Does ERP really help OCD?
Written by the clinical team at The Lyceum Clinic. Clinically reviewed by Sanah Younis, Founder and Clinical Director, BABCP-accredited (no. 1000792). Published 28 October 2026. Last reviewed 28 October 2026.
Clinical perspective: The Lyceum's specialist therapist in OCD.
How do you explain ERP to someone who is frightened of it?
'Right now, your OCD is a monster that lives in your house, and every time it roars, you feed it a compulsion to make it quiet down. But feeding it just makes it bigger. ERP is the process of starving the monster. Yes, when we stop feeding it, it is going to roar louder than ever for a little while. But if you stand with me and refuse to give it the food (the ritual), the monster will eventually shrink and go to sleep.'
What makes ERP stall?
It stalls when the client is secretly performing mental compulsions during the exposure. They are holding the dirty tissue, but in their head, they are repeating 'I am safe, I am safe, I am safe.' They are neutralising. We change the protocol by targeting the mental ritual: I make them hold the tissue and say out loud, 'I might get sick and die.' We introduce 'Response Prevention' for the mind, not just the hands.
For more detail, read about OCD therapy.
What do you say to someone who has had ERP before and it did not hold?
'I am guessing you did the physical exposures, but the therapist never taught you how to stop the mental reviewing afterward, or you never planned for the 'stealth return' during a stressful life event. ERP isn't a cure that makes the thoughts disappear forever. It's a skill. Your muscles just atrophied. We are going to hit the gym again and tighten up the mental boundaries.'