all.
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ERP specialists might feel no need to take insurance, since they are so rare they often have no shortage of clients, Szymanski, of the International OCD Foundation, pointed out.